One year ago today I was diagnosed with prostate cancer by my family physician of 42 years, the phenomenally skilled Dr. Brad (“call me Brad”) Fritz, who in 2016 also diagnosed me with my first rare form of terminal cancer, hilar cholangiocarcinoma, more commonly known as Klatskin’s tumour, a type of bile duct cancer.
My latest cancer diagnosis arose from a concerning PSA — prostate-specific antigen — blood test, an early detection of prostate cancer, that would require an MRI, followed by a biopsy of my prostate, to confirm Dr. Fritz’s diagnosis.
At the time, I was told that there would be a 3 month wait for an MRI (magnetic resonance imaging) test. By month’s end, I was told that the wait for an MRI was one year, and offered the opportunity to have a $2500 MRI at a privately operated clinic, not covered nor funded by the province’s public medicare system.
My annual income is $25,000. I would require more than one MRI. Paying privately for an MRI was simply out of the question.
I thought to myself, as a long time supporter of the NDP, “If David Eby or Adrian Dix were diagnosed with prostate cancer, would they have to wait a year for an MRI?” Not likely, I thought. Neither did I believe that either of these two gentlemen would avail themselves of a private MRI, given the optics of the situation.
As such, my coverage of last autumn’s provincial election took on a distinctively — and utterly out of character — harsh tone on VanRamblings.
Note should be made that prostate cancer is the most common form of cancer for men, with a five year survival rate of 90% for most forms of prostate cancer, and 37-50% for Stage 4 cancer. I kept thinking to myself, “What if I have Stage 4 cancer —which proved to be the case — if I have to wait a year for an MRI, and longer than that for a prostate biopsy, what are the chances I would even be around for an MRI appointment a year from the date of my original diagnosis?”
I spoke with the constituency staff in David Eby’s office — he’s my MLA, I’ve worked on all of his campaigns — who shrugged when I told them of my dilemma, telling me there was nothing they could do for me, I’d just have to wait.
I will note that the response of David’s constituency staff on this occasion was completely out of character for any of his past, or present, constituency staff, a one time aberration for an overworked constituency staff, too often subject to concerning — often fear inducing — protests outside of his constituency office.
My friend Kelly Ryan — a one-time host of CBC’s As It Happens — was none-too-pleased with the response of David Eby’s constituency staff. Neither was she overly pleased with the level of Dr. Fritz’s advocacy — who I believe and know to be the best, most caring, most skilled and most competent doctor in the city, who has always been an advocate of the first order for me, dating back to 1983.
As the weeks went by, Kelly (“Men! They just don’t know how to take care of themselves. They require a strong woman to advocate for them”) insisted I make a follow up appointment with Dr. Fritz, which occurred on December 5th, an appointment to which she accompanied me, none-too-happy about the circumstance, nor Dr. Fritz. I had a PSA test conducted at the LifeLabs clinic across the street from Dr. Fritz’s office, the week before my December 5th appointment.
Sitting in Dr. Fritz’s office, he expressed alarm. The results of my PSA test was off the charts, requiring immediate emergency action on his part. Right then and there, he contacted VGH and attempted to make an emergency MRI appointment for me. Fortunately, there was a cancellation in the prostate clinic biopsy clinic at VGH the next morning at 3:35am, which I was more than happy to attend.
The three MRI technicians who performed the MRI were outstanding. Dr. Fritz received the results of the MRI later that week, and made an early January appointment with uro-oncologist Dr. Miles Mannas (“Raymond, he’s the best. That’s why I’m referring you to him. If, as I believe will prove to be the case, you require surgery to remove your prostate, he’s the most skilled surgeon, and will provide you with the very best care. You’ll be in good hands with Dr. Mannas”).
Dr. Fritz made an appointment for me with Dr. Mannas for early January of this year. Dr. Mannas, in turn, made an appointment for me for a bone scan at VGH, to determine if the prostate cancer had spread. Even before my appointment with him, and the biopsy he would conduct, Dr. Mannas believed that I had prostate cancer. The only question was, how severe was the prostate cancer?
