Alex had some non-malignant prostate problems in 1993, which were treated successfully, however his PSA was monitored regularly after that. Early in 1997, Alex’s PSA rose from 7 to 11. His doctor referred him to a Urologist who performed a digital examination which found a lump. A biopsy revealed cancer of the prostate with a Gleason score of 5. As Alex says:

"I was dismayed at this and was about to have dinner with my wife and daughter. I did not alert them to the news until, at the end of the meal, my wife remarked that we had not heard from the Urologist. I then told them the news, but insisted that while we were not dealing with a "hair cut gone wrong," I absolutely wished the whole affair to be handled lightly. No tears! No "poor Daddy!" No "how unfair!" Because none of that would be of use, and would only serve to lower our quality of life. At this stage I would not allow them to discuss the situation with friends or relatives, as this also would be to no point. I insisted we face facts and get on with doing something positive.

"The Urologist ordered bone scans and cat scans and various X-rays to determine if the cancer had escaped the prostate capsule. The results seemed to confirm the cancer was contained in the prostate only. His advice was that, at Gleason 5, I could not just ignore the cancer and some course of action had to be contemplated as we could assume the cancer was aggressive. I was not happy to go the surgical route, because I was doubtful all the cancerous tissue could be removed beyond doubt. Also, probably illogically, I was worried that the operation itself may set off secondary cancers which could exacerbate the original problem.

"The second option of "external beam radiation" I also dismissed because as the prostate, bladder, urethra and bowel are so close to one another, it is impossible to "zap" the prostate satisfactorily without doing damage to the other organs. This would most likely involve incontinence, impotence, and pain and distress with bowel movement. I was not game to take this risk. The third option was brachytherapy, where radioactive seeds are introduced directly into the prostate in such a pattern as to cover the extent of the cancer, but leave surrounding tissue unaffected. This seemed to be an elegant, sophisticated solution, which appealed to both my technical and artistic upbringing. Something like the "bypass". All the above three solutions seemed to have comparable success rates but the brachytherapy the least side effects,

Alex was referred on to another Urologist who specialised in Low Dose (seed implant) brachytherapy, who said the constraints for this type of brachytherapy were:

* Prostate volume to be 40 c.c. or less,

* Gleason Score to be 6 or less.

* PSA of 10 or less but circumstance could allow some lee-way on this.

* Cancer to be confined to the prostate capsule.

* Life expectancy of at least 10 years.

Alex continues: "Fortunately I was in good physical condition, playing tennis two or three times weekly and going to the gymnasium twice weekly. The fly in the ointment was that my prostate volume was calculated at 63 c.c. I was put on hormone treatment in October 1997, to starve the cancer of testosterone, stop it growing, and hopefully to shrink the prostate back to 40 c.c. At this stage I reviewed my financial affairs, so that in the event of failure, my loved ones would be able to continue to enjoy life in the manner to which we had become accustomed. The hormone treatment was not particularly pleasant as I suffered from time to time what in women is called PMT, however a daily 100 mgm slow release Vitamin B6 tablet mostly offset this. As well I suffered a degree of lassitude, lack of drive (not only sexual), loss of concentration which resulted in me regularly being thrashed at tennis, but in April 1998, my prostate volume was calculated at 32 c.c. and my PSA was down to about 4.7. At this stage my Urologist could order the radioactive seeds and plan with his team the most effective placement of them."

Alex found he would be treated by a team of specialists including an anaesthetist, an oncologist, a radiologist, and a planner. Alex continues:

"10 June 1998 was D-day and I turned up looking forward to what I hoped would be the beginning of the end of the cancer. Two and a half hours later I awoke with absolutely no pain, and such little discomfort as to be negligible, even though some 30 needles had been pushed through my peritoneum into the prostate. The nursing staff kept asking me if I needed tablets or an injection for pain but this was totally unnecessary and I watched part of the soccer that night. The next day the catheter was removed and I was ready to go home.

"Unfortunately, because of the peculiar shape of my urethra as it enters the bladder, and the inevitable inflammation of the prostate due to the procedure, combined with my inability to tolerate anti inflammatory drugs, I was unable to pass urine. A catheter was introduced with a tap at the end instead of a bag, so I could go home and let things settle down. Seven days later the catheter was removed."

With medication for two weeks to help the settling down process, Alex recovered well. As he reports:

"Today, just 19 days after brachytherapy, I have played three sets of singles tennis (about two hours), no discomfort, no urgency to pass urine, no frequency and also no aces. I pass urine about three hourly at night but am able to drop off to sleep pretty quickly. During daytime there are much longer periods between voids which is very pleasant, and I take the precaution of voiding before going to a concert or out for dinner or going for long walks. Occasionally I am very tired and have an extra half a day in bed. I do not know whether this is the result of the radiation treatment or the result of my hormones beginning to re-adjust or a combination of both. I also still have some sweating at odd times. However, I am not fussed by any of this and am confident all will normalise in time. I have put on 2 kilos since the brachytherapy but put this down to lack of exercise and no gym work. So it is back to the gym, no more morning and afternoon teas, and my wife and I will continue as we have always done to enjoy each day as it comes around."