Two days after Dr. Larry Goldenberg, founding director of the Vancouver Prostate Centre, announced the launch of the Men's Health Initiative, voters decided which candidates would serve on council in the three North Shore municipalities.
Judging by the roughly 75 per cent of the electorate who failed to vote, a majority of residents decided the campaigns were unremarkable, nothing more than the same old political rhetoric.
That was disrespectful to all candidates and especially to Ron Polly, a 52-year-old mayoralty candidate in the City of North Vancouver who, despite being diagnosed with prostate cancer earlier in the year, saw his campaign through to the end.
Although some might suggest his dedication was foolhardy, it became obvious in the conversation Polly and I had last Wednesday that making decisions while dealing with prostate cancer is difficult - for health professionals too.
What follows is a peek into the most intimate details of one man's encounter with the disease. In Polly's words, it is "a down to earth account of my experience in the hope it will persuade more men to pay attention to their health."
According to the Canadian Prostate Cancer Network, paying attention means that men between 40 and 45 should "get a preliminary PSA test to serve as a benchmark" against which future tests can be evaluated.
CPCN also recommends men "get the actual PSA tests from their physicians," rather than settling for a general response such as "You're fine."
If you are curious, and I hope you are, a discussion of PSA and the normal ranges for PSA levels in various age and racial groups can be found at www.cpcn.org.
Polly's own story began 10 years ago when his father received a similar diagnosis at age 72. Still living with the condition, he had said nothing until he was told of Polly's diagnosis --not a good idea because that family history doubled Polly's risk of prostate cancer.
Fast-forward to September 2010 when, during a routine physical, Polly's PSA tests registered 7.9 ng/ml (nanograms per millilitre).
Although he had no other symptoms, not only was 7.9 a dramatic increase from his previous test, it was more than double the high end of the normal range for his age (2.5 to 3.5).
But PSA tests have something in common with women's mammograms: depending on what is going on in a patient's body at the time of the test, there can be false negative and false positive results. More confusing still is that, while "positive" does not necessarily mean cancer, the reverse can also be true.
According to CPCN, although people ". . . might conclude that the PSA test is not useful because it is unreliable," this is a mistake. "An abnormally-high PSA level indicates the possibility of cancer, just as a suspicious . . . area of a mammogram indicates the possibility of breast cancer in a woman."
So erring on the side of caution, his family doctor decided Polly should undergo a biopsy of his prostate gland at Lions Gate Hospital.
The March 2011 procedure revealed cancer in only one of the 12 zones tested. Diagnosis: low-risk prostate cancer, clinically insignificant.
But bearing in mind that both patient and physicians were still in the dark about Polly's family history it was fortunate that the recommendation was for active surveillance, including PSA tests and an annual biopsy.
"Oh, joy," as Polly put it. In May, again erring on the side of caution, Polly was referred to urologist Dr. Martin Gleave at the Vancouver Prostate Centre for further evaluation. That led to a second biopsy in September that showed cancer had spread to five of 10 zones sampled.
The clouds were gathering - and fast.
Devastated, Polly's only real option was surgery.
Nevertheless, he delayed the surgery until Dec. 19, took a chance and decided to go ahead with his run for the mayoralty seat.
That was not, he told me, because he expected to win, but because he wanted to raise important issues he believed voters had a right to hear. Raise them he did, right through to election day.
While losing in the polls, the gods made sure Polly won out when he rolled the dice on his health. The pathology report showed the cancer had not progressed beyond the perimeter of his prostate.
Being Polly however, that doesn't mean he is fresh out of issues - and his passionate new message might outstrip the importance of politics by a country mile.
"I was lucky," he told me. "Had I not had the PSA tests and biopsies when I did, had the cancer gone beyond the prostate, we wouldn't be talking here today.
"Somehow," he said, "men must be challenged to visit their doctors regularly, to get that baseline PSA blood test - and the digital exam recommended by VPC doctors and CPCN - before their 50th birthday."
"We need to persuade Premier Clark that covering the $35 cost of a preventative PSA test under the Medical Service Plan is not only the right thing to do for families, it would be far cheaper for the health budget than the cost of caring for a cancer patient in an acute care bed."
Sound logic; after all we fund mammograms, don't we?
Thank you, Ron, for sharing your difficult story. If, by its telling, you persuade only one man to seek that test, your message will have
succeeded. [email protected]
