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Ron Murphy and Jo live in Queensland, Australia. He was 68 when he was diagnosed in December, 2007. His initial PSA was 4.00 ng/ml, his Gleason Score was 9, and he was staged T3a. His choice of treatment was Brachytherapy (High Dosage with EB and ADT). Here is his story.

My Personal Journey through Aggressive Prostate Cancer and High Dose Brachy Rod Therapy

Symptoms & Diagnosis
Sex & Prostate Cancer
Self Vs Family - Dealing
Treatment 1 - Hormone Therapy
Treatment 2 - External Radiation Therapy
Treatment 3 - Brachy Rod Therapy
After-effects of Brachy Rod Therapy
Follow-up Testing

UpDate January 2009
UpDate October 2010

What is this article about? Why did I write it?

It's about my personal experience with serious and aggressive prostate cancer, from the time of my first symptom through its diagnosis and treatment to the after effects of the HDR - (High Dosage Radiation Therapy) which I refer to as "Brachy" rod therapy. My reason for writing this is the hope that my experience can in some way provide help and confidence to others who find themselves diagnosed with aggressive prostate cancer and elect to have HDR - Brachy Rod Therapy.

Unfortunately much of the available literature fails to answer the everyday questions, fears and anxieties of patients and their families.

The article is not so much meant for those patients who elect to have surgical removal of the prostate or for those who have LDR (Low Dose Rate) Brachy seed insertion , although there will be many points of common interest here for both of these groups as well.

It may appear to you that there is some degree of confusion or uncertainty about the best way to treat prostate cancer, but in reality this is not so. [There is in fact a good deal of "confusion and uncertainty" about the choice of treatment for most men simply because there are no studies which demonstrate clearly the outcome of the various options for the majority of men, diagnosed with early stage disease. But even men with aggressive disease choose differing forms of treatment - see the choices of men with high Gleason Scores on Gleason Score chart including Eric Taylor who had a very similar diagnosis to Ron's.]. There is only one kind of prostate cancer [It has been demonstrated that there are in fact many varieties of prostate cancer - at least 24 have been identified -, some of which are indolent which can be managed for many years; others are aggressive and require early attention.] and the different methods of treating it are, in most cases, dependant upon the stage or degree of aggressiveness the cancer has reached, coupled with the age of the patient and the lifestyle the patient chooses to live in the future. Most treatments will alter your present lifestyle. The thing which many patients find confusing is the long list of after effects which most doctors will attach to the different types of treatment and this can make final decisions difficult.

One way to narrow this information down is to contact one of the prostate cancer support groups and talk to people who have experienced different treatments. In the end, the final decision will be up to you, so try to keep an open mind and develop a positive attitude. Once you've made your decision go with it and don't look back.

In my case the decision was easy. With a Gleeson score of 10, I felt I had no option than go straight to the top of the range treatment which was "brachy rod therapy".

Cancer Council Queensland - phone 131120 - has produced an excellent booklet entitled "Coping with a Diagnosis" which you may find helpful. They can also put you in touch with your nearest support group (in Queensland).

I have to say here at the beginning, I personally believe the only way to cure cancer is through the application of conventional medicine. Various alternative remedies, which many cancer sufferers subscribe to, have been shown to go some way in helping conventional medicine keep the cancer in check but I don't believe alternative remedies will cure cancer by their sole use. I myself subscribe to three alternative remedies.

Recently I read that many diseases start to form in our body 20 to 30 years before any symptoms appear and in my case this could well be true. Many years ago I first noticed that the man standing next to me had a better flow than I did and I always believed this was because I didn't drink much water - at that time two glasses a day as a general rule. However, in all probability, this was the start of my prostate cancer symptoms. I have no medical training of any kind and this article is based solely on my observations of my own personal journey through aggressive prostate cancer.

By the time you the reader, reach the end of my journey, you will hopefully realise that being diagnosed with prostate cancer may not really be so bad after all - even though I had three friends who died because they were diagnosed too late and I know of another man who refused treatment because he thought the effect may have changed his life style to such an extent he wasn't prepared to accept it.

It's not my intention to suggest to you at any point what your treatment might be or what you might expect from that treatment. This is the job of your urologist who will recommend the best form of treatment for your specific circumstances. Age fitness and lifestyle are all a consideration after establishing the aggressiveness of your particular cancer. The reader must be aware that what follows in this article is a record of my particular personal experiences, some of which may, or equally may not, apply to your situation and I have made no attempt to discuss the subject of prostate cancer in detail. Each and every man will have a different prostate cancer experience.

I'm 69 years of age, married, weigh 72 kilos and apart from prostate cancer and slightly elevated hereditary cholesterol, I'm in perfect health. I live in the country, follow a healthy lifestyle, walk 3km most mornings and have a very positive attitude towards a healthy future. I haven't smoked for thirty years or consumed alcohol for sixteen.

Although aware that this is a fairly long treatise (16 pages in A4) if you've been diagnosed with prostate cancer, I recommend you read it all because some small part of my experience may very well relieve some of your present or future anxieties.

Sex and Prostate Cancer

I'm going to get in early on this subject because I think there's a lot of misunderstanding here and, next to life itself, this is possibly one of the most important considerations in a man's being. It's not true that radium and hormone treatment of prostate cancer will leave a man incapable of having an erection. [This appears to represent Ron's personal experience to date. Numerous studies demonstrate that the erectile function and libido of most men undertaking hormone and radiation therapy can be permanently damaged.] It may require more patience, warmth, and affection from your partner than might have previously been the case, and it may require some practice at first, but if you had an active sex life beforehand there is no reason why this should become a thing of the past. Having said this I must add that it's most likely the hormone treatment will greatly diminish your sex drive or desire so it's up to you to do something about this yourself. This is more of a mental problem than a physical one and it's not hard to fix if you want to. It's highly unlikely you'll ever bring intercourse to a wet climax, but that's no reason to prevent you from enjoying a healthy intimate relationship with your partner.

Having said all of this, it would be irresponsible of me not to add that 50% of men are said to become impotent within three years of brachytherapy so look on the positive side - stay active and you will probably be one of the lucky ones. Rollover and do nothing and you will most likely become one of the casualties!

Wives and family members more often than not, share equally the anxiety of a prostate cancer diagnosis. Sometimes it may even be more traumatic for a loved one than it is for the patient himself. With this in mind I asked my wife and children to share with me their own thoughts, and I recorded some of them at the end of this article. It may provide some consolation for your family to read these comments.

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My Wife and my Family

My wife, who's been beside me through the highs and lows of every single day since my diagnosis, puts up with my occasional emotional outbursts, and provides me with unconditional love and gives me a good reason for wanting a long life.

"As I sat next to my husband in Doctor X's surgery and listened in disbelief to what sounded like a death sentence, I was momentarily placed in a state of shock. Nobody lives forever but to be confronted with death without warning, and in such a matter of fact manner, seemed to be unbelievable.

For the next 5 days leading up to the bone scan I felt completely lost, devastated, I didn't seem able to handle anything very well at all, despite my husband's assurances he would be alright. On the day of the bone scan my spirits were lifted when the pathologist announced there was no cancer in the bone but this reprieve was short-lived and I was once again confronted with despair when we returned to Doctor X' s surgery for his analysis.

Over the next 10 days I lost 4 kilos in weight, felt scared, and there seemed to be little hope for the future. The thought of being alone weighed heavily on me. In 30 years, my husband had never been seriously ill and had shown no previous symptoms. How could this suddenly be happening now.

