Unanticipated Medical Challenge & Treatment Adventure

Often life is never what you expect; so after a medical check-up in Chiang Mai in 2014 for new health insurance coverage, there were some results that indicated further testing was needed.  Hey what – I am healthy!

A long journey of testing, some procrastination on my part, then follow-ups and double checking resulted in a finding – which did not please me! Those who know me would probably say that I am usually forthright, open and – generally matter of fact.

I have chosen to share my life challenging event – not just because I can – but more importantly, I am hopeful it provides other men (and their families) with an awareness of this disease – to consider doing important prostate check-ups!

Prostate cancer (PCa) managed to take a liking to me and my prostate. I expect it has been lurking down there for some years and it is an increasing popular disease in men. Lots of facts and figures around about this disease and treatment options but it is very much an individual prognosis and treatment plan for each man. Nothing seems straightforward about managing this disease and treatment options.

I had a number of visits to doctors in both Chiang Mai, Bangkok and even Sydney.  I found a urology surgeon I was happy with at Siriraj Private Hospital in Bangkok- it was like the Hilton Hotel.

Prostate cancer is the second most common cancer in men worldwide and even when successful, treatment can take a toll on your physical and mental health. I took a step back from the diagnosis to approach this calmly and logically knowing that this disease can have varied outcomes.

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So my facts!  Not that there is good news, but my initial prognosis was not too bad.  At the start of the journey, it was graded an intermediate (unfavorable) cancer stage that did not appear to have spread? So curability through aggressive treatment was recommended and was the way ahead for me.

I recognised that managing PCa is a battle and I invested the time and energy necessary to empower myself with the knowledge to make informed choices about my path of treatment. A strategy was decided, I found the best medical team and with the support of everyone made a judgment that it was better to get this PCa thing out of me, to be free, to get cancer out. It was rather an upsetting time personally and in many ways has been life-changing.

People question the Thailand health system.  From my experiences so far and depending on your choice of doctors and treatment centers it is very comparable to the west and at times better at less cost. I used a very qualified surgeon with years of experience and the largest and most up to date hospital in Bangkok to deal with this.

The surgeon undertook a robotic radical prostatectomy in Bangkok on the 25 April – Australian Anzac Day – as it turns out so this will be a “day to remember – for battles fought and won”?

I tried to take a positive outlook for a bright future with a prognosis for a curable outcome. So it was full steam ahead – to cure the beast. I vividly remember being wheeled from my room to the theatre with apprehension.  My anxiety level increased when the surgeon just before being taken into the operating room asked me to sign another form indicated I was fully aware that there was the possibility of “continence problems” as well as “erectile dysfunction” issues.  Now I am really worried – but it just seemed too late to change my mind, it was made up so let’s go for it.

Through a foggy consciousness, I was slowly awakening from my sedation – it was over and I was still here.  It didn’t seem painful and I was relatively comfortable.  Eventually, I was recovered enough for my trip back to the room.

That night and the next few days were long and tedious with challenges to move about – oh so slowly.  I was sporting a catheter and accompanying bag. While I could move about it was awkward and exhaustion was easy to come by.

Short trips around the room and down the corridor followed.  My food was fairly bland but sufficient to satisfy. My initial recovery was in the hospital for 4 days and then we went to a serviced apartment complex for 2 weeks until I could have “things” removed.

My son from Australia came to visit and to be with me during my surgery – very nice of him to represent the family.  There was some pre-op fun time so Ace, Shawn and I enjoying the Annantara Riverside Resort, Bangkok for 3 days in the lead up to surgery at Siriraj Hospital. A few nice meals, some Bangkok sightseeing, relaxation time by the pool, cultural history tours and a transvestite show were a few of the activities along with a riverboat ride. It all helped to stall the nervousness of surgery.

After surgery, there was a need to remain in Bangkok until my catheter was removed.  So for the recovery period, we managed to find a nice serviced apartment to while away the days doing some walking exercise in the gym, enjoying breakfast and getting rest – very tired I was.  It turned out through some drama (that’s a story for another day) that the catheter remained in for 2 weeks so the stay was longer than anticipated.

The results from surgery and pathology indicated that cancer appeared to have been removed cleanly. Unfortunately, it turned out to be a high-risk grade of cancer (T2c; Gleason 4+3 (7) with T5 – often considered a Gleason 8) but at this stage seemed it was confined to the prostate.  The doctors indicate I need to monitor with blood tests every 3 months for any signs of recurrence.  It seems that some 10-40% of surgery patients experience PCa recurrence.

We flew back to Chiangmai on the 9th May for recovery over the weeks and months that followed. So medical treatments in Thailand are great.  No worries to be taken care of here. I have never been a quitter and don’t intend to start now – so onward with this battle. I had the plan that  PCa was only a temporary hobby.

Taking about this disease

A lot of men don’t seem to discuss their disease and treatment openly for some reason? It’s not something to be shy or secret about our ashamed of from my perspective. Many men – both every day and famous – have survived this disease and the journey through curative treatment. I intend to follow them. The treatment side-effects are understood (and are gross) and I think the worst part of this whole mess because of the potential impact on the quality of life. But better crappy side effects than the other option – live for today as they say….!

My partner Ace and my kids were tremendous to me on this private journey and without their help, it would be a far greater struggle. I am sure the ongoing recovery phase will also be interesting! To date, the recovery after 3 months is going well with almost complete control of the bladder.  Other things are a work in progress.  December 2016 and routine blood tests are monitoring my PSA – another trip to the Urologist is due in January 2017 for a progress review.

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I decided to write about this so my friends and others have an awareness of this challenge and speaking about it is also an awareness piece and my attempt to highlight it for other men out there – one just never knows without screening tests.

Living in Chiangmai and spending a few years building our new home and garden, getting pet-friendly and trying to figure out a life that did not involve working from 9 -5 was, and still is, the only plan I have in mind. Now with a new casual function as an Honorary Consul of Australia, I am very determined to soldier on…for years to come. Cheers to life ……good luck with my future. …from here on!

But, one of the consequences of this disease is the ongoing need for monitoring after the initial treatment with curative intent.  So every two or three months I get to check my PSA to monitor any signs of recurrence and visit my urologist for follow-ups.

You can follow the results of my ongoing PSA & Urologist monitoring here.