Connections and consequences…

Over 360 years, the Royal Marines have created bonds of brotherhood that can be difficult to explain to those who haven’t experienced it themselves. To the extent of trusting each other with our lives. I felt this often during my career in the Corps, and particularly during the Falklands campaign in 1982, leading this band of young gentlemen: 5 Troop, B Company, 40 Commando Royal Marines. Bit of a handful sometimes, to say the least, but we got the job done. It was my absolute privilege and honour to lead them.

It was at the 30^th anniversary of that conflict in May 2012 that I had a fortuitous meeting with a fellow officer as the beer flowed. I told him what had happened to me, and he quietly replied that, although he didn’t want anyone else to know, he had been in exactly the ‘same boat’ as me a couple of years previously, and could recommend a specialist – who would tell it to me like it was.

It is rather difficult to overstate just why this assurance was so important to me – but let me try to explain…..

When you’re diagnosed with cancer, a big wavy-armed machine whirrs into operation – albeit too slowly for some people’s comfort or even safety.  That machine is staffed and run by experienced, skilful and kind people who doubtless want to give the best care to everyone who they encounter. Part of that care is about giving people ‘choices’… I had already experienced this with the “watchful waiting” phase which had subsequently suddenly flared up, rather like a chip pan that someone’s forgotten to keep an eye on.

With the greatest respect to all medical staff, what so many of us want isn’t choices. You want someone to say “I’m an expert in this stuff. Here’s what’s wrong. And this is what you need to do about it.”   

Don’t ask me – how do I know? I could be choosing to follow a course of action that everyone else can see is completely bonkers – and all in the interests of free choice….. WTAF, as our younger readers, were we to have any, might say..

I got an appointment with the consultant surgeon who I’ve decided not to name for reasons that will become apparent. Sue and I met him in his suitably impressive consulting rooms. I explained that I had been told my principal options were either brachytherapy or surgery, given the nature and extent of my cancer.

For those who don’t know (and why would you?), brachytherapy involves injecting radioactive ‘seeds’ into the prostate gland which are intended to kill the cancerous cells. The upside: you’ve still got your prostate (hurrah, with a slight sideways glance..) but on the downside, it can bring longer term problems with sexual function and continence. I didn’t fancy that very much. At all.  Having said that, the absolute slam dunk clincher was that, at least at that stage, if the cancer recurred, surgery would be much harder to carry out successfully. Much harder.

My mind was made up. When I told the consultant, to my great gratification, he said “I agree – surgery is the right choice for you”.  To be honest, this didn’t surprise me too greatly, since he had already explained that he had conducted thousands of such operations, so I knew he was pretty  likely to lean that way. So surgery it was to be. We agreed a likely date in early August 2012.

In the subsequent month, I had to be in San Diego for work meetings. Sue came with me and with the work done, we headed off on a short holiday, driving north up Highway One to San Francisco, avoiding LA (ghastly place – sorry LA) via Santa Barbara and onto wild, beautiful and remote Big Sur. If you’re ever out that way, Nepenthe in Big Sur is pretty much the most spectacular place you’ll ever find for dinner. A thousand feet above the glorious Pacific as the sun sets….

It was when we stopped to see the famous Bixby Bridge that things took a bit of a crap turn. I know I said previously that cancer has been pretty much pain-free so far for me. That was only partially true.

I was struck with the most intense and searing pain, deep in my solar plexus (bladder, if you so fancy), so strong that I had to curl up on the ground until it subsided. It turned out that, on top of the cancer, the biopsy had caused a serious infection in my prostate, despite the antibiotics I was given. When you think about it, given how the biopsy is done, it’s not surprising really. I do remember at the time, asking the urologist if the biopsy ..’could end up making the cancer angry (you know, with needles being stuck into it)….’?I know…. Seems like a naively daft question. But as I struggled on that Californian clifftop to catch my breath and with my eyes squeezed tight shut in agony, I truly felt like we had really pissed it off.

On return to the UK, the day dawned for the operation – which was to be a radical laparoscopic prostatectomy. In essence, that means the operation is carried out by ultra-precise robotic arms, controlled by the surgeon who actually sees everything on screens rather than directly. It means less extensive incisions and ideally, faster recovery. It was nonetheless, life-changing, frightening in its scope and especially its consequence and something with which I continued to struggle right up until the day itself.

When the time came to be wheeled down to the theatre, I had to fight so hard to keep my composure. I knew that my life was going to be very different going forward and I was very scared.

As I let Sue’s hand slip from mine and she kissed my forehead, I felt my chin trembling so much and I was transported back to being five years old and leaving my mum in the playground of Albert Street Primary in Fleet on my first day of school.

I held it together and the system took over.

Name, address, date of birth, consent form checking, brisk but caring explanation of what was going to happen – I did try to listen, I promise, but inside I was in bits. Canulas into the back of my hand and my arm. The dazzling lights from the theatre through the gaps round the door.

Nice chat about the weather – rain stopping for the Olympics…. Lovely. After all the forecasts too… Anyone know what’s on at the Games today?

And we waited. No anaesthetist. I did my best to relax as the conversation slowed a little and lulled. I reasoned that someone else’s life was being changed forever as well as mine, and that she was no doubt fully occupied with some emergency situation. I would just have to be patient and wait, and fight back the nerves and growing apprehension.

After twenty interminable minutes, the door burst open and the anaesthetist breezed in.

“Sorry I’m late everyone.  But we just won another medal in the rowing!”

I understand it’s thought to be bad form to strangle consultant anaesthetists just before they take control of your life, as well as probably being a little unwise.

But I was still so sorely tempted.

They began their work…. Within a short minute….. utter oblivion.

I came round nearly seven hours later to discover that the operation had not been as straightforward as planned due to the extensive infection from the biopsy, but at least the nasty little bastard was gone.

I met the surgeon a couple of weeks later – he told Sue and I that we had definitely done the right thing. Without acting, he believed I would have been lucky to have made it past Christmas. But the surgery itself had been successful and there was a 94% chance, based on those results, that I would be cancer-free in ten years’ time. We would begin quarterly PSA checks to monitor my progress.

Relief all round and reach for the Old Speckled Hen…. Bless her.

Roll on a few months….

You know the ending of Alien? I would say “spoiler alert!” but that film was a long time ago, wasn’t it?

Ripley and Jones the cat are about to settle into their rescue craft for their return to Earth believing the alien monster they have been fighting (Jones didn’t do much, to be frank) is dead.

Only for Ripley to find she was not completely right in that belief. 

I was put in mind of it, when, less than a year later, I sat with Sue, holding my hand, in the surgeon’s consulting room.

He told me that unfortunately, my PSA was rising again, and very regrettably, it turned out that I was actually in the 6%. 

The cancer was still there.