Last minute deals to idyllic Santa Canceraos

A major British cancer charity currently has sponsored adverts popping up on Facebook where individuals post photos of themselves the way they are right now. Everyone looks so happy and healthy and they're all thoroughly enjoying themselves. You could be forgiven for thinking you were looking at some glossy holiday brochure trying to persuade you of the delights of the Hotel Chemoterapia in the idyllic little resort of Santa Canceraos on the secluded island of Oncologia set in the azure waters of the Radiologica Sea. Honestly, I'd be tempted to book if I hadn't already been and found that the brochure was, how shall I put this, not entirely factual.

As is usual with Facebook posts, other individuals post comments and one post in particular pee’ed me off. I know the person posting would have meant well but, FFS, cancer ain't school and we don't need reports to take home to our mums. It read: “A shining example to all others suffering from cancer well done”.

“Shining example”!! “Well done” !!! $€£@#$%&! (That’s me cursing politely).

I feel inadequate, like I failed the class.

In fairness, the comment was about a woman who'd climbed a mountain a year after starting chemo but, come on, how many of us could do that? It's great that some can but it's no more than that one guest amongst many at the bug infested Hotel Chemoterapia who gets the spotless room with the clean sheets when everyone else goes home ill and covered in bites.

Now I probably wouldn't feel as sensitive about this if I wasn't feeling so drained right now. I have done for weeks. The pills I'm on must have started having more of an effect on me because I'm even more drained than usual. It's not that I'm permanently slumped in an armchair, I do still get on with things and I even have days when I'm out and about, but no way do those things include climbing a @#$ing mountain. One day this week I felt good so we went out and I've paid for it ever since.

I realise charities have to try to raise money so they can do the work they do, and this particular charity does amazing work. But, please, while you're showing what great results research can bring and how your particular charity is at the forefront of research (and it is!), can you think about the issues these money raising initiatives can raise along with the money and please don't forget that there are still a helluva lot of us who are bringing up the rear.

p.s. If a place such as the Hotel Chemoterapia in the idyllic little resort of Santa Canceraos on the secluded island of Oncologia set in the azure waters of the Radiologica Sea exists anywhere, please may I refer you to my Disclaimer

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Frankly, my dear, I’m shagged out

We just had a great couple of weeks in Spain, on the beach and in the sea every day. It was warm to hot, mostly dry, very sunny and, as always, full of friendly people, both locals and tourists, especially our mates who we now regularly meet up with. As you’ve probably gathered, we like the place.

The only downside was nothing to do with the actual holiday but everything to do with my energy levels, which were noticeably down on a year ago. Last September’s short break doesn’t count as I was in the midst of chemo then but, whereas in June last year we walked everywhere, this year I needed to take several cabs and I just wasn’t up to much after eating in the evening. I could easily have slumped into bed as soon as the sun went down. If I was in any doubt about feeling more tired before before I went away, those doubts are now gone.

Now, I don’t know if this is all down to the post-chemo malaise that I’ve been told can last for ages or if it’s something more permanent but it’s yet one more chip away from the “old normal” that existed until not that long ago.

I’ve had it suggested to me that this could all be down to getting older (bloody cheek!). OK, it could be, but does such age-related change come so suddenly? When I look at others my age and a little older I don’t see them flaking out but I do see them walking, partying and, if not full of energy, certainly not totally depleted of it.

Since getting back home a week ago I’ve felt even more drained. I think I’ve got a virus added to the already present fatigue but I’m plodding on making sure I keep active although I’ve had to cut out the gym. I find myself wondering what idiot said holidays are good for you? 

As if all that were not enough, my PSA blood test was due. As anybody who has to have regular PSA tests knows there’s something called PSA Anxiety. It goes hand in hand with Scanxiety and both can drive you mad. I managed not to think about it while we were in Spain but it’s been on my mind ever since the plane home touched down with me swinging from being convinced that the cancer is dormant and will be so for some time to the PSA result coming back sky high and the cancer being rampant everywhere – not just once have I gone through this but a hundred times in the last few days. I know it’s daft, but there you go. 

