I’ve spent most of the month since I last posted sitting out under a sun umbrella either reading or trying to write. A lot of the reading has been research for the writing, and has included spells in the National Library, Edinburgh Central Library and the National Records. In terms of fiction I’ve been deep diving once more into Dorothy Dunnett; I really enjoyed her second series of historical novels, the House of Niccolo series set in C15 but have always found her earlier series, the Lymond novels (C16) harder to get into and that’s my current task. So far so good.
I thought writing would flow more naturally once the worry about cancer receded but I’m finding it tough to get back into it. My process is to turn up for work every day with notebook or MacBook and trust that sooner or later the Muse will come and join me. I’m getting there but it’s slow going.
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I have occasional conversations with other men who have been through, or are still in the middle of, the prostate cancer experience. Those of us who have had the hormone treatment tend to gripe about the inexorable weight gain that is common amongst us. One chap said that he had named his moobs Thelma and Louise and I got to thinking about mine – Agnetha and Anna-Frid? Althea and Donna? Suggestions on a postcard, etc.
I was at the hospital today where it was confirmed that my PSA is <0.1 ng/mL which is effectively undetectable. No doctor will say that I am ‘cured’ because that is not how cancer works, but the news is that the treatment worked. Hooray for the NHS and Edinburgh Cancer Centre.
I will now have blood tests every six months for the next couple of years and then annually thereafter. The main side effects of the treatment for me have been weight gain, hot flushes (especially at night) and general fatigue and joint pain. I’m told that I can expect all of these to improve by the time of the next test in December.
I’ll probably write a more considered piece about the whole experience, but not yet.
Despite the metabolic havoc wreaked by hormone implants, I was delighted and relived to find out this week that my HbA1c remains in the ‘normal’ range (34mmol/mol, 5.3%). I was concerned that the weight gain caused by the hormones had messed with my type-2 Diabetes ‘in remission’ status; happily, it has not. I’m also happy to report a weight loss of 1kg (2.2lbs) over the past few days, so perhaps that is on the turn.
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I found a passing mention of a book called Wisconsin Death Trip by Michael Lesy published in 1973, based on his PhD thesis. The book reprints articles and news items from Jackson County, Wisconsin, primarily from 1885 to 1900. The book also includes photographs by local photographer Charles Van Shaike and the articles are primarily from the Badger State Banner as well as records from the local mental hospital.
Unfortunately, the book is now quite expensive, however a film adaptation was made for the BBC’s Arena, broadcast in 2000, narrated by Ian Holm. The film is very much available to view in excellent quality on BBC iPlayer and in lower quality on YouTube (links below). I watched the film twice, enthralled. It is very dark (and some may find it upsetting), the more so because the stories are narrated straight without commentary. And the music choices are excellent.
I found the objectivity of it very affecting, especially the many, many human tragedies. I had a powerful sense of the fragility of life and a dissociation from the usual internal narrative of what it is to be human. I sometimes get this in Family Tree Research which, at its most basic, revolves around a narration of birth, procreation and death. Some of that was on my mind when I had my initial cancer diagnosis although it also helped reconcile me to the diagnosis and informed my determination to live life to the full while I’m here.
Wisconsin Death Tripadded something else, a feeling of the shallowness of so much of life, of the wasted potential of our species that has such a high opinion of itself.
Yesterday (8 April) was an important day for me. I was prescribed two hormone implants that had to be inserted a set number of days/weeks apart; had I been prescribed a third it would have been implanted yesterday.
The implants are important. Prostate Cancer growth is associated with testosterone and the implants (Leuprorelin/Prostap) are designed to get testosterone out of the equation. In the usual case, that ought to stop cancer cell growth and also, during and after radiotherapy, stop cancer cell regrowth. That’s fine with me, but shutting down testosterone has side effects that strike different men in different ways. In my case I’ve had night sweats and weight gain. This morning before breakfast I was 10kg heavier than I was in October 2025 just before the first implant, without any significant change to diet or lifestyle.
The probable cause of the weight gain is the body’s reaction to the shock of androgen deprivation: it tries to store energy in the form of fat in order to synthesise the testosterone that has gone missing. That fat lodges primarily around the waist and chest. I understand that, but after spending a long time losing weight and keeping the weight off it is frustrating to put it on again even if it’s for a good cause.
In my head, today is the day on which the impact of the last hormone implant begins to diminish, albeit slowly. I have a hanger in my wardrobe for what I call my ‘target’ shirts. These are shirts that fitted me last autumn but don’t now. They are my proxy targets for recovery; I have no heroic ambitions but I would like to be back into those shirts by Christmas as a marker of progress. Six months to lose all or most of the weight it took six months to accumulate doesn’t seem to me to be unreasonable, assuming that the hormones and radiotherapy did what they were supposed to do and no further treatment is required.
