Bad News: Latest Prostatectomy Update
It is now – the day this post is published – three whole years since the operation (now Monday 6 May 2017, operation Friday 7 May 2014). I’ve recently been to the doctor to have my latest blood test. Thankfully it came back as ‘no sign’, so I’m still safe. At least for now. Yet my mind still works on me in a bad way. Even though I know there is no prostate left, and even though I believe that the surgeon was competent enough to remove all of the prostate, there is – and probably always will be – the nagging fear that at some point I will go for a test and get the news I don’t want. In reality, the only side-effect or sign of the terror of three years ago are five small scars and the knowledge that I am more susceptible to stress incontinence than I have ever been. Oh, and the reinforced knowledge of my own mortality.
The latter is probably the most stressful. Now that I have been released from the hospital, the tests that are done only have a tolerance down to 0.1. This is a long way above my last test – which went down to 0.01, using a more sensitive device – but it is only if the test comes back higher than 0.1 that any further treatment would be undertaken.
It is taking time to get used to the concept. I hear ‘0.1’ and think, ‘Wow – that’s high’, before common sense reasserts itself and relief kicks in. The test came back at 0.1, so I’m safe. But now that I think I might be safe, I have been taking stock of my life and reassessing my priorities. In response, I have recently applied for a job working alongside Jo. It would have meant either stopping or at least slowing down my writing. Sadly – or not – I did not get the job.
I say ‘or not’ for a reason. After submitting the application I woke up the following morning and suddenly felt apprehensive. As it is, I wave Jo off to work at 7 am. Then Owen off to school at 7.30. Then I get my own breakfast and sit down to start work. The concept of eating breakfast in a rush and then jumping into a car to drive to work, where I would be told by my ‘superiors’ what needed to be done that day, and then be assessed as to how well I had done the job, filled me with horror.
Okay, so I sit in the house on my own for most of the day, reading books on late antiquity, or typing books on late antiquity, or making endless cups of coffee (or undertaking the long trip up the stairs to make room for more coffee!), so my days can be lonely and, I have to be honest, I end up talking to myself. Sometimes I even know what I’m going to say next!! Life could be better.
But it could be far worse.
I like being my own boss, getting coffee when I want, leaving the house and going for a run, or taking a trip to the gym, or working on guitars or figures, or just sitting and staring at the wall. And all when I want.
I play football every Wednesday evening and a couple of weeks before Christmas I was the victim of a horror tackle. Bruised hip and elbow, and cracked ribs. (Yes, it really was that bad a tackle!) As I work from home, I just sat in my chair, dosed on Ibuprofen, and worked. No walking around holding my ribs in pain. No driving to work. No explaining to people why I can’t lift anything heavy as my ribs are in a bad way.
Maybe I should start looking on the bright side? I am still young. (Well, young-ish!) I have my health (Although only just!) I enjoy what I do. (Most of the time!) I have Jo and Owen. I have a lot of guitars and figures – and Jo bought me another guitar kit for Valentine’s day! Really, I am lucky. And very spoilt.
And I have verbally agreed – in principal – to write three more books for Pen and Sword, and am awaiting the contracts for two of them. Maybe I should have attempted to break out for a larger publisher who would forcefully promote my books, making it so that I really can earn a living from writing. But I have worked alongside the commissioning editor for P&S for many years and know that, should anything ‘bad’ happen, he’ll have my back and give me his full support. And at the moment I need all the support I can get.
Actually, there is one other side-effect of the operation, and this is very odd. After the operation I was told to wear hospital-supplied ‘support-socks’ – the type that stretch from just above the toes to the knee – to minimize the chances of blood clots in my legs. Although I took them off occasionally for hygiene purposes, the protection they offered to my legs made my leg hair grow like crazy. But after I finally took the socks off, the hair on my legs was worn off. In places. The hair on my right leg is short. The hair on the left side of my left leg is also short. The hair on the right side of my left leg is very long. And as I’m not the hairiest person in the world this makes my leg look weird.
Thankfully, it’s now winter so my legs are usually covered, and on Wednesday-night football the lighting is artificial so it isn’t very obvious. But how can I walk on a beach in summer with half a leg covered in hair? I look like a strategically-shaved wookie!
9 Comments
Your optimism is refreshing. Im glad to see you well. I am also looking forward to your future works.
Thank you (sorry about the delay – I have been on holiday and am only just getting back into the swing of things.) I hope that my future works don’t disappoint – ‘Gaiseric’ is out in July in the UK, not sure about the date for the Rest of the World.
Ian,
Very interesting post regarding your prostate treatment. I am shocked at your experience.
