By Simon Garfield
The scenery was truly breathtaking. In March 2012, 47 cyclists had negotiated a 27km climb to the Puyehue Pass on the border of Chile and Argentina, passing forests and mountains, hot springs and glacial melt-water.
At the summit one of them spotted a circling Andean vulture and joked that it might be a grim omen. Others noticed that one of their most experienced riders was looking distinctly grey.
Roger Kirby, a 62-year-old professor of urology, was taking part to raise money for the Urology Foundation.
He had been on similar rides in Malawi and Madagascar and prided himself on his ability to keep up with younger riders, but now he felt breathless. His father had died of a stroke following heart failure at the age of 49, and ever since he had been wary of the weight of genetics. So he resolved to have a cardiac check and some blood tests as soon as he returned to England.
The heart exam showed a little calcifying in the arteries, something fairly typical in men of his age, and the blood tests showed another common male attribute: a raised level of prostate-specific antigen (PSA). PSA produces the liquefying component of semen, and may ease the passage of sperm within the uterus. It is a vital protein for conception, but when it enters the bloodstream in increasing amounts it may also indicate the growth of prostate cancer.
Kirby had monitored his PSA level for more than a decade. At 50, it stood at 0.5, which was negligible. But it had risen gradually over the years to 1.5 and then 3.3, which he regarded as a light flashing on the dashboard.
Two weeks after getting back from South America, he took a second PSA test and found it had gone down a little, which reassured him. Six months later, in September, he had another test and it was 4.3, the highest it had ever been, so he underwent a high-resolution localised MRI scan.
The news wasn’t good.
There was a lesion on the right side, which his radiologist thought could be one of two things: prostatitis, an inflammation treatable with antibiotics, or a tumour. And so a biopsy was ordered, involving a local anaesthetic and a probe, and the removal of 12 samples from the suspicious area.The following day Kirby received a phone call from his pathologist.
“Are you sitting down?” He was. “I’m afraid that three of the biopsies show Gleason 7.”
The Gleason scale is a grading system particular to prostate cancer, made up of two scores, each defining the advancement of a tumour and the risk of spread to other organs, with 10 as the worst prognosis. A combined score of 4 or 5 would prompt concern, and perhaps a policy of watchful waiting. But with a score of 7, Professor Kirby had a decision to make.
He looks boyish for his age, with a full mop of greying hair and a slightly Bunterish face, and he is not averse to wearing a rugby shirt in his leisure time. He likes to think of himself as a rather stoical, stiff-upper-lip type of Brit. But in the case of his illness his stoicism had both cause and irony: Kirby is one of the leading prostate surgeons in the world.
Prostate cancer has not been short of publicity recently, and Kirby is one of the reasons why. The fact that the disease is now regarded as both common and a common topic of conversation is partly thanks to Kirby’s proselytising and fundraising. He has written more than 200 research papers on the prostate and several books, including one called The Prostate: Small Gland, Big Problem. He estimates that he has removed more than 2,500 prostates since the mid-1980s.When I ask Kirby about the emotional impact of his cancer and the irony of contracting the disease on which he has built a career, he is nonchalant to the point of perversity.
“I thought we’d better just get on with it,” he says. He is in the living room of his house in Wimbledon, and has half an eye on the television as Chelsea, his football team, compete in Japan. “One of my heroes is James Bond, so I was hardly going to go around weeping. And there was no doubt in my mind that I should just have it taken out.”
To read the entire interview on Guardian.co.uk, click here.
This article was originally published in Intelligent Life.
