The Hits and Misses of living with stage 4 prostate cancer (and a few of the things you gained but wished you hadn’t)

I’ve not blogged about living with stage 4 prostate cancer for a while but I do think people need to understand the consequences of late diagnosis in order that they are aware that they need to be proactive about their prostate health. Until we get a screening programme, which still feels light years away, all that we are left with is awareness and men actually doing something to make sure they don’t end up like me.

Having said that, this could have been a misery fest and that’s not what I wanted so I’ll start with the hits and try and keep it light.

Hits

• I’ve been a super responder to treatment and feel utterly blessed to still be living quite well 8.5 years post diagnosis which is remarkable given that I was given a worst-case prognosis of two years. It’s good to be good at something 🤣.
• I got to walk my daughter down the aisle.

I got to see three more grandchildren come into my life.

• I largely escaped the rate race of professional accountancy practice.
• I’ve developed a new career as a patient advocate, some of it paid which is great as it covers the cost of my pro bono work.
• It’s a real honour to be given the patient voice and speak at International Cancer conferences to try to ensure better outcomes for men.
• It’s an even bigger honour to be asked to record educational videos for health care professionals which also improves outcomes for men living with prostate cancer.
• I think, overall, I’m a better man because of my illness and the advocacy work I do. Not that I wasn’t a decent bloke beforehand, although some might not agree 🤣.

Misses

• I miss sex. Said no man ever 😁(hormone therapy, which is standard treatment for advanced prostate cancer, removes male hormone making traditional sex a thing of the past. I am grateful that it’s keeping me alive though. A decent benefit for sure).
• Erections. Old droopy drawers now which is a bit sad.
• I miss my libido. Doesn’t sound much but it matters.
• Body hair, mines done a runner.
• Running hard, fast, far. I am incredibly grateful to still be able to run albeit as fast as a stampede of tortoises 🤣.
• Muscles (lack of testosterone means you lose muscle mass).
• Bone density. That’s done a runner as well.
• A willy. Mines now in growing! I mean, it wasn’t big to start off with but now it’s gone 😜.
• Affordable travel insurance.

Things I’ve gained but wish I hadn’t

• Two stone, mainly round the middle. My kids used to call me Mister Blobby before I started running at age 45. I’m getting close to that again. Oncologists’ advice was “Wire your mouth up” 🤐.
• Man boobs. Bigger than the bosses 🤣.
• Fatigue. That’s the bane of my life. Every day without fail, about an hour after getting out of bed, my life battery just drains through the souls of my feet. That’s when I force myself to put my running shoes on and do something. I always feel better afterwards.
• Night sweats. Bloody hell, it’s hard being a menopausal man. I feel way more sympathetic to menopausal ladies!
• Feeling the cold. I’m constantly cold! Bit of a reversal from my office days when I put the air con on and the ladies complained about the cold 🥶.
• Peeing half the night. I must be up sometimes 3 or 4 times a night and that’s very wearing. Doesn’t actually seem to matter how much I drink either.
• Impact of all the drugs on my gut health. Makes the mornings interesting! The cost of loo rolls is ridiculous 🤭.
• Loss of sensitivity in the ends of my fingers. Now that could just be an age thing but so far in 2026 it’s cost me my favourite wine glass and Mrs C’s favourite mug. She wasn’t happy!
• The daily reminders of the illness. Like getting the following days meds ready at bed time and then taking them as soon as you wake up so you can have breakfast an hour later.
• Having to be up 6:30 on parkrun day because of the previous point.
• Fragile mental health.
• Mood swings.

It’s not all negative as you can see but, if you’d prefer to give the misses a miss and you are in the prostate cancer risk groups (black men and men with a family history aged over 45 and all other men over 50), please ask your GP for a PSA test and don’t take no for an answer. If I’d known that I’d had a right to a test at age 50 and done something about it, then maybe, just maybe, I wouldn’t have been diagnosed terminal at 60.