I finally had my bloods done yesterday and today I got the results. The bad news is the PSA has gone up but the good news is it’s still very low and now stands at 0.074 compared to the even lower 0.044 that it was 3 months ago. I’d hoped it wouldn’t rise again for a bit longer but it could be worse I suppose. 

The other thing that my bloods threw up was my neutrophils level, which is low at 1.5. I don’t altogether understand neutrophils but I think they’ve got something to do with the body’s immune system and help to fight infections and they should be higher than 1.5, so maybe that could account for me feeling like crap? 

To paraphrase Rhett Butler in Gone With The Wind: Frankly, my dear, I’m shagged out – but not, unfortunately, in the way I used to be pre-surgery.  Nevertheless I have plans for the next few days that I intend sticking to. An elderly friend of ours who we all affectionately call Uncle Albert reaches a milestone birthday on Thursday and is having a celebration get together. As befits his advanced years there’ll be plenty of seats available so I should be OK. In fact, sitting next to him I will appear positively youthful. 

Twenty weeks post-Chemo 

I saw my oncologist today and at the risk of tempting fate I’m pleased to report I’m doing fine. My latest PSA result has shown a small but welcome drop, taking me to yet another record low. Three months ago it was 0.049, today it’s 0.044. The 5 months of chemo that I finished back in November hit me hard but, as the drop in my PSA shows, it hit the cancer even harder although not enough to deliver it a death blow, meaning the bugger will be back eventually.

I have a few lingering chemo side effects which, although not major, are uncomfortable and annoying. There are a couple of intimate ones that involve fluid and swelling and make me look very well endowed on occasions (even more than usual!). I also have blocked eye ducts that stop my eyes from draining so, instead, they water a lot but despite watering they still feel like there are lumps of coal in them. Going to the gym has helped me regain a lot of my strength and stamina, but I still get drained very easily and it takes a few days to recover from a night out.

On the plus side the fluid retention that had puffed up my face and the rest of my body has now mostly gone. I didn’t realise quite how much chemo had changed my appearance until my partner and my Macmillan nurse mentioned it just a couple of weeks ago. It turns out they both hadn’t recognised me on some occasions but didn’t like to say at the time. 

So, for now, I just carry on taking the tablets and getting on with life. My next blood test is in 3 months.

No photographs please

New Year, New Me. I hope so. I really don’t like what cancer and its treatments have done to me but the worst part, the part that’s obvious to others as well as to me I mean, is my appearance. That’s became more obvious over the Christmas break when many photos have been taken, photos with me in them, photos that I’ve seen. Jeeeez, talk about aged. While I’m thankful to have had chemo and everything else to keep this bloody cancer at bay I really could do without the fat face, the big gut and the bald head that comes with it as though it’s a job lot, which I suppose it is. I need to lose 20 kilos by next week. Admittedly I shouldn’t blame every kilo on cancer, but sod it, I will.

As far as the chemo after effects are concerned, things are getting better. I’ve got a lot of energy back, unfortunately not enough to venture out on New Year’s Eve though, my finger nails are looking less unsightly and the ridges are growing out and, although I still look bald, my hair does seem to be starting to grow a bit faster and my facial hair definitely is, but it’s still not beard material – I reckon it’d take me a couple of months to grow one. My legs look like I’ve shaved them but, weirdly, the hair on my arms never completely dropped out. In those areas where the sun should never shine I’m like a prepubescent kid now. While I’m hoping things return to their normal hairy state down there pretty soon I am not looking forward to the itching, prickly, scratchy stage. I thought I felt a bit queasy during the chemo but it’s only now that the sickly feeling has subsided that I realise just how bad it was. It’s amazing what you can get used to without realising it.

Despite the photographic injuries to my vanity the festive season has been pretty good, considering I only had my last chemo 6 weeks ago and my last steroid just 2 weeks ago. I managed to get to Brussels for a day the week before Christmas, something that’s become one of our traditions over the last few years. The main reason for going is to buy the now essential Christmas chocolates, one of the few things left that we don’t have all year round, along with Christmas Pudding and turkey. This time while strolling around we found a cosy little bar that we’d never been to before. Unfortunately we only had time for one drink in there before having to rush for the train home, but we’ll definitely be paying it another visit. The trip exhausted me so much that I slept for 11 hours solid that night, but the day was so satisfying that it was worth it.

