Analysis
By Dagbayonoh Kiah Nyanfore II, USA.
I am not a medical doctor. I am a prostate cancer survivor. I am writing about my experience with prostate cancer in hope to help inform other men about the disease.
According to statistics, prostate cancer is the third most common cause of death of men over the age of 40 in the United States. “African-American men have the highest rates of prostate cancer and have the greatest risk of dying of the disease”. Also in the US, prostate cancer “is the leading cause of cancer in men”. Prostate cancer has no definitive symptom; and there is no confirmed or known cause for prostate cancer. Some factors, which are considered symptoms of prostate cancer, are symptoms which are also caused by other diseases.
First, let’s talk about prostate. The prostate is a gland in the male reproductive system. It is like the size of a walnut. As the picture shows, it is located below the bladder and is in front of the rectum. The prostate is also responsible for producing the semen, which helps nourish the male sperm. The urethra, the tube in which the urine passes, runs through the prostate. When the prostate is enlarged, it squeezes the urethra and causes problem or difficulties with urination. This causes men to frequently visit the bathroom. But enlarged prostate is not prostate cancer.
Prostate cancer is the outgrowth or buildup of the prostate cells. The cells grow out of control and may become cancerous and may spread to other parts of the body. This may cause death. Prostate cancer is called “the silent killer”, because it can stay in your body and you may not know, and then it kills you. But some men with prostate cancer whether in the US or elsewhere, died from other causes other than from prostate cancer.
The prostate can be divided into four parts or pockets. In my situation, the cancer was found in two pockets of my prostate. As I stated before, there is no confirmed cause for the development of cancer in the prostate cells. So I did not know how I got the cancer. Prior to knowing about my cancer, I watched what I ate and worked out three times a week. I was in excellent health. So when my doctor told me that I had prostate cancer, I was shocked. He lectured me about prostate cancer and gave me literature and a video on the disease. As I walked from the hospital, I said to myself, why me? On my way home, I was thinking about death. I thought about my love ones I would leave behind. I was sad when I got home and tried to force myself to sleep. I later read everything I could find on prostate cancer. I was in the fight of my life.
But my doctor also told me that prostate cancer is a slow growing disease and that my cancer was in the early stage. So I had time on my side, time to decide which treatment options that I should take. I found this information encouraging. It calmed me down a little. The hospital also advised me to join a prostate cancer support group. I did. The support group was very helpful to me. The group was made up of prostate cancer patients, former patients and prostate cancer experts.
But prior to joining the support group, I took a trip home, Liberia, to have time and quietness to think. Being home, gave me a peace of mind. I did not have to hustle and bustle and to think about this bill and that bill. In Liberia, I did not inform family members about my problem. I did not want them to worry about my condition. They had their own problems trying to survive hardship. The treatment options available to me included surgery, radiation, and hormonal therapy. Also I could have opted to do nothing but to “wait and see” or do “watchful waiting”, meaning do nothing but to monitor the progress of the cancer through periodic doctor’s visits. I felt this option was risky, that was taking chances, therefore I did not consider it.
After attending the support group meetings and researching on the treatment options, I decided on surgery, a removal of the prostate once for all. This was not an easy decision. Prostate surgery has side effects and consequences. For example, my sperm would be dried and I would produce no sperm when having sex. I would have no children physically. Also if the nerve was touched during surgery, I would have no feelings or desire for sex in my entire life and would become permanent impotent. Moreover, I could experience incontinence, bladder leaks, after surgery. I weighted all of these consequences. I wanted to live and was willing to face the results.
I did not choose the radiation option. Radiation treatment kills the cancer cells through a leaser bean. But it can also destroy other tissues. You will have to take radiation about five days a week for six or more weeks. It is like going through an X-ray machine. I had no problem with the procedure. But from my research, I learned that though the patient may be cured of the cancer after the treatment, the cancer may return to other parts of the prostate later in life. As an African who plans to return home where there are inadequate medical services, I did not want to take chances: in Liberia there was only one urologist during my illness. The cancer may return and I may not get the proper treatment at home.
