The incidence of prostate cancer in Ireland is growing every year, with 3,172 men diagnosed in 2010. Prostate cancer survivors have a variety of side-effects after their treatment and, while many make a full recovery, research has found that prostate cancer survivors are not prepared for, and have difficulty coping with, the severity of the physical and emotional side-effects of their treatment.
In response to this research, the Movember foundation in conjunction with the Irish Cancer Society will open two nurse-led clinics next year offering care, advice, support and education for men with prostate cancer.
Brendan Madden is a lean, agile man who looks much younger than his 65 years. He moved from his native Dublin to Connemara in the mid-2000s and in 2010 decided to go for his health check a few months early, as he was close by to his doctor's surgery.
"My PSA levels were high – I hadn't a clue what they were," he says. Prostate-specific antigen (PSA) levels are elevated in men with prostate disorders and used as an indicator that something is not right.
When Brendan's PSA levels continued to rise over the next few months, he was sent for a biopsy and diagnosed with prostate cancer. His options were radiation, chemotherapy or a radical prostatectomy. "Straight away I made up my mind. If I have it, I want to get rid of it. The operation is invasive and I was very sore and very cranky."
A few weeks after his operation, Brendan made his first outing to the annual cancer society conference. "I was really stiff and stooped and wasn't very mobile. That was getting on top of me because I'm very fit and active. I was really nervous and it took me ages to get there.
"When I got in there, it was like a Lazarus job. People were standing up relating their stories and I said, hang on a second, I'm not that bad really compared to what these people have gone through. I walked out of that place at 4pm and psychologically I was feeling a lot better."
Brendan's side-effects are mild. He has no incontinence but suffers some erectile dysfunction. "That can be cured. It's not the end of the world," he says.
His advice to anyone going through the same experience is to stay positive and to talk about it. "Go talk to someone who has had it, especially someone who is positive about it."
Tom Molloy (46), from Ashbourne, Co Meath, was diagnosed with prostate cancer three weeks before his 44th birthday.
He has a family history of cancer. Both his mother and father died from cancer and he sadly lost a cousin to breast cancer in recent weeks.
Tom's high PSA levels showed up when he was getting tests for high blood pressure and his levels were so high he was dealt with very quickly.
"My wife came with me to get the results of the biopsy. As we were walking in, my doctor said to my wife, I'm glad you're here. When he said that I knew it was bad."
Tom had prostate cancer and his tumour was big enough to ensure surgery was the only option for him. "First I was in shock but I knew I had a journey ahead of me now, so I got all the booklets from the cancer society. It was hard going and it took me a week to open them up for the first time." Tom was prepared for the side-effects of incontinence and erectile dysfunction. He escaped incontinence but has erectile dysfunction. "It doesn't bother me as much as I thought it would. I've got a daughter and my wife and I are at an age where we had decided we were just going to stick with one child."
With his family history, Tom worried his cancer might spread. "I was really bracing myself to be told I had six months to live. I had watched both my parents die of cancer. I didn't want any false hope and that was a very dark time, but when I got the results of my MRI and bone scan and there was no evidence of cancer having spread, that was like winning the lottery.
'My daughter was six at the time and I still have this image in my head of her at my funeral and growing up without me and eventually forgetting me altogether."
Tom started a blog, www.tommolloy.com, as a way of processing his thoughts and feelings about his experience. His cancer has changed his life in many ways. He left his job and found something more satisfying. "I was looking at spreadsheets of labour rates one day and I thought, is this what I beat cancer for? I would never have quit a permanent pensionable job in the middle of the recession if I had not had cancer but now I feel the fear and do it anyway."
"A big bug bear of mine now is not to let fear stop you doing what you want. I spent a long time staring into the abyss not knowing if I was going to survive and looking at my daughter and having come through all that, it's changed me."
Tom Hope (65), from Dunboyne, Co Meath, is a volunteer driver for the cancer society, and brings cancer patients to and from their treatment on a weekly basis. He was getting high blood pressure checks every six months when his doctor discovered a high PSA reading. "My sister is a nurse and she said please don't look up the internet," he laughs. After a biopsy showed some cancerous cells, Tom decided, in conjunction with his doctor and consultant, not to get treatment. The cancer was not spreading so they decided to monitor it regularly instead.
"I get PSA and blood tests every six months. They're always cautious. My last biopsy was in January and this time there was no cancer but they can't guarantee that it won't be there the next time. I'm satisfied with taking my risk, understanding that in three or six months I could go back and it could be everywhere."
One thing that Tom found extremely useful was going to cancer conferences. "I just go there to keep in touch with the treatments and symptoms because I feel if I know something about it I'm not as terrified. People get up at these conferences and say I had this five years ago, and you realise there's a lot of people out there who had cancer and have come through it. In the 1980s cancer was a death sentence. It's so important to talk and share and listen to what other people are dealing with or coping or responding to it. You realise then you're not the only one."
Dubliner Stephen Kenny (70) had a mild stroke in 2005 and was being monitored regularly by his doctor. "He asked me to make a list of anything that was worrying me. I had noticed one or two things. I was getting up in the night to go to the toilet. The doctor said that's quite normal in a man my age but that he would check it out." Tests revealed an elevated PSA level and a biopsy found cancer. "The most important thing is they discovered it early. Early diagnosis is a cure."
Stephen opted for brachytherapy, or internal radiation, because his cancer was confined to the prostate. "They implant radioactive 'seeds' or pellets into your prostate with a little gun. It's all scientific and computerised. There's about 70 or so pellets inserted into the prostate around the area of the cancer cells. The advantage of this treatment is you only get it done once. Within a week of getting that done, I was in Oxford at a jazz concert. I could go back to work, it was quite reasonably easy to get on with life."
However, the side-effects kicked in a few weeks later. "Because of the radiation you lose your energy. That was the first thing. My waterworks were working grand for about three months but then I got this leak, which was embarrassing. My consultant gave me tablets, which stopped it but then had to give me other tablets to help me go again."
When it comes to cancer, Stephen strongly encourages anyone over 50 to get checked regularly. "If there's anything that needs to be done, you can have it done early. In America they start checking men at 40. You have a responsibility to your own body to have it checked."
Irish Cancer Society National Cancer Helpline 1800 200 700 or www.cancer.ie.