Discovering something humorous a couple of transperineal prostate biopsy isn’t straightforward — the place, underneath native anaesthetic, a sequence of needles are punched via the pores and skin and muscle between the rectum and the bottom of the penis to succeed in the walnut-sized prostate gland under the bladder.
However the author, comic and broadcaster Jon Holmes is totally sure humour is the way in which to get via experiences corresponding to this and get extra males speaking about most cancers.
As he reveals for the primary time at present, he was identified with prostate most cancers final yr, regardless of experiencing ‘zero signs’.
Married with two daughters aged 14 and 12, Jon, 55, is the Bafta-award successful co-creator of the Radio 4 sketch present Useless Ringers.
He received a Gold Aria this yr for his Radio 4 programme Era Disgrace about his expertise of being adopted, and is the creator of The Skewer for Radio 4 and BBC TV, a multi-award-winning satirical tackle the week’s information.
Jon found he had prostate most cancers final February after PSA blood exams revealed he had a excessive degree of prostate particular antigens
He’s hardwired, he says, to search out humour within the darkest of locations.
And a brand new podcast, Jon Holmes Says The C-Phrase, is strictly the form of programme he says he desperately wished to tune into after the biopsy confirmed that — regardless of having no signs — he had prostate most cancers.
‘I so badly wished to speak to a different man about it,’ he says.
Whereas buddies he advised have been sympathetic and some ‘obtained a bit teary’, he says, ‘I completely didn’t need that tilty-head pity look’.
What he did need, in addition to amusing in regards to the indignity of all of it, was sincere dialogue of the realities of most cancers remedy.
As he explains: ‘I wished to know what a catheter would really feel like, or what do you do with a penis pump [used as a physiotherapy tool to boost blood flow after prostate surgery].
But it surely was actually arduous to search out different males to speak to about most cancers and I believed, ‘If I get via this, I’ll write a e-book or make a podcast for males with all types of most cancers that I might have binge-listened to had it existed.’ ‘
Every episode tackles a unique problem, from the shock of analysis to diabolical procedures — all issues males do not usually speak about within the pub.
Monty Python’s Eric Idle, who was identified with pancreatic most cancers in 2019, says: ‘Good lord, the issues it’s important to do together with your garments off in entrance of individuals, all that stuff.
It is simply so undignified. Particularly together with your arse hanging out in these horrible hospital robes.
Simply keep in mind that the final chortle is on you! You already know, it is OK to be humorous; I feel it is completely the most effective.’
Stephen Fry, who was identified with prostate most cancers in 2018, talks in regards to the ‘fear, embarrassment, frustration and indignity which you in a short time get used to…
Oh, it is good to chortle, is not it?’ he says. The truth that Jon is a survivor like me offers me nothing however the intensest pleasure.’
Jon admits sheepishly that it is opened his eyes to the myriad indignities most girls address all their lives — corresponding to mammograms and cervical smears, as nicely childbirth — however most males will attain late middle-age earlier than having an intimate medical examination.
‘Having one thing unsuitable together with your manhood is each man’s worst nightmare, so we do not speak about it,’ he says. ‘It is a lot simpler to debate what we noticed on Netflix final evening as an alternative.’
His most cancers analysis was totally serendipitous.
Final January, an advert from the charity Prostate Most cancers UK popped up on Jon’s social media feed, encouraging males over 50 to have a PSA blood take a look at: this measures ranges of prostate particular antigen, a protein produced by the prostate.
Excessive ranges could be a signal of most cancers. ‘I considered Stephen Fry and the way a lot he has achieved to lift consciousness of prostate most cancers,’ he says. ‘I believed: ‘I am going to get that examined’.’
And so, for the primary time in, ‘ooh, many years’, Jon known as his GP.
PSA exams may be unreliable, typically giving false-positive or false-negative outcomes; moreover, an an infection, train corresponding to biking, or just lately having intercourse can all briefly increase PSA.
‘My PSA was barely raised at 4.8 [normal range for a 55-year-old is typically 2.5-3.5], so my GP referred me for an MRI scan inside per week,’ Jon explains.
