Charlie took ill in May 2000 with symptoms of urinary retention and back pain. The family doctor attended and immediately called for an ambulance and admitted him to Blackburn Royal Infirmary.

The first thing that the medical staff did was to insert a penile catheter to relieve the urinary retention.

Following a series of short tests including D.R.E. – Digital rectal examination, P.S.A. – Prostate specific antigen (blood test) and Transrectal ultrasound guided prostate biopsy, Charlie was diagnosed within 3 days with prostate and testicular cancer. The surgeon explained that the prostate cancer was most likely to be the primary cancer and had spread from there.

Charlie was offered a choice of treatments that included oral chemical treatment or surgery with options of external beam radiotherapy or brachytherapy (radioactive seed implants) also a possibility. We were told at this stage that the prognosis following treatment was 2 years.

The cancer had already damaged the urethra and he needed a minor operation so we asked if he chose surgery as treatment for the cancer could the two operations be done at the same time, which they could. We decided this would be the best option for Charlie as he had a real aversion to taking tablets.

He was scheduled for his operations only to find that the first one was cancelled due to an emergency. The operations were then rescheduled but were cancelled again as the day they were due he was diagnosed with diabetes. At the third attempt he had his operations and although he was in pain afterwards he remained very positive.

Charlie continued with soluble co-codamol and regular check-ups at the urology departments until June 2001 when he started to have urinary retention again and was re-admitted to hospital. At this stage we were told that the cancer had grown again and was constricting the urethra. Surgery was not an option.

He went into kidney failure and was very ill; this time the prognosis was two weeks. We were told that the only option was for the surgeon to insert a tube that would bypass the urethra and help to drain the kidneys. If he did not have the operation he would just drift into a coma and die peacefully.

As Charlie could not make the decision at this stage we had to decide as a family what to do, do we let him drift off peacefully or have the operation which would revert back to the original prognosis and give us another year with him if we were lucky. We decided we wanted him to have the operation but we were relieved when a few days later while he was waiting for surgery we were informed that it may not be necessary as following the insertion of a supra pubic catheter his kidneys had started to function again.

Charlie came home with the catheter in situ which he found cumbersome and it was at this stage that he found he could do less of the things he loved doing such as his woodwork as he felt the catheter got in the way. He continued to attend urology for regular check-ups and to get the catheter changed.

As Christmas 2001 approached it was obvious to everybody apart from Charlie that his mobility was decreasing. Charlie was at this time in denial that he had cancer and referred to his operations as the little operation and the big operation. We all knew that when he talked about the big operation he was referring to the cancer but he never mentioned it by its name.

By February 2002 his mobility was really suffering and we realised as a family we needed more support so Carol contacted the family doctor who had given Charlie a lot of support during his illness. I asked if we could have support from a Macmillan nurse and we were allocated John.

We were given practical support, handrails fitted in the bathroom, a walking frame and at later stages hoists, commode, pressure mattress etc but more than that it gave us someone to talk to and to help us make decisions that were needed.

We were having problems with Charlie's pain relief as he was very reluctant to take anything and by now he was also prescribed Voltarol tablets which we had to crush in water and morphine solution.

Unfortunately one of the side effects of the analgesics is constipation and to Charlie this was more of a problem than the cancer so he chose not to take them or he took a couple of doses and the pain went so he said he didn’t need them as he wasn’t in pain only for the pain to return.

He was in pain but blamed everything from the chair he sat in to not lying on his sheepskin properly to the waistband on his trousers for causing the pain rather than the cancer. This was putting a strain on the family as everyone felt they had to watch what they said around him.

It was now that John sat down with Charlie and finally got him to admit that he had cancer. John reiterated to him it’s not the chair the bed etc that’s causing pain it’s your cancer.

John arranged for Charlie to start to go to the East Lancs hospice for day care as by now bathing was a problem and he could go there and have his personal hygiene done and also have relaxation therapy. The relaxation therapy was also offered to the family member supporting him as the hospice staff acknowledge the stress for a family supporting someone at home with a terminal illness.

On 15^th April 2002 Charlie was admitted to the hospice following a visit by John to try to stabilise his pain relief. He was fitted with a syringe driver that contained morphine and midazolam, following an adverse reaction to the midazolam the syringe driver was removed. He was hallucinating and we spent several days trying to convince him that the doors didn’t need altering and the shelving wasn’t an 1/8^th of an inch out nor was there lizards running across the bed or Chinese writing on the walls. When he returned home he could remember this period of confusion and would laugh about him having asked the domestic to help him take the door off so he could shave a bit off the bottom to get a better fit.

Charlie spent 4 weeks in the hospice where he continued to receive support from John and the ward staff and doctors. During this time he also attended Christie hospital in Manchester for a session of external beam radiotherapy but the doctor there said that it was pointless having further treatment as the cancer was now too far spread.

He had walked into the hospice using his frame but never walked again as while he was there it was discovered that the cancer had spread to his left shoulder (his arm developed a life of it’s own and sometimes slapped him in the face without warning), his right shin and his lower ribs and spine. It also travelled to his brain towards the end leading to him getting confused.

A case conference was convened to discuss the practicalities of him coming home, when he was asked if he was ready to come home he replied, “yes, I’ve finished all the woodwork here”.

On his return home he started to get support from the staff at Crossroads (domiciliary care) who would assist to get him up in the morning and put him back in bed before teatime. The family started a rota to make sure there were always two people available to transfer him in the hoist. He was by now living and sleeping downstairs.

Within a few days he was re-admitted to the hospice for a blood transfusion this time his stay was only for a few days.

On his return home the nurses from Great Harwood Health Centre visited regularly to provide catheter care and other support.

Charlie had a fairly good month and kept his spirits up joking with his carers from Crossroads but collapsed on the Tuesday of the Queens jubilee in June 2002. He was very confused and did not recognise family members.  He was this time admitted to BRI, as the hospice cannot take admissions at weekends or on bank holidays. He stayed in the hospital for two weeks before returning home.

Over the next few weeks he became more tired and was eating very little. He had also been prescribed morphine patches, as he was reluctant to take his oral medication.

On Saturday 6^th July he became reluctant to eat or take fluids and was only taking small sips with encouragement. A locum doctor attended and the district nurses. It was discussed whether he should be admitted to hospital but he was adamant that he wanted to stay at home.

On Sunday he slowly began to lose consciousness until by evening he had slipped into a coma. A locum doctor and the nurses had again attended and we were advised to just keep him comfortable.

On Monday both the family doctor and John attended and informed us that he probably would not see out the day. All his immediate family stayed with him including during the night. He died at 1.11pm  on Tuesday 9^th July 2003 with his family with him, relaxing oils burning and his favourite Glenn Miller tapes playing in the background. 

  Anyone 40yrs & over should get regular checks for Prostate Disease (It could save your life)

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