³Ô¹ÏÍøÕ¾

Hi, I’m Tim.

Diagnosed with stage 4, metastatic prostate cancer on July 7, 2015. PSA 120. Gleason score 9. Lesions in right femur (thigh bone) and left seventh rib.

Those of you with a maths brain might have already calculated that was nearly seven years ago. In that time, I’ve had early chemotherapy (docetaxel, six cycles at three-week intervals) with concurrent hormone therapy (Zoladex), targeted radiation, ongoing intermittent hormone therapy, and have undergone a TURP (transurethral resection of the prostate). I think it’s fair to say I’ve been through the ringer.

I was told at the beginning of this “journey”, I could expect five years of reasonable health, that six would be “exceptional”. And yet here I am nearly seven years on, at 57, largely asymptomatic, still surfing, writing, being a dad and a husband. I’ve had my share of dark days and the stress and anxiety has taken a toll on my marriage, my family, my ability to earn a living and sense of social connection. But I’m still here and, for the most part, life is good.

For those of you living through a similar experience, I don’t need to tell you how challenging this all can be. But I have learnt a lot along the way that has not just made life bearable, but meaningful, rich, fulfilling. That’s not to say I don’t still have down days, but they are increasingly outnumbered by days I feel profoundly grateful, content, thrilled to be alive at all. What I’d like to do here is present a few of the hormone therapy life hacks that have helped me not just keep my head above water, but find joy and peace in these strangest of circumstances.

My approach is probably best summed up in this handy, self-care mantra. Remember to take your M.E.D.S.

• Meditation
• Exercise
• Diet
• Sleep

These are the four pillars of my self-care, in no way designed to replace, but rather to complement conventional therapies.

Meditation is the foundation of this approach. The ability to cultivate a clear mind, to be able to drop into a place of mental quiet and stillness, to silence the cycling anxieties and uncertainties of a cancer diagnosis, is priceless. There’s nothing terribly mysterious about meditation – in essence it’s about quietening the intellectual mind, or what Buddhists call the “monkey mind”, constantly jumping from one thought to the next. This is done by focusing on the breath moving in and out of the nostrils and, depending on what meditation tradition you practice, may include repeating a mantra, visualisation or noticing subtle sensations in the physical body. I practice Vipassana meditation, but I don’t think it matters what technique you practice, they all share the same core element of quietening the mind.

Think of a clear mind like a blue sky and your thoughts as clouds. The blue sky still exists even when obscured by clouds. We can quietly observe the clouds as they drift by without cursing or identifying with them, and eventually the clear blue sky re-appears. My meditation practice feels like this. I don’t instantly drop into some transcendental bliss state or see rainbows and unicorns. But I do at times access a state of “no mind” where everything drops away, the clouds part and only a subtle vibration or hum is left that can be deeply comforting.

There are many different guided meditation apps and YouTube clips and CDs available, but part of its beauty is that meditation is essentially free and just requires your time and patience and a commitment to a daily practice to reap the benefits. Find a comfortable sitting position, cross-legged on a cushion on the floor or in a chair, or even lying down if you prefer (but be warned, you may well fall asleep), and simply focus on your breath. A guided Yoga Nidra meditation is a great place to start, scanning and relaxing the body from head toe. If the mind wanders, gently bring it back to the breath without becoming frustrated. Over time the moments of quiet will expand, from five breaths to 10, from one minute to five minutes to half an hour, leaving you refreshed and able to face the challenges of the day with calmness.

Studies have found significant improvements in mood, memory, cognitive function and reductions in levels of the stress hormone cortisol, from just eight weeks of daily meditation, and changes to the brain that are visible in MRI scans.

I generally sit twice a day, morning and night, for anywhere from 30 to 45 minutes each time. But as little as 15 to 20 minutes a day can still bring profound benefits.

In coming weeks I’ll unpack a few of the other hormone therapy life hacks that have helped me, in the hope they can help you too.

References

^{Singleton O, Hölzel BK, Vangel M, Brach N, Carmody J and Lazar SW (2014) Change in brainstem gray matter concentration following a mindfulness-based intervention is correlated with improvement in psychological well-being. Front. Hum. Neurosci. 8:33. doi: 10.3389/fnhum.2014.00033}

About the Author