I was so sure that there wasn’t going to be a problem that I didn’t even go with Wayne the day he was diagnosed with prostate cancer. Instead, I was sitting in a local park sipping a latte and playing with my son. After all, Wayne had only just turned 40 and the day was clear, crisp and sunny. It was only later, when I heard the crunch of his car on the driveway at a time when I knew he was supposed to be returning to the office that my heart thudded up into my throat and my feet started running towards his car. His face was stricken and his eyes were brimming with tears. As I slid into his arms he whispered one little word, “cancer” and closed his eyes. I don’t really remember anything else for hours after that.

Wayne turned forty in May and took himself off the GP for a general check-up in the interests of good citizenship. We were slightly worried about his cholesterol, which is stubbornly high despite his slim frame and active lifestyle. The GP took blood to monitor this, and requested a Prostate Specific Antigen (PSA) check at the same time. PSA is part of the “juice” that the prostate makes that the sperm ultimately swims in. PSA is all good and well when its in the prostate but the fact that its in your blood indicates that for some reason, the prostate is leaking. The PSA results came back as being 4.6 which is more than twice the level it should be for a man of Wayne’s age. Still, the statistics were firmly in our favour and we prepared for news of a hyperactive prostate or perhaps an infection, and Wayne was sent to see a urologist to have further tests.

Wayne’s urologist recommended a biopsy just in case, and we conceded especially after a second PSA test showed his levels had crept up to 4.8. The biopsy was done under general anaesthetic and two days later Wayne fronted up to receive the results. As I said, we were both confident of a good outcome and the resulting diagnosis just knocked us sideways. To my uninformed head, prostate cancer was an old man’s illness and Wayne, with his beautiful, athletic body and healthy lifestyle was not even vaguely a candidate for this awful thing. We have always eaten well, lived well and exercised. We wear hats and sunscreen. We fasten our seatbelts. We don’t smoke. Wayne is as slender and beautiful as an Olympian and has run more marathons and ultra-marathons than I care to recount. According to the literature, we’ve done everything right. So how do we get our heads around why this is happening to us? 

As I write, its only around a month since we found out the diagnosis and I know that we’re still at the very beginning of this horrible journey. But already I’m exhausted. Wayne seems to be handling it stoically, ploughing through the recommended reading and asking informed questions, meeting with doctors and prodding insurance brokers for answers, ticking all the boxes on his to-do list. I’m just trotting along beside him, trying to look useful but unable to hear anything or do anything except be confounded by the deafening white noise in my head. I feel like a deer in the headlights, stupefied and useless and about to be hit head-on by something colossal and unforgiving.

Wayne, and I’m sure all men with PCa, faces a brutal series of choices about how best to treat this. Some men choose to do nothing, an option termed “watchful waiting” in the hope that diet, lifestyle and homeopathic treatments might be able to contain or reverse the cancer until a more preferable treatment option becomes available or the cancer remits. But this seems unsuitable for us, since Wayne’s tumour is relatively aggressive and any time we spend waiting is only giving the cancer time to do more damage. There are several radiation treatments, some more appealing than others but the option that seems most suitable in our case is a radical prostatectomy, or the surgical removal of the prostate. On paper, it looks beautiful. If the cancer is contained in the prostate, and you remove the prostate then you have no more cancer. QED. In reality though, we face some small but nevertheless frightening potential risks including incontinence and impotence, which must be devastating for Wayne to contemplate, and not that great for me either I might add.

We have also learned that Wayne’s case is quite exceptional, in that he is so young. It is not unheard of, of course, but it is unusual for a man in his forties to have it. In fourteen years’ experience, our specialist’s youngest patient ever was 49, until Wayne came along and, at the age of 40, shattered all the record books.

As far as I can tell, Wayne’s experience so far has been a fruit salad of uncertainties including being confronted by a new knowledge of mortality, the prospect of surgery and its many awful implications. And these are mine too, but woven through them are other peculiarities, like the guilty memory of a sunny park when I shouldn’t have been there, the antiseptic smells of waiting rooms and crying behind the steering wheel of my car. Waiting is a curse, second only I guess to actually enduring the treatments. And yes, I am keenly aware of how I am making this about me, when it is Wayne’s disease. Of how I am feeling sorry for me when he is the one who needs to go through it. But the way I see it, I might not be the one with the prostate, but I do have a ring on my finger, a beautiful blue-eyed baby boy to take care of and a very large lump in my throat. Prostate cancer is not just a man’s disease, that’s for sure.

Something else that is now inevitable, and for me devastating, is the news that Wayne will be permanently infertile after the operation, regardless of whichever treatment option we choose. This is an emotional hurdle I never anticipated, and something I’m finding peculiarly difficult to deal with. I know we will always have IVF options and are almost certain to be able to have another baby, but it’s the intervention that bothers me, the removal of choice and the lack of a natural process. For some strange reason I am grieving the tiny pink person we have been trying to conceive, and who is now unavoidably delayed. This little detail has tripped me up more than any other news we’ve received this far.

