Which gate marks your fate?

Bruce Avery compares prostate cancer to being a lamb in a race – you don’t know which gate the farmer is going to open to determine your fate.

One thing the prostate cancer survivor does know is the best results are through early detection. Bruce and his fellow Manawatu support group member, Tony Curran, differ in age but are both from farms, both have a family history of the disease and both got yearly checks.

Although he has been cancer free for seven-and-a-half-years, 71-year-old Bruce Avery is more vigilant than ever in delivering his message for men to regularly have a Warrant of Fitness done. “Farmers spend thousands of dollars keeping their stock healthy and inoculating and drenching, yet many men don’t spend $50 to go to the doctor and get a check.
“There is no shame in a digital rectal examination and if you don’t want that, at least have a blood test to get your PSA (Prostate-Specific Antigen) levels checked.

What are the odds?
Bruce is one of five boys, or a “handful” as his mum used to say. Two of his brothers have also been diagnosed with prostate cancer, making Bruce’s resolve to spread the “get checked” message even stronger.

Bruce was raised on a farm before completing his mechanic’s apprenticeship. In 1982 he and his wife, Marilyn, bought a 45ha block at Himatangi, north of Foxton. As well as running his farm block, Bruce continued with his mechanical work, particularly on farm machinery and agricultural equipment, as well as building cowsheds. He has recently retired to Feilding but it was when they were at Himatangi that the Avery’s had their first brush with cancer.

Eleven-years ago Marilyn had a mammogram and was diagnosed with breast cancer.“We made the journey together through the lumpectomy, chemotherapy and radiation treatment.
“You live in hope and we were lucky because it had been diagnosed early. Marilyn’s a survivor and we had just got over that when, in 2011, a blood test picked up that my PSA was elevated. “I’d been having a WOF check since I was 50. Men do tend to forget about themselves but I had been having an annual check. “I had a biopsy and the prostate cancer and the need for surgery was confirmed.

“That was late in 2011 and I had to wait over the Christmas and New Year break and finally, in March 2012, had a radical prostatectomy and was sent home in nappies. “You have had the operation, the cancer is removed but it is not until later on that you know what the side effects are. “I was one of the lucky ones, I put a lot of effort into pelvic floor exercises so I wouldn’t be the leaky one. “Because my prostate had been removed my PSA should have come down to non-detectable, but my levels were still high. “I thought I was buggered. It was scary to have had your prostate removed and still have high PSA levels. “The next step was nearly eight weeks of radiotherapy with a 65km drive to Palmerston North every weekday for 2–3 minutes of treatment.  “The Oncology Department there was great. In you go, they line you up with the tattoo, zap you, then off you go, only to return the next day to do it all again! “My PSA came down and I knew I was on the right line.”

Looking for help
Bruce’s involvement with cancer support began when he went looking for help. “Cancer is the thing no one wants to get, then you do get it and you think you are going to die. Then you don’t die and so there is a lot to talk about. I wanted to know more and talk to other people who had experienced prostate cancer.”

Bruce was put in touch with Chris Bland who runs the Palmerston North Prostate Cancer Support Group. They meet on the third Wednesday of every month at Addis House and can have 12–20 men attend. For Bruce, attending the meetings made a real difference.
“I’m the kind of guy that if I want to buy a new car or tractor, I need to know the specs and figures and do my homework. “That is what the support group is for me. There are guest speakers from urologists to surgeons and radiation specialists. Prostate cancer is a very interesting subject and a lot of knowledge is shared between people who want advice and to talk about how they have been affected and listen to other people’s stories.” Every year, about 3,000 men are diagnosed with prostate cancer, over 600 die and 2,400 survive.

“Like breast cancer, usually early detection leads to better outcomes. That’s the message I want to push. Don’t wait for symptoms to occur as most men who are diagnosed don’t show any symptoms. “Don’t leave it too late, look after your health, go to your doctor and get checked,” implores Bruce.

A support network
There are 36 prostate cancer support networks across the country and training sessions are also offered to assist volunteers, like Bruce, to be able to talk to people and provide the correct information.

The Prostate Cancer Foundation’s vision is to eliminate death and suffering caused by prostate cancer by offering support to men who have been diagnosed with prostate cancer, along with their families and actively promote awareness of the disease through community promotions. Bruce says all prostate cancer money is fundraised and all cancer groups are relying on the same dollar which comes from generous people’s pockets.

