Before his cancer diagnoses Andrew considered himself to be fighting fit but all that quickly changed and he soon realised he needed exercise to help him heal.
In early 2010, I was 45 years old, in the prime of my professional life and totally in control of everything.
I was 185cm tall and weighed about 78kg, so I thought I was travelling pretty well on the health front as well.
That year, a routine blood test identified an elevated PSA [prostate specific antigen] score of 5.0, so my GP thought I better get that checked out. At first I brushed it aside thinking I was perfectly fine, but after some prodding by my wife I visited an urologist … just to get that ticked off. He noted a small lump on my prostate and followed that up with a biopsy. The pathology report came back clear, so that was the end of that. What a waste of time!
About three years later I had another blood test that showed my PSA was even higher. Another biopsy …. all clear again.
By November 2015, my PSA score was at 6.0 – significantly above the normal limit of 4.0. I thought, let’s play it safe and have yet another biopsy. This time, my self-assurance was splintered by a positive diagnosis for early stage prostate cancer. The good news is that it’s typically a slow moving form of the disease, with many men dying “with it” rather than “of it”. Mine was also localised and not considered a threat, so no need for surgery or radiation therapy. I had the luxury of a period of “active surveillance”. The caveat was that (at 51) I was younger than most other men with the condition, so the cancer would have more time to carry out its work.
In September 2017, almost two years post-diagnosis, the latest biopsy brings bad news. I’m one of the unlucky ones - the cancer is aggressive, and it is accelerating. I’m already past the option of radiation therapy with surgery heavily favoured while it’s still confined.
I had a fantastic surgeon. The surgery is expected to succeed, but there will be consequences. Cancer is a trade-off between an insidious disease and the fall-out from its treatment.
Anyone that has a prostatectomy will suffer some vile legacy complications that are an affront to your self-esteem, lifestyle-disruptive and, in my case, can bring on depressive episodes that cause you to withdraw socially.
Two days after the surgery, I am at home and at the beginning of the long road back. I have timed the operation to the minute. The cancer was at the perimeter of the organ and ready to spread to neighbouring healthy tissue. As bad as it seems now, I was perilously close to an even harsher reality. For the next week I have to wear a catheter, which was the first psychological blow, albeit a temporary one. Removing it was a relief, but opened the door to a deeper challenge: the indignity of incontinence.
I caught my first break a couple of days later when I stumbled across an article in the Herald Sun about an exercise program called “Ex-Med”. It’s brand new, affiliated with the Peter MaCallum Cancer Centre, and they are looking for 40 participants to take part in a pilot study aimed at using exercise as a primary rehabilitation for cancer patients.
I was accepted on the program and had my first physical appraisal in January 2018, which blew away the myth of my self-appraised high standards of fitness. Yeah, I’m tallish and lean, but apparently that doesn’t equal fit. A simple walking test cruelly exposed my limitations. So begins my 12-week fitness odyssey with nine other cancer patients.
Ex-Med provides a program tailored to your condition, treatment, age & physical capabilities. They challenge you to have specific personal goals. I had two: get over the incontinence, and achieve a level of aerobic fitness that would transform me from an average walker to a force with the running group at work.
My exercise program mainly focused on aerobic training, to keep my body weight light – to minimise impact on my incontinence – and to accelerate recovery from the surgery. I was given light, weight-based exercises to build my core strength, but that were also gentle on my abdomen, which was still delicate. I was also prescribed pelvic floor stretches to target the incontinence.
The 12 weeks were easier than I expected because I fed off the team camaraderie. This wasn’t a support group that sits around a table talking about cancer. We were doing something positive.
At the end of May, I had my exit assessment. I no longer suffered from incontinence. Six months earlier, I fretted at the thought of a crowded restaurant for fear of what could happen. I even had to prepare for the commute to work, just to be sure I could make it. Now, there are no pads and no worries. How do I know it was the exercise? Well, I know how I feel and I don’t take any tablets, which leaves exercise as one of the best cancer medication that any GP can prescribe. Oh, and that aerobic fitness thing? I’m 53 and I run the 3.8km Tan Track in Melbourne in under 18 minutes.
I am now fitter and more confident than I was prior to cancer. My resilience to adversity has never been stronger and I have re-engaged with my family & friends. I have the energy to take on more than I have ever done before. The only lingering question is why it needed three years of a cancer journey to realise how blessed I am and how fake my previous steel was.
I will always be indebted to Ex-Med’s founder and primary researcher, Associate Professor Prue Cormie. My exercise physiologist, Phoebe Jones, kept me on track the whole journey. These lifestyle outcomes are not achieved without help.