The results of the biopsy were inconclusive. Of the 12 samples taken, two had a shade of prostatic intraepithelial neoplasia and one had a touch of atypical small acinar proliferation.. The consultant told me this, as if I should know what this meant. Or rather that I shouldn’t – because this would have made me as clever as he was. Which would never do. I asked him to spell them out so that I could write them down, which he rather liked. “OK so that’s PIN and ASAP” I abbreviated. I’m not sure he liked that, his expertise abbreviated to a couple of soundbites. Either way, the very good news is that “you do not have high-grade cancer”.
The one ASAP was apparently more worrying than the two PINS. “Something is going on but we are not quite sure what” he explained. Or rather he didn’t explain. It could be pre-cancerous, it could be that it was cancer, but they weren’t quite sure. One thing I have learned through this process, is that medical diagnosis is as much about uncertainty as knowledge, about opinion as much as fact. And consultants add a medical mist to make every thing more mysterious.
The long and short of it was that he wanted me go another round with my close friend the biopsy probe. A second machine-gunning of my prostate. 12 more samples would – by the law of randomness – probably hit 12 different parts of my prostate. My wife, slightly perturbed by the word “random” wanted to understand this more. She is a woman of order who likes everything in its place – including it would appear – the needles in her husband’s prostate. Even if she had to insert them herself. She asked for clarification.
The consultant sighed a little impatiently, opened his small notepad and started to draw equidistant dots – four in a square and then two more to make the six of a dice. OK OK, we got the idea, we said. But he carried on regardless – slowly but surely making up the 4 x 3 of the 12. It was hard to tell whether he was bored, patronising us or just a little OCD.
And so I was booked in for a second biopsy, two weeks later – because by this time they deduced my prostate would have just about recovered from the first attack. Little did it know. Talk about hitting a guy where it hurts.
Before that, I had to endure the small matter of a Cystoscopy. This was all part of the programme of treatments following my original bladder infection. Gentlemen, do not Google this as the diagrams will bring tears to your eyes. Suffice to say that a man in a white coat inserts a camera through a very small tube in, order to have a snoop around your bladder. How small can a camera be? Well, tiny, but not quite tiny enough, if you want my opinion.
Before the painful part, a very nice nurse had me strip off behind a curtain and put on two gowns – one for the front facing backwards and one for the back facing forwards. Once I had mastered that little exercise, I had to empty my bladder. Next she took my blood pressure – which a I suspect was rather inflated. Then she put a clip on my finger and measured the amount of oxygen flowing through to my finger tip. I was impressed at 98%, until she said that most people could push it up to 100% with a couple of deep breaths. I like a challenge.
Well I managed 99%, so hey, not half bad. She claimed my pulse was 50-something which surprised me. She told me not to worry about it being so low – her husbands was 40 something and he was a triathlete. I didn’t mention that I was surprised how low it was, not how high.
So I walked away with my fashionable double-apron and a pair of shoes, like an extra in some Two Ronnie’s pantomime sketch. The consultant was a lovely old guy – understanding, sympathetic, reassuring and communicative. The sort of guy you would trust to insert a very small camera on a wire into a highly delicate part of your anatomy. This was absolutely not the time for the apprentice, the masochist or the surgeon running behind schedule. He led me into the day surgery, and I lay in the bed whilst he peeled back the apron. I close my eyes and thought of . . .
Fortunately he was in and out like a shot, and the retreat was less painful than the invasion. A quick look around inside, and “nothing to see here”, he assured me.
I lay in the bed afterwards composing myself and trying to restore what little was left of my dignity. I looked for consolation from the nurse, “My wife says nothing is as painful as childbirth, what does she know, hey?”. Her smile suggested that maybe mankind has a significantly lower pain threshold than womankind. But then, what would she know? I’ll take gas and air next time, or an epidural.
Back to my original friendly first nurse for comfort tea (in a proper cup) and sympathy. I was feeling a little better – until she insisted that I pass water again. “But I just did that 10 mins ago” I meekly protested, before shuffling off to the toilet like a child obeying his mother.
My relief at my ability to pass water fluidly without blood was immediately – well drowned – by the return of the previously mentioned AGONY (remember I mentioned AGONY?). “Ow Ow OW” I ventured again through gritted teeth and everything. Three “Ows” I gave it on the richter pain scale. I was in a private cubicle, nobody could hear me this time. Always better to suffer alone.
I tried to compose myself, emerged into the ward and staggered back to my chair – resisting the strong temptation to squeeze myself where it hurt on the open ward. She suggested painkillers might help. I said that I had forgotten to bring them with me. Foolish me. Did she have any? The desperate pleading in my eyes eventually worked, and she popped me a couple of paracetamol. “Maybe you have a particularly thin urethra?” she offered – words I never expected to hear. “Maybe I do” I said out loud , and thought inwardly “and probably a little longer than yours”.
My second biopsy two days later was a comparative doddle. I think I gave almost enough detail of the first one to avoid the need for repetition. It was infinitely less painful than the cystoscopy and half the pain of the first biopsy. Maybe it was the two painkillers, cleverly taken before the insertion this time. Or maybe the consultant was a little less enthusiastic. But it was fine, and a different nurse this time kept me talking about football at the respectable end of the table.
I was nervous before I went in – and glad of my wife chaperoning me through to the correct ward. Anxiety seems to make the simplest tasks unfathomable. We had come in separate cars, as she had a large class of small children to teach later, and if we were more than an hour, she would need to drive home without me. But fortunately, this time we waited only 20 minutes before my name was called.
“Here we go again” I thought. The re-trial jury has decided, the second verdict is about to be announced. There is a piece of paper with my name in it and a new set of scores for another 12 slithers of my body. Here come the results from the second round of voting.