A prostate catch 22

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Columnist Peter Leith takes the time to talk, lobby and observe. In this addition to his Aspects of Ageing true short stories, the 91-year-old tracks the journey of a young man with an enlarged prostate.

At the age of 36, with a wife and four young children, his doctor told him he had “a grossly enlarged prostate” and booked him in for a cystoscopy to discover if it was cancerous. The night before the procedure took place, when he asked the male nursing aide who was shaving his belly, why he was doing that, the aide told him that if cancer was discovered they would “probably operate and remove your prostate”. He didn’t sleep well. But as it turned out, the news was good and no surgery was required.

Every two years for the next 30 years, he had a cystoscopy to assess the size of the prostate and check for cancer.

At the age of 70, cancerous cells were discovered in his bladder. Over six consecutive weeks, he had three-hour sessions involving catheter irrigation of the bladder with a live BCG solution to eliminate the cancer cells.

The two-yearly cystoscopy program continued for eight more years. After one of them, he met with his urologist to discuss how long they might be continued. The specialist’s reply was blunt but honest: “Until one day we discover that you have prostate cancer.”

“What then?”  he asked.

“We operate and remove it,” was the reply. “But you must appreciate that the older you are, the more risky the procedure becomes.”

“And if I have it done now?”

“No more risk of prostate cancer, but you are likely to lose your erectile capacity and, in any case, ejaculation will be internal into the bladder. What do you want to do?”

Faced with this catch 22 situation, what would your decision have been?

Do you have a story or an observation for Peter? Send it to [email protected] and put ‘Sunday’ in the subject line.

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