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This is his Country or State Flag

Philip Sabine lives in Tasmania, Australia. He was 69 when he was diagnosed in January, 2013. His initial PSA was 6.70 ng/ml, his Gleason Score was 8, and he was staged Unknown. His initial treatment choice was Surgery (Other) and his current treatment choice is None. Here is his story.

THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2014 SO THERE IS NO UPDATE.

Well, that's done and dusted.

Cancerous prostate removed: will now die of something else.

This is how it happened.

......

From about my mid thirties I have had problems piddling, too often and a bit dribbly. Was told once to sit down to pee. Good advice: less mess and better drainage. Had a Digital Examination (DE): enlarged prostate.

Never trusted PSA tests, false positives AND negatives! Why bother? What's the purpose? I now realise that it is better to have PSA levels checked than not.

......

Over the last 3 years I have had DEs and PSA tests, PSA

In Jan 2012 I was given a referral to a Urologist and never took up the offer. A year later and I could not leave my GP's surgery without an appointment and 2 PSA tests organised!

Result: PSA 6.7 and see see Urologist in a week.

Another thing: got help to stop drinking alcohol (my idea). Campral was a great help.

@Urologist's.

DE + ultrasound scan: enlarged prostate, right lobe extended, possible cancerous tissue, which lead to....

Biopsy.

Right lobe cancerous, Gleason 4+4.

Whoops!

Had CT scan and bone scan.

Looked at options. Age 69, sexually active, not much else wrong (or at least under control), so.... Radical Prostatectomy organised.

Visits to Physiotherapist specialising in pelvic floor and continence. A good move.

Feelings?

Intrigued, another adventure. Concerns brushed aside with humour. E.g. referring to the prostate as my "Naughty bits' ancillary giblet" and soon being able to again win a pissing competition.

Hoped that the cancer was contained and if it wasn't, well, there that was for later. No point in worrying about things that may not happen or are false. That is what I said out loud. I could still function OK at work but where I came unstuck was dealing with paying the bills. Had to deal with the Biller, Medicare, Private Insurer and the system(?) that links them. Needed help from my partner, Fiona, to work it all out. For a Techo to have these problems was upsetting. Bureaucratic complexity for it's own sake on top of unmentioned internal turmoil.

Be warned: keep up your private health cover and borrow a friend and say a few Oms.

In Brisbane.

Operation at end of April, in Brisbane, at the Wesley, by Dr Why (can't use Who).

The Wesley with help of Rotary have several nearby lodges (motel type accommodation) at reasonable rates, for patients and family. Stayed there before admission and after discharge.

Thoughts in the weeks leading up to the operation included doubts about having the procedure. Had the right decision been made? What about this new thing, Focal Therapy? Dr Why and I talked by phone about the options and their after effects mostly resolving my concerns. Only after actually meeting Dr Why, the day before the operation, and seeing the results of that morning's MRI did I really accept and understand that: I had cancer. That horrible word. Seeing the MRI images on a laptop and seeing numerical values change on the screen as the cursor moved over darker areas was more real to me than seeing things written on paper or spoken words. Odd, but, being a Techo … All that technology was more believable than my own abstractions and repressions of my condition to that point.

MRIs are very noisy, even with dampening, and repetitive. Imagined myself front row at a Philip Glass concert for 45 minutes.

The Big Day.

'Prepped' the Monday night before offering myself up to the really, really beaut professionals at the Wesley. Even the orderlies were beautiful! (mostly). Humour, again, helped me through the morning till going into theatre early afternoon.Like suggesting that the prostate be photographed afterwards placed between nose and top lip for the Movember people. An offer wisely not taken.

Operation performed using a Da Vinci S robot. What a piece a gear! Look it up on YouTube, there is good footage from Melbourne.

Prostate about 3 times larger than normal. Some tissue removed from right nerve bundle. Looked as if cancer was contained, later biopsies confirmed this and a Gleason score of 4+3, better than the previous 4+4 !!.

Remember being lifted off the operating table with the Anaesthetist saying "Ichi Ni San" and me continuing to count to ten in Japanese. Later coming-to feeling as if I had been trampled by a draught horse. Saw the Foley catheter and thought "If I had paid more money would I have got a more up-market penis extension?"

On the ward.

On the cancer ward (that word again) late Tuesday afternoon. Catheter, drip and handy buzzer. "Don't be tough, ring as soon as you feel pain". Chew gum, try to fart, walk. (It is the chewing action that assists the bowels to move! Didn't know that.) It worked a day or two later.