A few things that I’d usually have done in the lead up to Christmas fell by the wayside this year, mainly connected with going out and seeing people. A case of the spirit being willing but the body saying “you must be joking”. Nevertheless we had a really good time. Nothing raucous, just chilling, no all nighters in the East End like we used to, if only we still could, but some long walks, lots of nice food and a little booze. I never did drink much and used to get sozzled on a pint, two at the most, but these days I just need to look at a bottle of booze and I start swaying. I’m a really cheap date if anyone’s into an ageing, fat, bald bloke. Next Christmas I hope to be a lot better. 

Happy, Healthy New Year everyone.

Persistent little bugger

I should have had my sixth and last cycle of chemo today but it’s been postponed by a week as I’ve had a bad infection for the last two weeks that I haven’t been able to shake off, maybe down to my weakened immune system. It started with a sore throat and I was told to go to A&E.  There I was given intravenous antibiotics, which might seem over the top for a sore throat but when you’re on chemo any little bug can turn into something far more serious, e.g. sepsis.  I was also given some oral antibiotics to take home, but they didn’t seem to help much. I have some different antibiotics now though and today I’ve noticed a definite improvement so, fingers crossed, I’ll be ready for next week.

Cycle 5 has not been uneventful in other ways, either. The previous side effects have been present for most of the last three weeks, in particular the severe fatigue, the pain, the constipation, the loss of taste and the very low mood – I’d really underestimated the effect chemo would have on how I felt in my head – but in addition a couple more annoying side effects increased this time, like the uncomfortable ridges in my now discoloured finger nails. My finger tips feel different, too. I can still feel things but the sensation has changed, things feel almost silky when I know they shouldn’t and my hands briefly seize up from time to time for no apparent reason. I go to get hold of something or press something and it’s like non-painful cramp sets in. My eyes, too, have been affected – they’re sore and very watery.

I’m coping with the chemo but it’s hard to downplay its relentless negative effects, apart from highlighting the one big positive that shines through like a beacon in the fog, putting all the negative stuff into the shadows, and that is my PSA level, which is down again to 0.102, beating the last “lowest ever” of 0.158 and for me it makes it all worth it and reaffirms that I made the right decision about having chemo. No one can say how long the low PSA will last, could be 6 weeks, 6 months or 6 years, but as far as I’m concerned any amount of time that the cancer is held back is a bonus.

Fingers crossed for cycle 6. 

Chemo side effects lottery

Four years ago, back in 2012, it was brought home to me just how important it is to know what medical procedures really entail and what the possible risks are. I’d foolishly thought the warning at the end of the TRUS Biopsy consent form that I was about to sign was just a standard thing that had to be there so I didn’t pay it much attention, but I found out different when infection from the biopsies led to my first bout of sepsis. Ever since I’ve made a point of reading up and asking questions whenever I’m about to have something done to me and, generally, I take medical matters much more seriously.

So by the time I started my first cycle of chemo a couple of weeks ago I thought I was prepared, but I wasn’t. The speed with which the side effects started and their intensity were a complete surprise to me. I’d expected a slow onset followed by a gradual build up whereas the reality was the exact opposite. 

From the little bit of personal knowledge of chemo that I’ve now got, and bearing in mind that we’re all different and I’m only an expert on me, it seems that the whole chemo side effect thing is even more of a lottery than those side effects that happen due to surgery, radiotherapy and hormone therapy, all of which I have first hand knowledge. There are lots of possible chemo side effects, the list is extensive, looks scary and can vary depending which chemo drug you’re on. Each one is like a number on a Lotto Lucky Dip ticket in that you know what they could be because you’ve seen the list, but you only find out what ones you’ve actually got after you’ve parted with your money or, in this case, had the chemo put into your body.

