Liam’s story: Prostate cancer

Biography

My name is Liam Lynch. I was born in Cork City, Ireland on Oct 17th 1937, the second in a family of five. My father was a builder. When I finished my secondary education in 1954 I went to work with him as an apprentice carpenter. During my apprenticeship I attended relevant evening courses at the Crawford Municipal Technical Institute, Cork. In 1958 I was successful in an entrance examination for a Teacher Training Course in Technical Education – Woodwork. This was a 2 year full-time, scholarship based residential course.

On completing the course successfully, I worked in second level education for a few years. I gained further qualifications and went on to lecture at 3rd level in V.E.C. schools, R.T.C. Cork and C.I T. I retired in 2001 having completed 41 years teaching.

I met my wife Mona in 1960. We married in Dec 1962. We have 5 children, 4 sons and 1 daughter. They have 2 children each, thus giving us 6 granddaughters and 4 grandsons, aged from 3 to 19 years. Two sons live in Cork, one in Kilkenny and our youngest son and daughter live in Phoenix, Arizona.

Diagnosis

For many years I’ve had high blood pressure and cholesterol problems. Together with taking medication I have had yearly blood tests. These are usually done around my birthday each year. Results were good up until Oct 2016. My G.P. was concerned that my prostate-specific antigen (PSA) reading had changed from previous readings up to 4.

As he requested, I returned in 6 months and my PSA reading had changed again to 9. I was referred to a Urologist and met him on June 13th 2017. He carried out tests at his rooms and arranged further tests to be done in hospital. Resulting from these tests he informed me on July 6th 2017 that I had prostate cancer.

Following this I had a colonoscopy and a bone scan, neither showed any trace of cancer. The Urologist arranged for me to see a Radiation Oncologist at the Oncology Department at Cork University Hospital.

My family and I knew very little about radiation therapy. Thirty years previously my wife’s sister had radiation therapy for an inoperable brain tumour but did not survive. Having no knowledge of current radiation therapy practice I had no fears other than the fear of having cancer itself. Within the past 3 years both my brother and sister died from advanced cancer, both having received chemotherapy.

Meeting the radiation oncologist

On August 17th 2017 I met the radiation oncologist. After an examination he told me radiation therapy would be appropriate for my localised prostate cancer. I was then invited to take part in a clinical research study looking at abiraterone acetate in combination with prednisolone and gonadotropin – releasing hormone agonist for the treatment of prostate cancer.

All aspects of the study were explained to me. I readily agreed to participate. Medical examinations and various tests were carried out to ascertain if I was suitable for the study. The study involved taking 5 tablets daily for 126 days. During this time I dealt mainly with, a most impressively caring radiation oncology nurse and radiation oncologist. On specific days of the study I had further examinations, tests and procedures, including hormone injections. I responded very well to the study treatment. My PSA reading was barely discernible. The tumour volume had shrunk quite a bit. While I had some side effects, they were mild and temporary.

I attended the Information and Support section in the radiation oncology department. The practicalities of radiation therapy were explained to me. A personal diary was given to me. I would use this each day during my treatment, as my appointments were recorded each day for the following day. The barcode on the diary was used to auto-queue. I was brought to the radiation therapy waiting room, shown where the bathrooms and the water fountain were and how to auto-queue.

I had a radiation therapy planning CT scan to determine the most suitable points to direct the treatment beams. Three tattoo marks were drawn on my skin on my lower body for this purpose.

The Radiation Therapy Department in C.U.H. is an extraordinary place – it is the staff that makes it so, together with the patients and those who accompany them. Everyone was in good spirits, even those who were very ill. As my treatment spanned for 37 days, I became familiar with everyone and a lively rapport prevailed between us all.

Daily routine

My daily routine at the Radiation Department went as follows:

• Arrive at Department waiting room 60 minutes before appointment time.
• Use an enema at this time to encourage my bowels to empty. (You receive an enema on each visit for next visit).
• Return to waiting room and wait for it to take effect.
• Once required, go to the bathroom and empty bowels as well as bladder.
• 30 minutes before appointment time you quickly drink 2 cups of water.
• Wait for 30 minutes, do not go to the bathroom during this time.

This preparation routine was manageable, but I disliked using the enema and its effects. Naturally this purpose was explained to me and I understood it. It was explained to me that I needed to have an enema daily so that I could ensure that my bowels were empty or the same size daily.

The actual treatment itself was not problematic. I was positioned on a treatment couch in the treatment room by radiation therapists who were guided by the tattoos on my skin. They left the room and the machine was switched on. I didn’t feel anything and only saw the movement of the machine. The therapists returned to the room some minutes later when the treatment was finished,

The radiation therapists were a credit to their profession, always welcoming and in good humour, treating every patient with dignity and respect and always using patient’s first names.

The times of my treatment varied each day from 9am to 7.30pm. These appointment times were always arranged with my agreement and there was never a problem if a time had to be changed. Some patients travelled long distances in specially arranged buses, thus the waiting room could be quite full or sometimes quite slack. My wife and I enjoyed the social interaction and comradery in the department.

Many of us mentioned how we would miss the daily routine as we approached our last days of treatment.

Side effects

I experienced some side effects, skin reaction, bowel irritation and especially fatigue (tiredness). The radiation therapists and the radiation oncology team advised me how to manage these side effects. I used one of the many recommended moisturisers E45 for my skin and recommended chemical free toiletries. I was given dietary advise to ease my bowel problem together with advice about over the counter medication recommended by the staff.

Fatigue, this was and still is the most serious lasting side effect. I rest when I need to and exercise by walking. I do a little gentle gardening, but my main hobby of woodworking in my workshop has suffered the most. I do intend to get back to it as my energy improves.

Daily activities

Having radiation therapy 5 days per week for 37 days naturally impacted on my daily activities. Although retired, I was used to keeping myself busy in my woodworking workshop, visiting family and friends, attending evening classes, sketching and playing indoor bowls. Nevertheless I prioritised my treatment as it was crucial in treating my condition.

My advice to others

While I am slow to give advice to gentlemen facing into radiation therapy for prostate cancer, from my own experience I would suggest:

• Come with an open mind
• Get rid of any preconceived ideas
• Accept advice from medical staff
• Do all that doctors and medical staff ask of you
• Be positive
• Keep in contact with family and friends

I am slowly returning to my normal regular life and daily activities. Recently, together with my wife and two friends I enjoyed a holiday abroad in the sun. The best ever.

Yet, I will never forget the 6th July when I was told I had cancer. I will also never forget the exceptional staff I met in Cork University Hospital Oncology Department. This includes everyone, receptionists, security staff, cleaners, nurses, therapists, regular doctors and specialists, together with fellow patients. It was an enlightening experience that I am not going to forget.