By Cathalynn Labonte-Smith
At 1:25 pm on September 2nd, I think of my daddy, pale against a surgical table, a blue hospital cap hiding his nearly transparent white hair, a mask gently placed on his face while he inhales the sleep-inducing vapours and counts back from 10. The surgical team waits for him to go under with their arms folded.
I imagine him in a private room later that evening after his nearly four hour surgery, because it’s the year 2020. Due to the COVID pandemic hospitals are closed to visitors, even family.
My mother calls around 7 pm to let me know that he’s fine and that his surgery went well. A nurse contacted her from the hospital. Relief washes over me. After two years of waiting for this moment, countless scans and re-scans and other tests and delays due to COVID, at last my dad has this tumour removed.
Attention Men and those Who Love Them
Men do you know what your PSA is? If you’re male and over 45, a simple blood test will give you a base line Prostate-specific antigen (PSA) test. This test is used with a digital rectal exam to screen for indications of prostate cancer. (Only men have a prostate gland; a doughnut-shaped gland between the bladder and penis, surrounding the ureter.
Prostate cancer is the most common cancer among Canadian men (excluding non-melanoma skin cancers). It is the third leading cause of death from cancer in men in Canada.
– Canadian Cancer Society
Of all the times over the years that he’s been told by his proctologist that his prostate is abnormal, why did this walnut-sized organ harbour an aggressive cancer during COVID?
It is estimated that in 2020:
– 23,300 men will be diagnosed with prostate cancer.
– 4,200 men will die from prostate cancer.
– 64 Canadian men will be diagnosed with prostate cancer every
day.
– 11 Canadian men will die from prostate cancer every day.
– Canadian Cancer Society
The pandemic meant that his treatment would be delayed, as the hospitals weren’t working at full capacity to reserve space for the potential epidemic. Also, it meant that my mother wouldn’t be able to accompany her nearly 80 year-old husband when he received treatment. In the immediate future, it meant that the diagnostic scan appointments he required would take longer to procure.
Dad lives in Powell River, BC, so this meant that travel to every appointment to his specialist, every scan and treatment by ferry and car. The 85-minute ferry trip from Powell River to Comox isn’t the most reliable of routes. Partially because of the open water crossing is prone to cancellations due to storms. Also, the brand new ferry to Texada Island has broken down, so the Comox ferry has to fill in, shearing off two sailings per day indefinitely.
It is estimated that about 1 in 9 Canadian men will develop prostate cancer during their lifetime and 1 in 29 will die from it.
– Canadian Cancer Society
Fortunately, the BC provincial government subsidizes travel to medical appointments by ferry, plane or other means, so Dad doesn’t have to pay for the ferry and when a companion needs to accompany him. Although, he does have to pay for gas, meals, hotel (if necessary), and other related travel costs.
Nada Laser Treatment for Canadians
Dad asked his doctor if laser treatment was an option. Laser focal ablation clinics claim to destroy tumours with heat generated by lasers, offering less invasive therapy with no longterm negative side effects, like impotence and urinary incontinence as evidenced in a University of Texas study.
His doctor said, “No.”
Dad says, “It was the Canadian ‘No’. It’s not available in Canada.”
Instead, Dad was offered hormone therapy to shrink the tumour before treatment, chemotherapy or radiation; the latter two would be administered at the Victoria Cancer Clinic. Brutal rounds of chemotherapy in another city didn’t appeal to him. The chemotherapy he may not be able to withstand until the end of the treatment, because of an underlying condition and his age. Radiation would involve implanting thousands of radioactive seeds in the affected area and could cause painful inflammation that could cause urinary and other problems. The cure seemed worse than the disease in both cases. Dad also declined the hormone therapy that suppresses the male hormone of testosterone that stimulates the growth of prostate cancer due to it’s unpleasant side effects not unlike menopause (source https://www.mayoclinic.org/tests-procedures/hormone-therapy-for-prostate-cancer/about/pac-20384737) , including:
- Loss of muscle mass
- Increased body fat
- Loss of sex drive
- Erectile dysfunction
- Bone thinning, which can lead to broken bones
- Hot flashes
- Decreased body hair, smaller genitalia and growth of breast tissue
- Fatigue
- Changes in behaviour (moodiness)
- Problems with metabolism
I contacted the Canadian Cancer Society on chat regarding laser treatment of prostate cancer for Canadians. “Cathy” said,
The treatments that are available in the USA may not be available here in Canada. Due to the difference in our health care system, people may have to pay for certain procedures which may make them more available there. . . In Canada, the treatment plan is set out the oncologist who reviews all the medical data that he or she or the team has sent the cancer patient for and they will base their decision on many factors.
She gave me a link to the latest research being done in Canada, an article about lasers used in conjunction with light-sensitive drugs derived from seabed bacteria. This treatment is just in the research stage. There’s nothing online about using lasers guided by MRIs in Canada, as is being done in the US to treat patients now.
After talking to other men who had gone through treatment of the same condition, it seemed to Dad that surgery was the better option. However, because of his age he had to undergo additional tests to see if he was fit to withstand the anesthesia. The tests showed that his physical age was 10 years less than his chronological age. The specialist approved his surgery.
I feel sad for those over 23,000 men a year who can’t access a treatment for their prostate cancer, that has a higher chance of leaving their bladder and sexual functions intact, if these laser treatment clinic claims are true. So the question is, how do we get laser treatment for prostate cancer patients in Canada?
