From Malignant to Remission my story.
Year 2009. I had a good life and successful career serving in the Malaysia army for 36 years. Having retired ten years ago, I was at the prime of my life, fit as a fiddle and with annual hospital certified clean bills of health to boot. I have the normal diseases of Hypertension, Diabetes, Osteoarthritis and High Cholesterol that came with age. All under control with exercises, diet and medication.
I was not aware that I was sleeping with the enemy for the past several years. Sure, I had some urinating problem that came with prostate enlargement. It was men talk that it was all right and nothing to worry about. It was just an inconvenience; eating pumpkin seeds will solve the problem.
Doing a PSA test and biopsy in late 2009, proved my good health was only skin deep. I should have known better than not to have PSA tests earlier. I paid the price for not listening to the advice of my family members. I was diagnosed malignant at stage three local advance.
I was offered, and opted to undergo my medical treatments for cancer at HUKM Cheras. My oncologist said the magic words “ You are curable.” He then proposed a dual modality treatment for me, comprising Zoladex hormone injections for three years and 32 daily sessions of radiotherapy.
I do not recall if my initial shock and denial stage had caused any trauma affecting myself or my family. My wife and I immediately went on a short holiday in Hatyai, Thailand; knowing fully well, that I would soon be tied down going to the hospital for treatments. I was positive throughout my ordeal. I had clear and objective discussions with my urologist and oncologist during every of my hospital appointments.
I have since then started to do wide readings into cancer on a daily basis. I was particularly interested in holistic and other comprehensive treatments for cancer. It was during my six weeks of daily radiation sessions at HUKM that I had seen and met many other cancer patients. All of them, without exception, were in a state of despair and low morale. They all looked miserable, unsmiling and had abandoned all self-esteem. Such was the profile of most cancer patients.
I am glad that I am strong and positive from day one. My leadership training in the army, quick knowledge acquisition and strong support from family members and close friends were a great help to my confidence and in my fight against cancer.
I had fought back and survived to celebrate life. Having been there and done that, I now have a strong calling to help others who are less fortunate than me. I have the empathy, dedication and skills for my new role in my life.
Today, after ten long years as I toiled in my journey with my prostate cancer, I beat it. I am in remission. I am thankful to God, the medical team in HUKM and IKN, and everybody who had been part of my journey. I wish to write this article for others to read so that they may be more confident with themselves in their own journey with prostate cancer. I shall mainly describe my strategy, activities and my personal thoughts for the past ten years.
To begin with I wasn’t really traumatised nor shocked as most people would. I accepted cancer as with any other medical problem. I had believed that our hospitals would be able to cure me. I did not realise its seriousness until I started to read into the disease. My father who was 80 plus years old had actually died from prostate cancer. I did not relate its genetic impact on me and my siblings. I had left it to the hospital to sort me out so to speak. I could not afford to see any private hospital specialists as I know the cost would be exorbitant. I am really glad that I am a pensioner and would have free medical treatments at government hospitals.
I left the decision of what treatment was best for me to my Oncologist because I had absolutely no idea. Zero. I am very thankful that my Oncologist in HUKM was quick and decisive. As soon as he had described the problem to me, he had said “you are curable”. I listened to his treatment plan without really understanding fully what it entails. So I just followed faithfully his prescription for EBRT radiation and three years of hormone therapy. I was lucky to have some acceptable side effects. Erectile Dysfunction being the most serious and the constant hot flashes till today. It is OK for that as I am still alive and I did not get incontinence, a side effect I dread most.
Hopelessness, fear and uncertainty started to set in slowly during my journey as I meet other prostate cancer patients and as I read more into it. Sadly I began to loose a friend or two to prostate cancer now and again. I feel for them and their families. They deserved more from life. How did I cope ? It was so hard to get by. I kept thinking on how do I balance Fear with Hope? I dreaded each quarterly appointment for my PSA tests, particularly on the day before and prayed that my PSA would not rise. I am thankful that my PSA held on well albeit rising in small quantities.
I began to have a personal understanding of prostate cancer. I understand that, whilst prostate cancer is life threatening, it is a very slow growing disease; but there are exception. The PSA reading is not a prostate cancer marker per se. An exceptional rise may be caused by cancer, but many other activities can rise or lower the PSA reading. I had learnt not be intimidated by our PSA reading. I had learnt the significance of my cancer staged at 3 local advance and of my Gleason score of 3 plus 4. In the course of my journey, I read intensely from books purchased and also from the libraries.I also browsed the internet relentlessly, I find there are as many theories as there are writers and most of the studies presented conflict and are sometimes confusing. I am also very thankful and grateful to family members and friends giving me comfort and telling me what is good or not good. But sadly whilst they mean well, these advice comes from people who do not have prostate cancer, nor do they know much about the disease.
Conventional primary medical treatments are very effective to treat and manage prostate cancer. Survival rates are almost 100% for the first five years after treatment. Secondary treatments for prostate cancer relapse get more complexed and difficult, particularly when the prostate cancer had spread out to distant sites. I am hopeful and confident that should I have a relapse later, there would be new medication and approaches to tackle the problem. I am already 76 years old and I cannot expect too much.
I believe and affirm fully to our Sarawakian Ranger Regiment’s battle cry “ Agi Idup Agi Nglaban” if there is life there is fight. With knowledge and confidence I decided to have my personal plan to maintain a status quo with the remaining prostate cancer cells which I believed had survived my primary treatments. I am now responsible to myself to fight the prostate cancer. I know that exercises and toning my body would be top priority, eating well and getting a balanced diet are just important and also that God will answer to our prayers. I write a personal blog www.feelgoodfeelinggood.blogspot.com to keep track of my knowledge related to prostate cancer. I joined and participated in prostate cancer support groups to share and contribute whatever I can. The hardest part of my plan is still personal discipline to do what I need to do daily. How do I regain my penchant for life again? How would anyone with prostate cancer? I will try my best to live my life as best as I can and I will try my utmost to forget about my rising PSA reading. I am now into remission and I feel fine. My new PSA baseline for 2016 is 0.18 and it has plateaued out at 0.19 for the past nine months in 2016. A new PSA baseline in 2018 is 0.36 and in 2019 it is 0.92. Year 2020 baseline was 1.5 and 2021 baseline was 2.37.Doubling time decreased to about 12 months. A PSMA scan in March 2021 showed no metastasis. My PSA as at April 2021 was 3.07. It is slowly rising but I am managing and coping well.
You may read more about my personal battle with cancer in my posts herein. It is purposely and appropriately written in military speak and in real combat situations.
Do not deny yourself or your charge of help needed. Fight back. Join your local support groups.