My first uplift came from the Wesley Oncology Clinic where Doctor Tsang's careful explanation of all the possibilities gave me a way forward. Soon after this a friend, herself a nurse, whose husband had recently gone through the same treatment, convinced me that all would be well, and if I needed any more convincing it came when my husband's radium treatment started at Nambour and I accompanied him to the clinic each day. There, in the waiting area, I would look into the faces of smiling people, most of whom had cancer and appeared to be very positive about their future. Having always been a little afraid of cancer myself, these cancer patients passed on their attitude to me simply by my being able to observe their calm and seemingly happy state of mind.

Over the following weeks of treatment and post-operative period, there were times of anxiety to be sure but these passed and life returned to much like it had been."

My Children

" Being one of four grown-up siblings, when first hearing of the cancer, we all felt quite overwhelmed, and immediately wanted to be part of the information train and overall emotional support network. On a deeper level, I feel that as adults with young families of our own now, our attachment to our father takes on a different form to that of young children who are still very dependent on their parents. It's also not as intense as the fear experienced by a wife losing her life-time partner. None-the-less, from a personal emotional perspective, and as a counsellor myself, I see the cancer as an opportunity for siblings to make up for any quality time together that might have been lost over the years. For me it was a time to write a journal of my earliest childhood memories and create an atmosphere for healing old wounds before the chance was taken away. On this level the journey taken with my fathers cancer has been different for all us because, I believe, how siblings respond to, and cope with a parent's cancer, is ultimately dependent on what kind of relationship has existed between them since birth. So, unlike a heart attack which is so sudden, cancer offers families time for healing old wounds, saying things that needed to be said, finding love and forgiveness that may have been lacking in the past.

A final consideration, and a most important one, is that while everyone is offering positive support to the "cancer sufferer" it's important that loved ones, particularly partners, have a strong emotional support network around them too, in order that they can share and release all the many consuming emotions and fears that they are experiencing."

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DIAGNOSIS

November 7, 07 For the past week I've been getting up several times each night and it's become very difficult to pass urine. I'm spending long periods of time just sitting on the toilet with a very weak flow.

November 15, 07 The situation hadn't improved so I visited my local GP who sent me for a bladder scan and PSA test the next day. He did not give me a physical (digital) examination but I do recommend that this should always be done because aggressive prostate cancers don't always show up in the PSA test.

November 20, 07 Scan and PSA test showed levels only slightly above normal but to be sure I was directed to a urologist for a further examination.

November 27, 07 The first thing the urologist did was to give me a DRE (Digital Rectal Examination) and I will refer to this man as Doctor X. He seemed to lack all physical sensitivity and during this examination I experienced extreme discomfort which I know to have been unnecessary. I was advised that I had a 1 centimetre tumour, as well as a smaller cluster on my prostate and I should have a biopsy ASAP.

December 3, 07 Doctor X had provided me with a prescription for a Microlax enema which I applied at home on the morning of the biopsy, which was to be carried out at a nearby private hospital. I was anesthetised whilst core samples were taken from my prostate. It was a painless experience and I returned home immediately afterwards. There were 12 cores in all, 1mm in diameter up to 17mm long which were then tested by the local pathology lab.

Gleason Score The Gleason Score referred to herein goes from 2 to 10. [This was correct at the time of writing. From January 2010, the scoring system changed and the scale is now 6 to10] It's an analysis of the biopsy which grades the aggressiveness of the cancer. That is how rapidly it's likely to grow. A Gleason score of 2 might not be cause for immediate concern, but at 10 you have a real problem. The Gleason Score should not be confused with the PSA level which is the result of a partially accurate diagnostic blood test used to indicate the presence of prostate cancer. In an article I read recently, by the Cancer Council of South Australia, the median time 50% of men survive with treatment after the PSA starts to rise is reported to be 17 years. So a rising PSA in an older man would not necessarily be considered as a threat. Watchful waiting [Better known as Active Surveillance] is often recommended.

December 6, 07 Three days after the biopsy my wife and I sat in disbelief as the urologist delivered, what can best be described as, a probable death sentence. The biopsy resulted in a Gleason score of 9. Anything above 6 was dangerous and as the topmost Gleason level was 10, I was informed that my cancer was very aggressive with one large tumour and some smaller outcrops as well, my long-term outlook was not good at all. There was absolutely no subtlety in his delivery and I expected my wife to go into shock. Fortunately she didn't until later.

Due to the manner of his presentation, my urologist Doctor X, had me absolutely convinced I was going to die. That evening I sat down and made a complete list of every single thing I had to do in order that my wife would not be left with problems or loose ends when I passed away. The following day I started to put these things into effect.

Whilst I didn't have too much trouble accepting the possibility of death after the initial shock had passed, and I was busy with arrangements for the future, my wife was not fairing so well and this caused me a great deal of distress.

I was to have a CAT and bone scan at the nuclear medicine clinic to see if the cancer had spread outside the prostate into the bone or other areas and then see the urologist again after this.

December 11, 07 Immediately after the scan my spirits were lifted considerably when the clinic analyst told me I was all clear. There were no cancer cells outside the prostate. What GREAT news this was for both my wife and I. So now down to see the urologist.

This meeting was to leave us both even more devastated than the previous one had done.

Doctor X told us not to take much notice of the scans because with my high Gleason score indicating an aggressive cancer it was most probable that there would be cancer cells in other areas. The scan would only pick up the larger clusters so my situation hadn't changed. When I told him he was being very negative he simply replied "Do you want me to give you false hope?"

This comment was generally in line with the rest of the prognosis but it still surprised my wife and I by its fatality. It also surprised my daughter, a psychologist, who had come along to support us and record the meeting so I could later recall all the details. Doctor X said I should start radium treatment and he would arrange this with the Nambour Clinic.

When I said I preferred to have this done in Brisbane he left it to his receptionist to arrange a meeting for me at the Wesley Hospital.

Doctor X's receptionist was unable to find a phone number for the Wesley, even though we watched her look everywhere and it was now 5 o'clock so she would attend to it first thing in the morning. When I checked with Doctor X' s surgery next day no appointment had been made so I decided I'd had enough and started making alternative arrangements myself. My local GP referred me to the Wesley Hospital and, a good friend, a highly regarded doctor herself, listened to my tale of woe and put me in touch with Doctor John Yaxley a well known Brisbane urologist.

It is not in any way my intention to question the medical knowledge or ability of Doctor X. His prognosis may be correct, only time will tell. I was however, not prepared to have the psychological (and therefore physical) wellbeing of myself and my family left in the hands of a person with such total disregard for our feelings or for the personal and unnecessary trauma such disregard had caused. I would like to add here that I've spoken to several other cancer patients who had similar experiences with their urologist. If you're not happy check around and go elsewhere.

I decided to have the biopsy results checked a second time so arranged for the slides to be sent to another laboratory where they were graded by one of the country's leading prostate pathologists. Unfortunately for me the results came back with a Gleeson score of 10 - one higher than before.

December 17, 07 Checked with the Premion Oncology Centre in Nambour and they confirmed that as yet no referral had been received from Doctor X.

December 20, 07 The Wesley Radiation Oncology Centre is operated in conjunction with the Premion Group. There are 3 locations - Brisbane, Nambour and Tugun on the Gold Coast. My first Premion appointment at the Wesley Hospital was with one of their oncologists, Doctor Gail Tsang, a beautiful person with the ability to put you at ease and make you feel human and needed. By the time my wife and I left her surgery I had a new-found positive outlook towards the future and that night saw my wife sleep well for the first time in over three weeks.

