In amongst the two treatment threads – hormone and radiotherapy – you do get other forms of support and medical attention. I’ve already mentioned the Macmillan nurses, and their rather unexpected prescribing intervention, but there is also the Oncology team in general. They monitor your progress at regular intervals, which is why there seem to be so many blood tests. I must confess that the radiotherapy was quite reassuring to attend. It gave a focus to the diagnosis, and meant that it felt that something was actively being done about it.
As you approach the end of your course of treatment, with no real evidence in yourself of whether it has had the desired effect, you wonder about being left in some sort of limbo with only a series of “what if?” or “what next?” questions. One thing you do know – you only get one crack at radiotherapy, because it will take its toll on your lifespan. They remind you that the treatment is actually quite invasive, and the radiation is targeted at your prostate to kill the cancer cells. And radiation doesn’t disappear overnight, so the effects of the treatment can continue for maybe three to six weeks after the sessions stop.
For my final Radiotherapist Review I had a few questions lined up:
How will we know if or when the cancer has “gone”? This is something they’ll monitor via blood tests, checking to see that the PSA is reducing, and that there is nothing abnormal going on elsewhere. If they get suspicious, instead of another biopsy, it would be a MRI scan to check out what was going on there.
When can I go back to a normal (fibre and vegetable) diet? Straight after the last treatment is fine to start eating and drinking normally, after all there is no need to keep wind out of the system any more. She advised that I shouldn’t dive right in. So an evening meal of onion bhaji, followed by a chicken vindaloo with cauliflower bhaji and tarka dall all washed down by a bucket of Cobra is probably not a good place to start!
Will my peeing ever return to “normal”? Yes, eventually it should settle back to something more familiar, but it could take a few months. It is a topic to make sure I discuss with my doctor, as it could be an indicator of issues that need investigating. The hormone treatment is likely to continue for some time yet.
Has the tingling I’ve had at the back of my neck on my shingles scars been caused by the radiotherapy or is it more down to the sweating? Basically anything that is happening that far away from the groin area is unrelated to the radiotherapy. She felt that it was either an internal effect of the hormone treatment or more likely as a result of the sweats.
One problem they found with me was that my testosterone level wasn’t reducing as much as they’d like. I must be a well hard macho geezer! I did ask about physical activity – was that likely to cause the production of too much testosterone? After all, six hours of sex twice a week (really?), plus at least three hours of walking football each week might be a bit too silverback for the hormone jabs to deal with.
But no, that wasn’t an issue. The testosterone will be produced without having to do anything even remotely macho, butch, hunky, or otherwise traditionally and gratuitously male. The Stampede doctor is monitoring that, and will change the hormone treatment accordingly if it remains high. The Prostap that I’ve been on is an “agonist”. These injections work by blocking messages from a gland in the brain that tell the testicles to produce testosterone. They may switch me to an “anti-androgen”, which are tablets rather than a jab, and they stop testosterone from your testicles getting to the cancer cells instead.
Right now, as I write this, I am just into the post-radiotherapy phase, with continued support from the oncology team for possibly another 2½ years, depending on the outcome. As well as being “handed back” to my GP, I will continue be part of the Stampede Trial, so regular checks of the PSA and other blood components will be monitored by an Oncologist, and we’ll have to see if the treatment has been successful. I hope so.
Chapter 2 to follow.
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