Oops.
My next checkpoint with the oncologist is in early June, by the way. I do not expect any nasty surprises but I’ve learned to take these things as they come. I do have some general blood tests lined up for next week though which ought to show if the metabolic impact of the hormone implants has had any hidden consequences.
In the meantime, I’ve put off today’s gym session after an accident with an 18.5kg dumbbell on Monday resulted in blood, steristrips and bandages.
No serious harm done but it does inhibit my ability to use the gym equipment a bit and I don’t want to run the risk of reopening the wound.
I am on the next stage of recovery, resistance work in the local gym. I am following a set of core exercises suggested by an exercise specialist at Prostate Scotland. Today was my third session.
The core issue is that the hormone implants and radiotherapy tend to reduce muscle mass and the resistance work is intended to restore it and also help create a cancer-suppressive environment in the body. The exercises I have are targeted at the main muscle groups and include deadlifts, a first for me. I’m not a complete stranger to resistance work but in the past it has always been as an adjunct to cardio training, mainly running; this time the resistance work is the main course and any cardio is an adjunct to it, at least for the first few months until things get back into balance.
The target is to find the weight for each exercise where I can manage 8 – 10 repetitions before having to stop, then doing three sets of them. Once I get used to that weight and can do, say, 10 to 15 repetitions, I raise the weight a notch, and so on. I would like to get back to running, but it isn’t a priority at present.
I won’t know how well the hormones and radiotherapy worked until early June when tests are scheduled.
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I’ve been reading a lot lately. I mentioned Stevie Smith a couple of posts ago but I’ve also been dipping into Thomas Hardy’s poetry (there is a lot of it, of varying quality), Malcolm Guite’s first volume of the Arthurian corpus in epic verse, Galahad and the Grail, and Patricia A McKillip’s Ombria in Shadow. The latter is an object lesson in writing Fantasy to a very high standard and has given me plenty to think about as regards craft and technique in general.
I also read The Hobbit for the first time since the girls were small; it is an odd book. I enjoyed revisiting it but every so often the writing irritated me. Still, I enjoyed it enough to make the mistake of revisiting the first of the Peter Jackson Hobbit films to see if time has improved it; it has not.
It has been a tiring and expensive week. Expensive because Kirstin and I have booked to go away for the first time in a couple of years save for two city breaks in York. We’ll be in Italy for seven days in May and I dare say that you’ll read more about that in due course. It marks the end to the cancer uncertainty, a significant birthday for Kirstin and also, later in the year, our 40th wedding anniversary.
More expense: I was at the opticians and bought new glasses with a new prescription. Even using the various promotional deals on offer, new varifocal glasses are not cheap.
And finally I bought a new sports watch. I have previously owned two Garmin Forerunner 235 watches that I used primarily for running though they can also be used for swimming. I bought both of them second-hand and very cheap on eBay 3 years ago. One of them gave up the ghost but the other works well enough although the battery is going and it gets cranky sometimes; I’ll keep it as a backup. I bought a new one, albeit one model back from the current and as discounted ‘new old stock,’ because it has more functions that directly relate to the work I need to do for cancer recovery in the gym, and also for recording assorted metabolic functions that the Forerunner does not include. The new one is another Garmin, a Vivoactive 5 bought at substantially less than its old retail price and much less than the current Vivoactive 6.
Keeping it Understated
I’m tired mainly because I made a start on getting back into the exercise this week. On Monday I was swimming, pootling up and down the local 25m and feeling better about it than I expected. Tuesday was a brisk/vigorous 5k walk. On Wednesday I thought I’d go round our local hill, an old favourite route of mine; I aimed to alternate walking and light jogging with the emphasis on the walking but in fact I jogged most of it. For both the swimming and the jogging the aim was not to attempt anything heroic but simply to do the activity as best as I could to get my body back into an exercise frame of mind. I’ve also been doing some light resistance work in the house. I can report that I am feeling aches in all the right places and plan more of the same for the coming weeks and months, building in focus and intensity.
On the same theme, I had a phone call yesterday from Lisa, a prostate cancer specialist at Maggie’s. We had a very good chat about my stage in process (still in treatment because hormones are still in circulation in my body and the radiotherapy is still doing its work even though the daily sessions have stopped) and about my approach to exercise for the remainder of the treatment period and for recovery thereafter. I’ll write more about this once I’ve worked things through, however by the time she phoned I had already made a donation to Maggie’s in return for two running/gym vests. I’m happy to promote Maggie’s and happy to wear the shirts in the hope that they might prompt questions and discussion.
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