Doctor Tsang gave me a digital examination which was gentle, precise, and relatively painless. She carefully explained the process of external beam radiation treatment in conjunction with brachytherapy which would provide the best outcome for my level of Gleeson (10) aggression. She covered many of the side effects and long term possibilities as well.

She explained that treatment starts with hormone therapy. This would begin with a short course of 50 hormone tablets followed by a hormone injection a month later which could be administered by my local GP. This would be followed by another hormone injection every three months for the next 18 months. Hot flushes would be a side effect of hormone treatment. The HDR brachytherapy in conjunction with external beam radium treatment had proven extremely effective in the control of aggressive prostate cancers. I also learned that Doctor Yaxley was a highly regarded urologist who performed brachytherapy operations at the Wesley every week. This helped to boost my confidence even further.

That afternoon I visited Doctor Yaxley's surgery. He was working until 8.30 every night up to Christmas which was only four days off and would see me as soon as possible. His receptionist, another incredibly capable and friendly person, organised a flow-test for me and arranged to contact me at the first available opportunity.

Two weeks later she made good on her word and to my great surprise Doctor Yaxley would see me the following Sunday afternoon. Here was a truly caring doctor.

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Treatment 1 - HORMONE THERAPY

December 21 07 My treatment commenced today with the first of the hormone tablets.

January 3 08 Thirteen days into the hormone tablets I had my first Zoladex injection. A prescription by Doctor Tsang was ordered in by the local chemist and administered by the local GP. This Zoladex prescription is for a large needle which contains a slow release pellet and is injected under the skin of your stomach. The first 3.6mg pellet lasts a month. The following pellets are 10.8mg and last 3 months. These injections are painless.

January 13, 08 Much like Doctor Tsang, John Yaxley had the ability to put you at ease as soon as you were in his presence. His digital examination was not painful and his explanation of brachy rod therapy with all its possible side effects didn't leave you gasping for breath or running for the door. His easy yet professional manner left you with a sense of wellbeing. Unfortunately my wife wasn't able to attend this informative meeting but my daughter filled in once again and recorded the interview for my further reference.

I had been diagnosed with a T3 stage tumour, internationally tumours are staged from T1 (not clinically detectable) to T4 (metastasised). My Gleeson of 5 + 5 = 10 was on the topmost level.

I would have 23 sessions of external beam radiation over 5 to 6 weeks commencing March 12, a week later the HDR brachy rod operation would take place at the Wesley Hospital in Brisbane. This would allow for almost three months of hormone treatment prior to the start of external beam radiation for which my wife and I would drive 50 minutes to Nambour each morning rather than drive 2 hours to Brisbane daily.

January 16, 08 It's almost 6 weeks since my second meeting with Doctor X, after which, death seemed for me to be an inevitable certainty. Fortunately, following my first meeting, 2 weeks later with Doctor Tsang, my life took on new meaning again.

I'm not really an emotional person so I was a bit surprised by what happened this morning. My wife was away at the time and I sat quietly looking out the window contemplating my situation when suddenly without warning my head fell into my hands, all thought vanished and I broke down and wept. A few minutes passed before I regained my composure and at that moment I felt a great burden had been taken from me and that everything was going to be all right.

January 22, 08 I have my second meeting with Doctor Tsang. The PSA level has fallen from 3.5 in mid-November to 1.1 over two months. I take this as a good sign.

February 4, 08 My local GP administers the second Zoladex hormone injection of 10.8mg - it's the first of the 3 monthly term.

February 18, 08 I attend the Wesley Hospital for "planning". This is a physical process in which your lower abdomen is scanned to determine the exact position for the forthcoming external beam therapy. Radiation will be beamed through my prostate in 6 separate locations each day - 3 across the front of me and 3 across the back.

To ensure my body would be placed, each day, in exactly the same position on the radium table, I am now placed under two right angled laser beams and three tattoo marks are made on me. One on the side of each hip and another just above the pelvis. A more permanent pin prick is then added to each. Don't empty your bladder (like I did) before you start this planning process or you will have to wait until it fills up again.

Doctor Tsang came to see me before I left and I was given a prescription for Flomax tablets. They would relax the muscles in the prostate and allow urine to flow more freely and should be taken when I start radiation therapy in three weeks. Had I known of their existence I would have started taking these long ago! They are also prescribed for men who have restricted urine flow but do not necessarily have prostate cancer.

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Treatment 2 - EXTERNAL BEAM RADIATION

March 12, 08 Today I started external beam radiation at Nambour and made the same mistake as with the planning exercise. I emptied my bladder beforehand so had to have three glasses of water and wait for my bladder to partially fill again.

One of the Premion nurses discussed with me a range of general advice including the use of aqueous wash instead of soap for bathing and aqueous cream for any areas of skin which might be aggravated by the treatment. Avoid high fibre foods, fruit with skins, nuts and seeds, as they may lead to diarrhoea. Also avoid green leafy vegetables which can cause gas and distort the colon.

For the radium treatment three technicians helped me to lie on an x-ray table above which was a cantilevered arm which would rotate around the table and beam radium through my body. Two laser beams were run across the table at right angles and the technicians carefully moved my body to within a millimetre of exactly the same position each day by lining up the original tattoo points with the laser lines.

March 17, 08 Urine flow contracted after 2 days of treatment but has improved slightly after taking a Flomax tablet at night. "Hot flushes" ["hot flashes" in US English] which are a side effect of the hormone treatment are regular visitors. Perspiration is heavy from the waist up. They occur mostly at night but will also present themselves several times during daylight hours. The fact that they last only a few minutes makes them easy to manage.

March 26, 08 In a discussion with Premion's Doctor Knessel today, he indicated the possibility that in my case some cancer cells may have gone outside the prostate area given my Gleason score of 10 but it's the hormone treatment which will be the most effective element in treating this and that's why the hormone treatment continues on for 18 months.

March 28, 08 I'm now half way through the 23 treatment course of radium. Those patients who are having radium only have 37 treatments which generate a total output of 75 RADS. Whereas the brachytherapy on top of 23 treatments totals up to 87 RADS.

As yet I have had no side effects from treatment apart from tiredness at night and some constriction of urine flow. That is, apart from hot flushes which continue as before.

Some mornings I'm up at 5.30 in order to attend a 7.30 appointment at Nambour. Unlike the local GP's surgery, the Premion clinic is always on time and the actual treatment takes less than 10 minutes.

It would be quite ungracious of me if at this point I didn't have something to say about Premion having had considerable exposure to their organisation since my first meeting with Doctor Tsang in December last year. The first thing that caught my attention on that occasion was the friendly and caring attitude shown by the reception staff, each one of them, and their efficiency followed to the same standard. I remember how despondent I was feeling at that time and what a boost they gave to my confidence. I've spoken previously about the saviour Doctor Tsang turned out to be so now let me go back to the Premion Clinic at Nambour. The same positive, friendly and caring attitude jumps out at you the moment you walk through the door. It comes from the receptionists who get you started, the doctors who sit down and discuss your progress once every two weeks, the nurses who will help with a problem anytime you want and most important of all are the many highly skilled technicians who control your daily treatment. Surprisingly every one of them knows each patient by name and their caring attitude leaves you with a feeling of positive strength in your own future. I can quite honestly say that I know of no other organisation whose staff are so united in their purpose and seem to be so clearly dedicated to your wellbeing.