3am Thursday, bladder spasms, dull pain going to sharp, finger and toe clenching variety. Buzzer. Ileus, Nil by mouth for a day. Let the autonomic nervous system work it all out. Whew! Got over it.

The hospital staff were wonderful, and I was not on pethidine! One young nurse with braces on her teeth said "Will I take your blood pressure first or blood sugar?". I suggested that as a multitasking woman she could do both together. Then I said "Ah, but I can multitask, I can walk, chew gum and fart". To which she smiled sweetly and replied "Yes, but that is all you can do!" Thank you Louisa.

Discharged.

Back to the lodge Saturday.

Fiona was a massive help for what happened next.

The deepest, blackest depression I have ever experienced dug it's deep pit for me to fall into late Saturday night. It was not caused by the operation but maybe morphine but mostly me. The past few months and especially the last week probably helped to focus attention on to some issues from my childhood (nothing needing a Royal Commission, he hastily added). The Brisbane climate, birds and plants (similar to my old home) and contact with family again, some not there... All it took was a cuddle to snap out of it. Again: borrow a friend and say a few Oms.

Catheter expected out a week after operation. Urethrovesical anastomosis leak. Catheter in for 3 weeks. Sorry Dr Why, I am a blot on your excellent statistics, you deserve better, mate!

Back Home.

A week later back to Hobart. Fiona to work, me to contemplate my catheter and walk.

The shorter the time that the catheter is in place the better off you will be. Nerves and muscles tend to get used to it being there. It takes far longer for 'things' to return to normal. Now the catheter is out. PFM exercises a priority, along with help from chums, attitude, diet and walking. Using pads at night and while walking. Not using pads while at home, if I pee myself then it will be lesson to not do it again and to keep exercising. Still in contact with the Prostate Cancer Support Nurse at the Wesley for advice. Bladder control is still a work in progress and there is progress!

Got the glums, felt non sexual, confronted by continence aids, more Oms more cuddles.

Sexual activity. Difficult to publicise but... here goes. Another work in progress. There is 'movement at the station' and is helped with Cialis and Levitra and a funny little stretchy ring thingy. Use your imagination! Penetration is possible, even at this early stage, ditto orgasm. Use it or lose it! Practise makes perfect. Time is the great healer. Actually all of them are true and relevant. I don't expect to be as I was pre-op any time soon but am sure that it will happen, maybe months or a year later. Hey! look forward to the practise and remember that you are still alive and prostate cancer is gone.

Some things discovered along the journey so far.

Anatomy.

The bladder sphincter (or internal sphincter) is smooth muscle (over which you have no conscious control) located at the top end of the urethra which, in blokes, is located within the prostate. So when the prostate goes so does this sphincter and why PFM exercises are vital. The urethra still contains some smooth muscle after the operation.

The external sphincter refers to the pelvic floor muscle system that wraps around the urethra and clenches it like a pair of hands with fingers interlaced and palms together.

The operation, no matter how skilfully done, is still an assault on and a disruption of your system and will take time to heal. Wounds and their repair, catheters etc all affect nerve function. Postoperative ileus, dull penile sensation and emotional problems are examples and will sort themselves out in time with medical intervention (where necessary), good company, good food, no booze (or very little) and walking.

Emotions.

Sometimes things get scary. By prepared. Even a Prozac swallowing smartarse can be affected (he said, from personal experience).

Medical care.

Continuing PSA tests, why?, because I found out that PSA is a reaction of your system to prostate cancer cells and they may have escaped and be lurking somewhere. Had thought that after a prostatectomy PSA tests would return zero anyway. No. Earlier, I said that the cancer was gone, well, most likely it has.

In my experience there are two groups of people that have exhibited exceptional professional teamwork: Film crews and lately the medical staff at Hobart Private and the Wesley Hospital in Brisbane. Especially, Dr Why stands out for his professionalism, experience, exceptional skill and humour. I left him commanded to communicate progress with cryptic SMS messages. This has the effect of getting one to think about the ongoing experiences and progress in abstract and with humour which is very therapeutic. A cunning plan!

PS

9 weeks and a day have past since the operation. Back at work. Coping OK. My greatest concern is that I have mixed my tenses in this document.

Philip's e-mail address is: philip.sabine AT gmail.com (replace "AT" with "@")

NOTE: Philip has not updated his story for more than 15 months, so you may not receive any response from him.


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