Another common aspect of all these consultations is that this is rarely the case.
Having been referred to GD, a urologist in Hamilton, by my GP Luisa, I received a phone call from Hamilton Urology asking me to drive to Matamata to see Glen for an appointment at his monthly clinic there. I got the impression that there's a bit of urgency involved and he had no other appointments available.

Matamata is a 40 minute drive from where we live, as opposed to 20 or so minutes to Hamilton. No big deal for them, but felt like the wrong direction to be going for such a big deal for us.

He was running behind schedule and we had to wait for a while but eventually a couple, slightly older than us emerged and didn’t look too distraught. I have no idea why I found that encouraging.

Glen obviously spent a few minutes writing up his notes for the previous man and reading up on mine and then, came out to greet us. With some trepidation we took our seats in his consulting room which was right off the hospital foyer.

After the obligatory introductions and small talk it was time to get down to the action which, of course involved Glen and me behind the curtain, me semi-naked on my left side on his examination bed with my knees drawn up, and he with his rubber gloves on. This procedure is a DRE (digital rectal examination) which term is entirely self-explanatory. The last one I had was in my GP’s surgery and that was a breeze so I was somewhat surprised that this time was much less gentle and quite uncomfortable.

I guess the person doing the examination knows what they need to look for and must simply get on with it, and don’t leave anything out for fear of upsetting the patient or his dignity.

Glen told us there and then that he had discovered sufficient abnormality that he was going to want to do a biopsy. At this point I was still on the bed and he told me to stay put while he went to find a rectal swab. The reason for this, he informed us, was to get an idea of what bacteria and other bugs I have inhabiting my rectum so that he can prescribe the correct type of antibiotics which I am to take immediately prior to and subsequent to the biopsy which will take place within a week or two at his rooms in Hamilton. He came back into the room with the requisite swab between thumb and index finger and I was relieved to note that a rectal swab is quite literally barely noticeable to the patient, especially in contrast to the rummaging which had only just occurred.

He also examined the enlarged lymph node in my left groin and concurred with RF that what was required in this case was a FNA (Fine Needle Aspiration) in which a ‘very fine’ needle is introduced (How do you do?) into the lump and a sample of tissue is removed for analysis. Needless to say he whipped down my undies and had a good old poke around in there. I was encouraged by his comment whilst he held one of my testicles in each of his hands: “Nothing wrong with those”.

And like RF, he examined my legs and feet. Of course I now know that they were looking for a possible primary site should the lymph node’s enlargement turn out to be the metastasis of some type of cancer.

We spoke about about possible reasons for the lymph node’s enlargement but did not settle on any particularly favoured theory. Except that Glen did seem to be fairly confident that it was not going to be the result of metastasis of the (probable - at this stage) prostate cancer. He said the inguinal area is not the right ‘drop zone’ for prostate cancer.

I remember, at about this time, the first sneaking suspicions that we might be dealing with something more sinister, but nobody was saying the words.

Back in the seat in between Nikki and Glen’s desk I learned that the biopsy he was talking about was a TRUS (Trans Rectal Ultra Sound guided biopsy). This involves an ultra sound probe being inserted into the rectum and a long thin specialised biopsy instrument being passed through it and up against the wall of the rectum, on the other side of which lies the unsuspecting prostate. At this point a spring-loaded hollow needle pops out and grabs a sample core of tissue and then snaps back inside the bore of the instrument. Glen explained this process in a beautifully understated and calm way but I wasn’t having a bit of it; from then until the day of the appointment my thoughts were never far from the consulting room in my mind where this procedure was carried out a thousand times with endless variations and degrees of discomfort.

Of course I had never had this done before and so I didn’t have a lot to go on, but the good old internet search soon helped me out there. That, and a documentary I had seen many years ago which followed the broadcaster Paul Holmes through his experience of prostate cancer. I don’t think I actually saw much of it but the bit I did see was where he was on the examination bed in the required position and passed his packet of cigarettes to his support person immediately prior to the procedure. I remember thinking he was either very honest, or very stupid to be quite so open about his smoking habit while undergoing a procedure to evaluate his cancer - on national television. I suppose it’s like when the GP asks you how much you drink and you say “Oh not very much at all” before giving a figure equating to about half of the truth - they know though don’t they? Of course they do.

I actually saw Paul Holmes in the flesh once, I was walking out of the Wellington airport terminal and he was getting into the back of a black car. The window was down and I remember being surprised by the size and intensity of the cloud of cigarette smoke which escaped as he was whisked away. Anyway there was a fair bit of wincing as the probe was introduced and then at the moment when the biopsy was actually taken Mr Holmes nearly jumped off the bed. That was in 1999 though, and I wonder whether that was done under local anaesthetic.

Glen assured me that in my case this procedure would be carried out under local anaesthetic and in most cases is ‘tolerated quite well’. Oh good. He said they will numb the area with local anaesthetic and then take a series of between ten and twelve biopsies. Twelve! It just gets better.

He reassured us that this is treatable, and whilst he can’t give us anything definite, as this is the beginning of what may be a long road, if they can’t cure it completely (which will be their aim) I am more likely to die with prostate cancer than from it.

So we left Matamata without any certainty, except that we knew something was wrong, but funnily enough, strangely optimistic. As though we had passed control of the situation to an expert and he was going to make sure everything is OK.