It’s a truism that doctors make terrible patients. They’re frequently hypochondriacs. They dose themselves with pharmaceutical samples, work extraordinary hours, many are unwell but are in denial.
The exception to this was my boss when I worked in a clinic in a major teaching hospital. Always full of intellectual and physical vigour this acclaimed psychiatrist could be absent from work due to commitments as an expert witness, or when on holiday, but he simply was never ill.
Then one day when I reached the clinic the medical secretaries told me in hushed tones that ‘the boss was off sick’!
Naturally I was surprised but unconcerned. After all we all get the flu from time-to-time.
‘He’s under the knife’, one of them said euphemistically.
‘Oh, I replied’, ‘what’s wrong do you know’.
‘No’, said the other, ‘only that he was called in at short notice – it must be urgent?’
In due course a colleague told me more of what was going on. ‘It’s his prostate’, they said.
Now I thought I knew a little of prostate cancer because years before when working as a 17 year old trainee welfare officer I had met an old guy who suffered with it. A retired farm worker, he advised me one day, as I filled in the form about his medical condition required of anyone going into an old peoples’ home, that I should always pee when I needed to.
“I was out with my grandchildren and their friends one day, and in the back of the car”, he said, “and they wouldn’t stop to let me take a leak. That’s how I must have got it”
“I knowed it wuz wrong, cus it hurt something orrible!”
I couldn’t imagine the boss ever being placed in such an impasse, but I was concerned because the words ‘prostate’ and ‘cancer’ create such a morbid spectre for we males who, unlike women, prefer to watch football and drink beer to being ill.
Prostate cancer tends to be slow in developing and affects men over the age of 50. Although perhaps the most prevalent cancer in men it’s common for it to remain undetected simply because for many there are no symptoms. Treatment options for prostate cancer with intent to cure are primarily surgery, radiation therapy, radio-surgery, and proton therapy. Other treatments, such as hormonal therapy, chemotherapy, cryosurgery, and high intensity focused ultrasound (HIFU) also exist in some parts of the world.
I guess men are sensitive about prostate cancer because it’s part of the reproductive system. We’re notoriously proud of our ability to impregnate right up into old age. Author Saul Bellow, for example, was 84. In the U.K. around 6,489 children a year are born to fathers aged fifty-plus.
It’s one thing to volunteer for ‘the snip’, and quite another to have what many construe to be problems with their ‘wanger’.
No one knows what causes prostate cancer. It’s quite indiscriminate, if you leave aside gender bias.
The test for prostate reminded me of one of my father’s favourite medical terms; ‘Bosfotic’. Today this has come to mean ‘drunk’, but ancient soldiers and sailors, whilst agreeing with the modern meaning’, knew a bosfotic to be ‘the yolk of an egg shot up the bum with a pop-gun.’ No doubt it originates from some kind of enema treatment administered to hung-over, or malingering servicemen by wise physicians who wished to discourage such behaviours, but I digress.
During a biopsy a urologist or radiologist obtains tissue samples from the prostate via the rectum. A biopsy gun inserts and removes special hollow-core needles (usually three to six on each side of the prostate) in less than a second. Prostate biopsies are routinely done on an outpatient basis and rarely require hospitalizations. Most men report discomfort during prostate biopsy.
Early diagnosis depends on having regular physical health checks, or noticing increased urination at night, difficulty starting and maintaining a steady stream of pee, blood in the urine, (always a bad sign), or painful urination.
Recent research shows that you are far more likely to be cancer-free if your surgeon has performed more than 250 prostatectomies, (prostate removal to help stop cancer). So if this is proposed you are best advised to ask just how experienced your surgeon is in performing these operations. In men whose cancer is confined to the prostate, surgery offers the best potential for cure, with around a 90% success rate.
We could look at epidemiology, (the wheres and hows of the complaint), but there’s little point unless you’re a doctor. Suffice to say it’s more readily diagnosed, and therefore treated, in westernised societies.
As for the boss – he was back at work within a few weeks of his operation, as bright and energetic as ever. By a strange co-incidence my elder brother went under the knife this month and had his prostate removed. I hope he recovers as quickly as the boss.
Stephen Bray writes in a stream of consciousness, but sometimes is a good read . . .
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