April 8, 08 Hot flushes have increased in regularity over the last week - mostly in the evening but also by day. Constipation is occurring to a minor degree and I'm having trouble sometimes keeping up with all the liquids I've normally been consuming - 15 glasses a day. Flomax tablets caused sinus problems to occur but using 'Logicin' nasal spray seems to have cured this after three applications. This may be a recurring problem. Some very minor anal bleeding has started at the end of bowel movements.

April 10, 08 Bleeding has increased. Oncologist has prescribed suppositories to correct this. As yet no other side effects apart from some midday and nightly tiredness.

April 15, 08 Bleeding is still occurring. It appears to be coming from the soft wall tissue of the colon. I am hesitant to apply any muscle pressure whatsoever with bowel movements and have increased suppositories to three each day. This problem is of concern to me.

With an intake of 14/15 glasses of liquid each day the passing of urine has become more regular and urgent and is accompanied with a degree of burning discomfort each time. Urine flow on the 4 or 5 nightly trips is restricted even with the use of a Flomax tablet each night. Perhaps the tablet should be taken earlier in the evening.

April 16, 08 Today saw my 23rd and last radium treatment at Nambour. The 6 position process takes only a few minutes each day compared to the 1 hr trip there and back.

I now have 6 days to wait before my Brachytherapy operation at Wesley Hospital. The hot flushes have become more frequent but last only a few minutes so are not too difficult to handle. Anal bleeding with bowel movements is still a problem.

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Treatment 3 - BRACHY ROD THERAPY - HDR - (High Dosage Radiation Therapy)

April 21, 08 Entered Wesley Hospital for "Brachy" to be performed at 7.30am tomorrow. Liquids only meals for 3 days. Dr Timujin Wong the anaesthetist came to see me at 8 o'clock to discuss the procedure - an Epidural and I would be out-to-it for about 2 hours. The night nurse provided a litre of laxative fluid with orders to drink it all ASAP and then go to bed. This was followed up at 5.30 next morning with a couple of enema suppositories and instructions to 'hold' them in as long as possible. Earlier in the afternoon I had a visit from the ward orderly, a very large Samoan who looked like a front row forward [a large rugby player - a linebacker would be the American equivalent] with great tattoos on his arms and an electric razor in his right hand. I was saved from what I had expected would be my first embarrassment.

April 22, 08 At 7am, with an empty bowel, a close shave, and a hospital gown around me, I was wheeled over to the Pre-Op room. It reminded me a little of a production floor in an abattoir with patients and hospital staff going in all directions. The anaesthetist's assistant, a very pleasant woman, placed a painless injection in the back of my hand while telling me what a tremendously capable doctor I had in John Yaxley which gave me a great feeling of security as I was wheeled into the operating theatre. What a hive of activity this was. There was the anaesthetist and his assistant, my oncologist Doctor Gail Tsang and several other medical assistants. John Yaxley arrive shortly afterwards, had a cup of coffee and chatted happily with everybody whilst I passed out.

Over the next hour and a half I had 15 hollow metal rods inserted through my perineum, that is the area between the back of the scrotum and the anus . The tips of these rods were very accurately positioned directly into the prostate whilst externally their projection was held in position by a pre-drilled template which causes some degree of discomfort as it presses against and spreads the lower part of the buttocks.

During the operation a catheter tube is inserted through the penis in order to drain the bladder. This catheter remains in position until the brachy rods are removed and did not cause any undue discomfort.

Upon returning to the ward you are placed on your side, turned every few hours to the opposite side and you remain in this state until the rods are removed the following afternoon. During this period you remain on a liquid diet and are confined to bed for 2 days over which time you are wheeled to the radium room 3 times where your approx 15 centimetre long brachy rods are connected to hollow tubes and attached to the radium unit. The radium delivery takes about 20 minutes, is painless, and you are then wheeled back to your room, always remaining on your side.

April 23, 08 Over the 2 days of brachy treatment I was given several morphine injections so apart from the first night, prior to insertion of the rods, when I got very little sleep, there wasn't much discomfort to speak of aside from having to spend the entire time lying on my side so the protruding Brachy rods would not be disturbed. Every few hours the nursing staff would turn me over onto the other side.

At around 4pm on the second day I was wheeled down to the radium room for the third and final treatment then to the recovery area for the rods to be removed. I hadn't been sedated for this exercise so I was a bit apprehensive but the rod removal turned out to be a bearable exercise and the surprising presence of my oncologist Dr Tsang gave me relief and confidence that all would be OK.

Removal of the catheter proved, for me, to be more traumatic. Before its removal an irrigation wash is being put through the bladder to clean up any blood clots which may have formed and on this occasion the wash stopped flowing, due it turned out, to a single blood clot which blocked the tube. Blood clots in the bladder can sometimes be a problem but I had only one and no more developed. My problem was that I couldn't urinate and that had everybody a bit concerned. Luckily for me this problem corrected itself later that night. All of this fades into insignificance compared to the act of actually removing the catheter from my penis. Only once in my life had I ever had a 'wax job'. I was 14 years old and my mother thought it was time to lose my teenage moustache so on went the wax and off came the hair in one hit.

The catheter was held in with three pieces of adhesive tape, firmly attached to my genitals, and its removal was the first piece of real pain I had experienced throughout my entire seven weeks of treatment. I now had my second ever 'wax job' and it happened so quickly I'm sure the nurse moonlights in a beauty salon somewhere. That night I had my first solid meal in three days and despite my protests that I was quite capable of showering myself, my nurse insisted on supervising me in case I fell over. Just as well because I was having a great deal of trouble being able to urinate.

Having the ability to lie on my back for the first time in two days meant I got some sleep that night.

April 24, 08 The morning started out well until the urge came to empty my bladder. At no point in my life had I ever lost bladder control or been incontinent but I didn't make it to the bowl and watched in horrified amazement as a small amount of my bladder's contents emptied onto the bathroom floor before I managed to bring things under control. I wound up cleaning part of the bathroom floor and washing my under-shorts. About an hour after this I had the same experience again, second pair of shorts to wash out.

After breakfast I seem to have regained some control of my bladder and restricted function had returned. Discharge from hospital now depended on my ability to satisfactorily empty my bladder. Each time I went to the toilet the nurse would follow it up with a bladder scan to measure its contents. I would then have a glass of water and the process was repeated until my bladder held less than 100mls of liquid. At one point the volume was increasing rather than decreasing but luckily for me the head nurse took a turn on the scan and taught me how to perform a 'back to back pee' which brought the level down and by midday I was free to leave.

As always my ever caring and attentive oncologist Dr Tsang came to see me before I left. "Don't lift anything heavy, get plenty of rest, and see me in 6 weeks." I still had anal bleeding which accompanied each bowel movement and I had developed extreme burning pain in the penis with every urination. The longer you took to get to the toilet after the first bladder warning the greater the pain. I invested $19 in a 'wet bottle' just in case and just as well because I had to use it in the car the next day.

April 25, 08 I'm going to the toilet with great frequency and the burning is extremely painful but my greatest concern is over the anal bleeding.

I would like to put in a very big thank you here to the nursing staff of Ward M4 at the Wesley Hospital where the brachy patients are cared for. From the Wardsmen to the Head Nurse I have nothing but praise for these caring people.

