To say my children that I have cancer was the most difficult conversation I’ve ever had
In June of this year, Paul Henderson received test results that showed increased PSA levels (prostate-specific antigens). In this weekly diary, he will share how life is in the following weeks: the tests, the scans that fear and how it is when you have to sit down with your loved ones to discuss the possibility of cancer.
It was a warm, sunny day in mid -June, shortly after 2:30 p.m., and I was sitting with my wife Marilyn in an inconspicuous doctor’s office in the Whipps Cross Hospital. After we had carried out tests, scans and biopsies for suspected prostate cancer in the past two months, we were almost certain that the news would be bad. But no matter how prepared we thought we would hear the words, the formal diagnosis met both hard.
After the first shock, I tried to collect as much information as possible. Armed with a notepad and pen, I asked what I hoped were the right questions and tried to process what came back. In a quick episode, Dr. Chowdhury, I have adenocarcinoma, the most common type of prostate cancer; that it was in the middle of stage or in level 2, which means that it had spread beyond the prostate gland, but not on the lymph nodes or beyond; And that my Gleason score 7 (4+3) was, which indicates a medium -sized to high risk of spreading cancer.
“Your cancer definitely looks treatable, but we have to book it for a bone scene to make sure that he has not metastasized,” said Dr. Chowdhury. “It looks unlikely, but we have to be safe.” And if it spread to the bones, I asked. “That makes things more […] complicated.”
The conversation only lasted about ten minutes, but felt equally irrelevant and monumental. This advice was undoubtedly one of many that the doctor had, but at that moment it meant everything for Marilyn and me. We went to the parking lot in silence and then held up. After all the waiting and anticipation, we finally had the news that we feared. And now I had to face the moment I’ve been afraid since April – and told our children.
Although we live with the possibility of a cancer diagnosis for two months, we decided not to say Nyah (22) and Fox (19) until we knew what we had to do. Nyah lived at home after graduation last summer, while Fox studied in Durham for his study exams in the first year, and we did not want to distract him from his studies. We also believed that it was important to break the news together. It was the most difficult conversation I’ve ever had.
The day after he came home, we both put them down and I told them the bad news. When it came to saying the words “I have cancer”, the C-word caught in my throat. After the initial shock we all landed in tears. Fox hugged me when his life hung away. With 6 feet 3in and with wide shoulders, he is larger than his old man, but at that moment he was a little boy again. I kept him closer than in years. Then it was Nyah’s turn; She buried her head in my shoulder and pressed hard. They then alternately changed Marilyn. I was incredibly proud of them all because they were so brave.
As soon as the initial shock had decreased, we spoke. I explained the situation as best I could and tried to be as positive as possible. I didn’t draw it, but I also wanted them to feel optimistic. Although the tumors in my prostate, especially on the left, were quite large, the forecast for cancer in stage 2 is very good. Most patients, over 97 percent, survive at least five years and it is highly treatable. I am relatively young (56), fit and healthy, so I was not panicked, I calmed her down.
You then asked the same question: What happens next? That was a little more difficult to answer. At the end of my consultation, when the doctor had told me that I had cancer, he explained that I had two treatment options. I would have to choose between the operation to remove the prostate or radiation therapy to try to kill the cancer cells. To make this decision, he referred me to the St. Bartholomew hospital, where I would meet specialists from both areas to discuss the best way forward.
In the meantime, while I was waiting for my appointment, there was the little matter of the bone scene, which could simply change everything …
Frequently asked questions
Answered by Prostate Cancer UK Specialist nurses
1. What are the different types of prostate cancer and is there a type that is “worse”?
Most men who were diagnosed with prostate cancer have a type known as adenocarcinoma. However, there are some much rarer forms of the disease. Since these are unusual, they were not examined so extensively and we know far less about them. Some of these rare types of cancer can be more aggressive, which means that they grow faster and spread to other parts of the body. In many cases, men with a rare form of prostate cancer also have a certain adenocarcinoma.
