Part 52: The big C

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By Jacco Zwetsloot

In March 2012, while working at the Dragon Hill Lodge's Discover Seoul Desk I took a bathroom break. It required much more effort and strain to relieve myself than normal. Having heard that a reduced stream could be caused by a prostate problem, I resolved to see a urologist as quickly as possible.

I soon had my first ultrasound prostate examination. It reminded me of a scene from the movie "Fletch" in which Chevy Chase sings "Moon River", bent over the examination bed with his pants around his ankles while the doctor examines him from behind. I tried to sing it too but the shock and discomfort of the ultrasound probe making its way in threw my timing right off.

The doctor could tell right away that my prostate was larger than normal, and the blood test drawn that day came back with the expected result that my prostate specific antigen (PSA) count was very high. This came as a surprise, since I had undergone a full body medical exam the previous November. I learned that the two possible reasons for a swollen, overactive prostate were benign prostatic hyperplasia (BPH) which can be treated with pills, or prostate cancer.

For the next month or two I took the pills prescribed, but the swelling did not go down much. The next step was to undergo a prostate biopsy to see if something malignant was afoot. For that I went to a university hospital near my house, where I was given the same kind of drug used when one receives an endoscopic stomach or colon exam. The procedure basically involves using yet another probe equipped with biopsy needles to take several samples of the prostate right through the rectum wall. It was not much fun, but the sedative helped me forget and I was discharged that afternoon.

Both my parents had died of cancer and I long expected to get it myself one day, so I resigned myself to the diagnosis well before it came. When I sat in the doctor's office a few days after the biopsy it did not come as a shock at all to hear that the tumor in my prostate was malignant, aggressive and fast-growing. What was a little shocking was that I had developed a cancer that usually manifests in much older men: when I was diagnosed, I was only 38. Not the youngest that doctor had seen, but among the youngest.

Because of my relative youth, and the contained nature of the tumor (a bone density scan and MRI showed no signs of metastasis to other parts of the body) I was told that the best form of treatment was simply to remove the whole organ ― a prostatectomy. But it would have to be done at another hospital, where they were more familiar with younger patients, and where there was a doctor specialized in that surgery.

With the diagnosis in hand I went to work and handed in my resignation letter. I told my bosses at the hotel and at Galaxyjean that because of the nature of the illness and the recovery period afterwards, I needed to quit the job. Although I did not look forward to the surgery, I was glad not to have to go back to that chaotic and stressful work environment afterwards.

Before the operation, I had to have my eye pressure checked to make sure my eyes would not explode during the procedure (or something like that; apparently I was to be lying on an incline with my head lower than my feet throughout). My surgeon used a remote controlled "robot" device to make some keyhole incisions and remove the cancerous prostate through my belly button, and then join all the tubes back together.

I awoke attached to an IV drip that had morphine in it, but only for 24 hours. On the one hand I am grateful that I did not have days' of opioids prescribed because of the risk of addiction, but on the other hand I was disappointed that there were no dreams, rush or high during that short period I was on them.

Thankfully, post-surgical checks and scans revealed that all the cancer had been removed, and I would not need any follow-up chemotherapy or radiotherapy. In the years since, I' have managed to remain cancer-free ― knock on wood. Although Mr. Cortez asked me to return to Galaxyjean, and Mark Kim wanted me to come back to the Dragon Hill Lodge, I took the illness as a sign that this particular job was not good for my health.
My wife kindly advised me to take some time off and do something fun, so that is when I decided to go back to school and get a master's degree in Korean studies, with a thesis focusing on North Korean graphic novels.

My urgent advice to all men reading this is: if you begin to have difficulty passing water, for instance if the stream is not what it used to be, see a urologist quickly. It may not be cancer, but even if it is, if you get it early enough, it can be treated. And it is not just a disease for old, retired men.

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