My side effects included hoarseness, hiccups, extreme change in taste, sore mouth, muddy feeling mouth, blood at the start of every pee, constipation, diarrhoea, sore skin, fatigue, feeling weak, a sickly feeling in the mornings, very weird dreams and, the worst of all, severe pain in every bone, joint and muscle. Some side effects, like the blood in the urine, only lasted for a few days, while others have come, gone, then come back again. 

Certain side effects happen to everyone, although to different degrees, so can be planned for and prevented. Sickness falls into that category and I was given steroids to deal with that, starting with intravenous ones and followed up with pills and so far, although I’ve felt a bit sick most mornings, I haven’t thrown up.

Other side effects, like hoarseness, are rare and might not happen at all so it’s a case of having to deal with them as they hit you. I dealt with hoarseness with a special mouthwash from the GP and gargling with bicarbonate of soda. They both really helped but because the onset had been so quick – within two hours of having the chemo – I wasn’t even sure it was a side effect and wondered if I’d caught a cold, but my chemo nurse said that it could be the start of oral thrush, a more common chemo side effect.

Another thing I didn’t have ready was effective pain relief because there was no saying I’d have any pain at all. As a result, by Day 3 I was really suffering and by Day 4 I was becoming less able to do anything because of the debilitating effect of not being able to sleep and not being able to move. I could hardly get out of bed and was feeling very down.

I tried “baby-dose” painkillers, the sort that most of us have handy at home, but they did nothing to alleviate the shooting pains in all my bones and joints, even my fingers and toes. I’d got to the point where I was having trouble walking, sitting, standing, laying down and just about every other activity and I felt as though every nerve was trapped and that I’d aged 20 years overnight.

As soon as I told my oncologist and my Macmillan nurse just how bad I felt I was immediately prescribed Co-codamol 30/500 (not baby-dose ones) and Ibuprofen 400mg. I could have got even stronger ones if I’d needed them, but luckily I haven’t so far. Once my pain was brought under control I managed to get some sleep again and was then able to do almost everything I wanted to with a bit of effort. Such was my confidence that on Day 9 I tried doing without my painkillers but soon found that I had tried too soon. Within a few hours I restarted them and began to feel much better. They work so well that later that same day, and the next, I was able to go for a couple of long-ish (very slow) walks. On both days the weather was too good to waste looking out of the window so it was good to be able to enjoy it. The walks knocked me out in a nice way, but relaxed me and helped me sleep like a log.

I’m now about half-way through the first chemo cycle, the point when my body should start to recover in preparation for it all to start again with cycle 2. Now that the pain is being managed I am pretty sure I can get through all the chemo but if you’d asked me a week ago before I had the right painkillers I’d have been very unsure. I was definitely faltering and had told my partner that if I said I was going to stop treatment that he was to talk me round using every reason he could think of. Whereas all the other side effects on their own were things I could have just put up with, the pain would have been the thing that mucked it all up. I’m really glad that’s not now going to be the case because it’s still my aim to live to be a cranky, cantankerous 90 year old and I stand more chance of achieving that aim with chemo than without it. Ask my partner and he’ll tell you, based on the last ten days alone, all I’m missing is the birthdays. 

Chemo – 1 cycle down, 5 to go

I had my first chemo session a couple of days ago. I’m pleased to report that the place felt far less oppressive with people in it (see previous post). It was not busy but the atmosphere was fine and, importantly for me, there was humour, too. 

The chemo session itself was pretty low key and the most discomfort I experienced lasted just seconds and was the cannula going into a vein on the back of my hand. That didn’t happen until after a hot pad had been warming up the area for a while before in order to minimise discomfort. 

The first thing to go in was some saline, which didn’t take long and, straight after, two IV drugs Dexamethasone and Ondansetron followed. They took about half an hour and then the chemo drug Docetaxel went in, which took a further hour. All this time I spent in a reclining armchair and I had a cup of herbal tea while I was mucking around on my iPad. I was connected to a drip for about 2½ hours in total.