Back

AFTER-EFFECTS OF BRACHY TREATMENT

April 26, 08 Over the last two days I've developed a great deal of discomfort in both hip joints which I suppose is to be expected considering the outward pressure placed on the lower buttocks due to the position of the brachy plate prior to its removal.

April 28, 08 I'm now going to the toilet 6 to 8 times a night and even though I'm taking Flomax tablets the flow is very light. On the last two attempts the flow was almost non existent which prompted me to phone the Wesley Hospital in case I had a problem. I was told that "with that frequency my bladder was probably empty but if it didn't improve I was to go to the nearest hospital." Fortunately that was not necessary. They also suggested I try Ural to ease the burning.

April 30, 08 Still bleeding so I contacted the doctor at Nambour where I had the original radium treatment. He suggested that I had probably ruptured a small blood vessel or haemorrhoid (which I don't have) so a course of suppositories should fix the problem.

May 2, 08 Today the local doctor gave me my second 3 monthly hormone injection, checked my urine for bladder infection, which was clear, and agreed I should stay on the Ural sachets.

May 3, 08 Have now taken 30 Ural sachets over the last 5 days with only slight improvement in pain relief.

May 4, 08 Have now taken 12 suppositories for bleeding but no relief. I get tired around 7.30 every night and find I need to take a nap after lunch as well. A few days ago I read a small information leaflet I'd picked up before leaving the hospital entitled "Pelvic Floor Muscle Training for Men" [commonly referred to as "Kegels"] and have been practicing this technique 60 times (2 x 30) each day. I'm still getting up 6 times each night to pass urine.

May 7, 08 Have now used 21 suppositories but bleeding still persists with each bowel movement, a fact which continues to bother me. I don't believe this bleeding is a direct result of the radiation treatment, it's more likely the radiation weakened the walls of the colon and some strain on my part has caused a blood vessel to rupture. I'm still passing water six times a night and apart from the blood loss I have no problem or discomfort with bowel movements which are numerous.

May 11,08 Today the bleeding stopped and the incredibly painful burning is starting to subside slightly. I believe the pelvic muscle exercises are perhaps responsible for this improvement. Additional rest is probably providing help as well.

May 13, 08 Yesterday was our wedding anniversary and following right on top of a big family Mother's Day lunch, my intake of 'non vegetarian' foods was much greater than normal. The result of this was the return of restricted flow and greater burning so it seems that, for me at least, diet has an immediate impact.

May 15, 08 As yet I've made no mention, since the brachy treatment, of another problem. My frequency at night was often accompanied by painful groans as I made my dash to the bathroom. I was aware that this was causing some distress for my wife which I wanted to avoid, so by moving to another bedroom I was able to get through the nights with less stress for both of us.

During all this night frequency over the last 3 weeks I've been amazed at the accuracy of the subconscious mind. In the beginning I woke to get up every hour, then every hour and a half and in every case the timing was within 5 minutes.

May 16, 08 A wonderful night, I went to the toilet only once. My liquid intake has been cut back to 10 glasses a day with no liquid after 6pm apart from a small amount of water with the Flomax tablet around 6.30 and the burning has subsided to a discomfort level. I'm continuing to practice Pelvic Muscle Exercises.

May 17, 08 Another good day with just 2 toilet trips last night.

May 18, 08 Once again only one toilet trip last night with no discomfort to speak of either day or night. One week ago I discontinued the daily consumption of fresh garlic and ginger which had always been added to a vegetable juice each morning. I also deleted the daily whole fresh orange thinking these things may be adding to the burning. I will re-introduce them one at a time to gauge the result.

May 19, 08 Last night I'm back to getting up 3 times but I don't see any problem here. My hip joint muscles have been sore for the last few days, slightly reminiscent of when I came out of hospital but this will probably pass. Speaking of coming out of hospital I made the mistake of changing my showering technique. During the daily radium period I washed my genital area with an aqueous wash as the clinic had suggested and the rest of my body I washed with Dove moisturising soap but when I came home from hospital I dispensed with the aqueous wash. This caused me to develop a moist irritation between the genitals and the upper thigh joints where my body hair had come away with the catheter removal. The discomfort was at its worst by night when I was in bed and when I returned to using aqueous wash on that area the problem disappeared immediately.

May 21, 08 When my bladder tells me to go I try to drop everything and do so at once because the longer I wait the more painful it is but apart from the odd times the burning has almost ceased completely. I will try to find out if it was the brachy rods which caused the penis nerve to become so sensitised. The night before I was up only once and twice last night. It's now one month since the brachy operation so Doctor Yaxley is probably correct when he said it would be one to two months before I returned to normal.

May 23, 08 Three times up last night. My hip muscles are almost back to normal and I think that problem may have been the result of over-doing the pelvic muscle exercises. Thirty times in a row twice a day was probably a bit much so it's now back to ten contractions several times each day.

Apart from frequency, which is every time I have a drink, wash my hands, see running water and several times in between as well, about 18 times normally during the day, my only real problem now is the hot flushes. Five or six each night at which time I perspire profusely from the waist up. Luckily they only last a few minutes so if this is going to be my biggest problem I'm doing very well indeed.

May 24, 08 Up only once last night so at one month after the Brachy operation it's about time to bring this story to a close. Apart from some minor discomfort where the rods were inserted through my flesh, and this eased off after about two weeks, I think I've done fairly well to feel so good so quickly.

May 25, 08 As we have done, several times over the last few weeks driving to Brisbane, it's been our practice to stop at a mid-point service station and use their facilities. Today I didn't think I needed this so we continued straight through. This was not a good idea. By the time we reached the city centre, with a distance still to travel, my bladder had become extremely painful to the point where loss of control was fast becoming a probability. We were saved by the lights which allowed me time to switch driving positions and make a desperate grab for the 'hospital bottle' which fortunately I now always carry in the car. I'm probably one of the few people who managed to have a pee while going across the Victoria Bridge and get away with it. I might add it was slow and painful so the moral is if you have to travel any long distance stop in at some midpoint. Or get your wife to drive and don't go out without your bottle.

June 1, 08 Everything is going really well. I've managed to maintain the once only toilet call each night (3am always) and the hot flushes are the only problem I have. My foreskin is no longer irritated by the newly growing hair (from catheter removal) and limited erection has returned to normal. Libido (sex drive) will not be especially active while hormone treatment is taking place but this is something which can be corrected or balanced with the right kind of mental attitude.

Something I failed to mention earlier, is that soon after I commenced radium treatment my penis shrunk back into my body and that's where it likes to stay so I have to search for it every time I unzip my fly. Some men may find this physical change to their anatomy a bit unsettling at first but you soon get used to it.

With most of the problems now behind me I'm looking for a return to pre-trauma lifestyle. The treatment which I received, and continue to receive, is said to be the best there is for my particular condition.

Back

FOLLOW-UP TESTING

In two weeks I meet with Dr Tsang, my attending oncologist, for the first follow-up interview but as yet I've had no test of any kind so I don't know to what extent the cancer has receded. Hormone treatment in the form of three monthly Zoladex 10mg injections will continue for another fifteen months so the hot flushes are going to be around for a while yet. This hormone therapy is the most effective treatment for the cancer cells which most surely will have escaped outside the prostate. These are the more serious ones and could be in the pelvis, the lymph nodes or other surrounding areas. The radium therapy and brachytherapy treatment will have hopefully taken care of the prostate area. Beyond 18 months, hormone treatment appears to have limited value because it is claimed that after this time the cancer cells become resistant to the treatment. However this particular research finding is relatively recent and many of the specialists in the prostate cancer field, believe that possibly another 3 to 5 years need to pass before the evidence becomes conclusive. [There is a good deal of debate about how, when and why some (but not all) tumours become hormone independent. The only certainty is that it is not correct to say that all hormone treatment will fail in a short period - Doug Adam's story is a good example of this.]

