'Put aside the foolishness': Prostate cancer survivor urges Jamaican men to put life over fear of rectal examWednesday, September 22, 2021
BY KELSEY THOMAS
KINGSTON, Jamaica — Since the age of 40, Gilroy Graham has been doing his annual medical including his prostate-specific antigen (PSA) level checks and digital rectal examinations. Twelve years into this routine, he received concerning test results which later revealed dreadful news no man wants to hear: he had prostate cancer.
“Things like cancer, is something that everyone would wish that it didn't happen. So, it was all sorts of things, questions as to well, you know, 'Is this the end? How is it going to affect me going forward?” the 63-year-old Graham shared.
Graham said his general practitioner first alerted him to the potential problem in 2010.
“I would have been 52 years old at that time, when I went to meet with my general practitioner to discuss the results of my annual medical. She mentioned to me that when she looked back at my PSA levels over the past three years, she realised that there was a gradual increase in my PSA level and that was a concern to her,” he explained.
The father of three said he was then recommended to Urologist Professor William Aiken to do further tests to determine whether there was a problem.
“I met with him and he had some PSA tests done. The results came back and he said yes, he was concerned about it so we watched it for a little while, I believe maybe a few months. The PSA continued to rise gradually and so he then recommended that I do a prostate biopsy,” he explained.
A prostate biopsy is a procedure to remove samples of suspicious tissue from the prostate.
But the results of Graham's first prostate biopsy were inconclusive. However, it was the dreaded test that most men fear — the digital rectal examination — that made Professor Aiken confident the cancer was there.
“He [Professor Aiken] was able to feel that there was some irregularity on the prostate so he sent me back for another biopsy, this time with specific instructions to the doctor as to where he wanted him to pull the samples from and so he did that and the results came back and it was concluded at that time that I had prostate cancer,” Graham shared.
The news weighed on his shoulders “like a tonne of bricks” but Graham's support team did not falter.
“I have a very close friend who was diagnosed one year before me with prostate cancer and had gone through the process: surgery and everything, had it removed and had recovered, so I went and I shared with him what we had discovered with the urologist. He had some books about prostate cancer so he leant those to me so I was able to read. I asked questions, I asked him questions, I asked my urologist questions about my concerns. In addition to that, I have a very, very supportive wife and children so all of them were there to support me through the process and I would say that that helped a lot,” he recalled.
Prostate cancer is the most common cancer diagnosed, and also the leading cause of cancer-related deaths, in men.
Its symptoms include difficulty starting urination; weak or interrupted flow of urine; frequent urination, especially at night; difficulty emptying the bladder completely; pain or burning during urination; blood in the urine or semen; pain in the back, hips, or pelvis that doesn't go away; and painful ejaculation.
Graham had no symptoms.
“This is one of the messages that I would wish to send to some of the men out there who have not been testing. There were no indications that I had prostate cancer, so mine was at an early stage. The only way we were able to determine that there was a problem was because of my PSA which was rising.”
The next step for Graham was watchful waiting which involves regular testing to observe the prostate cancer until it has spread to distant sites or starts to cause symptoms such as pain or blockage of the urinary tract.
“I think it was every two or three months, can't recall the exact period but it was regular tests to see whether or not the PSA level would have continued to rise.
“What had happened though is over like six to nine months, my PSA continued to rise. During that period, I had time to look what were the different options that were available to me to treat it. I opted for a radical prostatectomy,” Graham said.
Radical prostatectomy is an operation to remove the entire prostate and some of the tissue around it, including the seminal vesicles which helps to make semen.
“From my research and discussions with Professor Aiken, I came to the conclusion that that would have been the best thing for me because once you remove it then the chances of it coming back are very, very slim,” Graham continued.
He noted, however, that there are several risks that come with radical prostatectomy.
“I know the elephant in the room that most men have a problem with or a concern about is erectile dysfunction and continence — those are the two main things that I would say would have been at the top of my mind.
“I had open discussions with Professor Aiken about that and he said it's a risk but he had performed many of those surgeries before,” the prostate cancer survivor shared.
Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex, while continence is the ability to control movements of the bowels and bladder.
Graham said he had no issues with either but noted that just immediately after his surgery in 2011, there was some leakage which lasted for roughly a month.
However, even after Graham's surgery, his PSA levels continued to rise.
“We continued to test every three months and we realised that the PSA level was beginning to rise again and so I had to do radiation therapy. That would have been in 2012,” he said.
Now, almost a decade later, Graham remains cancer free. And, he's back to his yearly check-ups.
“It's like a tonne of bricks that was weighing down on my shoulder has been removed. Well, that was just the start of it because what you look at is: the longer the period that goes with you being cancer free then I guess it is the more you feel that okay it will not come back so after five years, I felt even better and now almost 10 years now, next year will be 10 years, 2022, so it's really a relief,” he shared.
The survivor has since changed his lifestyle and diet, eating healthier and incorporating more exercise in his daily routine.
“I have been exercising more frequently. I am more careful now with what I eat. I still indulge in some of the things that they claim are not all that good for you but I try to do it in moderation, so I consume more fruits and vegetables and I exercise. I used to go to the gym and I used to ride bicycle but currently I focus more on walking, so I walk three to four days a week and do some light exercise with weights.”
Stressing that prostate cancer is real, Graham said: “The statistics are there to show that there is a very, very high incidence of prostate cancer among men in Jamaica. I have several friends who have had it. So, it's real. However, it's not a death sentence. What you want to do is to be able to detect it very, very early and how we do that is through the annual medical check-up and test. That's how I caught mine.”
“My advice to men out there is just do the annual medical. Get your PSA level check and also part of it, you would need to have the digital rectal examination done. And I know that that is a taboo among a lot of men but we just need to put aside the foolishness and be done with it. It's your life, it's your health. I mean if you want quality of life, the last thing you want is to have prostate cancer and you leave it there, it really destroys your life but if you detect it early it can be treated and you can have good quality of life going forward,” Graham encouraged.