Cancer has always been a difficult subject to talk about, but tackling the barriers that keep the disease taboo has become an increasingly important part of helping people survive and cope. As part of Male Cancer Awareness Month, ex-serviceman David Howarth has shared his experience of being diagnosed with cancer twice with Yorkshire Cancer Research.
“My father always said you don’t have a day off work unless you’re in the hospital,” says David, from Pontefract. “This is still the way most men think around here. We need to get more blokes to open up about their health.”
David, an equity release advisor at Age Partnership, was first diagnosed with cancer in 2011. The 58-year-old grandfather had passed blood while going to the toilet and decided to call 111, the free NHS helpline for urgent medical help.
Tests found an abnormal growth in his bowel called a ‘polyp’, which turned out to be cancerous. He began a course of radiotherapy, followed by surgery to have the polyp removed.
David said: “I didn’t really twig I had cancer at the time. I just thought unless I get a six-month warning that I’m going to die, I shouldn’t worry about it. You’ve just got to carry on the best you can.”
After his radiotherapy, David was told the news that he would need to have the lower section of his large bowel, called the rectum, removed. This meant he would be fitted with a permanent stoma – an artificial opening attached to the bowel that allows food waste to pass out of the body. The waste is collected in a bag, which needs replacing regularly.
“My operation didn’t go too well initially,” David explains. “I had wounds that took a long time to heal. When I first saw the stoma, I was scared to death of touching it. It took some getting used to, but thankfully I’ve had no further complications.”
David’s second experience with cancer happened just four years later. He noticed he was passing urine more often, and mentioned this in passing to his doctor. Having already been diagnosed with one type of cancer, David had become aware of the symptoms of other cancers and knew this might be something to worry about.
A blood test, known as the ‘PSA test’, showed raised levels of a protein called ‘prostate-specific antigen’ in his blood, which indicated that he might have cancer. He was referred to hospital and a small sample of tissue, called a biopsy, was taken from his prostate. The biopsy contained cancerous cells.
“I was told the cancer was advanced and that I couldn’t have radiotherapy treatment because I’d already had that for my bowel cancer and it could cause too much damage to healthy tissue,” David says. “My first thought was that the bowel cancer had spread, but they told me I was just unlucky – it was a completely new cancer. Ironically, I felt relieved, then I wondered what I’d done to deserve two lots of cancer. But after that I just had to see what the next steps would be.”
David underwent an operation known as a ‘prostatectomy’ to remove his entire prostate gland. This resulted in him becoming completely incontinent. After two years of wearing pads and leg bags, he had further surgery to fit a small device called a mechanical sphincter, which means he is now able to control when he urinates.
Earlier this year, a routine test once again showed raised PSA levels, and David discovered that the prostate cancer had returned. With radiotherapy not an option, doctors told him that his cancer could not be cured and he would be given palliative care. This sent alarm bells ringing.
“My wife and I were shocked. You hear the words ‘palliative care’ and you immediately think ‘let’s get a room booked in the hospice.’ The truth is palliative care doesn’t mean you’re going to die. I could die from natural causes before the prostate cancer kills me.”
David now has his PSA levels tested every three months. He also undergoes a scan every six months to check how his cancer has progressed. Eventually, when the tumour has reached a specific size, he will be given immunotherapy, a new type of cancer treatment that boosts the body’s natural defences, to supress its growth. Immunotherapy drugs are part of routine practice for some cancers and are currently undergoing clinical trials to see if they work for prostate cancer too.
In the meantime, David is focusing on getting life back to normal, enjoying holidays with his wife and attempting to regain his previous fitness levels, which once saw him running 100 miles a week. Despite living with a colostomy bag, he has enrolled on a 16-week high-intensity interval training (HIIT) course, which involves short bursts of rigorous exercise. His ultimate aim is to complete a marathon before the end of the year.
David’s efforts have been hindered by an old back injury from a 13-year career in the armed forces, which included serving in the Falklands War and the first Gulf War. He’s also trying to overcome the effects of diabetes caused by damage to his pancreas during radiotherapy. However, he firmly believes that being physically fit can not only help in the healing process but also prepare cancer patients for future treatment.
David devotes a large part of his life to sharing his experience with medical professionals and other patients in the hope that he can help to improve quality of life for those diagnosed with cancer. He is a member of a bowel cancer support group called ‘Bottoms Up’, which meets in Castleford and Wakefield.
David explains: “I take part in patient focus groups and I’ve recently started going into Pinderfields Hospital to talk to newly diagnosed patients about what they can expect. I break the ice by telling jokes, and try to remind them that it is possible to get back to a normal life. When doctors communicate, they often forget the human side of things. I’m trying to bridge that gap.”
Cancer has become a topic of conversation in David’s office. He’s encouraged a colleague’s dad to be tested for bowel cancer, and he’s eager to raise awareness of the national bowel screening programme, which involves a home testing kit and helps detect cancer early. Participation in the programme is low, with 4 in 10 people in Yorkshire failing to complete the test1. At the moment, men and women aged 60-74 are invited to take part. David would like to see the age lowered to 50.
“It can be difficult to get men to open up. It’s hard to break the barrier down. When I give talks about my experience, the women always have their hands up, but the blokes just sit quietly,” David says. “We need to make people aware that they don’t need to be afraid of cancer. People are surviving a lot longer. If the cancer is caught early enough, there can be a good outcome. The problem is that people don’t come forward enough. Talking about it is the first step to changing that.
“The other side is making GPs more aware of the signs and symptoms of cancer so they know when to refer people. In the end, early diagnosis costs less to the NHS. Part of it is getting individuals not to panic and go to the doctor, and the other part is making sure that when they do go, they get the tests they need.”
For more information about cancer in men, including the signs and symptoms to look out for, please visit the Yorkshire Cancer Research blog at www.ycr.org.uk/malecancer.
1. PHE, National General Practice Profiles, Cancer, https://fingertips.phe.org.uk/profile/general-practice/data#page/0/gid/1938132829/pat/46/par/E39000029/ati/152/are/E38000001/iid/92600/age/280/sex/4
Contact: Nikki Brady, Senior PR Officer, Yorkshire Cancer Research. Tel: 01423 877228. Email: firstname.lastname@example.org
Notes to Editors
- Harrogate-based Yorkshire Cancer Research was founded in 1925 and is the largest independent regional cancer charity in England (Registered Charity 516898). We are not part of a national charity.
- We are committed to reducing the devastating impact of cancer on the lives of people living in Yorkshire.
- Our mission is to work in partnership, fund research and support initiatives that will help people in Yorkshire avoid, survive and cope with cancer.
- Current statistics show that 575 people are diagnosed with cancer in Yorkshire every week. Incidence and mortality rates are higher than the England average due to social deprivation, post-industrialisation and lifestyle choices but also availability of healthcare services and difficulties accessing early diagnostics, clinical trials and the latest treatments.
- We aim to:
- Be the leading authority on cancer in Yorkshire, understanding the problems and priorities in the region and sharing knowledge with partners.
- Raise awareness of cancer and how to prevent it by working in local communities, schools and colleges, sports clubs and with other health-related organisations.
- Promote screening programmes and fund research that can improve the diagnosis of cancer so we can detect and treat it at the earliest opportunity.
- Invest in innovative research projects at every stage of a cancer patient's journey.
- Campaign for fair and equal access to the very best healthcare services and a greater share of the money spent nationally on research.