For at least the next year I will have a PSA blood test every 3 months to establish my progress. I understand the PSA test is approximately 70% accurate and it is the increase in the PSA level which would alert a Urologist to a possible problem.

June 6, 08 Six weeks have now past since I left hospital and today was my first follow-up meeting with Doctor Tsang. To my surprise, her laptop contained a record of every problem and query I'd had during that time, even though none had been directed to her. So it appears the Premion Group and Wesley Hospital do take an interest in their X-patients and keep tabs on their progress.

A digital (physical) examination indicated the prostate tumour had shrunk, and as well as could be determined, I was in good shape. My interest had now moved to the future, so I asked what happens if any of the cancer cells had escaped the prostate area, which in my case, being Stage T3 Gleason 10, I had always thought to be highly probable.

My first line of defense is the hormone treatment, the 3 monthly injections of Zoladex which will continue for another 12 months. Should this treatment fail and I have a breakout in some other part of my body, the next step will be radium treatment once again or chemo. If, in the worst case scenario, cancer should enter my bone, there is as yet no cure but there is treatment for pain relief. So in the final analysis all is OK.

There is absolutely no point worrying or getting stressed about any of this because it won't help the final outcome in any way and could turn a positive outcome into a negative one.

Quite apart from the conventional medical treatments which Doctor Tsang referred to, there are the three herbal remedies which I've been taking since my original diagnosis and will continue to take into the future. To repeat what I said at the beginning of this story, I don't believe alternative medicines will prevent cancer but I do believe there are those which can help to prevent its spread. Because I don't feel this would be the correct forum to discuss the matter, I have included my E-mail address for anybody who might be interested further.

My first PSA test following the Brachy therapy is due in 5 weeks, a few days before I see the Urologist. I don't anticipate any negatives in this so it's about time to bring this exercise to an end.

I sincerely hope that some part of my experience will ease the anxiety of another human being. If so the writing of it will have been worthwhile.

Finally I need to thank once again all of those people at the Premion Group who made it so easy for me, every day of my radium treatment, the nurses in Ward M4 at the Wesley Hospital who looked after me so well, my urologist Doctor Yaxley, who performed with such skill in the operating theatre, and my oncologist and saviour Doctor Tsang who lifted me from despair to peace of mind. These are the people, who's skill and devotion is so often taken for granted.

My gratitude also belongs to my children, who took the time to be with me when I needed them and who were greatly resourceful in finding much information, especially in the early stages of my diagnosis.

EPILOGUE

July 25, 08 Today I had my first post-op meeting with my urologist Dr Yaxley. Last week's PSA test showed a level of 0.1, below which a result cannot be obtained [This is so, using normal PSA protocols - ultra-sensitive tests can measure lower levels]. It looks like things are going very well for me at this stage. I was given the usual flow test and digital examination and told I could cut the Flomax tablets back to every second day. Each night I need to extend the time at which I go to the toilet so my present once only trip at 3am will ultimately become 6am and I won't get up at all during the night. Sounds to me like a good objective.

My sincerest hope for a speedy recovery goes out to all those distressed by any ailment.

UPDATED

January 2009

5th December 2008.

One year since my initial diagnosis with a Gleason score of 10 [When Ron was diagnosed the pathologist graded his tumour as Gleason Score 9. Ron very sensibly sought a second opinion and this time the tumour was graded as Gleason Score 10. Diagnosis is changed from time to time as more information comes forward and this is especially true for subjective issues like tumour grading. On this website the original diagnosis is shown annotated where appropriate.] It's been an eventful 5 months since my last visit to urologist doctor Yaxley. My PSA reading is still 0.1 and according to Dr Tsang's recent digital examination; the tumour on my prostate has gone down a little. I 've had some good months, some not so good. I did manage to eliminate all nightly trips to the bathroom but have recently returned to getting up in the hope it will help to reduce fluid retention which I may have - (In August, 4 months after the Brachy Rod Therapy, my weight jumped 10% within a few days without any apparent reason).

Hormone Therapy Side Effect

Early September saw me on a plane trip to Europe during which I was sitting down for about 30 hours. Up until this time my only recovery problem had been "hot flushes (flashes)" from the 3 monthly hormone injections but the day after arriving in Europe I was taken to the hospital with swelling to much of my body, especially the legs and feet. After testing, I was diagnosed with "fluid retention", given some tablets which had no effect, and some ointment to rub on which had the effect of peeling the skin off my feet. I discontinued with both these remedies. A few days before returning to Australia again, I was advised to take Aspro heart tablets which, along with a pair of pressure stocking for my legs, gave me a more comfortable trip home.

Speaking with a few members of the local Prostate Cancer group, I learned that this swelling is a common side effect of the hormone treatment, and this was confirmed when I saw my oncologist Dr Tsang 2 weeks ago. It seems I'll be stuck with this uncomfortable swelling until the hormone therapy treatment is over. The leg swelling isn't too bad but sometimes my feet hurt. If I get the knee length pressure stockings on before rising it helps and if I'm sitting for long periods I have to keep moving my feet.

I find that I get tired and fatigued much quicker than I did before and I find myself sometimes in need of a rest during the afternoons. Otherwise I'm in good health, exercising regularly and able to maintain a positive outlook for most of the time.

Radiation Treatment

I recently discovered some interesting information about the process by which radiation therapy kills cancer. Apparently the radiation works on the DNA of the cancer cells in the affected area leaving them unable to divide and multiply, so that over time the cancer cells die off and the tumour shrinks. This of course is an over simplification of the whole process.

Human Trials and Alternative Therapies

Tea Tree - On November 24th I became part of a "human trial" being conducted by Professor Max Reynolds at Nathan University (Brisbane) to test the effectiveness of Melaleuca (Tea Tree) extract on Prostate Cancer. Each day I take 2 capsules and 2 suppositories but I don't expect to hear about any results for a few months. My body has started to smell a bit like eucalyptus. [Professor Reynolds is a director of NeuMedix Health Group who are selling MAC (Melaleuca Alternifolia Concentrate) although the small study in which Ron is participating has not yet been completed. There are no scientific studies cited to support their claim for this product.]

Blueberry Juice - In addition to the Melaleuca Trial, I joined another group testing double strength "Doctor Red" Blueberry Extract - taking 25mls in water 3times daily. This product is reported to have had some very good recuperative results already so the trial should come up with a definite result one way or the other. The manufacturers claim that the product eliminated prostate cancer from a patient in a previous non-scientific trial. About 3 months ago I had taken 2 bottles of normal strength Dr Red and it appeared to reduce the size of a skin mole I had so I'm keen to see what happens now after having a 3 month break.

Pawpaw Leaf Tea - Each week I make up 4 litres of pawpaw leaf tea (brewed from my own pawpaw groves), and drink 3 glasses per day. I've been doing this for 12 months now - since I was first diagnosed. Apart from the slightly bitter taste of the pawpaw leaves, there appears to be no negative side effects from the tea. (This is Australian Pawpaw, not to be confused with the American Pawpaw).