I thought I was going to get away without more pills to take home but the nurse brought me a bag containing four lots and a “Drug Plan” explaining when the different ones had to be taken and why. Two are the pill form of the ones that went through the IV drip, Dexamethasone and Ondansetron. The other two are Metoclopromide, which I take now, and Prednisolone, which I don’t start taking until I have stopped the others in a couple of days from now. Their main purpose is to counteract sickness so it’s important to follow the plan, but they have side effects. The Dexamethasone mustn’t be taken after lunchtime because even that early in the day they still impact on sleeping, as I found out on the first night when I remained wide awake most of the time. So far the pills have performed their primary function with distinction as I don’t feel sick at all (yet). 

I was also given some Movicol, a laxative. I’m not sure which one of the meds causes constipation but believe me it works quickly. I held off taking any Movicol for two days because I’d hoped things would settle down. They didn’t, so I have and now await the torrent.

Less than two hours after leaving the chemo place I started to get hoarse and less than 24 hours later I had almost lost my voice. Could be coincidence but on the advice of the chemo nurse I went to see my GP because she said I might have oral thrush caused by the chemo. It seemed a pretty fast side effect to me but I’ve been prescribed a mouthwash called Nystan. The hoarseness has improved a bit but my taste buds are now very confused. Taste changes are a side effect of chemo and things had already started to taste a bit different, so I’m not sure if it is the Nystan but everything now tastes very weird. I hope that doesn’t last long.

I am drained except when I want to be – all day through I long to sleep but late at night when I’d much prefer to be able to sleep my mind is racing and I have a spurt of mistimed energy. 

I’m still holding off on shaving my hair. In my head I’ve decided that as soon as it starts falling out I’ll finish the job off, but it’s still a daunting prospect. Getting rid of it in one go is not the same as losing it gradually over years plus the eyebrows and eyelashes will be falling out at the same time. I’m sure there was a Star Trek character with the sort of looks I’m going to end up with but I can’t remember which one. If only this was an episode of Star Trek. I remember the Emergency Medical Hologram in Star Trek Voyager merely dishing out a few pills to completely cure someone’s cancer. Imagine that, eh!

Chemo pre-assessment

My chemo will take place in the same building where I had radiotherapy in 2014 and 2015 but there’s a marked difference between the radiotherapy and chemo departments if my pre-assessment a couple of days ago is anything to go by. Both are very modern and very clean but what I found different was the feeling of the place although, to be fair, I was there on one of the days that it is closed so maybe the atmosphere will be different when it’s got patients and staff in it.

The only person there was the Chemo Nurse who had phoned me a week earlier. We went through the paperwork together and I learned that in addition to Docetaxel I’d also be having two other drugs through an intravenous drip – Dexamethasone and Ondansetron, which I’d get first. At the end I’d get some saline, too. I also had the possible side effects that I might experience explained to me and was asked if I had any questions. It’s important to get one’s priorities right and the first question I had was whether or not I could go away on holiday to Spain for a week in September. The upshot is that it’s not the definite “no” I thought it was, but neither is it a “yes”. I’ll have to see how I do and then see what my oncologist advises. If I do manage to get away I mustn’t go into a swimming pool because of the chlorine and I’m only allowed into the sea up to my waist so as to avoid swallowing any sea water, which is not my preferred tipple in any case.

I was told a lot of things I expected to hear, but some of the “surprises” were that I should use a regular toothbrush with soft bristles instead of an electric one because, I think, the inside of my mouth will be more prone to sores, cuts and ulcers which could get infected, and to only use alcohol free mouthwash. As my immune system will be compromised I’m also not allowed what were described as “smelly cheeses”, so no Brie or Camembert for example, and meat and eggs have to be well cooked. Although salads are ok, they must be thoroughly washed. 

As I’ve mentioned in previous posts, I enjoy the foods that are described as “healthy”. I’m talking about low fat things, skimmed milk, soya, sugar-free and things like those. I’m told the general advice now is to do the opposite as I’m not to lose weight and I must eat things that’ll boost my energy. I’ve never found it difficult to put weight on and I’m worried that I’ll end up very overweight. 

