I have a tattoo. In fact, I have three and I didn’t choose them. No, they’re not jail tats applied involuntarily, and I didn’t get them in a dingy tattoo parlour frequented by sailors in some far-off port.
They are three tiny dots administered by an extremely competent therapeutic radiographer whilst I lay comfortably beneath a scanning machine as a prelude to receiving radiation treatment for prostate cancer. A few months, however, would pass before I reached that stage.
March 22 2021
My journey with cancer began over a year prior to receiving my tattoos when after a week or so of discomfort in my nether regions (we’ll get to the medical and technical stuff later), I contacted my family physician, a kind and caring person. Since I’d been piling on the years, I suspected, or hoped, it would be benign prostatic hyperplasia (BPH), also called prostate gland enlargement, a common condition as men get older. Among other minor symptoms were frequent trips to the washroom, mostly at night. As this was early 2021 during covid, it meant a phone interview.
After explaining my symptoms, my GP prescribed a drug to help with BPH and off she sent me for a lower abdomen ultrasound and bloodwork, which included screening for PSA (prostate-specific antigen) in the bloodstream. Although it’s no longer considered completely dependable as a one-off indicator of prostate cancer, sudden peaking of the PSA can be, and compared to a prior test, it did reveal that mine had indeed shot up.
May 6
Next step was an appointment with a urologist in early May where I performed a urine flow test — aim for the sides, I was told — same as one does when using a guest’s washroom. I guess I didn’t pass as I was then scheduled for a cystoscopy at St. Mary’s hospital.
Nov 17
Now things were getting serious. I was in St. Mary’s hospital now, figuring out how to don a hospital gown — find the ties, gap front or gap back? Gap front in this case. The procedure only took a few minutes and I suspect it wasn’t my urologist’s first time, but it was mine.
Since the active area can be sensitive — you think? I appreciated the numbing prior to insertion of the device, picturing it the size of a garden hose with a Nikon SLR on the end. I only felt mild discomfort, however, and it was over very quickly, except he wasn’t done with me as a further check required a good old digital test and I don’t mean the computer term. Again, minor discomfort and this one wasn’t my first go around. The verdict: “You’ve got a couple of bumps on one side of your prostate gland. I’ll send you for a biopsy to see what’s up.”
December 30
A little over a month later, I was in for the biopsy, preceded by a full body bone scan the day before. Once more into the gown, open at the back this time. This was a little more invasive than the digital examination. It involved an ultrasound probe to guide the needle which would take samples.
There’s only one place this could be inserted, where there’s a distinct lack of sunlight. Details, details. “We’re going to be taking twelve samples,” said the doctor, “and you’ll only feel a tiny pinch.” It was a tiny pinch, accompanied by a click. I couldn’t help counting down — twelve, eleven, ten, nine . . .. It was all over in minutes, and not near as uncomfortable as any of my anxious moments had predicted. “All done,” said the nurse. “You did really well.”
“Yes,” I said, “and without any practice.” I’m not sure I meant my comment to be funny, more ironic, but it did get a chuckle from the medical tag team.
January 10 2022
I was back at the urologist’s office to hear the results. This was getting more serious, and as my pessimistic voice had suggested, it was indeed prostate cancer. “But don’t worry, it’s curable,” said my positive thinking urologist. I was happy to hear that, half hoping that meant a prescription for a cure-all medication, but it was to be a little more involved than that.
Next stage I was to consult with oncologists as I would have to decide on which treatment to undergo — radiation, chemotherapy, or surgical removal of the prostate. First was a video call on January 14th with Dr. G, a radiology oncologist at the Grand River Cancer Centre (GRCC). He was upbeat and positive, also saying my cancer was curable. This would mean brachytherapy, performed by Dr. D, his colleague, followed by external beam radiation. I also had the option of surgery should I choose that route. Dr. G went into detail about the treatments and recommended a Queen’s University online program which would help me decide.
A few days later I spoke on the phone with Dr. H, another oncologist at GRCC who was also upbeat and positive and assured me that chemotherapy wouldn’t be necessary as the malignant bits were still hiding in the prostate.
January 25
With my hugely supportive wife, who has been amazing, we travelled to St Joseph’s Hospital in Hamilton for a consultation regarding surgery. The specialist there told me that normally I would have been considered too old, but as I was in good health it was a viable option with the same outcomes as radiation. I did learn that the surgery would be performed, not by the surgeon alone, but with an updated version of Robbie the Robot who would make seven small incisions to remove my prostate.
Rather than the surgery option in Hamilton, I decided I’d prefer radiation at my local hospital, only fifteen minutes away, but first I explored the online Queen’s University program. I was able to click on so many permutations related to treatments that it left me feeling indecisive about which direction to take. Surgery was out for me, but I wondered if external beam radiation without the intrusive brachytherapy would suffice.
I’d already had CT, bone, MRI scans, and bloodwork., and on February 7th I met with Dr. D at the GRH Cancer centre who explained brachytherapy in more detail. The sound of the process did not excite me, neither did the digital experience that followed. Just to be sure, his intern had a go, too.
By now, loaded down with information, it was close to decision time. Having ruled out surgery, I was tempted to avoid the invasive brachytherapy and opt for the more straightforward external beam radiation. I left a message with Dr. G advising him of my thoughts, and doing his due diligence, as he stated, kindly called me at home on a Sunday morning to discuss the treatment further. He allayed my concerns and I committed to the procedure.
