Monday, 25 August 2014

A crab with a nasty bite – Cancer pagurus

Red Hermit Crab, Dardanus megistos, Maldives 2008
As a kid I was always fascinated by crustaceans with large pincers. They were easy to find in the pools by the breakwaters at East Wittering where we joined our cousins for annual holidays in the fifties. Cancer pagurus, the Edible Crab, was one of the names we absorbed during our Zoology ‘A’ level course. The name Cancer is celebrated as a sign of the Zodiac and we played with our star signs and their meanings like most young people in those days. As the years advanced relatives and friends passed away with the disease with the same name. As middle age approached the people who succumbed to cancer were our contemporaries – acquaintances, loved relatives and dear friends. There were success stories too, medical science has learned much since our childhood and many people we know have successfully endured treatment and are now fit and healthy.

Recently I visited my GP and requested a PSA test and was asked why I wanted one. I replied that a brother had high PSA readings and had been monitored for some years, and I felt I needed one as my waterworks didn’t seem quite right. Blood was extracted and the results showed a higher than normal reading (4 is fine, 7.8 is regarded as too high) and I was given an appointment for a biopsy of the prostate. This was a not too bad, if undignified procedure. 12 tissue samples were taken, 6 from each side of the prostate. A few weeks later I was asked to see the specialist again (last Friday) when I was advised I had prostate cancer. The good news was that it was in its mildest state affecting the top of the prostate on both sides (Gleason score 6). One option is to do nothing and 28% of people who choose this find the cancer expands and treatment is then required during the next ten years. If I choose this option I will be monitored every 4 months (PSA levels checked, MRI scans) and if things get worse I would have to choose a course of treatment. 

There are three treatment options (surgery; external beam radiotherapy; brachytherapy) each having its up and downsides. Having discussed this with Sue, we agree that I am not going to wait, but get treatment while I am still reasonably fit. So now I have to read the literature provided carefully and ask questions. My local health trust is teamed with Macmillan Cancer Support, and a nurse from MCS is my key worker who will answer questions and liaise with all the areas that are involved with my treatment. They are now one of my favourite charities! I am now waiting for an appointment with a surgeon to discuss treatment options.

Why am I making this public at this time? I have always been a believer in the principle of sharing knowledge and experiences. I hope that if any of my readers have experience of prostate cancer that they can share with me to aid my choice of treatment, they will feel free to do so via either Comments below or a private email (see "Contact me by email" option on the right of this post).

Also, I would like to get the subject out in the open so everyone knows and I don’t have to pussyfoot around the subject.

How do I feel about this development? It was hard to hear the news, even though I knew that the appointment meant there was something to tell me. However, I am fortunate that I know about it at an early stage, and that treatment options are available. Also that my NHS trust appears to be well organised in this area. I think I have absorbed the news now and hopefully I will be able to deal with treatment like other ailments I have had. Perhaps the hardest thing is the mental adjustment, but I am a pretty sanguine person and now I know where I stand, with Sue’s support and the strength I know will come from friends and family, I intend to carry on as normal, subject to the inconveniences of treatment 

Finally, I have always been proactive as far as medical matters are concerned and have never been backward about consulting my GP. My diagnosis has proved the value of this approach. I urge any man, especially in later years, who has any problems downstairs, to ask for a PSA test so that an early diagnosis can be made. Insist on it if you experience any resistance from your GP. I had no such problem, although I was asked why I wanted it.


  1. Hi Colin, you probably won't place me but we have "bumped" into each other at various places in Sussex photographing butterflies. Sorry to hear of your news, I feel you have done the right thing by being very proactive in this matter as my father had prostrate cancer and was diagnosed early and successfully treated. He has been clear for a few years now he went on to be treated for bladder cancer as well, this was treated successfully as well, now in his eighties amazingly he takes it in his stride. I too had a PSA test and the results were good but it might be time for me to get another test as this was a few years ago, thanks for the reminder. Good luck with your treatment, it does seem as though the doctors are getting to grips with this now after men's health in the past seemed to be neglected.


    Arthur Greenslade

    1. Hi Colin, further to my reply to your e-mail, I can also comment on the experience of a not-related person six months younger than me (i.e., 69). He had a poor diet all his life - few vegetables and fruit, overweight, little exercise, much alcohol and he smoked. He was persuaded to have his first PSA test a couple of years ago. The result was a reading of 30 units (Canadian system of measurement). A biopsy indicated much cancer. He opted for radiation therapy. The cancer was too large for surgery. The radiation "killed" the cancer. He has to have periodic PSA tests and if the level rises, he will receive radiation again. Note that a result of this treatment caused impotence.... I have heard that surgery often has the same effect. Good luck with your decision. Malcolm.


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