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Ray was in his mid 60s and enjoying a healthy, active retirement when he was diagnosed with prostate cancer. He decided to have surgery, and later radiotherapy, to try and treat his cancer.
What made you first go to the doctor?
I went for a thorough general check, because I was 65. I asked for a bowel cancer check, ECG, blood pressure and any other tests, including a prostate test.
Did you have any symptoms?
That's the odd thing; I had no symptoms and no reason to suspect anything was wrong. Most men don't think about it.
What happened after the tests?
Part of the test for prostate cancer is a digital rectal examination, and the doctor could feel a lump on the prostate and the PSA (prostate specific antigen) was at a level that required investigation. When he told me that I had prostate cancer that really shook my system, because when you're told you have any form of cancer, your world is turned upside down. Particularly when you have absolutely no symptoms.
How did you react at the time?
The urologist said, 'You have three options; you can have an operation, radiotherapy or you can do nothing at all'.
I said, 'The third option seems pretty good to me, what happens if I do nothing at all?' He said, 'Well, you mightn't be here in 12 months' time'. We had to wait until the biopsy was healed before we could do the operation (about six weeks) and, in the meantime, I had to take pills designed to hold the cancer at bay.
What he didn't tell me was that the pills would kill my libido. I could no longer have an erection and I didn't know it. It wasn't until about 10 days later, my wife said to me, 'Is there something wrong with me lately? What has happened to our relationship?'
We were very sexually active and I realised I wasn't paying her the normal attention. That was a result of taking the pills, but I only found that out after a long time. I just wished he had said to me in the first place, 'This is the side effect'. Then I would have been prepared for it and expected that reaction.
How successful has your treatment been?
The doctors tell you there is a good chance you might be impotent. There is also a possibility that you can be incontinent after the operation, but that is nothing as long as you can live. I had the operation and it takes two to three months before you are back to anything like normal. About three months after the operation I thought, 'Well, things are starting to get back to normal. I'm cured and everything is going to be okay', but it didn't turn out that way.
What happened?
If the cancer is totally removed with the prostate, then your PSA will remain at a low level (or virtually nil), because there is no prostate cancer there to drive the figures. I watched the PSA tests very closely and, after six to nine months, the figures started to go up. The urologist said we had better think of some further treatment and recommended that I had radiotherapy. He suggested 33 daily treatments of five per week, about a six or seven week course, which is very debilitating.
What was the treatment like?
The first couple of treatments are pretty horrifying, but then you get to know the people who are with you there and form a little group, have a laugh and it's okay.
The doctor had said, when I asked him, that there is about a 25 per cent chance that radiotherapy will get hold of what has spread from the cancer. Twenty-five per cent is better than zero per cent, so I took it. I had some nausea and later on some diarrhoea, and I got very debilitated and tired at the end of the treatment, and it was not possible for me to drive myself every day.
I have been on hormone treatment now for 18 months. It's four years since they discovered the cancer and I'm feeling very well and positive, but how long that will go on, one doesn't know.
How has it affected your life?
You do have a changing attitude to life. You are very thankful for every day. Those who are positive tend to make the most of every day. Do all sorts of things. All the things you've ever wanted to do, enjoy life, get stuck into any projects, because you don't know how long you will be able to do it.
There are some who are negative and, being in this situation, they say, 'Well, we can no longer participate in life. We know it's short; we'll just take it easy and do nothing at all'. Those people tend, in the main, not to live as long as those who are positive, so there is an advantage if you can have a positive attitude to life. That, to me, is the only way to go!
How has it affected your relationship with your wife?
There is no sex life once you are impotent. There are other ways in which one can be loving, but in my case she has accepted the fact that our life has changed and we are perhaps more like brother and sister.
In some ways, we have possibly grown a little closer, a little more understanding and a little more forgiving, if one might say that, for little things that crop up in life. But she feels as though she has been cheated and I can understand that. She also understands that it is not my fault that this has happened. It is just one of those things of life. A bad penny that's turned up!
How important is your relationship with your doctor?
It is important to have a network of medical support. The relationship with the doctor is very important. I have a good doctor who I can talk openly to. He knows I want a copy of every test that is done and I keep those in a file and discuss them with him from time to time. If you can't be totally frank, then you should go to another doctor.
I think it is tremendously important to have a team of people helping you who you can refer to and, if you don't get the right answer from one, you may get it from another.
Traditionally, men are not good at investigating their own illnesses. Does that play a role in prostate cancer?
One of the symptoms is a tendency to frequent urination, particularly at nighttime. If a man has to get up two or three times a night, it may indicate that his prostate is becoming enlarged. It doesn't necessarily mean prostate cancer, but even that should alert a man to do something about it and have it checked out. But we don't do anything about it, as a general rule, until it becomes really bad.
How do you feel about your future now?
I think if you keep positive, keep involved, keep your mind on doing the things that you want to do, and get out and about and enjoy life as much as you can, that's the way to view your future life. I don't care if it ends in 12 months, two years or three years - I'm ready for it. I don't think that my wife has accepted that fully and that's a little sad, but we try to make sure that our affairs are in order and do the best we can in the meantime.
A support group is of great help. We have a lot of fun, we laugh. We had our meeting the other day with a lady from the Cancer Council and we all said, 'Well what a lovely lady she was, but we could do nothing about it'.
If you could say just one thing to someone who has been diagnosed, what would it be?
I would say make sure you get a second opinion and try to contact somebody who may have it. The other thing is, for goodness sake, take an interest in your problem. Having prostate cancer is not a death warrant that is going to happen overnight. It is a slow-growing cancer; you have plenty of time. If you manage yourself well, you will have plenty of time to enjoy whatever time you have left to the maximum.
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