Mar 17
Now things were in motion, and I was back at GRCA for mapping. This meant another gown challenge and a catheter inserted where I’d rather it wasn’t, and another ultrasound stuck, yes, once again where there’s never a sunny day to plot the way for the brachytherapy action.
I should explain that this procedure means day surgery under anesthetic when needles that emit radiation are inserted directly into the prostate. Sounds like fun, eh? All the previous procedures were at times a little uncomfortable but never painful, but I was happy to be in dreamland for this one.
It took place at GRH on April 17th. I was in at 5:00 a.m., pre-opped, and anesthetised by 6:00 a.m. Last thing I heard was “Think happy thoughts.” I believe the actual procedure took over two hours, but it was close to noon before I resurfaced. Again, I didn’t feel any pain or much effect from the anesthetic. The biggest challenges were to keep drinking water, pee in a measuring cup to ensure things were working as they should, and down a hospital muffin that in no way challenged one from Tim’s just down the hall. By late afternoon, except for the muffin, I’d performed well enough to go home.
Still feeling a bit dopey from the previous day’s experience, I was back at GRCC the following day to receive the tatts, three barely visible blue dots, one on each hip and one at central station. The locations were determined by a specialized scan to target the prostate for the external beam radiation.
June 3
This was the date of the first of twenty-three treatments I’d receive, one each weekday for a month. Most days I was scheduled for 8:00 a.m. It’s only a short drive to the cancer centre for me, and with my parking pass I was able to park in the “Oncology Patients Only” of the parking garage. I felt special.
On the first morning, I checked in at registration as I would every day. Over the previous year, I’ve flashed my health card more times than a credit card on Black Friday. From reception in the radiology unit, I was directed to the specific waiting area, usually room C. It was always quiet and most days I’d barely sat down when three smiling radiation therapists, all female, suddenly appeared and introduced themselves. I was so impressed with how they were always friendly and cheery, and very professional. It made the complete process almost enjoyable.
They led me into the treatment area, each one attending to their specific role. “Climb on to the table, lie back, and pull down your pants to mid thigh,” I was told. They did toss a towel over the focused area, grand central, and I was prepared, wearing my stylish dress sweatpants. This became a daily routine. Meanwhile, with a therapist on each side of the table, they gently pushed or pulled me into position in perfect alignment with the targeting tattoos, then they left. Can’t have gone for coffee, surely, I thought. No, they were quite sensibly avoiding any collateral radiation in a side area where they controlled the full process, even watching me on CCTV. I was alone with a gleaming monster of a machine, something you don’t see at Canadian Tire (I checked the flyer). It’s called a Linear particle accelerator and there are six of them in full use at the cancer centre.
I lay perfectly still, soft music playing, and relaxed as I gazed up at the LED lit images on the ceiling of apple blossoms. Nothing to it, I thought, then the table I was lying on began to move, and with a quiet whirring, two arms moved around me to perform a mini scan that would confirm the target. These retracted, then with more whirring and occasional clicks, the large circular bit that emits the radiation rotated completely round me and the table. It vanished then reappeared and stopped above me, aimed directly at the little blue dot. I tried not to imagine myself in that scene in Goldfinger where Bond is on a similar table with a laser beam approaching and he says, “Do you expect me to talk?” and Goldfinger replies, “No, Mr. Bond. I expect you to die.”
No chance of that. It was all over in fifteen minutes. The lovely young women were immediately back in the room to eject me and prep for the next patient. I did learn to pull my sweatpants up quickly before they whipped off the grand central towel. And that was it. Never felt a thing, except for a bladder that felt like the Hoover Dam about to break. That was the only requirement, ensuring it was full before the procedure.
My treatments are all finished now, other than a hormone lowering injection every twelve weeks for a year. It’s performed by a nurse at my home. There were side effects from the radiation, but none that were painful or too onerous — a confused bladder and unique bowel movements for a while. Psychologically, I like to think I managed the journey well. I might have been a little apprehensive at times, but no undue anxiety. This, of course, depends on the individual, as do any side effects. I did hope all the radiation would imbue me with a superpower like Spiderman. I’d love the ability to instantly recognise and give the botanical name of any plant in my garden, or always remember the reason I went into the basement.
Is my cancer cured? It appears so based on treatment stats, and I feel fine. I will be seeing my oncologist again and I expect to have follow up tests to confirm.
The reality is, without treatment, the cancer, which was an aggressive form, by now could have already spread to other parts of my body, beyond any possibility of this relatively straightforward process.
There are many types of cancer, some more serious than others. How any person reacts to a diagnosis and treatment is subjective. There are potential side-effects and long-term effects that must be discussed with healthcare practitioners. This was my journey. It’s not something to make light of, but I’d have to say I believe it was helpful for me to try to approach it with equanimity — and a sense of humour.
Now, I’m going to check out tattoos to add to my collection, something to celebrate completion of my treatment — maybe a linear particle accelerator. They’re pretty darn cool.
Here I must acknowledgement every single person who aided me in my treatment — the doctors, nurses, especially Suzanne in post-op, receptionists, and radiation therapists. Everyone at GRCC, Grand River Hospital, and St. Mary’s Hospital were polite, professional, and caring. I was so fortunate to be under their care. Thank you.
Bottom line, guys — get tested. There’s nothing to it and it can save your life.
*** Feel free to share this account with anyone you think might find it helpful.***
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