Jason Winters Tea - Each day I also drink 3 cups of Jason Winters Tea and have done so for the past 12 months (since diagnosis). This is a pleasant tasting caffeine free tea made from Red Clover Gotacola and Chaparral (a dried leaf which some American Indians have always used to treat prostate problems). It's claimed (with some scientific and much anecdotal proof) to be a cure for cancer. The one drawback with this tea is that each cup produces a hot flush but I'm so used to them now that it doesn't bother me. Interestingly, conventional tea does not produce this side effect.
(note) When my local doctor wouldn't accept my leg swelling as lymphodema caused from the hormone therapy, he sent me for every imaginable blood test and scans as well as heart checks. The blood tests indicated that all my organs were functioning well so my alternative remedies are, in my opinion, certainly not having any adverse effects on me at this stage.

Diet - Throughout my diagnosis and treatment, everyone (including medical professionals) has been amazed at how healthy I look. Despite being a drinker until 20 years ago and a smoker until 30 years ago, I have maintained a very healthy diet regime and exercise program for at least 20 years. A diet rich in fresh fruit and vegetable (without being strictly vegetarian), and very little sugar, salt and dairy. I have no doubt that this has held me in good stead now.

Intimacy with Impotence - A few months ago I came across a book written for prostate cancer sufferers by Ralf and Barbara Alterowitz called Intimacy with Impotence. Having put many of their suggestions into practice I found that my wife and I were able to return to much of the intimacy and closeness we had before. I took no notice of references to such things as Viagra and other treatments which the book covers but is not really about and I can strongly recommend this book to any prostate cancer patient who wants to find his way back to the intimacy he once shared with his partner. [Husband and wife team Stephan Wilkinson and Susan Crandell contributed their views on erectile dysfunction for the book Over the Hill and Between the Sheets: Sex, Love and Lust in Middle Age after Stephan's radical prostatectomy. These excellent pieces show clearly some of the differences between the way men and women regard the issue and are well worth reading. Susan's essay is What's Sex Got To Do With It? and Stephan's is entitled Mechanical Failure.]

Now at 69, and looking forward to a big 70th celebration in June, I'm doing just great. As a colleague of mine used to say "Life is for living". And it is.

Back

UPDATED

October 2010

17/09/2010 Update from Ron Murphy - Queensland

Last night sitting in the cockpit of my boat I thought it was time for an update on my condition. A bit odd I suppose because it was one of those really beautiful moments in my life life that I wished could go on forever. But I know it cannot . I'm anchored peacefully in Cid Harbour in the middle of the Whitsunday Islands, Great Barrier Reef. I think how fortunate I am. It was a perfect evening, the sea was millpond calm and lit up like a Christmas tree from the masthead anchor lights of more than fifty other yachts here in the anchorage on this night. Beethoven's Fifth piano concerto, my favourite piece of music, was playing quietly on the stereo and I was looking out at the darkened silhouette of the mountains surrounding this quiet bay. I've been sailing the 560 miles up to here on a regular basis for more than 30 years but this will be my last time. Not so much because of the prostate cancer, but the weather on this trip has been cyclonic, and with only one other crew member to help sail, at 71 years of age it has been an exhausting voyage this time around.

Having prostate cancer has given me an appreciation for life, far greater than I ever had before. Every day really is a bonus for me so I try to make the best of each one. My daughter Roslyn, a professional counsellor, helped me to realise that wisdom is really the ability to know what is important and what is not, everything else is simply knowledge, and I've come to realise that for me the most important thing in the world is my family. I went through this very lengthy and self-cantered introduction just to let you know how good life really can be even after you're introduced to death.

It's been almost three years since I was diagnosed as a Gleason 10 Stage 3 subject, and two and half years since the Brachy Rod operation. My last PSA test indicated 0.01, and a bone scan 2 months ago came up negative - got to be happy about that!! I'm now on annual doctors visits and my doctors are all very pleased with how I'm going. Compared to some of my Cancer Support Group colleagues on the Sunshine Coast, I have to say that to date I have fared extremely well. Eighteen months of hormone injections finished about a year ago and whilst I still get several hot flushes every day, it's much better than the ten to twelve I was getting in the past. I've never had any incontinence problems and apart from the occasional short lived bout of colon bleeding, my organs are all ok. I do have occasional mood swings. There are a few problems however, so I haven't managed to get away totally scott free.

The first problem is that I have been continuously developing boils on some sensitive part of my body. The worst so far being inside my nose. My immune system doesn't seem to be able to fight off the common skin infections we all carry and these things turn into boils. I prefer not to take the antibiotics prescribed by the local GP as I may one day need them for something more serious. As a foot note; I am just getting clear of a boil under my chin and there's a new one starting in my nose again - now that's a worry!! (there's a phone call just now from my local GP who tells me not to take the antibiotics he previously prescribed and to come down and get another prescription!!). I take the new script "Cleocin" and I can't believe it; after just 3 tablets the nose boil has cleared up. Somebody else might be interested in this one.

The second problem, a little more serious, is that I have lymphodema which, according to the Lymphodema Clinic I attend, is a side effect of the external beam radiation treatment (EBR). In my case the lypmhodema was triggered by a plane trip to Europe (I wrote about it earlier) which my wife and I took eight months after the EBR treatment finished and I believe it could have all been avoided if I had been made aware of this possibility. The lymphodema clinic at the Nambour Hospital carries body stockings which they can make available to people at risk when going on a long plane trip. In my case I suffered severe swelling of the legs and feet and went to hospital the day after I arrived in Europe. I now wear elasticised knee high stockings every day. I need rubber gloves to put them on and they do prevent much - but not all - of the swelling. Both feet are partially numb over more than half their area but the good news is that the swelling retracts overnight when I'm in bed and I wake each morning with both legs looking normal. I must add I am not the only person in our support group with this problem and for some reason the Urology profession seems unprepared to accept that this is a side effect of the EBR treatment.

Problem number three, which affects all prostate cancer victims, is the loss of libido. It's a sad thing to say that I know prostate cancer victims whose marriage has either ended in divorce or some form of estrangement so its not all that surprising if I say I know, or rather I knew, three younger aged men who chose to have no treatment at all rather than have their current lifestyle altered to this extent. In my own case I have been surprised by my total loss of libido. Two years after the Brachy Rod operation, I am just beginning to experience the partial return of physical ability to have an erection, be it ever so humble and brief, but the libido is non-existent. I would be less than truthful if I said this hasn't had any emotional effect on my marriage. I sometimes get a bit irritable, short tempered, but our marriage has remained in good health and very happy regardless.

One final observation is that I get tired more easily, either in the afternoon or around 7:30-8pm and I've lost a considerable amount of muscle mass from my arms even though my long term weight has, all of a sudden, gone from 70 to 76 kilo.

Of all the "alternative" remedies I was taking, I still brew and drink 4 litres of pawpaw tea each week, but have discontinued all others. The Doctor Red Blueberry juice appeared to have no real benefits, and the Jason Winters tea I discontinued with because it would appear they were sending me the wrong one for about a year - which I think negates their claims.

The Tree Tree trial turned out to be a real flopper for me. The organisers didn't even bother to contact me when I had finished taking their product. I can't believe I was silly enough to stick a large suppository in my rear end every night not to mention the terrible taste of the capsules!! What sort of trial was this then? It seems to me that most of these alternative remedies are little more than the product of somebody looking to make a lot of money out of we unfortunate souls who will try anything to stay alive. The Pawpaw Tea which I brew myself (from my own pawpaw tree) each week seems to have a very broad acceptance as a worthwhile remedy. I have no idea if it's helping me or not but I'm doing ok and its not doing me any harm. The taste is bitter but you soon get use to it.

