Prostate cancer: The later you get diagnosed, the greater the risk

Irish Examiner

23-05-2025

Whenever I'm asked, 'How are you?', I have a stock reply, which I've had for decades: 'If I were any better, I'd have to take a pill!'
It's an inherited attitude, the O'Flynn/O'Leary (my mother's side) approach to life: Embrace it, love it, live it. Be alive; not just head down and trudging through, but, even in this ever-darkening world, keep all the senses wide open to all the goodness still out there.
And yet, were it not for the diligence and the expertise of the medical profession, I might not be here.
I've always been a fitness fanatic, ever-active, even now. Because I occasionally push things physically, this has also meant regular visits to the GP, which guaranteed regular health checks. Probably when I was about 50, my GP decided that this should now include a PSA check.
I don't know when I was first diagnosed as being at risk of prostate cancer, when I was put on a watch-list, or when I was finally told I had the disease, but it was a good number of years ago, long before I went to Brussels to work for MEP Luke Ming Flanagan. I know that because during those five years, I let things slip a little, didn't get the PSA tested, the biopsies done, as often as I should. And I almost paid the price.
Diarmuid O'Flynn on his cancer diagnosis: "There are no guarantees with any surgery, but the latter offered the best chance of ridding myself of this cancer. I was on my own when I got the news and very quickly, no hesitation, decided: Go in, get it out. I could have waited to consult my wife, Siobhan, but knew she'd fully support my decision — she did." Picture: Larry Cummins.
On my 66th birthday, June 25, 2019, I had to retire from Brussels; it's mandatory for parliamentary assistants. Back home in Ballyhea, when I went to get checked with a new consultant in Cork — the previous one had also retired — it was discovered that the cancer had spread around the prostate, and immediate action was required.
I can't say I was overly concerned — I wasn't. My attitude to this kind of thing is fairly pragmatic: Do whatever can be done, and after that, what will be will be.
I was given the usual options. I remember that some involved treatments with radiation — direct or with pellets inserted in the prostate — and chemotherapy. Another was surgery: go in and cut it out, all of it.
There are no guarantees with any surgery, but the latter offered the best chance of ridding myself of this cancer. I was on my own when I got the news and very quickly, no hesitation, decided: Go in, get it out. I could have waited to consult my wife, Siobhan, but knew she'd fully support my decision — she did.
The risks attached to prostate surgery were explained to me in great detail, and they were serious, potentially life-changing. The big ones were incontinence (urinary and/or bowel), the possibility of having a bag or two attached for the rest of my days, and erectile dysfunction, with a few associated add-ons. Not very appealing, but neither was the alternative.
Erectile dysfunction
I underwent keyhole surgery, and had several apertures opened in my stomach. It went smoothly, and the results were positive. All the cancer was cleared, the biggest tumour being about 35mm. I woke up to a new attachment: A catheter. This would be my companion for a few weeks to allow my nether regions time to adjust to the new reality. It was awkward, but you get used to it.
Those few weeks would also decide whether the first major risks outlined above had come to pass. I was a bit nervous about it, but also hopeful — the odds are excellent that you'll recover both the bladder and bowel functions. I did, and quickly.
The erectile dysfunction, however, was a different matter.
Diarmuid O'Flynn at work building a greenhouse in the back garden of his home. Picture: Larry Cummins
The nerves that control an erection pass through the prostate — removing this entails cutting through those nerves. When the prostate is gone, the surgeon will rejoin those nerves, but there will be fallout, and most of us who have prostate cancer surgery will need either chemical or mechanical help to have an erection again.
One such treatment is an injectable alprostadil, directly into the penis, and the first time I got it still sticks out — pun intended. This was because the injection didn't just work, it overworked, with the result that because I had a train to catch from Cork, I lied to the nurse about the effect — 'Oh yeah, it's gone down now' — and headed off, only to have to try to hide the very obvious bulge in the trousers as I waddled to the bus and then the train. It was bloody painful, too.
I related that story to much hilarity to my golfing buddies in Doneraile — that and a few others, all based around the operation.
That's how men often deal with stuff like that, isn't it? We joke about it, make little of it, and get on with things. And, in truth, I do make little of it.
I'm upbeat, but it's no joke
Yes, I'm macho, but not so macho that I'd prefer to be dead than suffer erectile dysfunction.
I'm physically diminished — a side effect is reduced penis size, and a new kinky shape — but not so that it affects me in mentally or emotionally. While I'm not keen on the injections or the pump (a mechanical aid), the blue pills are a tonic. It helps, of course, that I'm at an age where my family is complete, sex drive long gone from overdrive to 'What's for dinner?'
However, make as light of it as you like, but prostate cancer is no joke. According to the Irish Cancer Society, 4,000 of us are diagnosed with it every year, which means one in six Irish men will have that diagnosis in their lifetime.
The later you get diagnosed, the greater the risk — running from it, delaying the testing, that doesn't work very well.
But if it's so serious, why do I take it so lightly? I assure you that it's not because I'm not familiar with death. From nine siblings, over the last few years I've lost two sisters to illness, Réidín and Gráinne, the two who probably, above all of us in the family, loved and lived life to the full.
Before that, I lost two brothers, Jack, from pneumonia, and Tiger (Tadhg), in a single-vehicle car crash.
Diarmuid O'Flynn: "The news in the last few days that former US President Joe Biden has been diagnosed with prostate cancer surely reinforces the fact that any of us, all of us, are vulnerable."
Another brother, Donal, has had my back through thick and thin for decades, but, for the last three years, due to serious health issues, his courage and mental strength are being tested in ways that few of us ever experience.
His suffering is our suffering, so I know pain, physical, and psychological. I know both the reality and the finality of death.
I'm also taking medication now for a rare blood cancer, which was caught early with a good prognosis. Before that, I had skin cancer treatment. And in July, I'll be having a dodgy lump in my thyroid removed ('It started with a cyst…'). But that's life, isn't it?
I still feel I'm one of the lucky ones.
The news in the last few days that former US President Joe Biden has been diagnosed with prostate cancer surely reinforces the fact that any of us, all of us, are vulnerable.
I write this in the hope that out there, there is a man who'll read it and think: 'You know what, I'm going to my doctor, get my prostate checked out'. Do it today.
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