MEN: you must come clean about your naughty bits!

And just to be quite clear, by ‘naughty bits’ I refer of course to those parts of your anatomy that dangle in your trousers, or get squashed-up and rather uncomfortable when you’re sitting for too long in some modern train seats. I suppose I could have said ‘reproductive organs’, but you wouldn’t still be reading this if I had – and that would have defeated my main aim, which is to reach as many people as possible. Because what I have to say is very important. In fact, it’s about life and death. So if you know of, or suspect any of your male friends who might be experiencing problems to do with their ‘waterworks’ (one of my favourite English euphemisms, with its reference back to the pioneering sanitary engineering works Sir Joseph Bazalgette, and others, in the mid-19th century!), then please tell them about this blog post. And of course women can, and must, play their part too, by being alert, vigilant and sympathetic. And as I will explain, it sometimes helps if they can be a bit nosey and ask a few prying questions.

What I’m talking about is, of course, the prostate gland – although most of the men I’ve discussed it with in various hospital wards all call it the prostrate – which is a fair description if you’ve had to endure one of those post-pee night-time moments when everything between your legs seems to catch fire. Mercifully they’ve been quite few and far between (maybe once a week?), but by gosh they do make you wince and leave you, yes, prostrate. So, and just to get a few simple facts straight, the prostate is the gland that produces the liquid part of semen (‘cum’ in porno films), the wonderful nutritious medium in which those little tadpole-like sperm swim about on their way to unite with an egg and thereby form a new human being. It’s located quite deep in the body cavity, just beneath the bladder. Clearly it’s an important part of the reproductive cycle, but from mid-life onwards, Mother Nature seems to have regarded it as somehow less important and has left it open to various problems and diseases – just as she has done with those other essentials to the birth of a new human being, but at the other end of the process: women’s breasts. As anyone who has ever followed the News will know, prostate and breast cancer are the big killers of many elderly and middle-aged people.

Everyone over the age of about forty must have known somebody who has been killed by one of those two cancers. Sadly, in my forties and fifties the deaths were mostly of women, but in the following two decades the numbers of men who have joined them suddenly increased. Quite rightly there has been a lot of attention paid to breast cancer and its screening and this has had a big effect on the mortality figures. But with prostate cancer progress has been far less rapid and is only now just starting to gather pace. Currently it is taken very seriously and there are some top brains working on it – as I have recently discovered. But I will never forget stories I have been told about friends – and sometimes intelligent, highly-educated professional people – who have died of prostate cancer, often in their sixties. Their widows have talked about their shock when their husbands revealed that they had been passing blood in their urine. But by then the cancer had progressed too far to take any remedial action. At a drinks party quite recently I heard somebody complaining that their husband had to cut down on his drinking in the train on the way back from the office, because it was making him get up and pee during the night. I didn’t know the man in question, but it sounded like the hypothetical drinking wasn’t the problem, but his prostate was. I hope she took my strong advice to persuade him to see his doctor, ASAP.

My own prostate problems began in my mid-sixties, when I noticed I was getting up at night with greater frequency, to have a pee. For several years it was just once or twice and I thought nothing of it. But after I’d turned 65 it increased, and about then my NHS doctor did a routine health check and asked me about my night-time pees. So I told him, and he had my blood checked for increased levels of PSA (prostate specific antigen), a protein which can reveal prostate cancer. My PSA levels increased slowly over the years that followed and I had to endure six prostate biopsies, which aren’t a lot of fun, as they have to insert a tube into your body through your anus, which leaves you feeling very sore afterwards – and gagging for a drink, which you can’t have because you’re on a massive antibiotic dose. This is because prostate biopsies are very prone to infection (your anus isn’t the cleanest part of your body!), as I discovered after my last one, which laid me out over Christmas and New Year – and several weeks thereafter. It also led me to decide-on the title of my eventual autobiography: Six Prostate Biopsies and Still Cycling to Work.

High PSA levels don’t inevitably mean you’ve caught the Big C, but they are an indication that all isn’t well. In my case, my raised PSA levels were most probably caused by a massively enlarged prostate: mine is roughly eight times as large as normal. In some instances, a big prostate goes with being heavily over-weight, but I’m quite fit, so the condition I have is known as BPH (benign prostatic hyperplasia). In my case, doctors think it’s benign, as six biopsies and a full MRI scan couldn’t detect any symptoms of cancer. But we will only be certain in just under three weeks when the results of the biopsies following my recent HoLEP operation come through. And that brings me to my short stay in Addenbrooke’s NHS Hospital, Cambridge; I gather it’s one of the few places in England that can cope with prostates as big as mine.

The HoLEP procedure involves the insertion of a tube (a catheter) into your penis. This becomes the route into the body for a laser device, which removes the material from within the prostate and sends it back down the tube, where it is stored, ready to go to the laboratory to be examined (optically) for signs of cancer. As you can imagine, all of these are very high-tech processes and the actual lasering-out requires a very experienced specialist surgeon, working with a highly professional team. And thankfully I had both in Mr. Tev Aho’s team at Addenbrooke’s (his Twitter feed is fascinating: @drtevaho). After the operation, which Mr Aho was very pleased with, I developed a few problems and had to spend an extra night in hospital, but yesterday afternoon I returned home and last night I only peed twice (and I gather this will improve over the next six weeks). Now I’m home I’m feeling hugely improved, even if my pee still resembles rosé wine, and I emit loud farts rather too often to join respectable company (my digestion reacted badly to the antibiotics). Strangely, I think Pen, our Labrador cross bitch, likes it when I fart, but Baldwin, our young Jack Russel dog, is rather less enthusiastic. I gather the gastric winds will drop in two or three days and the rosé symptoms will clear up over the next few weeks. Phew!

But the main point of this blog post is so simple. Signs of prostate problems MUST be taken seriously: PLEASE don’t cover them up, or pretend they’re not there. Prostate abnormalities don’t inevitably turn out to be cancerous, and besides, some forms of prostate cancer aren’t particularly aggressive and many men die with, rather than of, it. And to wives, sons and daughters I say: PLEASE keep an eye (or an ear) on your father or husband’s night-time movements. If he’s going to the loo too often, then you absolutely mustn’t stay silent: say something to someone – anyone. In my experience, when it comes to prostate cancer, embarrassment and silence are the biggest killers of all.

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