Of best times, biopsies, and Beirut phone booths - Roger Butt

It was to be the year of a lifetime. In January of 2009, I embarked on a much-anticipated sabbatical from my job with the federal government, a chance to shed the mantle of bureaucrat for that of world traveller.

There had been a warning. I’d had annual PSA tests after my father had been diagnosed with prostate cancer in his mid 60s. In July of 2008, after a routine medical, I received the news: a PSA of 6.36. When a follow-up test came back at 3.88, I convinced myself that the first was an aberration. How could I, at 48, active, fit and in excellent health, really get prostate cancer?

So in the wee hours of January 3, 2009, I departed Ottawa for Guatemala, thoughts of cancer buried deeply in my mind. I focused on learning Spanish and the culture and politics of Latin America. The next five months provided the most amazing experiences of my life: engaging with ex-guerillas in Guatemala and Nicaragua; Mayan ruins at Tikal; the Inca Trail to Macchu Pichu; the Galapagos Islands; Buenos Aires; Rio de Janeiro; and on it went.

I returned to Ottawa in early May and arranged for my overdue PSA test. To my shock, it was 12.26. My doctor referred me to a urologist and ordered a second test. But I was scheduled to leave for Tel Aviv on May 15. After discussion with my partner, who would join me on this leg of the journey, I decided to go, arranging to get the second result by email.

Four of us arrived in Tel Aviv on May 17 and set out to explore the enigmatic land of Israel and the West Bank. Now, though, the prospect of cancer was never far from my mind. Two days later I read the pointed email in a Tel Aviv internet café: my PSA had dropped but was still at 9.79. After an email exchange with my doctor, I decided to complete the two-month Middle East journey, vowing to appreciate it all the more. The final biopsy arrangements were confirmed in a late night telephone call with my doctor from a pay phone in Beirut. By now, my travel companions had returned to Canada and I was left to deal with this alone.

Despite it all, I remember feeling lucky and grateful. Canadians benefit from a healthcare system that offered early diagnosis and quality care. In the Middle East, most do not enjoy such privileges. Early diagnosis of prostate cancer simply would not happen. Moreover, the quality of care one receives very much depends on one’s ethnic origin and economic status. Palestinian refugees in a Lebanese camp could not hope to access quality medical care nor could the Syrian restaurant owner who feared being bankrupted by medical costs for his ailing mother.

After an amazing odyssey through six Middle East countries, I ended my journey in Istanbul and returned to Canada on July 15. My biopsy happened on July 20 at the Montfort Hospital and it confirmed the cancer diagnosis. I cancelled plans to travel to Southeast Asia and focused on treatment options.

My prostate was removed on November 23 by Dr. Cagiannos and I awoke to good news of a successful nerve-sparing operation. On December 23, one month after my surgery, we flew to St. John’s to attend my sister’s wedding, a joyous occasion to mark the end of the best and worst year of my life. My PSA dropped to negligible, where it has remained for the two years since. And I completed my first sprint triathlon in June, 2011.
Dealing with prostate cancer while travelling in the developing world gave me a new perspective on our healthcare system. It was working for me even while I in a Beirut phone booth.