There are fundraisers, of course, like prostate cancer run/walks, that are virtual right now because of the pandemic. Several are coming up on October 4th in Ontario, for example. There is one in Vancouver on Father’s Day, that’s still accepting donations for 2020 at: https://www.prostatecentre.com/node/320. Donations can be made to the Canadian Cancer Society at: https://www.cancer.ca/en/donate/?region=bc&s_srx=cancer.ca-navbar-en
Other strategies could be prostate cancer patients asking their doctors about the laser treatment, and asking their provincial and federal governments for it to be made available as a treatment option either in Canada or to be sent to the US for the treatment.
Hospitals with No Visitors
Dad was dropped off by a family member at the door of the North Island Comox Hospital on the morning of the long-awaited surgery. It was about a year from his diagnosis to the day of his operation. No one was allowed to go in with him to check him in. It has to be one of the worst feelings of the world to have to see an elderly parent walk into a hospital for major surgery by themselves.
None of us could be there to hold his hand when he was in pain, bring him ice or a blanket from the warmer, adjust pillows, call the nurse when his IV bags were close to empty, break up his day with chit chat, organize a TV in time for America’s Got Talent, or to just sit quietly in the corner watching over him until needed.
He doesn’t use a cell phone, iPad or laptop to communicate. We hoped there’d be a phone in his room, but would he remember the number to call to organize the ride home? He called Mom when he was up to it. There was some confusion about the cell phone to call to arrange the ride when he got discharged and which day he was to go home. There was a mix up with ordering the TV, perhaps he missed his shows. But Dad was stoic, as usual. He didn’t want to inconvenience the nurses, so it worries me that he went without some comforts during his stay, or at least waited too long for help.
I asked him how it was being there without Mom. He said, “It’s nicer to have a relative in the hospital. But it would’ve been an inconvenience to Mom to be there. She would’ve had to find someone to take care of the animals,” he said.
“We could’ve taken care of the dogs, and fish, and birds. We offered so that she could at least be close by,” I protested.
“I don’t like to inconvenience people,” he said. For a short stay, it was tolerable, but for an extended stay I can’t imagine how difficult it is for the patient and their family without visits. Those with loved ones in long-term care facilities, or who have to stay in hospital for long stays have my deepest sympathy at this impossible trying time.
I’ve had many major surgeries and hospital stays. I don’t know what I would’ve done without having visitors to break-up the boredom and lift my spirits. Having your partner being able to visit at any time is such a comfort when you’re in hospital, but that’s my experience.
Dad overheard the nurses commenting that they like the hospital without visitors around bumping into them and asking for directions. He said it made for a quiet stay without the comings and goings of visitors.
I wonder if after COVID there will be more visitation restrictions. It is true that visitors can be nuisance to the smooth running of a hospital. Some patients have a never-ending cast of loud visitors, who steal all the chairs scraping them along the floor, use the patient’s bathroom, much to the annoyance of the other patients sharing the room trying to rest, are in pain, or need some privacy.
But visitors also lift the spirits of patients and can form a sense of community in a shared room. Especially if they bring gifts, like home-baked cookies, chocolates, or a get well card, for both their loved ones and the roomies. Or if they bring in a calm adorable pet to visit the patients, that the nurses have cleared prior to the visit.
Visitors also increase the risk of the spread of contagious diseases to patients and vice versa. Will this pandemic make hospitals and care homes rethink visitors and put limits on visitors like they haven’t before?
Having spent time in isolation rooms myself, where everyone has to put on PPE before entering, perhaps that will become the norm when visiting patients? Rather than completely banning visitors post pandemic? Or a combination of limiting visitors to one immediate family member with PPE precautions? It’s hard to imagine hospitals going back to the open visiting policies they had on most wards in the past.
Dad arrived home four days after his op after a draining trip home in his camper van. Luckily, he could sleep on the bunk in van in the ferry parking lot for a few hours while waiting for the ferry to arrive, as well as on the ferry. Most patients just released from hospital after surgeries or illnesses have to wait uncomfortably in their cars.
I was at his home a couple days prior to his release helping prepare for his arrival. We assembled a new 75″ TV in his TV area on the main floor, and got in the supplies and prescriptions ordered by his doctor.
Dad couldn’t say enough nice things about how he was treated at the hospital from the nurses and his doctor, to the food services and janitorial staff.
“It’s a sweet little hospital,” he said.
Dad was pale and weak after this trip and had lost weight after not eating for days. He went straight up to bed to start the healing process. The worst part for him was the pain caused by the catheter.
A few days later when it looked like he was settled in and Mom had everything she needed to care for him, we returned home to Gibsons–a 40-minute drive, 45-minute ferry ride, and another 75-minute drive away from Powell River.
I’ve checked in with them by chat or phone most days. After about a week, Dad turned the corner and his pain eased off. After 10 days he was finally able to come downstairs to enjoy his gigantic TV complete with headphones.
Tomorrow, 12 days post-surgery, Dad will once again make the journey to Comox to his doctor’s office for his post-surgical follow up and more importantly to have the tortuous tubing removed.
If laser therapy was available in our country, he could’ve been spared this whole ordeal. He still has months of healing ahead of him. It’s unknown as to what extent he will regain full function and what complications he may have due to the surgery. However, his prognosis is extremely good.
The Write Cup 