So where to next? For the time being, we have booked the radical prostatectomy surgery for Tuesday 6 September, and have been told by many medical practitioners that we have every reason to expect the best possible outcome. But Wayne will require a lot of time off work, and it doesn’t really take away our anxiety as we consider the potential risks. Then there’s also the tough logistics to be negotiated, like time off work and babysitters while we bank blood and sperm, or while we consult with any number of doctors, nutritionists and support groups. At the same time, its financial year end and we both have our own companies and must churn out all the reports that the systems demand. Our personal tax returns are also due, while at the same time we wade through the requirements of our health funds and insurance companies. Then there’s work, which is busy for both of us, and the demands of a hopelessly active toddler. Yes, I am desperately stressed, I admit, and not always dealing with this in a way that I am proud of.

Part of me feels like that, if things were fair, the clocks would stop and the blinds would cover the windows and the whole world would converge on our house offering endless shoulders to cry on and whisper wise words of support. They would nod understandingly as I howl and fling furniture at the walls, and pat me on the back and make me cups of tea. In an ideal world Wayne and I would have nothing else to do but focus on each other and beating this thing for once and for all. But the reality is cruelly different, and life goes on, and we must fill out the forms, meet the client’s deadlines, remember where we parked the car and find something to cook for dinner. I would like to do nothing except lie with my head in Wayne’s lap and listen to his breathing and the rain pelting against the glass. Instead, I sit in traffic and thump my steering wheel, I wait in line at Medicare and cry into the onions. This is the most brutal thing I’ve ever had to do.

One of the small ways we’ve managed to feel proactive during this whole messy business is to inform ourselves as much as possible. As I type Wayne is reading one of eight text books on the subject that we have borrowed or bought or stolen. We have scoured the internet and the local library and we’ve started attending a prostate cancer support group that is offered by our hospital and has been absolutely invaluable. I have learned so many valuable things that I wish I had known five years ago, which would have given us some defense against this dreadful disease. But then again, I must concede that had somebody told me this, I would have dismissed them as a new age hippy freak health nut and not given it any more thought. Ah yes, hindsight is 20/20.

Something I am grateful for every day is that when detected early, prostate problems are almost never a death sentence. In fact, in healthy people where the disease is caught in time the success rate of treatment is almost 100%! On the other hand, if we had waited a few years before becoming aware of this problem who knows what kind of dreadful thing we might be facing. We will now be forever committed to annual check-ups and hugely grateful to the medical professionals who picked this up before it became an even more serious problem.

While it’s impossible to know absolutely why cancer happens to good people, we have learned that there have been a lot of contributing factors such as previous illnesses, stress levels, deficient diets and so on. I read an excellent metaphor that likens developing cancer to playing a poker machine at the casino. You get one strawberry, and nothing happens. You pull the lever again and get two strawberries. Nothing. But sometimes the odds stack up exactly and you get five strawberries in a perfect line and bingo, the lights begin to flash and your life is changed forever. So while I waffle on about the things that might have contributed to Wayne developing prostate cancer, bear in mind that its never just one thing, but a domino effect of systems out of whack that put pressure on other systems, and there is still an awful lot of random, brutal luck involved.

One of the principal contributors to prostate cancer is the wrong diet. Similarly, certain types of food are amongst the most powerful remedies, as effective as any sophisticated cancer drug and a whole lot more pleasant to consume! Perhaps one of the most effective in the case of prostate cancer is the innocuous little tomato, especially when cooked because the cooking helps release lycopene and selenium. Lycopene is the red pigment in tomatoes and a powerful anti-oxidant shown to be associated with decreased risk of chronic diseases such as cancer and cardiovascular diseases. We now try to eat tomatoes every day. Other foods too, are wonderfully potent. These include all soy products, especially soy beans and also garlic, ginger, broccoli, cabbage (in fact, all cruciferous vegetables) and fresh fruit. Vitamin D is also marvelously effective, and this can be obtained in safe doses from a good multi-vitamin and around fifteen minutes of sunlight a day. Turns out the properties of green tea are nothing short of miraculous, bearing in mind it does contain caffeine but also some very powerful anti-oxidants called polyphenols that can actually kill cancer cells. Unlike ordinary tea, the leaves in green tea have been steamed after picking, and are not fermented. This makes a difference. An added bonus is the role green tea can play in maintaining a healthy body weight. Polyphenols are also found in smaller amounts in regular tea, coffee, red grapes, kidney beans, raisins, prunes and red wine.

There is a herb called Saw Palmetto which is available from health food shops. It has an excellent track record in promoting a healthy prostate, but you should make sure you tell your doctor you are taking it because it can “mask” PSA levels in the event of a pre-existing condition.

Then there are the “bad” foods, which can potentially compromise your body’s resistance to cancer. I am the biggest fan of a well cooked fillet, but I have been deceiving myself. I now know that I should have been reducing, or eliminating red meat from my family’s diet. One of the strongest links with promotion of prostate cancer (and other types of cancer too, particularly breast cancer) has been established as being dietary fat especially animal fat. Many tests have confirmed that a diet rich in red meat and animal fat leads to higher death rates from prostate cancer. This has something to do with arachidonic acid, an omega-6 fatty acid found in animal fat which is converted by prostate cancer cells into a hormone that actively promotes the development of the blood vessels (angiogenesis) that cancer tumours need in order to grow.

