On 8th December 2008 I was diagnosed with prostate cancer. Ironically I have been working in the area of Gerontology for the last fifteen years and so was aware of the issues facing ageing males. The texts are clear on the main risk factor for prostate cancer namely age. More than 70% of all new cancers are in men over the age of 65 – I was 69. In Australia 1 in 11 men will develop prostate cancer before the age of 75 while it plateaus at about age 85 years. Autopsy studies have shown that at the time of death, approximately 70% of men have cancer in their prostate gland, but these are not clinically relevant. It has been estimated that 15%-30% of males over the age of 50 and as many as 80% of males over the age of 80 harbours microscopic, undiagnosed prostate cancer.

The texts also state that having a family history of prostate cancer is a risk factor. Several studies have found men with an affected brother have a higher risk compared to men with an affected father. In my case the truth of this finding was seen in the fact that my brother (age 66) was diagnosed with prostate cancer one month prior to my diagnosis. Researchers have shown the cumulative risk for men with at least two cases of prostate cancer in their family (father and at least one son) was 5.26% at 60 years, 15.36% at 70 years and 30.68% at 80 years. The latest guidelines recommend that men with two or more relatives diagnosed before the age of 60 begin screening between the ages of 40 and 45, and
have repeat screenings every 2-3 years until age 70.

Looking back on why I had not been more vigilant in having a yearly PSA reading, the main reason I believe, was the fact that in 2000 I had had a cardiac arrest and since then had been pre-occupied with my heart. The thought of prostate cancer never entered my mind. It was only in October last year when I had a blood test and got the result – a PSA reading of 21 which by December had reached 28 –I knew I was in trouble.

Thus began the journey living with cancer.

Firstly was the waiting time to get an appointment with an urologist and the one recommended by my GP had no vacancies for seven weeks. As this period passed so began a series of CAT scans, bone scans, and finally a biopsy of the prostate gland. The result was aggressive cancer (9 on the Gleason score) and that it was a T3 meaning it had spread to tissue near the prostate. The treatment recommended was six months of hormone therapy to be followed by seven weeks of radiation five days a week.

Prostate cancer cells rely on androgen, male hormones that include testosterone, to survive and grow. The aim of hormone therapy (also called testosterone deprivation therapy or androgen deprivation therapy) is to eliminate testosterone production and the treatment is very effective. The injection I received was the drug Zoladex which lasts for three months and costs $1,108 – fortunately I am a pensioner and so the standard charge of $5.30.

So began a period of experiencing side effects associated with this medication. In my case these have included the loss of libido, erectile dysfunction, minor joint aches and pains, breast enlargement and weight gain.

Another significant side effect has been the experience of hot flushes which is caused by the decreased feedback of testosterone to the hypothalamus in the brain. Hot flushes are very much an individual perception which is a dynamic process of physiological factors (warmth, sweating) and psychological factors (anxiety, concentration, agitation).

The experience of cancer is very much a different experience to a heart attack. The latter brings one face to face with mortality in a dramatic fashion and is soon remedied with by-pass surgery, stents or medication/lifestyle therapy. Cancer is more like a long journey or pilgrimage. The results are not immediate and so one has to learn to live with the awareness that one is living with cancer.

For a religious order priest, and I would presume also a diocesan priest, it is very much a journey you make alone – for there is no partner in your life to share intimately the experience of cancer. You are aware of the prayerful support of your community and friends but the journey is very much a personal one. You draw on your faith, the witness of others you have seen make the journey, a confident prayer life, personal strengths such as resilience and trust, the expertise of one’s doctors, and ultimately a belief that “whatever will be, will be – Que Sera, Sera”.

Confronting a life threatening illness is a challenge to put into practice much of what one has learnt, taught or preached during one’s life of ministry.

The choice is left to us how we respond and gerontological texts speak of the empowerment this choice gives us as we take responsibility for our coping with the illness and facing what lies ahead. The pilgrimage involves the soul listening to one’s body and learning to be comfortable or at least coping with the ongoing prognosis, the side effects of therapy, living with a chronic illness for which there is no complete cure.

Body and soul

An amazing world of experiences involves you in the interplay between your body and your soul. Dreams take on new meanings; in your prayer life you become more intimate with the Lord, Mary, the Saints and deceased relatives and friends, especially parents; you recall journeys and experiences that have had a big impact on your life perspective. It may be an extraordinary lecturer you had like Simon Tugwell OP who introduced you to Julian of Norwich and All Will Be Well; perhaps it was the reading of Cardinal Bernardin’s The Gift of Peace; or was it the serenity you felt at Mary MacKillop’s grave?

Perhaps the biggest challenge on the pilgrimage of cancer is to see the whole world around you as inherently sacramental. The places you live in, visit or travel become sacred places to meet the care of Jesus and Mary – the doctor’s surgery, the trip to the hospital, the privacy of your own bedroom, the communal experiences you share with your community, walking into a TAB!

It is at the time of sickness people know how to make you sacred by the rituals you have always shared, the words spoken, the prayers said with you, the symbols they bring you, the songs they play, and the way they hold your hand. For me this is the early stage of living with prostate cancer.

Three more months of hormone therapy to be followed by radiation therapy and already the experts are telling me to be ready for the experience of fatigue.

Hopefully I will maintain a sense of humour and faith as shown by Cardinal Basil Hume when asked if he wanted mass celebrated in his hospital room.

His response was “God will find another way to show me his love”.

Ray Mulvogue

For more information, visit: http://www.prostate.org.au