You can beat prostate cancer, just make sure to get that tumour before it gets you, writes DÉAGLÁN DE BREADÚN.
IT'S THE last thing you want to hear. You've got cancer. Except it's not said like that; the wording is more polite and considerate. But the bad news still has to be broken and, no matter how it is dressed up, you are left with the realisation that the Big C is inside you, working away.
I was on assignment for this newspaper down the country when I pulled into the side of the road to ring up for the test results. I had a news deadline to meet and was hardly concentrating when I made the call. A previous biopsy had come up with nothing: why should this one be any different?
Suddenly, I was all ears. They had taken eight tiny "cores" out of my prostate and one of them came up cancerous. A door opened on a whole new world of terminology. Something called "the Gleason score" stood at six; this turned out to be a system for grading cancer tissue from two to 10.
In time I discovered that being diagnosed with cancer does not have to be the end of the world. But I had grown up in an environment where "cancer", "incurable" and "terminal" were pretty well synonymous.
I placed my mobile phone on the car seat and considered the situation. A few minutes before, I was tootling along without a care in the world. Now my whole perspective changed and there I was, staring into the jaws of eternity. Looking back, I am tempted to smile at the melodramatic thoughts crowding into my mind. My life seemed to be over: goodbye to family and loved ones; no more beautiful scenery; that long-planned return trip to Rome would never happen; I would never read any more books by Dostoyevsky. A lot done, more to do, as it were, but time had just run out.
It all seemed so terribly unfair. But I went ahead, finished my assignment, filed my copy to the news desk and drove on home. I woke up the next morning feeling as perky as usual, until an invisible hand grasped me around the throat and a voice whispered inside my brain: "You've got cancer, buddy."
Those early days were the hardest part. Had the malignancy spread beyond the prostate into the bone? A bone scan was arranged at Tallaght Hospital and, following a tremulous wait, the news came through that the result was negative. Hallelujah.
My experience of the health service was almost entirely favourable, barring a few minor irritations. Everyone I dealt with - doctors, nurses, secretarial and administrative staff, therapists - was kind, considerate, efficient and, above all, humane. This is not to deny that others have legitimate complaints.
I had never been seriously ill before and was deplorably ignorant of the world of medical science. I hardly even knew what my prostate was for and it came as a pleasant surprise to discover that it was "about the size of a walnut" and played a major part in the reproductive process.
If there was a book in this, I already have the title: Me and My Walnut. There were other surprises to come. I thought the medical people would decide what form of treatment I should undergo, and was intrigued to discover that this was being left up to myself to a considerable extent.My choices boiled down to surgery or radiotherapy. A third option, "watchful waiting", was ruled out under the circumstances. Best to deal with the problem right now.
Several long nights of the soul followed as I weighed the options. Various friends and acquaintances who had tried one or the other gave their opinion. I was beginning to discover that every cancer patient is unique and what's best for one isn't necessarily right for another.
Go for surgery, some said. It's more final, complete and definitive: "If thy prostate offend thee, pluck it out." Others recommended radiotherapy as the kinder, gentler option, where the risk of side-effects was considerably less. A key point to be considered was that, if surgery failed, you could still have radiotherapy, whereas if radiotherapy failed, surgery could be quite problematic.
Cancer is a great leveller, affecting high and low. Senior US politicians such as John Kerry, Colin Powell and Rudy Giuliani have all been afflicted. A quick perusal of the internet revealed that Kerry and Powell took the surgical road, whereas Giuliani chose radiation.
A kind friend gave me an article by the head of a multinational company, describing his happy experience of radiotherapy. So far, so reassuring, until I noticed the date on the article: 1996. Was the guy still alive? A rapid trawl of the web revealed that he was.
In the end, after prolonged consultations, I decided radiotherapy was the best option. It seemed to suit my particular circumstances best, although many men have opted for surgery and never regretted it.
Happily, all the indications were that my tumour was confined within the prostate. Prostate cancer has few symptoms, although frequent urination may be one. Some men show no symptoms at all. In my own case, alarm bells started ringing after a routine prostate-specific antigen (PSA) blood test.
Cancer, by definition, never comes at a good time. I was particularly busy and hated being distracted. In addition to my new role as a political correspondent with The Irish Times, I was also actively involved in the National Union of Journalists, as well as updating a book on the Northern Ireland peace process for a second edition.
But when cancer strikes, everything else takes second place. Scrambling my way up the learning curve, I discovered that radiotherapy is a form of X-ray treatment which destroys cancer cells by damaging their DNA. Normal tissues can also be damaged during treatment but are usually able to repair themselves. Cancer cells lack this ability to recover because they are more disorganised structures.
This conjures up a pleasing image of cancer cells as marauding drunks who are finally expelled from the pub at closing-time and find themselves with nowhere to go for the rest of the night. Radiotherapy is like the head bartender who kicks out the drunks and locks the door tightly behind them. And so it was that I found myself making a daily pilgrimage to St Luke's Hospital in Dublin to have my prostate "zapped".
There were 37 sessions which extended over a period of about eight weeks. The side effects included tiredness and difficulty passing water but it was far from a harrowing experience.
I learned a lot from my daily visits and from sitting around waiting my turn. I always knew cancer had a broad reach but was still surprised to meet so many people that I knew. The Equality Authority could never support an anti-discrimination case against cancer, which does not distinguish between old and young, black and white, citizen and immigrant, rich and poor, male and female.
It was touching to see young children, some of them from immigrant families, going for treatment at the same time as me. One could not help being moved either by those women patients who had cut off the fine, flowing tresses they had so proudly groomed over the years. Their bravery was inspiring.
I also became quite attached to St Luke's Hospital, which I affectionately dubbed Cancer Central. In my youth it was a name that struck terror. If you heard someone was "above in Luke's" you felt sure that person was a goner. But surely there is no hospital in Ireland with a more beautiful setting, in the heart of leafy south Dublin.
Squirrels gambolled in the grounds as I parked my car each day prior to treatment. It's a pity the place is being closed down and sold off. The site should be retained as a medical facility, perhaps for convalescent purposes.
My treatment over, I am back at work full time and getting on with my life. Continuing tests will show whether I have licked the Big C but the outlook is very promising and the medical people are highly optimistic.
If I have a criticism of the health services, it is this: there should be more alerts and a greater awareness of prostate cancer. A man is one-third more likely to get it than a woman is to get breast cancer. Men who are in middle age or older should ask their doctors about a PSA test or call Action Prostate Cancer on 1800 380 380. Guys: get that tumour before it gets you.
Deaglán de Bréadún's The Far Side of Revenge: Making Peace in Northern Ireland is published in a second edition next month by Collins Press, Cork.
Readers are invited to e-mail healthsupplement@irish-times.ieoutlining their own experiences of the health service, whether good or bad.