Similarly, being derived from animals, it is beneficial to reduce or eliminate all dairy products as well (she types, sipping her tea with milk. I never said this was going to be easy.) Milk’s main purpose is to provide sustenance for baby cows, which double their birth weight in the first forty days or so of their lives. In order to achieve this, milk contains all kinds of growth hormones, proteins and other things that promote rapid growth in doses too high for a healthy human body to successfully process. On the other hand, it is ideal food for rapidly growing tumours. Even cows don’t drink cows’ milk once they reach adulthood! I’ve always thought that dairy was a responsible thing to consume as a woman at risk of osteoporosis, but I never stopped to think where the cows were getting the calcium from (the grass, of course.) Then there are all the other things that are pumped in to the cows in order to promote and maintain the massive production of milk quantities, including female hormones (which in the wrong doses play havoc with our reproductive systems, hence their possible contribution to prostate, breast and ovarian cancer) as well as antibiotics. These disruptive agents are just as prevalent in the meat from dairy cows (usually found in mince and hamburger meat) as they are in milk. One book I have read goes so far as to say that dairy has as much of a role to play in prostate cancer as nicotine does in lung cancer.

On the subject of bad food, white foods, such as white sugar, white flour and highly processed foods promote the wrong kinds of insulin levels in your blood, and over a prolonged amount of time this too, significantly increases your cancer risks. Look, I’m not a doctor or a nutritionist but if you think there might be some sense in the various things I’m saying then why not undertake a bit of research of your own.

Then there’s the role of stress, one of the many “strawberries” that can contribute to the onset of disease. In our case, as our nutritionist pointed out, we have been subject to a lot of stress in recent years, even if we weren’t able to articulate it at the time. Wayne has been divorced, we have immigrated and are raising a baby who has been ill and doesn’t sleep much. We are remote from our families and Wayne in particular is easily stressed by his environment and circumstances, as those of you who know the “sergeant pillowslip” story will attest. Intense and prolonged stress has been shown clearly and specifically to be associated with the onset of cancer. This is because oxygen available to the tissue cells is decreased because of elevated blood fats and increased blood thickness which follow stress. Similarly, stress decreases oxygen available to the protective white cells of the body's immune system, thus debilitating them. In turn, the immune system, having been constantly stimulated by stress, becomes exhausted and impotent, allowing other potential hormonal upsets to occur. In this condition, the body's defensive white cells, although capable of destroying the cancer cells, make no effort to do so.

Now, I know you’ve heard it all before, but your lifestyle itself is the most powerful drug you will ever employ as part of a cancer prevention strategy. Please don’t smoke. If you do, consider quitting for the sake of the people who love you. Make sure you exercise in order to maintain healthy bones and organs, even ten minutes a day makes a huge difference. And with all the fervour of the newly reformed, I believe that meditation too promotes a positive mind-set, a calmer mind and a healthier body.

Do I sound like a doomsayer? I don’t mean to. It’s just that it has finally hit home to me how fallible my body is after all, despite the decade or so of parties, alcohol and reckless driving during which I was convinced I was immortal. And even more fragile than my body is my heart, which is bruised and straining under the weight of this appalling cargo. Good health is such a blessing, and my responsibility is more than just to myself, but to everyone who has ever told me that they love me.

I’ve already mentioned the mountains of reading we’ve undertaken as a way of coming to terms with this disease, and arming ourselves for the recovery. As part of this process we both read Lance Armstrong’s Its not about the bike which I highly recommend to everyone. In this book, Armstrong makes mention of a patient who taught him that cancer survivors are, in fact, the lucky ones. While this raised my eyebrows at first, I am beginning to make a murky sense out of that statement. For me, a shock of this magnitude teaches several things; how I have taken my body and my health for granted for so long and why I shouldn’t, about who my friends really are, and about what’s really important to aim for every day like a kiss from my child, a letter to a friend or a glass of wine with my husband while we listen to the rain pelt against the glass.

I have heard the clichés many times before, like how I will never lie on my deathbed and wish I had bought a flat screen TV, but this rings true all the more clearly now. I have had to completely re-think what is important in my life and possessions, crippling workloads and bad traffic are not part of this. As I hope I have shown, cancer has been a terrifying, humbling and strangely life-affirming experience. While I don’t want to take anything away from what Wayne is going through, and has yet to face, I must concede that this has been just as harrowing for me as it has been for him, and I know the same is true for his family. Illness is insidious because it doesn’t just attack the patient, but the hearts and spirits of everyone around them.

And hence the purpose of this typically long and rambling mail; I may not have a penis or a prostate, but I can still get the willies. And now that I know better, I will do better.

Thanks for listening.

Love, Andrea, Wayne and Sebastian.

xx