I had the surgery about two months after my decision. I had the da Vinci robotic method or radical prostatectomy. With this treatment, surgery is done remotely with the help of a computer. Incisions are minimal and there are no cut marks on your stomach after the surgery. The recovery time is shorter. I found this method to be better than the traditional prostate cancer operation. The surgery was successful and also the nerves were spared. I spent only one night in the hospital. I recovered within six weeks.
My PSA (prostate specific antigen), a blood test, is now 0. Treatments for side effects took awhile. I have been prostate cancer free for over seven years. I have a normal life. I was blessed to have a support system during my cancer and after the surgery. Besides the cancer support group, my family and friends were very supportive. Moreover, I was in a relationship during my illness. My friend was committed to the cure and was there with me to see it through. You need a support system when you are going through the illness. You need also to do some reading on the disease and ask questions.
If you are diagnosed with prostate cancer, do not give up life. If you are in the United States, ask your primary care doctor, family members, friends or others for referral for an urologist. You need a good doctor for the treatment option that you plan to take. Consult more than one urologists and talk to their former patients if possible. I talked to three urologists before my operation. Try also to join a prostate cancer support group if you can. Group members share their experiences regarding the disease. This too will help you. In fact, it was at the support group meeting that I learned about the urologist, who performed my surgery. I changed my original urologist, because the da Vinci method was not his specialty. Do not be afraid to make changes that you think are in your best interest. This is your life you are dealing with, do not play with it.
Most men who are faced with the decision for prostate cancer surgery are concerned about ED, erectile dysfunction, which is a major side effect of prostate surgery and of other options. ED is the inability to have and maintain erection for sexual intercourse. But this problem should not stop you from seeing about curing the disease. You can have ED from many factors, including diabetes, high blood pressure, blood vessel disease and excessive drinking, even if you do not have prostate cancer surgery. These problems can stop or slow the flow of blood to your penis, causing erectile dysfunction. When this happens, you feel inadequate as a man. A study indicates that diabetes, high blood pressure and other artery related problems alone account for about 70% of the ED cases. Moreover, between 35 and 50 percent of men with ED got it from diabetes.
There are medications for ED. Some are Viagra, Cialis, Levitra and Muse. Now it is not a shame to use them. Some celebrities these days are using them and openly doing commercials for the medications. If these medications are not working for you, there are other alternatives to consider. You can try Boston Medical Group, vacuum pump and penile prosthesis. Though these treatments are expensive, some insurance can cover them. Sex is great, but life is greater. You can have both worlds if you first take care of number one, your health.
My experience with prostate cancer has changed my life. I have changed my lifestyle. Although I go out, I am generally a home body. I do not allow matters to upset me. I have gotten married after years of living as a single man. I appreciate the simplest things of life, relationship with people, commitment to God, and the consistency of personal principles, honesty and integrity. Life is precious, and I will nurture it!
Since I had my surgery, some of the questions people have asked me include:
(1) If I did not experience a symptom for prostate cancer, how was it known that I had prostate cancer?
I usually have annual physical or checkup. It was during a rectum exam that the doctor noticed a roughness of the surface of the prostate. My PSA was high. The doctor advised me to see an urologist. The urologist did a biopsy, which involved the taking of tissue culture for exam. The results showed cancer cells in my prostate. My Gleason score, the grading of the prostate cancer, was average. I was lucky, and it was by God’s grace. The first biopsy was normal. But later the doctor called and told me we should do another one to make real sure. It was the second biopsy that showed the cancer. I thank God to make the doctor to call for a second test. Otherwise, I would not have known that I had prostate cancer.
(2) If the prostate cancer is a slow growing disease, how come many men die from it?
Death from prostate cancer occurs all the time. But perhaps some men may fail to have annual checkup and therefore may not know if their prostate is malignant or cancerous, permitting the cancer cells in time to spread to other parts of the body. As I also stated before, sometimes the cancer can return and cause further damage. However, compare to other cancers, the survival rate for prostate cancer is far better. From my experience, a major key to surviving prostate cancer is early detection and early treatment of the disease.
In conclusion, I suggest that if you are a man over forty years old, see your doctor for a rectum exam or do a prostate screening. As Louis Farrakhan once said on a radio talk show, it is better for someone to put his/her finger in your anal than for you to go six feet. Have a regular checkup. If you have a prostate cancer, see about it right away. Do not wait.
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