‘I wasn’t fearful, I believed my PSA was in all probability excessive as a result of I would run to the appointment.’
When the scan was ‘inconclusive’ he was given a prostate biopsy.
‘I did not know what was concerned, however I knew I did not just like the sound of it,’ Jon advised Good Well being.
Jon went to Ashford Hospital in Kent, close to his residence, on February 26 final yr with out his spouse, Nikki, an arts and schooling challenge supervisor, ‘as a result of I am a bloke and I did not need any fuss’.
After stripping from the waist down, he needed to lie on his again and put his toes into stirrups, whereas an ultrasound probe — ‘I am positive it was a whole digital camera crew’ — was inserted into his rectum to information the biopsy needles.
‘At which level you realise all dignity is misplaced,’ he says.
‘The physician defined he would take 23 samples from completely different areas of my prostate utilizing a spring-loaded needle gun.
‘A nurse was assigned to carry my hand due to the intense ache,’ he grimaces.
‘They even shot the needle gun a number of instances earlier than aiming it at my perineum [the area between the base of the penis and anus] so I would not be alarmed by the extremely loud sound.
I used to be warned that my perineum would swell to the dimensions of an orange and I would not be capable of sit down correctly for per week after. All true.
‘But it surely was after they strapped my penis and testicles to my abdomen with tape to carry them out of the way in which, whereas a very terrible monitor performed on Coronary heart FM within the background, that I believed: ‘That is ridiculously humorous. That is priceless comedian content material.’ ‘
And he instantly began compiling a psychological checklist of ‘spectacularly undignified moments’ on his very surprising most cancers journey, along with his analysis confirmed per week later.
For the podcasts, Jon contacted different most cancers sufferers — together with the comedians Stephen Fry , Mark Metal (throat most cancers), Richard Herring (testicular most cancers), Matt Forde (spinal most cancers), in addition to Eric Idle; plus actors Colin McFarlane (prostate) and Ben Richards (bowel most cancers), rock star Mike Peters (leukaemia), and journalists Jeremy Langmead (prostate), Nick Owen (prostate) and Jeremy Bowen (bowel) — to debate most cancers in uncooked and typically hilarious element.
Every episode tackles a unique problem, ‘from fingers up the bum to catheters, through biopsies, surgical procedure, stomas, feeding tubes, penis pumps and incontinence pads’.
Jon can not keep in mind the final time he noticed his GP earlier than requesting a PSA take a look at. The GP checked his prostate (‘the finger-up-my-bum technique’).
‘He additionally took some blood and that was that; I did not give it some thought once more,’ says Jon.
He was anticipating his MRI to be clear as he was young-ish, match and in any other case wholesome.
However the outcomes, delivered per week later by an oncologist through Zoom, have been devastating.
Jon recollects: ‘He stated: ‘I am sorry, it is dangerous information, we have detected indicators of most cancers in your prostate.’
‘I did not hear anything. I simply thought: ‘I’ve obtained most cancers. This cannot be taking place to me.”
Thankfully, the most cancers was slow-growing and stage 2 — contained throughout the prostate.
In September, Ben Eddy, a advisor urological surgeon Jon noticed privately, operated to take away his prostate.
This surgical procedure causes momentary erectile dysfunction and incontinence as a result of nerve harm; in some instances the consequences are everlasting.
‘The very first thing the surgeon stated to me once I wakened after the operation was: ‘We’ll get these erections again!’ ‘ recollects Jon.
Round 20 per cent of sufferers with good erectile operate will not get their erections again spontaneously after surgical procedure, Mr Eddy explains. Elimination of the prostate additionally means males ‘do not ejaculate — that is extremely tough for them’.
‘But all that is virtually taboo as a result of societal strain says sexual operate is what defines you as a person. It takes a era to vary that mindset.
However males are doing loads higher when it comes to speaking about well being than they have been 25 years in the past,’ he continues.
‘I’ve handled so many males for prostate most cancers whose buddies are already sufferers.
Nevertheless, older males discover it tough not simply to speak about most cancers, however the manly issues too: ‘I’ve misplaced my erection’ or ‘I am leaking urine’.
