‘I feel cheated’: One man’s struggle to deal with prostate cancer diagnosis

PART 2

We are driving to Mbombela to meet the urologist. My rural GP recommended him on the strength of “dad says he is very good”. A cancer survivor herself, she reassures me t it is beatable and she will “pray for me”. That sounds serious. Deadly serious. Bordering on terminal, I think. And then I don’t think and simply drive, zombie-like.

“Let’s do this cancer thing” I hum to myself, remembering a phrase my son used when he left for Canada singing his upbeat version of Let’s Do This Thing. What will be will be. I try to remember I have had a good life. Very good. No regrets. And yet something deep inside nags at me and says it feels like this arrived a decade or two too early. I feel cheated. But no-one gets the right to determine the end game. I think. And think. And then I don’t think again.

The Mbombela urologist does the same procedures the Milpark one did some 20 months before. He gives the same diagnosis: Cancer likely. Schedules a biopsy a fortnight later to confirm the diagnosis and get my actual Gleason reading. It’s a day procedure under general anaesthetic. But I can’t get my results.

My urologist says he is going to the bush. I feel a moment of envy, even though I have been living in the bush for a long while. He says I must wait a week until he gets back. It’s an uncomfortable thought. Like waiting to hear your sentence. Even though you have not been convicted yet. Feels both unfair and a relief at the same time. One more week of freedom before I hear if I am convicted.

Those days of waiting are a mixture of a fast-disappearing ray of hope and a heavy, dull wait for the inevitable outcome. I kill the days on my bike. Exhausting long sessions of off-road riding. I’m feeling fitter and stronger than I have been in a long, long while. “It’s a ruse” my scientist son tells me, “you are desperately ill”. His chillingly accurate words ring in my head as I ride on and on. Don’t feel in the least bit ill. Maybe I can ride myself free of this crippling illness? Ride on. Ride enough to finish me off for the afternoon. Anything to free me from my head. Free me until dusk sets it.

The darkness brings back the worry. I’m restless and infested with anxiety. It’s like there is something eating my inside and no therapy can stop it. I feel helpless. Alone. My whole life sweeps across my thought process. Chapter by chapter. On reflection it feels kind of OK. Like I have done enough and had enough. Yet it doesn’t feel enough. It feels like I’m being cheated. What about my grandchildren who I may not get to see grow up? What about the decade or more I believe I’m still owed? What about all I was planning to do in my late life years? My thought process haunts me.

I toss between the thought of how much is enough and the one that says I’m being greedy. I don’t deserve more. I’m already part of the fortunate few of less than 10% of the global population who live to the age of 64. The logic of the data doesn’t suppress the unease. The inordinate right to life keeps rising, keeps demanding. I try to smother the thought process.

I listen with all that my ears can hear to the sounds of the bush about me. I consciously and actively live in the present. Suddenly everything is illuminated. Each cricket or cicada or bird sounds like a beautiful orchestra. I listen to the notes. No longer seeking an identity for each call. Just listening to the chorus. And the notes. And thinking how beautiful life is. That’s what takes me to sleep and wakes me. Night after night.

The urologist returns from his bush adventure. And the dreaded call arrives with him. He communicates in a cold and factual way: “You have cancer. Aggressive cancer. Gleason 8. You need to see me urgently to discuss treatment. Schedule an appointment.”

I hear his words but I’m not really listening. It’s like the words are injected into my consciousness. They arrive uninvited. I’m still holding the phone. Looking at my partner whose face has become contorted with pain and fear instantly. I have nothing to say to her but to confirm what she knows. We sit in silence. Knowing this battle is just getting started.

Days later we return to my Mbombela urologist. It’s a solemn silent journey. We are in the hands of the gods. Or so it seems. My urologist looks genuinely pleased to see me in that somewhat doctor-like detached way. He is looking relaxed from his bush venture. He carries a demeanour of authenticity which is appealing, despite the ferocity of the news he bears.

He describes how he will need to surgically remove my prostate through open surgery. He will carve me open from belly button to pubic area to access the prostate that sits at the base of the bladder behind one’s intestines. Sounds messy. A two- to three-hour procedure that could cure me. He couldn’t really say what the margin of risk was. But he said he has done this sort of thing many times before. It’s how things are done in the rurals. He wants me to schedule myself for this “open surgery”. I say I need a few days to think it over. And we leave. Just like that.

A comatose deadness hangs over me on the drive. I am at a loss about what to do. In the absence of direction, I give my doctor daughter a call. She is in my corner for sure and I’m feeling the need for some home-based, love-infused opinion. I have scarcely finished my report when she is declaring forcefully: “Come to Joburg and I will arrange for you to see the best urologists here.”

Bless her. Gives me a break. Buys me more time. And maybe a different therapy.

The idea of being slit open like a fish under lights for a few hours was not at all appealing. Not even the authenticity of the surgeon could save my discomfort with the very thought of it. Joburg sounds like an essential escape route from here.

Within days we have been scheduled to see a leading urologist in the leafy northern suburbs of Joburg. I know this space well. This was my erstwhile stamping zone: the semi-sophisticated northern suburbs where work and accumulation are symbiotic first cousins. The urologist’s waiting room drips with the same elitist comfort and style. On the walls of his rooms hang countless certificates of his accomplishments academically. The sight of them makes my stomach churn. But he fits the display part. This urologist is suave, confident, eloquent, like a kind of supercharged, overconfident professional. Not the steely artisanal authenticity of my Mbombela man.

More like a movie star who revels in his fame and adorns himself in a string of Golden Globe awards. He glances at my file and categorically prescribes a menu of cancer-beating drugs that reads like this: brachytherapy of 75 odd radioactive bombs inserted into the prostate while under general anaesthetic in a day procedure to nuke the cancer from the inside out; six weeks of daily radioactive beam therapy across the pelvis area to mop up cancer cells; six months of testosterone blocking hormone therapy to starve the little cancer bastards from feeding off my testosterone.

“That should do it,” he says. Downsides: incontinence, hot flushes, libido destroyed, erectile function definitely impaired. All of the above could be temporary or permanent, depending on all sorts of pre- and post-operative factors. Shew, it sounds rough.

There is one single appeal in all of this nightmare menu: no surgery. All the rest sounds too awful to contemplate. Is this all medical science has to offer in the 21st century? All these drugs? All these downsides? I am bewildered and dumbstruck.

“What chance of these drugs freeing me from the cancer curse?” I ask.

“A 95% success rate,” says the suave urologist with a steely confidence honed from decades of experience of selling this drug cocktail.

“And what happens if I am disposed to be among the unfortunate few five percentiles?” I ask, distrusting my good fortune of having survived a life truly worth living.

“Then it’s chemo” says the urologist.

“But we are not there yet” he exclaims as a throwaway line, in a matter-of-fact kind of way.

• This is the second story in a new feature called First Person. If you have written a personal story and you want to share it email karrasa@arena.africa

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