One of the more definite side effects of the chemo is hair loss. It’s a dead cert, in fact. I haven’t yet got used to having lost most of my other hairy bits due to the radiotherapy and hormone therapy so the prospect of losing what’s left on my head and face is quite depressing – we’ve all got our weak points and that’s mine. My body is getting more like that of a woman’s with every hormone pill I take and it’s only the hairy bits that still make me feel like me, so being told about something called a cold cap that might prevent hair loss on my head that I could try if I wanted sounded a very attractive prospect, all things considered. It’s not guaranteed to work but I was going to give it a go. Except I can’t. The reason I can’t is that they don’t make cold caps big enough for my big head or, if they do, the chemo place doesn’t have any. So within 3 weeks I’ll probably be bald all over.  A mate suggested that I could put myself in control by shaving the lot off before it falls out, something that looks so easy when you see people shaving their heads to raise money for charities like Macmillan, but the thought of doing it for real does not feel so much like taking control as giving in, which I suppose I will have to do.

Other things I have to do is carry my Chemo Book around with me when I go out and have an overnight bag ready by the door in case I get an infection that is so bad that I have to go to hospital.

After going through the paperwork and questions the chemo nurse showed us around and then I had my bloods taken. The place isn’t big but has everything required. As the patient I’ll be given sandwiches because each session takes around 2½ hours, and both me and my partner will be given a cuppa, but there’s a small kitchen we can use if we want to bring food with us so he can eat, too. 

I know I’m not in a humorous situation, after all, cancer is no laughing matter but whenever possible I’ve used humour to help me get through the last few years. It’s not how everybody does it but we’re all different and that’s how I need to do it. I get my laughs where I can and, it seems, so do others because while writing this I found a site that gave me a few laughs and from which I pinched the idea for an image. 

Humour is what was missing from my chemo pre-assessment and I missed it. I had arrived on a high, having spent the previous four days in Dorset enjoying weather that was reminiscent of the Côte d’Azur and revisiting places that we hadn’t seen for over 25 years, such as Studland, Corfe Castle, Swanage and Weymouth and partaking of our favourite local delicacy, freshly caught crab sandwiches. Maybe chilling and de-stressing was not a good strategy, maybe I should have stayed home and dwelt on my situation instead, because the whole pre-chemo thing was far too matter of fact, realistic and clinical for me to handle and I came down from my high with a bump and left feeling like a black cloud had descended over me.

I’ll have my first cycle of chemo tomorrow. I hope it’s not all doom and gloom and that I’ll find the humorous side somewhere. 

Uncertainty 

A few things have happened since I last wrote. The best was 12 days in Spain lazing on a beach all day every day with warm evenings spent in a beautiful little town with friends we had met during previous visits. None of us knew we’d be there at the same time and seeing all of them really made the holiday extra special for us. In fact, it was one of the best holidays we’ve had and for 12 days the bloody cancer went to the very back of my mind. It was great. Then we came back. 

Two days after returning I had my blood test and two days after that I saw my oncologist. The holiday was definitely over when I learned my PSA had gone up again since the previous blood test three months earlier. Not so much this time, but enough to prove that the last increase was not a blip. My PSA now stands at 0.556 (post surgery, post radiotherapy, and with hormones). We chatted about my situation and it was confirmed that I’ll be starting chemo soon. I would be starting this week but I’m awaiting a camera up my tail end (a sigmoidoscopy) to see if I have a problem there after having endured four days of excruciating pain about a month ago. I could have had the sigmoidoscopy done earlier but I went to Spain instead, and I’m glad I did. The worst of the pain has gone now, thankfully, although things have definitely changed down that end from the way they were.

I was a bit worried that at my last appointment I might have persuaded my oncologist to go down the chemo route, so asked her if she really thought that was my best option. She replied that if I was coming to her now, all fresh, as a new patient, that she’d be putting me straight on to chemo. That answered my question and gave me food for thought. I was given some more of the same a couple of days later when I was speaking to my Macmillan nurse who said, (and I’m paraphrasing and taking it out of context here), that I have advanced prostate cancer. I stopped her to make sure I’d heard right and she seemed a bit concerned, asking “has no one ever said that to you before?”.

No one had, but I wasn’t surprised to hear it and I told her so. I suspected the cancer was advanced in much the same way that I was pretty sure I had it long before I was told. When I was given my initial diagnosis, despite already knowing in my head, I was shocked to hear the words uttered. This time, though, there was no shock whatsoever and there still isn’t. As I explained to my nurse, for me it helps to have it confirmed because I now know which information I should be focussing on when I need to read up on something.

