Evan Saugstad: My prostate, my journey – full bladder, empty rectum; are you joking? (part 6 of 8)

Although September is known as Prostate Cancer Awareness Month, I have chosen to tell my prostate journey for Movember, Men’s Health Month. I have also chosen to discuss subjects that are not normally found in our local newspaper; one’s personal health, one’s sexual health and one’s cancer.

Movember is the month where the largest percentage of donations are made in support of curing men’s cancers and improving our health.  Please support Movember.  

If the discussion of a man’s body parts, or medical procedures or men’s sexual health offends you, then skip the rest of this.  Just be assured I am still alive, still kicking and still adjusting to life with cancer and cancer treatment.

“Two more minutes, 47 steps, I can do it. I can make it,” I kept repeating to myself. 

I was lying stretched out on the bed of a linear accelerator at the BC Cancer Centre in Prince George, the machine rotating back and forth above me as it delivered another high energy zap to a precise spot near where my prostate used to reside. 

This was round two, so to speak. My prostate had been surgically removed in 2019 but had not succeeded in ridding me of my cancer. It was 2022 and I was now receiving one of 33 external beam radiation therapy treatments, or EBRT for short. 

No moving, no twitches allowed, as the x-ray beam shot through my body seeking the cancer where my doctors think it’s hiding. Full bladder and an empty rectum are mandatory requirements to ensure the beam does not destroy or damage any of my still good and useful parts. 

An overly full bladder was my present concern, with limited ability to hold back because of nerve damage, a byproduct of surgery.  Keeping the valves from spontaneously opening was the issue. No one, including me, wished to see what a full bladder could do to the psyche of everyone involved. I knew, and had reminded staff several times, that once started, I had no stop left in me, and in this case “mind over matter” does not work. 

“Click,” went the machine as it turned off and settled back into it resting spot. “Only one more minute to go,” I thought, as I began bouncing up and down trying to assert some command over my situation.   

On came the lights and the technicians entered back into the room. “Wait, wait, we must lower the bed… don’t fall, watch out for your head…,” said one as I began my hasty exit from the bed a bit ahead of their protocols. 

“Sorry, been climbing mountains for years and I have to go,” I replied, and with that, the 47 steps, partially dressed, back through the lobby and into an unoccupied bathroom. 

How do I spell relief? E-M-P-T-Y.

Well… can start by saying every drop hit the toilet, despite the extreme pressures one’s body is not designed for, and only partially controlled by one’s pelvic floor muscles, and end by saying the body is much happier when one’s bladder isn’t demanding to be emptied. Still wonder why the designer’s made patients walk so far to find the bathroom, knowing many have 105% full bladder by the end of the process.

I left off last November waiting for a bone scan to determine whether shadows in my pelvis from a previous CT scan were cancer or not. It’s an important bit of information as if one’s cancer has moved from soft tissue into bone, then the next steps are more limited, and come with an acknowledgement that cancer is winning. 

Last December, I had another chat with my doctor. Good news, as the previous month’s bone scan showed nothing to indicate cancer. The not-so-good news was that my PSA was still climbing and nearing the point where EBRT may no longer be effective. 

Once again, it was time to move past my waiting and watching phase. It was time to go to Prince George for the six-plus weeks of what I soon would know amounted as a medically acceptable form of torture. No, not talking about the machine, as that is painless. 

It was also time to get my COVID booster and a flu shot to help minimize the chance I could be sick during treatments, as either could unnecessarily delay treatments. 

An early trip to Prince George in January 2022 got things started, with usual winter conditions in the Pine Pass; only two vehicles upside down. 

After a couple of years of phone calls, I finally got to meet my oncologist face-to-face and be readied for treatment. First, three small tattoos were placed on my belly to ensure the CT and linear accelerator machines would always be lined up and conducted to and from the same spot, and at the same angle throughout the 33 treatments. Then, a preliminary scan to allow the doctor to determine the best angle and intensity for the radiation beam, one that would avoid the bladder and rectum. 

My first CT scan confirmed my bladder was 90%+ full, which set the standard for all subsequent scans, and my rectum empty. But I soon found out that it’s not always as easy to have both ready on schedule, and especially challenging without some of the nerves that control bladder function. 

I got through this first trial on time and with no issues, but it did give my “Kegel” muscles a workout in maintaining control of an overly full bladder. Kegel exercise, for those who don’t know, is where one uses their pelvic floor muscles to help control bladder function.

Please support Movember as Men’s Health Month, give generously, and help fund cancer research. If you are over 40 and have not had a PSA test, ask your doctor to prescribe one. If you wish to skip that part, book your own appointment, pay $35, and get your own.  It could save your life. 

Evan, and always willing to talk about my journey and answer any questions you may have.