The rare types of prostate cancer include:
Neuroendocrine tumors (small cell or large cell)
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Transitional cell carcinoma
Some of these rare types of cancer do not cause PSA values. As a result, you may not be detected by a routine PSA blood test. The diagnosis can therefore only occur if cancer has already spread outside the prostate, often after a biopsy.
2. What is a Gleason game?
After a prostate biopsy, the tissue samples are examined by a specialist called histopathologist under a microscope. You check for the presence of cancer cells and describe your results in a pathological point.
Cancer cells in the prostate can look different, depending on how likely it is that they grow and spread. This appearance receives a Gleason degree that resembles between 1 and 5. Grade 1 and 2 normal prostate cells and is usually not reported. Prostate cancer is generally rated as Gleason 3, 4 or 5. The higher the number, the more aggressive the cancer is likely.
The Gleason point number consists of two numbers:
The most common degree that can be seen in all samples.
The highest other class in the rehearsals.
These two numbers are put together, the most common note is listed first. For example:
If most cancer cells are pattern 4 and the highest other pattern 3 is, the score is 4+3 = 7.
A score of 3+3 = 6 usually shows a very slowly growing cancer.
A score of 7 indicates a faster growing cancer, whereby 4+3 are generally more aggressive than 3+4.
The values of 8, 9 or 10 indicate that faster growing, more aggressive cancer spreads.
3. What does it mean when cancer metastasized?
You may hear the terms metastated, metastatic or advanced prostate cancer. These mean all the same – that cancer has spread from prostate to other parts of the body. This occurs when cancer cells flow through the blood or the lymphatic system, so that cancer is no longer contained in the prostate.
In this case, prostate cancer is no longer curable, but treatments can be offered to reduce cancer and to slow down growth or to prevent further spread such as hormone therapy. In recent years, research has developed a number of new treatments for advanced prostate cancer, which means that men thankfully live longer than ever.
Metastatic prostate cancer can sometimes cause symptoms in the areas he influenced, for example bone pain, anemia or problems that come in the urine. At this stage, additional treatments may be necessary to tackle these symptoms and not the cancer yourself in order to improve the quality of life and to keep the patient as pleasant as possible.
4. How should you talk to your children about your cancer diagnosis and treatment? Is there support for you?
It is never easy to bring the news to relatives where prostate cancer was diagnosed with them. It can be particularly difficult if this conversation with your children is together. Even if they are young adults like Paul’s children aged 22 and 19, a parents’ disease can shake their world.
Men often tell us that they are not sure how to best approach the conversation. Although there is not a single “right” method, you will find some guiding principles here that help you navigate you so that your family feels loyal and remembers that everyone approaches these conversations differently.
Choose the right moment
Sometimes it helps to wait until you have a clear treatment plan before talking to your children. This could mean that tests and consultations enable time. The conversation can feel less insecure for everyone if you have answers, e.g. B. “This is what I have and that’s how we will handle it”.
Choose a time when you are not interrupted and later leave space to think. It is common for questions to come hours or even days later. So get involved in you regularly. Some men also consider what could still happen in their children’s life – exams, travel, big events – if they choose the timing.
Take into account in view of their age and experience
The way you speak is naturally different, depending on whether your children are young, teenagers or adults. In young adults, they may be more open about the details of the diagnosis and treatment, while they still adapt their words to their emotional readiness.
If you have previously experienced illnesses in the family, you will recognize this, but remind you that every situation is different. Above all, be honest. Children, regardless of their age, often feel when something is held back, and the uncertainty can accept fear. Keep them up to date. Even small updates – “I had my appointment today; you don’t have to see me again for six months” – can help you imagine the worst.
Support for you and for you
It’s not just you who need support. Your children can benefit from talking to a consultant, a medical specialist, a trustworthy person at school or reading information for family members. Organizations such as Maggies, MacMillan and Fruitfly Collective have more information about talking to children about a cancer diagnosis. Encouraging them to seek help is not a sign of weakness. It is a way to strengthen the whole family.
Cancer is discouraging, but openly with their children can deepen trust, reduce fear and help them stand together with the trip.
Recognition of emotions: yours and theirs
Let them know that it is okay to feel anxious, angry, or insecure. If you name emotions, you can feel less overwhelming.