Doug’s Story:

Prostate Cancer Journey

Introduction

My name is Doug Moore, I’m 64 years old, a part-time pastor and prostate cancer support group leader in St. John, New Brunswick. I’m also a recurrent prostate cancer survivor.

My patient journey had an unexpected beginning. The Christmas of 2007, when I was 59, I was roughhousing with one of my sons and slipped, accidentally injuring myself. The pain kept lingering, so I went to see the doctor. It ended up just being a muscle sprain, but, my doctor noticed that I was long overdue for a check up. He measured my vital signs and did a digital-rectal exam, to check for prostate abnormalities. What he felt prompted him to send me to a urologist for more testing. That’s how I was diagnosed with prostate cancer.

Reaction/Choices

I was shocked by the news, because I wasn’t showing any symptoms. I had no idea that this sort of cancer often had no telltale signs. Right away, I gravitated towards the worst thoughts: what’s life going to be like, will this be debilitating, am I going to die?

At the time, my PSA, or prostate-specific antigen, level was 3.8 – at the upper limit of the normal range. However, six of my 11 biopsy samples tested positive for cancer, and my Gleason score was 7, meaning the cancer was moderately aggressive.

My urologist offered to do a radical prostatectomy, and also suggested I see a radiologist, which I did. Neither specialist pushed their area of expertise. The choice was left to me and my wife. We decided to go with surgery. My urologist believed the cancer was contained in the prostate gland, and if I required subsequent treatment, that it was best to have the surgery first.

Surgery

The procedure went well, and my PSA level dropped to 0.1. Although I had issues with urinary incontinence and impotence, they got better with time. At my one-year follow-up, the incontinence was almost completely resolved. Surgery impacted my work, since I wasn’t able to travel much, and I had to be careful for a while about how much I lifted or to take it easy when playing with my grandchildren.

Recurrence

Unfortunately, during the same one-year period, my PSA had risen, suggesting that there was some remnant cancer. I was 60 at the time, and my doctor felt that I would face growing challenges if my levels continued to go up. He recommended radiation therapy, so I had 35 treatments – five a week for seven weeks – in combination with hormone therapy.

Learning that my cancer was recurrent was a lot worse than my initial diagnosis. You get used to the idea that you’re a cancer survivor, so it’s disturbing to learn you’re still a cancer sufferer. When I had my surgery, I continued to have different options. When the surgery wasn’t successful, I played my next card – radiation and hormone therapies. If that failed, the next card would be chemotherapy. If that didn’t work, I was out of cards.

Side/after effects

After radiation therapy, I felt extremely weak and sleepy all the time. It also damaged my bladder, causing incontinence to return. This has been the biggest issue, in terms of quality of life. I was in the hospital three of four times because of bleeding and blood clots that clogged up the urethra. I take a bladder medication three times a day to help with that, and I use a catheter.

For weeks, the idea of using a catheter seemed impossible – the one they used at the hospital had a balloon you pumped to keep it in place. I thought to myself, how am I going to do that? Of course, I learned that the device you use for self-catheterization is more of an oversized drinking straw – there’s no knob or balloon. You push it in, through to the bladder, the bladder drains, and you pull it out. The whole process takes a few seconds.

Kegel exercises also help strengthen the bladder muscle, but not everyone fully recovers. I’m almost there. I’ve gone from catheterizing myself every day to every three days.

Impotence is another common side effect of treatment, because of damage to the nerves around the prostate. There are various treatment options, from Kegel exercises to mechanical devices like pumps to erectile dysfunction drugs.

  • “Please note that hormone therapies can contribute to impotence and, depending on the therapy used, may also cause hot flashes, loss of sexual desire, nausea and diarrhea.”

The more you know

It’s important to understand these and other issues that may occur after treatment, in order to deal with them properly. Resources like this website can help you understand the different terms and issues related to your disease and treatment. As a pastor, I had seen dozens of men living through prostate cancer, but I didn’t know what things like PSA or Gleason score meant.

Knowledge provides comfort. The more you know, the more you take ownership of your disease, and the less you feel ashamed. Men are more open these days. They aren’t afraid to talk about having and surviving prostate cancer. It affects private areas of our bodies and our sexuality. If you look at our female friends going through breast cancer, they’re making their need known. Men aren’t like that, but it’s changing.

Recovery

My radiation and hormone therapies ended two years ago. Health-wise, I feel strong and carry on an active lifestyle. At my most recent follow-up, the doctor said my PSA was “perfect,” so it looks like I’m in remission. I still go for tests regularly – at first every three months, and now every six months. They haven’t said I’m cancer-free or that they don’t have to see me anymore, but I’m hopeful that day will come.

The doctors and staff have been so helpful and encouraging. As tough as it has been, some positive things have come out of my experience. I used to live my life looking for tomorrow and next week and next month. Now, I find myself appreciating each day. I relate to people better. As a pastor, I visited people who were sick all the time. Being the one in the hospital bed changed my perspective.

During my recovery, I realized that I wanted to connect with people who had walked this walk. I’d also like to be involved in helping encourage men to get their prostate checked. The reality is, if I hadn’t gone to see my doctor because of an unrelated issue, I would still be walking around today, thinking I was fine. There’s little warning for prostate cancer, so you don’t want to leave your diagnosis to chance.

Support group

There had been a support group in St. John, but there wasn’t one when I was looking for one. My doctor asked me, why don’t I start one? I didn’t know anything about the disease or the language that went with it. He assured me that it was his job to explain; my job would be to talk about the experience of having prostate cancer. That pushed me to take a action. I now lead a group that meets every month, and our e-mail list has grown to 40 people. Spouses are always welcome – in fact, a lot of the men who attend our meetings were brought in by their wife or girlfriend. And women need support too.