The good news. The bone scan indicated the prostate cancer had not spread into my bones, unlike poor Joe Biden (who, given the results of his bone scan, indicating spread, has 5 – 7 years to live). The not-so-good news: my Gleason score was 9, as bad a score as is possible (no one has a Gleason score of 10). The prostate cancer was so severe that neither radiation nor chemotherapy would be offered. The only route: surgery, preceded by months of hormone therapy. Surgery to remove my prostate is schedule for mid-November.
One of my concerns about the surgery — my second surgery ever, my first surgery the removal of my tonsils at age 4 — was the loss of my sexuality, long an important part of my life. That concern was soon put to rest. With the 4 apalutimide tablets I take each morning, along with 4 Zytiga tablets — each of the tablets is huge, and hard to swallow — as well as the prednisone tablet Dr. Mannas has prescribed that I take each morning, all of the testosterone in my body has been knocked out, my sexuality gone, obliterated. And you know what: it’s no big deal, I had nothing to fear or be concerned about. In fact, it’s kind of a relief. I have been very, very lucky in my love life to have been loved by strong, beautiful women of accomplishment and great intelligence, and consider myself to have been very, very fortunate in my romantic and sexual life.
The other salutary result of the medication I’m on: my latest PSA test indicated a negligible result, perfect for my upcoming prostate surgery.
The down side to all the medication I’m on (more on that tomorrow) is that I am constantly fatigued, have a difficult time getting out of bed in the morning, and conducting the affairs of my life. To some great extent, I have become incompetent in the conduct of my life, when for many years I considered myself to be “a man’s man,” able to take on any chore, with a ready approach to any challenge.
No more.
Fortunately, in addition to acting as the best possible advocate for me lo these many months, my friend (and saviour) Kelly Ryan has afforded me the opportunity to “co-parent” Teague the dog, only the friendliest, most loving waggly tail dog in the whole world, a loyal companion who I take for several walks a day most days, when I might otherwise remain prone on my bed fatigued and lifeless all day long, my iPad by my side, who resides with me on occasion — as he did for most of July and early August, and for much of this past week.
Writing on VanRamblings, keeping up with daily posting has become all but impossible. The only things that keeps me active on VanRamblings are the prospect of Kareem Allam becoming Vancouver’s next Mayor — a man I believe to be brilliant, skilled, humane and well-schooled, the most sophisticated political operative I have met in the 60+ years I have covered politics, a charismatic political figure — who believes in and practices the politics of joy — who fills me with hope for our world, who I believe will emerge as a transformational Mayor for our city next year, as well as our nation and perhaps beyond in the years to come, our best Mayor since Philip Owen, or going back to the 70s, Art Phillips.
And for the next six weeks, writing about the Vancouver International Film Festival, long our window on the world, and most cherished arts festival.
In the past, whether covering municipal, provincial or federal politics, or my most beloved VIFF, it was not unusual for me to dedicate 20 hours a day attending political events or festival screenings, arriving home to write about each until 5am, creating videos, or transcribing interviews. No more.
I am all but bereft of energy.
I have 8 weeks remaining on my daily regimen of apalutimade, Zytiga and prednisone — which Dr. Mannas tells me is at the seat of my daily fatigue / lack of energy — in the lead up to my mid-November prostate surgery. Post surgery, it will probably be another 6 to 8 months before any semblance of energy returns.
How do I feel? I feel lucky. I feel fortunate to have a roof over my head within a housing co-op I have called home for 41 years this year. I feel fortunate to be surrounded by my Co-op neighbours, the finest people it has ever been my good fortune to work and enjoy life with, who couldn’t be more supportive and caring. I feel gratitude to VanRamblings’ many readers who hang in with me despite all.
Now, Dan Fumano — PostMedia’s first rate civic affairs reporter — will be disappointed with me (as will Charlie Smith, the once upon a time superb editor of The Georgia Straight) for writing at too great a length today. “Raymond, keep your columns at 750 words. Any longer than that and you’ll lose readers.” I proffer an apology to Dan, to Charlie and to you.
Sadly, my prostate cancer is the least of my health woes. More tomorrow.
