Writer Speaks Out on Prostate Cancer: The Need for Support

On September 13, 2023, writer and broadcaster Manchán Magan revealed on RTÉ Radio’s Brendan O’Connor Show that he is facing terminal prostate cancer. The 55-year-old disclosed that his condition had metastasised, leaving him with a prognosis of just a few months to live. This announcement underscores the critical importance of discussing prostate cancer, a disease that affects thousands of men annually. In Ireland alone, approximately 4,000 men are diagnosed with prostate cancer each year, leading to around 500 deaths annually, according to the Irish Cancer Society.

Prostate cancer often develops slowly, and many men diagnosed with it do not succumb to the disease. The prostate gland, found only in men, is located below the bladder and in front of the rectum, playing a vital role in reproductive and urinary functions. According to professor David Galvin, a consultant urologist at St Vincent’s and the Mater hospitals, a significant number of prostate cancer cases go unnoticed, with nine out of ten men showing no symptoms at the time of diagnosis. The causes of prostate cancer remain largely unknown, though genetics significantly influence risk. If a first-degree relative has been diagnosed, the likelihood of developing prostate cancer increases to approximately one in two or one in three.

The experience of John Wall, a 54-year-old resident of Lahinch, Co Clare, illustrates the unpredictability of the disease. Although he was aware of his grandfather’s prostate cancer, Wall never considered it a personal risk. After experiencing nighttime urination and leg pain, he underwent a series of PSA tests, which indicated potential issues. Initially misdiagnosed with prostatitis, further investigation revealed an extremely aggressive form of cancer. Wall underwent a complex surgical procedure in Belgium, involving a radical prostatectomy and the removal of lymph nodes.

Recovery posed significant challenges for Wall, who now manages ongoing incontinence and lymphedema. He credits the support he received from healthcare professionals with enhancing his quality of life. Despite these efforts, Wall faced emotional and relational difficulties stemming from his diagnosis. “When I was diagnosed, I had nobody to talk to,” he reflected, emphasizing the isolation many men experience.

Men diagnosed with prostate cancer often encounter serious mental health challenges. Studies indicate that approximately 14.4% of men who survive prostate cancer report clinically significant depression. This mental health impact is particularly pronounced among those with advanced or metastatic stages of the disease. John Foley, a 61-year-old retiree from Tullamore, Co Offaly, experienced similar struggles. Diagnosed at age 56, Foley’s journey began with rising PSA levels that prompted further testing. Following his diagnosis, he faced multiple treatment challenges, including severe incontinence after surgery.

Recognizing the emotional toll of his diagnosis, Foley sought help only after reaching a breaking point. After connecting with the Irish Cancer Society, he joined a prostate cancer peer support group, which provided essential information on managing side effects. Through this network, he learned about treatments for incontinence, which significantly improved his quality of life.

The discussion around prostate cancer also highlights the importance of screening. Early diagnosis can lead to better outcomes, yet many men remain unaware of their options. Professor Galvin advocates for a structured national screening protocol to ensure regular testing for all men. Currently, Ireland participates in Praise-U, a European pilot project aimed at enhancing early detection through targeted screening efforts.

Surgical interventions for prostate cancer can lead to various side effects, including impaired sexual and urinary function. While some men may return to their pre-operative state, others face lasting changes. Active surveillance may be an alternative for those diagnosed with low-grade cancer, delaying the need for immediate surgery.

The emotional and physical impacts of prostate cancer extend beyond the individual. As both Wall and Foley have noted, the repercussions can strain personal relationships. Wall expressed how the journey affected his marriage, ultimately leading to separation. “Prostate cancer has significant repercussions for you and your partner,” he stated, underlining the need for open communication and support.

Mental health challenges are prevalent among men with prostate cancer, with many experiencing anxiety and social isolation. Foley emphasized that seeking support is crucial, stating, “There’s no way you can do this on your own.” He encourages men to reach out to support networks and health professionals early in their diagnosis.

Several organizations in Ireland provide valuable support services for those affected by cancer. The Irish Cancer Society offers a range of resources, including a freephone support line, Daffodil Centres in hospitals, free counselling, and peer support services. Similarly, the Marie Keating Foundation and ARC Cancer Support offer programs tailored to meet the needs of cancer patients and their families.

The experiences of Wall and Foley serve as powerful reminders of the importance of communication and support when facing a prostate cancer diagnosis. As they advocate for greater awareness and improved screening protocols, their stories highlight the critical need for men to engage in conversations about their health and seek assistance when needed.