I am a prostate cancer survivor here in Canada. Not sure what is available in the UK other than the options they gave you but I had a procedure called HIFU for High Intensity Focused Ultrasound. I call it a procedure because it really doesn’t qualify as an operation. Almost totally non invasive (no surgery) and very effective. Basically the process “cooks” the offending cancer cells and is administered via the rectum. You are “out’ for less than two hours and go home with a catheter in place after another hour. This wait necessary for the lower body freezing to go away so you can walk. Catheter is removed after two or three days. That’s it. PSA’s over the past 4 years of 0.02.
Enjoyed your books on Belisarius and Stilicho immensely and am looking forward to others in the series.
Hi John
No need to be shocked! HIFU is only available in the UK at a few hospitals as part of ongoing trials, so I didn’t have that option. (Don’t forget that the NHS in the UK is extremely wary of trying new treatments without extensive trials – probably for legal and cost reasons.) Boy, am I jealous about you getting that treatment!
Great news about your low PSA results: long may it continue! I’m at 3 1/2 years, but in the UK after two years my tests were changed so that the lowest I could get is 0.1. Lower than 0.1, no problem: higher than 0,1 …. Hopefully mine is still as low as yours!
Glad you’ve enjoyed Belisarius and Stilicho. Only four more to get …. 🙂
Mr. Hughes,
I’m an avid fan (is it possible to call myself that if I’ve only read one of your books?), and personally, I hope you completely recover from the cancer.
P.S. The only person I know of who has the same cancer is the governor of Pennsylvania, Tom Wolf.
P.P.S. Personally, I thought Lars Brownworth’s Lost To The West: The Forgotten Byzantine Empire That Rescued Western Civilization was more reader-friendly, but I thought your book, Patricians and Emperors, was more accurate, and therefore the winner.
The main thing to take from this is that a simple blood test can save your life. So if you are a chap, or love a chap of a certain age – please get tested and be brave. It is hard and Ian has been through ups and downs, but we are 4 years down the line and our son is grateful his daddy got that test. Come on chaps – you can get tested too, not for you – but for those who love you.
Patrick, thank you for your encouragement. ‘Reader-friendly’ is a nice compliment, but ‘more accurate’ is a better one!
To anybody else reading these comments, please follow Jo’s advice. Although getting checked resulted in me having the prostatectomy, I have seen first-hand the result of not having a check – and it is far less pleasant than the experiences I went through. I’d go so far as to say ‘horrific’. Get checked!!
Dear Ian,
I am the father in law to Clare Clay nee Surbutts who you know and who sent me your blog. I found it very interesting as I am starting to go through a similar prostate cancer experience. I always get my PSA done annually and over the last few months it has risen to just .05 over the 6.5 limit for 75 year old man. After an MRI which showed nothing I elected for a prostate biopsy and the result was all clear apart from one biopsy slide that had a couple of low grade cancer cells. My cancer gleeson score is 3+3 = 6 and of a low grade.
My hospital want to put me on an Active watch but it does concern me because I would like to have this cancer irradiated if possible. They have advised against a full removal of the prostate, which I initially thought was the best option, but I have now discovered the new HIFU treatment which looks amazing and wonder if you or any of your friends have had any experience of this treatment. I live in Torbay and would have to travel to Southampton but that is of no concern if I can just be rid of this awful diagnosis which is affecting me and my lovely wife Gill.
I would be very interested in any information you may be able to give me and send you my very good wishes for the future.
Kind regards, Mike Clay.
Hi Mike,
Sorry to hear that you’ve also been diagnosed with this affliction, but happy that it has been caught early.
Has the hospital explained why they want to put you on ‘Watch and Wait’? From what I can remember of the whole process, such a low score and with reference to your age, do they think that this is the ‘slow-growing variant’, which you die with rather than die because of? That is what is implied by the low Gleeson score. (Mine was 7 and aggressive in 2013.)
I decided against irradiation, as at my tender age (don’t laugh!) there was a good chance of getting secondary tumours due to the radiation as I got older. As for full removal, I believe that as people get older there is a greater risk of complications: I had to go through several tests after the prostatectomy and got the impression that I was odd in that my recovery was swift and uncomplicated. Then again, I was at least 20 years younger than anyone else on the ward!
As for HIFU treatment, I agree that it looks amazing, as do the tablets(?) which highlight the cancer as a foreign body, causing your immune system to attack and remove it without any external interference at all. Sadly, I don’t know of anyone who has gone through either of these procedures in the UK: maybe someone reading this can help out?
Reading between the lines, I think you may have a similar outlook to me concerning the cancer. I was told that they had caught it early and that a prostatectomy would remove the cancer leaving me healthy. Physically, that appears to be true (not ‘certainly’ true – I have a test coming up!), but for me, now, it is the mental aspect that is the hardest to cope with. Even after 6 years, my stomach gets into knots at the thought of the next test!
Hopefully we will get more information about other treatments soon, and ones that don’t rip bits of your anatomy out and incinerate it!
Good luck in the near future, and I hope you receive information that helps.
Ian