As a Farmlands shareholder for nearly 50 years, starting with the Feilding Trading Society, Bruce is particularly appreciative of the support Farmlands has shown towards prostate cancer awareness and the Blue September campaign. “Last year Farmlands came on board with initiatives across their branches raising $93,000 for prostate cancer. We are very grateful for the Farmlands support.”

As an active volunteer, Bruce attends the Prostate Cancer Foundation of New Zealand annual conference, the Fieldays at Mystery Creek, home and leisure shows as well as presenting to groups and clubs.
“I have no problem talking to people about prostate cancer. I’ll be at our stand at an event and a couple will walk past and the wife will nudge the husband in a way that means, you should be getting checked,” says Bruce.

“Often it is a real partnership. Having my wife by my side was the best thing I had to support me and keep me going. “We all need a support person in the early stages, just a pair of ears and a different understanding. “The support group is for wives and partners and family too. While volunteers don’t give out medical advice – we leave that to the experts – we can relay information that is shared with us, which can be helpful. “If prostate cancer is diagnosed early there is a greater chance of a better outcome. My goal is for more people to survive and to do that we need people to be more aware of the benefits of getting checked. It’s that simple: get checked.”

Farmer manages his health first
At the age of 52, Tony Curran knows all too well that prostate cancer is not just a disease that affects older men. Tony farms 17km east of Dannevirke on a hill country sheep and cattle breeding/finishing block of 382ha. He had been having regular PSA tests in his early 40’s because “that’s what you do”.

In late 2014 his PSA levels started to change and his urinary problems stated to worsen. Tony’s father Ted, also a farmer, had prostate cancer and died at the age of 85. Because of his Dad’s history, Tony’s specialist wanted to get a handle on where Tony was at. “I was docking and got a random call that there had been a cancellation, so I let the sheep out of the yards and drove to Palmerston North for an urgent CT scan.

“That was followed by a biopsy and once they discovered prostate cancer I was put on active surveillance. That period is an anxious time as you don’t know how fast the cancer will grow or if it will spread. “There are people who simply treat it straight away and have their prostate removed but being a younger man, I was more conscious of the possible side effects.”

Active surveillance continued with another biopsy in 2015 and blood tests until a routine biopsy in November last year revealed the cancer had moved up a grade. The cancer cells were still small and contained within the prostate but treatment was advised. “We sought different options and decided to go with robotic laparoscopic prostatectomy as we believed there would be an improved chance of nerve repair and the recovery would be quicker.”

The Currans were grateful to have private medical insurance which was a great financial assistance and meant they could pick a time for surgery that fitted in with their farming calendar. Tony had his prostate removed on 22nd May in Tauranga by the surgeon who had pioneered the robotic surgery in New Zealand 12 years ago. At 7 weeks’ post-surgery Tony felt he was 80 percent recovered and at first he was tired but went back to working on the farm. He made sure to have more rests and longer lunches.

“I’ve been looking after myself while the farming operation is quieter. Surgery is invasive no matter what method you choose and a lot of work needs to go into retraining the bladder and building the muscles back up.” Tony says talking about prostate cancer is important. “I attended the prostate cancer support group in Palmerston North and met Bruce Avery and Chris Bland. The work they do is great and the information shared by the men at the session I attended was informative.  “Men often delay treatment and can be put off by a complete change in lifestyle as a result of having their prostate removed. “People need to hear that younger men can develop prostate cancer but it doesn’t have to be all doom and gloom. In my case, I will be back to 100 percent and I think it is heartening for people to hear that. “I went into it as a fit man with a positive mindset and the knowledge I needed, having talked to other men who experienced robotic surgery.

“It’s also important to have the right support around you. My wife Jocelyn, a former nurse, was great. I knew the business side of the farm was taken care of and a neighbour helped out on the farm. Having support in place makes the whole job happen a lot more easily.” Tony says that their experience has prompted people to get checked. This pleases the Currans as they want to be open and educate people. “I know for our son, who is only 19, that because of his family history he should start being tested in his early 30’s.”

“Prostate cancer is not going away and be it hereditary or caused by unknown factors, it shouldn’t be embarrassing to talk about. “The key message is to get checked.”