The comedy author is looking for the humour in his analysis. Believing that males who speak and chortle do higher after most cancers remedy
‘In our NHS service [Mr Eddy and colleagues run a community urology clinic in local GP surgeries], we’ve got a month-to-month assembly the place males can include their wives and companions and have a day with a most cancers nurse speaking about erectile operate and incontinence restoration.
It has been vastly profitable as a result of they chat, make buddies and so they community afterwards.
‘Wives and companions play an enormous half in getting males speaking,’ he provides. ‘In my expertise, single males do not do in addition to married males, as a result of they bottle issues up.’
He additionally believes that males who speak — and chortle — do higher after most cancers remedy.
There’s strong proof that males usually desire to ‘soldier on’ if they’ve troubling signs than search out medical recommendation.
Analysis revealed within the BMJ in 2013 based mostly on information from virtually two million males and two million girls discovered the GP session price was 32 per cent decrease in males than in girls — with the best hole between the genders between the ages of 16 and 60.
And whereas males signify 52 per cent of most cancers instances, solely 38 per cent of the calls to the Macmillan Most cancers Assist Line come from males.
The charity Most cancers Assist UK provides six-week help teams to anybody struggling to maneuver on after a most cancers analysis, together with men-only help teams, that are all free.
It is necessary for males to satisfy others with related experiences, in an setting the place they really feel in a position to take action, explains Charlotte Poulter, the top of service for Most cancers Coach.
‘Males are usually not used to seeing different males who’ve had most cancers specific their feelings, so it is necessary for them to know it is OK to be susceptible,’ she says.
However whereas help is on the market, many males do not know it is there.
Kate Fulton, a medical psychologist with the help charity Maggie’s, based mostly at The Royal Marsden Hospital in London, says the share of males accessing assistance is at all times decrease than girls.
Maggie’s runs men-only prostate networking teams and androgen remedy workshops for males who’re being handled with hormone remedy.
‘They’ll speak in regards to the challenges — erectile dysfunction, weight achieve, scorching flushes and adjustments in temper — which for some will probably be lifelong,’ says Kate Fulton.
‘Remedy for widespread male cancers corresponding to prostate or testicular can change your view of your masculinity and your identification which may be very exposing,’ she provides.
However whereas, in 2023, Maggie’s supported greater than 311,000 visits throughout their 24 centres, lower than 108,000 (35 per cent) have been made by males.
‘It goes again to societal expectations and what it means for a person to speak about being anxious or depressed or frightened or unhappy.
‘There’s stigma round psychological well being and likewise stigma round most cancers — and notably so for males who play a number of completely different roles, which can make them really feel they have to be robust.
‘They’re husbands, fathers, brothers, sons, they’re suppliers and fixers. They need to shield their households slightly than burden them.’
She provides: ‘We all know from analysis that holding a most cancers analysis to your self makes folks really feel extra remoted and that may worsen experiences and outcomes.
‘But it surely’s arduous for older males notably to even acknowledge that they should speak. They nonetheless assume they must be stoic and ‘simply get via it’.’
The excellent news is that that is altering with the youthful era.
‘We see far more openness in our youthful males’s teams,’ says Kate Fulton.
‘Males of their 20s, 30s and 40s do speak about most cancers with their buddies, there may be way more openness.
‘Sharing actual tales within the media corresponding to Jon’s programme makes an enormous distinction to different males,’ she provides.
Within the studio making the brand new podcast sequence, Jon says there was a number of laughter and virtually no crying.
‘We have been at all times on the lookout for the enjoyable, the chink of sunshine,’ he says.
‘My cause for making the sequence was to demystify most cancers and clarify the method from first exams to restoration.’
He’ll even be encouraging listeners to inform their very own tales.
‘I need to encourage clear dialog about most cancers remedy between males, share recommendation and, the place attainable, discover the humour in it.
‘As a result of the one technique to cope with this factor is to chortle at it and deal with it with the utter disdain it deserves.’
- Jon Holmes Says The C-Phrase begins on BBC Radio 4 on July 9, with episodes launched weekly on BBC Sounds.
