“A world in which no-one has to say: ‘If only I had known sooner’. A world in which no-one ever has to say goodbye too soon."

Elizabeth Holmes

It’s some years since I eased back on manual work on the farm.

Since then, as much as age allows, I have tried to keep fit by pumping iron at the gym twice a week, using a Nordic track cross country ski machine and walking. An important part of my fitness regime was an annual check-up at the local medical centre.

In 2020, after the usual routine tests, although I hadn’t had any problems, I asked the doctor if I could have a relatively new test, the Prostate Specific Antigen (PSA) test for prostate cancer. I had read about it, but the doctor had never made me aware of it.

The test showed that my PSA, a hormone secreted by my prostate, was on the high side, so the next step was to have a scan and biopsy. The biopsy, done under a local anaesthetic at the Borders General Hospital, involved entry though my rectum and 12 samples being taken from the gland.

The result came back that six samples on the right side of my prostate had aggressive cancer. The description 'aggressive' should be explained as many prostate cancers are stable. If a patient is elderly, it may not affect him before he dies of something else.

My cancer required immediate treatment. The good news was that it was still contained in my prostate and hadn’t spread into other organs or my bones.

As a bonus, the Western General Hospital, in Edinburgh, was among the world’s best in treating prostate cancer. Despite Covid, there was no waiting list.

I was given appointments with a surgeon who explained the procedure, benefits and side effects of surgical removal of the prostate and with another who explained the pros and cons of treatment by radiotherapy.

Comprehensive literature and CDs of the interviews with the surgeons were provided by the NHS to help me decide. I opted for radiotherapy which was less convenient, but seemed to have fewer side effects. A friend, around the same time, opted for the surgical removal of his prostate and is doing fine.

The next step was to reduce my testosterone, which feeds the cancer, through a course of hormone tablets and four hormone injections into my stomach.

The effect of these was that I experienced something like the female menopause with hot flushes. I lost my body hair but not the hair on my head and my six-pack disappeared under fat.

Over the early months of 2021, I had various scans. Three tiny gold seeds were implanted into my prostate under local anaesthetic. These enabled the surgeon to target the cancer more accurately and minimise damaging surrounding tissue.

Then, for 23 working days, four and half weeks in all, I received the first part of the treatment, external beam radio therapy (EBRT). Using bullseyes previously tattooed on my stomach, I was positioned exactly on a bed.

After that, a huge machine revolved round my body, stopping periodically to deliver a radioactive ray from different angles at the tumours. I was fully clothed except for my tummy. The procedure was painless and took about 10 minutes.

Ten days after the EBRT, I returned to the Western General for the final part of the treatment, brachytherapy. Until recently, this involved implanting radioactive seeds into the prostate.

Over time the radio activity dwindled away. The seeds, their job done, remained in situ.

Very recently a further development of this procedure had become available, which not only hits the cancer harder but has fewer side effects. This latest machine had only been in Scotland two months. I was the second man in the country to be treated by it although the surgeon had used it previously in Canada.

Because the operation took seven hours, I was given an epidural rather than a general anaesthetic. My body had no movement or sensation below my waist and I remained fully awake.

Taking a bearing from the previously implanted gold seeds, the surgeon penetrated my prostate though my perineum, the area between my rectum and my genitals, with 18 fine steel tubes. This part of the operation took two hours.

For the next three hours, I lay absolutely still while the surgeon, using advanced computerised technology, calculated exactly how much radioactivity to beam down each tube. The last part of the operation involved inserting radioactive filaments into my prostate via the tubes.

After half an hour, the filaments, tubes and a template which had been stitched onto my skin to guide their siting, were removed. The job was done and over a few hours feeling returned to my lower body.

My recollection of the experience was that, while it was sometimes uncomfortable, it was never painful. The support from doctors, nurses and radiographers – in fact, the National Health Service in general was magnificent.

In the short time since my treatment finished, some significant advances have been made in the detection and curing of prostate cancer. While the PSA test remains the gold standard, computer analysis of subsequent biopsies using ‘Galen’ technology now gives much faster and more accurate results than the human eye.

The completely new Nanoknife administers electrical pulses though electrodes into the tumour. This destroys the cancer without any cuts or incisions. The technique is simple, quickly learned and enables surgeons to carry out twice as many operations as traditionally.

New hormonal drugs, often combined with those currently used, can significantly prolong survival in these with advanced cancer and vaccines are being developed to prevent it altogether. Despite all those breakthroughs, the best cure of all remains an early diagnosis.

At present, ladies are reminded when their mammograms, or cervical smears are due. No such reminders exist to warn men that cancer may be developing in their prostates.

A consequence of this is that many men are unaware of where their prostate is and what it does until it goes wrong. Some 11,900 men die annually in the UK from prostate cancer.

When I asked the doctor for the PSA test, I was in excellent health with no sign of a problem with my water works. Had I waited for a further year, the malignancy might have leaked into other organs and my bones which would have been much more serious.

As there is no national screening programme for prostate cancer, it is up to every man over 50 to take charge and request the PSA test. This simple and easy step taken in time may be the difference not only in length but also quality of life.