Evan Saugstad: My prostate, my journey – the final chapter? (part 7 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.

January 2022, I was now in Prince George at the BC Cancer Centre receiving 33 consecutive internal beam radiation treatments (EBRT), trying to destroy the cancer that prostate removal surgery had failed to eliminate. 

When a prostate still exists, the beam is aimed to destroy it and the cancerous cells within. But, when it has been removed and the cancer escaped from its confines, beams are aimed at the adjacent area to where they are likely to be. I was given an estimated 70% chance of success, even though no scan has shown anything, and I had no feeling or indication as to where my cancer may be. 

My EBRT is scheduled over six and a half weeks (weekdays, minus stat holidays). Each treatment only takes a few minutes to conduct (about one minute for the actual treatment). One lies still on a bed in the same position as the original scan, confirmed by tattoos with light beams. The linear accelerator rotates around the body, takes about the same amount of time and energy for each treatment (can vary slightly for changes in room or body temperature, weight gain, etc.), and are aimed at the same spot. 

A CT scan is conducted to ensure a full bladder and empty rectum. The beam is aimed under the bladder, where the prostate used to be. As these beams can damage healthy body tissue, such as the bladder, they are conducted when the bladder is full, as this lifts it up and away from the area of treatment. If the rectum is full, it puts downward pressure on the bladder and makes it more difficult for the beam to avoid the bladder. Any damage can be permanent and result in loss of function or control. (I have been told more than once I am full of s*#t, and on a few occasions, this did confirm just that.) 

More than a few times, my scan showed unacceptable rectum content, and that necessitated a trip back to the bathroom to empty, which always included the bladder, then swallowing another litre of water and a 45-minute-plus wait to be reprimed. It once took three tries and a whole morning. 

The EBRT works by altering the DNA within cancer cells. Cancer cells without DNA struggle to replicate themselves (grow), and when unable to, they die. As it takes time for these cells to die, side effects can linger for weeks, if not months and occasionally years, as both cancerous and healthy cells will be affected. I don’t ask how this beam knows when to stop, or how it gets through the body to only affect the treatment area, I just trust the science. 

The BC Cancer Centre has excellent and caring staff and are very accommodating for those who must travel to Prince George for treatments. When asked, they will try to book afternoon appointments for Mondays and early mornings on Fridays to allow for travel home. Although I choose to stay with family, the Kordyban Lodge is adjacent to the Cancer Centre and offers accommodation and meals for patients at reasonable costs. 

On April 14, I had another call with my doctor. This time, great news, maybe I am finally on the 70% side for a change. My PSA down to .08 (no, not a breathalyser), lower than it was after my prostate was removed, and at a level she expected if treatments were successful. We discussed any side effects from the treatments; there was not much; my bladder control was still mostly OK, erectile function still possible, yet unpredictable, rectum still works and am still a bit tired but have good strength. My next PSA would be in August, so until then, no more anything. 

I had a PSA test Aug. 16, followed by a call from my oncologist Aug 30.  Great news, my PSA dropped to 0.01, and as far as she was concerned, the ERBT has been successful, and this cancer no longer exists.  To be certain, there will be a follow up PSA in six months and if it’s still at this same level, then yearly after that. Hopefully this is the last, and I won’t have to test hormone therapy as a last resort. 

Because I am willing to talk about this when asked, I do get questions, such as which procedure would I recommend. I don’t, as this is something between you and your doctors, and your beliefs in which of the side effects are more likely to occur or affect you (both have them).  Although most won’t ask, erectile dysfunction is on the mind of many. Yes, it happens; yes, it is not as good as it used to be; and yes, with exercise, you can get some control back, but just don’t expect to be able to practice your exercises at the gym, as society has a dim view of such things.  

And remember, when you see that “old” guy standing at the urinal for what seems forever, he may be like me, trying to shake the last drop out where it belongs. Have some compassion, as it too could happen to you. 

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.