Despite not feeling any sense of shock my general situation was already unsettling me and I suppose that didn’t help. Everything is up in the air. I don’t like uncertainty and there’s too much of it right now. Sometimes I feel down and on the verge of tears. I’m not sure if my increased emotional state has come about as a result of the hormone therapy or if I’d be feeling like this anyway. My day to day tiredness and the further problems in my bowels mean that any short term plans involving others have to be made with the proviso that I might not turn up and long term plans are well and truly on hold until after the chemo. I’m told that I shouldn’t dwell on things. For “things“, read “cancer“. That’s easy to do if you haven’t got it and all the crap that goes with it but not so easy when you have.

One regular event that I do have in my online diary, bowels and fatigue permitting, is the cancer choir I wrote about a couple of posts back. I went to the first one last week. Loads of people turned up, mostly women who outnumbered the men 2 to 1, but I was one of over a dozen men who had cast caution to the wind and decided that it didn’t really matter any more if we disgraced ourselves with our singing voices. It was brilliant. I thoroughly enjoyed myself and I’m going back this week.

The choir takes place in Chelsea not far from a place where I briefly worked 40 years ago, the famous Royal Marsden Hospital, a centre of cancer excellence and expertise. In fact, the research side of the cancer choir is connected to the Marsden. I’m proud to say I worked in the most important department in the hospital. Doctors and nurses looked up to us and were forever calling to ask us questions to which they had no answer. I am, of course, referring to the wages department. We were located just across the road from the main hospital in what had once been a well to do residential property. I made a detour to walk past it on my way home last week and saw that it had been returned to its previous residential grandeur. When I worked there all those years ago I was a rebellious teenager who thought he’d live forever. I lived for my weekends, had no fear and never thought I’d be in the same situation one day as the many patients I saw walking through the hospital doors. That was another life and it all seems such a long time ago now.

Where’s all my chest hair gone?

I looked in the mirror recently and there, looking back at me, was a 60 year old bloke with adolescent girl boobs and a bikini line to be proud of. I had been noticing the gradual changes happening to my body but they now all seem to have come together in a crescendo after creeping up gradually since I started taking Bicalutamide 10 months ago. 

I suppose gradual change is easier to get your head round than sudden and maybe everything’s come to the fore now because of the adverts all over the place about getting fit after Christmas. Whatever the reason, all the changes are playing on my mind more now than they were. 

The fuller boobs and the loss of most of my body hair are change enough, but there are also the rounder hips, sore nipples, a wider midriff bulge, feeling tired and taking ten times longer to write this than it should take because I can’t concentrate as well as a year ago. 

If I’d been asked before the cancer happened what would be a really bad side effect, a shortening of my “manhood” would have been near the top of the list. Now that the shortening has happened, due to the surgery not Bicalutamide, I’m amazed to find that I’m more pee’ed off with losing most of my body hair than any of the other things.

In fairness I had been warned about the changes that could happen to me but nothing I’d been told explained how the changes might actually make me feel. Everything is very matter of fact – you might lose your libido, you might gain weight, you might lose body hair, you might be moody, you might grow boobs – nothing that really explained how self conscious I might feel in intimate situations or that I’d feel like a plonker at the swimming pool or on the beach.

There are cancer information booklets on “body image” but the vast majority of information doesn’t strike me as being geared up for men, as though we wouldn’t be bothered about such things. Maybe the implication is that we shouldn’t be bothered, or am I being paranoid? Is paranoia another side effect of hormone treatment?

If having something about body image to refer to is helpful to women with cancer doesn’t it follow it might also be helpful to men? Having it there in front of me in black and white would be a validation and acknowledgement of what I’m feeling. Maybe a few pointers on how to handle the psychological side of changes to my body written from a male perspective with a male audience in mind would be supportive. 

If nothing else I think all men affected by cancer are worth more than a couple of paragraphs as an afterthought, which is what it feels like we’ve got at the moment.