One other thing I'd like to mention here because I think it's important. I used to sail my boat every once in a whole if I felt like it but I now make a point of getting out for two days every week and this activity has done a great deal to improve my state of mind. My wife no longer likes the water so I try to make sure her need to spend quality time with me is well catered for, as well as time needed for my own inner restoration. So weather its golf, fishing, riding a motor bike, whatever your interest, get out there and do it while you can.

Well, that's about it for the present. With any luck I'll be around for another update next year and finally a very big thank you to Terry for the great job you do in keeping Yananow up to date and helping so many people in their time of need.

Keep smiling
Ron Murphy

UPDATED

April 2012

Its now 18 months since my last update and 4 years since my Brachy Rod therapy operation. I'm feeling in excellent medical condition. The Karvia tablet I was taking each night for blood pressure (now on average 127 to 140 over 72) has been discontinued so my only medication is a 10mg Vitorin capsule each night for cholesterol. That level is now down to 3.9 (was always around 5.5 to 7.5). When I suggested to my GP that I would like to discontinue with the Vitorin he gave me the option to cut out the cholesterol tablet but also cut out the chocolate which I eat every night. In my defence it is dark chocolate, however I have decided to keep taking the Vitorin.

As of February, my PSA level is 0.03. Unlike the first 12 months of treatment, I don't seem to get noticeably as tired now (walking 3-4klm per day and sailing every weekend keeps me physically and emotionally balanced). Although finishing Hormone Therapy 18 months ago, I continue to have a few "hot flushes" daily, and have developed sensitive nipples, which Dr Tsang tells me will stay around for at least another 2 years. I also get a little grumpy sometimes. There's something else I must confess to...

As a Gleason 10, I regularly find myself checking up on those people in the 9 - 10 range who have preceded me by a couple of years. I remain aware always of the possibility that bone metastasis can occur, so if I find myself with an area of physical discomfort I am inclined to jump to the wrong conclusions (in this I'm not alone). For instance, I have had some pain vaguely around the coccyx region of late so my immediate reaction was to assume my cancer had metastasised. Although there may be many explanations, in my case the discomfort here could be attributed to the lining of the colon wall being weakened by the radium treatment. It could also be a fracturing of the blood vessels inside the colon area - caused from constipation and straining. As a precaution I'm now booked for a colonoscopy. By choice I do have these regularly anyway, and benign polyps are always found and removed.

On the alternative side, I have read most of the books written by Doctor Ian Gawler - a one-time bone cancer patient himself - and I can highly recommend these books to any cancer patient, particularly his work on "mindfullness" and "pain control". you can find him at http://www.gawler.org/ . I also still drink 3 glasses of pawpaw tea each day. There's no way of telling if this tea is helping me keep fit but its certainly not doing any harm so I plan on continuing this practice.

In conclusion, I try to live in the present as much as possible, eliminate stress as best I can, and don't dwell on the future. Right now I'm probably the happiest I have been since my diagnosis 4-1/2 years ago.

All the best for now.

Ron Murphy

UPDATED

July 2013

Since my last update in April 2012 I've had no serious problems other than 2 or 3 hot flushes each day and the occasional mood swing. I do have E.D.but so do many other P.C. patients. Sometimes I feel tired in the afternoon but I don't go down and it soon passes.

For a Gleason 10 / T3 the long term effects of my initial treatment have been very good, I appear to be in excellent health and I like to think the 3 glasses of home grown pawpaw tea I still drink every day has something to do with it.

I've just spent 2 months traveling around India and Cambodia I don't want to be one of the people who get to the end of their days and say their biggest regret is they didn't do the things they wanted to do.

According to a book I read by a long term palliative care nurse this is repeatedly the most common regret of people who have reached the last stage of their life.

My PSA has just jumped from 0.03 to 0.1 a 3 fold increase which is what happened on a previous test 4 months ago but a leading pathologist said this may have been the result of physical exercise the day before the test and a retest on that occasion proved this to be the case so I'm hoping this is the case once again. These levels are very low but my pre-diagnosis level was only 3.6 so I am just a little apprehensive until I get the results of my retest next week.

Having said this I've really learned you have to get out there and live your life to the fullest while you still can. You will live much longer and be a lot happier if you do.

Don't sit around thinking you have some sort of death sentence, if you do you will have, so get out there and enjoy your life while you still can.

Keep smiling and keep as fit as you can.

Ron Murphy

UPDATED

August 2014

It's 5 years since my treatment finished,and Little has changed since the last update a year ago . A diagnosis of Gleason 10 T3 meant my treatment consisted of external beam for 24 sessions followed by high dose Brachy rod then ADT hormone injections for another 18 months. My PSA reading has been jumping from 0.03 to 0.1 then 0.03 again so I'm not too sure what's happening here but I appear to be in very good health. I still make pawpaw tea and drink 3 glasses of it each day and have just returned from a month boating trip to the Whitsundays.I get out on the water every weekend if possible and I seldom have time to sit around and relax. A couple of years ago my weight jumped from 72 to 75 kg. and I try to keep it within this range. I do still get a couple of hot flushes every day but they are minor compared to the old days.

I read everything I can find by Dr. Ian Gawler, this has been a Godsend to my physical and mental state. There's a lot of information around out there but much of it is repetitive or confusing, Gawler is quite different.

In conjunction with a Cancer council nurse I was recently involved in a direct telephone hookup with two groups of 8 recently diagnosed PC patients over a six week period as part of a research programme which turned out to be very beneficial to all.

If we choose to change the way we think about things, the way we see things, we can change our whole life. So !!! Keep smiling . If you're reading this you'r probably ok, and should expect a reasonably long life.

Regards,

Ron Murphy.

UPDATED

September 2015

The year has been very kind to me once again, considering I was a Gleeson 10 T3 and my H D Brachy Rod operation was 7 years ago

I appear to be in perfect health My PSA is 04 and my only side effects are erectile dysfunction from the 18 months of ADT treatment which ended 6 years ago and a few hot flushes each day which are not too serious.

I still drink 3 glasses of paw paw leaf tea each day which I brew from leaves of the pawpaw trees I grow, I do believe this has been a big help to me but I have no way to really tell so for the moment I will stay with it. I do keep physically and mentally active with a 15 or 16 hour day and I do have a positive attitude towards life.

If there is any downside to my life it is that I have lost some of the ability I used to have to show an abundance of love and affection to those closest to me and this is truly a great loss to me. It is of little consolation that many of the other men in my local PC group experience a similar problem.

UPDATED

December 2016

Hi fellow prostate cancer colleagues it's December 2016 and i'm still much as I was this time last year.

My PSA level is 0.01 and at least for the present I am in very good health. Apart from a cholesterol tablet each day I am not on any medication I walk 1/2 an hour most mornings and live a healthy lifestyle with plenty of activity and exercise.

I still make and drink four litres of papaya {pawpaw} tea each week, don't have any way of knowing if this is what is helping me but for a Gleason 10 diagnosed 9 years ago I am in very good shape and let me not forget for one moment the excellent treatment given to me 7 and 8 years ago by a very competent medical team.

So the very best of luck to all my fellow prostate cancer comrades wherever you are.

Ron Murphy in Australia

Ron's e-mail address is: rjmrjm AT aapt.net.au (replace "AT" with "@")


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