Health Update …

 

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Since posting my previous blog giving details of a number of events and publications in which I’m due to be involved in this current new year – and sending out an email with the same information – I’ve had quite a few enquiries about the current state of my health, many expressing the hopeful assumption that this projected activity means things have improved. As indeed they have.

To recap [new readers, as they say, start here] I was diagnosed with aggressive prostate cancer toward the end of 2017 and most of 2018 was taken up by various forms of treatment at University College Hospital in central London: chemotherapy, high dose-rate brachytherapy, radiotherapy and hormone therapy. All of these have now finished, save for the hormone therapy, which is likely to continue for another year.

I was fortunate in that I managed to avoid the more serious of the possible side-effects from the various treatments, fatigue aside, and doubly fortunate in the quality of care I received from everyone at UCLH. At my most recent meeting with one of the consultants in charge of my case, she assured me that the treatments had rendered the cancer no longer active and that, in the case of aggressive cancers like mine, there was, statistically, a 30% chance of it returning. Odds that, in the circumstances, I’m happy to take.

Since I was diagnosed, I’ve been aware of quite large numbers of men who have been similarly diagnosed and whose treatment is ongoing or is now complete; in a good number of instances the treatment has been successful and the cancer has not returned.

Diagnosis – most usually now through an analysis of PSA (prostate specific antigen) through a simple blood test – is becoming more accurate, treatment more effective, and yet I still hear of men over the age of 60 who are refusing to be diagnosed or, even worse, denied this simple diagnostic test by their doctor on the grounds that it is fallible and inaccurate. If my GP hadn’t phoned me once she had seen my inflated PSA score in the results of my annual blood test and recommended making an appointment for me at UCLH, I would not have been diagnosed and treated so soon.

I beg you, if you’re male and over 60 and haven’t already been tested, please do so. You can find more details on the Prostate Cancer UK website. The worst that can happen is that it’s a false alarm and you will have wasted a relatively small amount of NHS time and money. The best, if you register positive, is that you will get the necessary treatment sooner rather than later.

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Problems of the Prostate & Other News …

As some of you will already know, towards the end of last year I was diagnosed with prostate cancer, for which I’m currently having treatment at University College Hospital, London. The cancer is quite aggressive [9 out of a possible 10 on the Gleason Scale], but has still not managed to breach the capsule of the prostate itself. Because of the position of the tumour, surgery is not an option, so I’m following a proven course involving on-going hormone treatment and chemotherapy, both of which have begun, with radiotherapy to follow later in the year. The care I’ve been receiving is excellent and I’m feeling very positive about the eventual outcome.

These kinds of treatments are exhausting though, and there are times, during the chemotherapy especially, when your blood count is low and you’re particularly liable to infection. [Chemo kills the good cells along with the bad!] With this in mind, I’ve decided to set aside the plans that were in place to mark the publication of Body & Soul in April, and kick up a bit of a shindig when the paperback appears, most probably early next year.

The book itself, however, the fourth in the Frank Elder series, will duly be published by William Heinemann on April 19th, and the first in the series, Flesh & Blood, has just been re-released as a fine-looking Arrow paperback.

B & S Front

F&B 1

Elsewhere, and even as I write this, producer David Hunter and his team of actors are ensconced in a BBC Radio Drama studio, doing their best to make sense of my final two scripts for the Inspector Chen series for BBC Radio 4, Enigma of China & Shanghai Redemption. No transmission dates as yet, but, be assured, I will pass them on as soon as available.

Chen 1

Chen 2

And finally, just when I was thinking it would never happen, BBC Radio 4 Extra are repeating the mammoth undertaking that was mine and Shelley Silas’ dramatisation of Paul Scott’s magnificent Raj Quartet. Starring the likes of Anna Maxwell Martin, Lia Williams and Benedict Cumberbatch before he was, well, Benedict Cumberbatch, the programmes were originally broadcast in 2005 and have not been heard since. Each is broadcast three times a day and then available for a month or so on the BBC Radio iPlayer.

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If you want to find out more about prostate cancer, this is an excellent place to go.

Problems of the Prostate

The phone rang, as it often did, around one in the afternoon. Another cold call, I thought, from someone in the Indian sub-continent offering to sort out the problems on my computer.
“Mr Harvey?”
“Yes.”
“Mr John Harvey?”
“Yes.”
Usually, by this time I’d have said something moderately abusive and set down the phone.
“This is Doctor B…..’s surgery.” I recognise the voice. “The results of your blood test have come back and your PSA is above the acceptable level for men in your age group.”
So … not a computer problem.
“Are you likely,” she asks, “to have been sexually active in the 48 hours before taking the test?”
Momentarily, I’m thrown. How long ago did I take the test? Five days? Six? “Erm, it’s possible,” I stumble.
“Is there any way of being certain?”
I could call my partner at work, I think. And then, almost immediately, I could not call my partner at work. And besides, who am I kidding? I’m a 76 year old male. Wouldn’t I remember if I’d been sexually active five or six days ago?
“I’d like to refer you,” the doctor says, “to the Uro-oncology department at XXX hospital.”
Oh, God, I think. It’s cancer. When my hands have stopped shaking, I log onto the internet to learn the worst.

Less than two weeks later I’m sitting across from S……, a Clinical Nurse Specialist in Prostate Care. He is calm, articulate and clear. Reassuring. My PSA, he says, is only slightly elevated above the normal level for my age. He asks about other symptoms, difficulties peeing at night – too little, too often, too much – suggests a rectal examination in a way that makes it seem no more out of the way than drinking a cup of tea.

I lie on my side with my knees pulled up towards my chest; guarded by a thin glove coated in gel, S….. does the deed. It’s over quite quickly and a lot less painfully than I’d thought; not painful at all, actually, merely strange and only vaguely uncomfortable. S…. asks would I mind if the female medical student observing takes the opportunity to perform the same operation. As she gels up, I realise I’m hardly in a position to refuse.

The results of the examination are positive; my prostate is hard and firm, which is as it should be. S…. suggests another blood test to see if my high PSA was an aberration; outlines the other means of diagnosis, biopsies, ultrasound, the possibility of taking part in research study. He is so good at this, so practiced, that I believe everything he says completely. I am actually enjoying sitting there, being the focus of his attention. If there is anything seriously amiss, it’s S….. I want to be looking after me. Is this, I wonder, the start of some kind of Munchausen syndrome?

Buoyed up, I treat myself to a flat white at Tap Coffee before catching the bus home. S…. phones just a few days later. My PSA has dropped several points. He would like to schedule another test, hopefully to confirm a downward trend. An appointment is fixed for six weeks time.

I know from the internet and the material provided by the hospital that problems of the prostate are not necessarily cancerous; the most common – BPH or Benign Prostatic Hyperplasia – is, well, benign. Most men aged 70 and over are likely to have cancerous cells in their prostate that will never pose a life-threatening risk. But I also know that prostate cancer is the most common cancer in men, and, after lung cancer, the most fatal. 10,000 men die from it every year.  And the various diagnostic tests available are less than reliable.

Oh, boy!

Six weeks roll around. Imagine my disappointment when I discover I am not scheduled to see S…. at all, but a Senior Clinical Researcher and Hon. Consultant Urological Surgeon called R…… Is this good or bad? As it turns out, good. My most recent PSA score has continued the downward trend and is now safely (but what’s safe?) back inside lower limits. R…. sees no need for further investigation or treatment and dictates a letter to my GP accordingly. “This pleasant gentleman …”

Time for another flat white …