Lyrical Prostate

 Ifor Thomas, prostate cancer

Why should you care about Ifor Thomas if you don’t have prostate cancer? Because in this space we are a cancer support community. We care about each other’s journey with different kinds of cancer, and we seek to be supportive. To listen to what the others in our group are going though strengthens our bonds with each other and increases our understand of what cancer takes away from us and what it brings.

September is Prostate Cancer Awareness Month. I haven’t yet done a prostate post, so this addresses that. This year, besides prostate cancer, I’ve talked about people with other cancers: bladder, breast, colon, environmental, leukemia, liver, lung, melanoma, ovarian, pancreatic, and uterine. 

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Body Beautiful is a collection of poems by Thomas, a Welsh poet, that is mostly about his prostate cancer. The poems are lyrical, with vivid images, and his voice throughout is strong and reflective.

What makes this book special is that a man actually took the time to write about his prostate cancer, he writes about it well, it’s humorous at times, and it’s poetry that I understand. Sometimes the cancer poems of others are either too academic or obtuse for me to know that they’re talking about someone who is struggling with cancer.

Thomas describes his happenstance diagnosis, the surgery, his stay in a recovery ward with eight other men, and his release back into society.

It was a fluke that he found out he had cancer. Out of curiosity, he volunteered for a UK-wide medical survey to see how likely people were to develop different cancers, and they discovered his PSA number was high. A biopsy of his prostate revealed three out of ten tissue samples showed cancer, and he was graded with a Gleason 7, which indicated an intermediate risk. The doctors let him decide whether to go on active surveillance, or start treatments with either surgery or radiation in Cardiff, Wales.

The book was published in 2005, which means that Thomas did not have access to all of the developments in medical treatments for prostate cancer of the last twenty years. This gives us a look back into the near history of how prostate cancer used to be handled in Britain.

A doctor tells him that during surgery they will remove his prostate, lymph glands, seminal vesicles, and left-side nerve bundle, which seems extensive to me for a Gleason 7, especially if his cancer was contained within the prostate. They did an MRI on an older machine, but I don’t know how accurate that was for determining containment. Today we use the PSMA PET scan that is more precise. 

Perhaps twenty years ago, surgeons just took out a lot of stuff to make sure they got all of the cancer, just as surgeons used to take out extra tissue for breast cancers. Deliberately taking out a nerve bundle would affect his erectile functioning, and Thomas jokes with a friend that it was a choice between having a functioning “knob” or staying alive.

We read about “rust” appearing in his sperm after the biopsy, the MRI and bone scan, his checking into the hospital the night before his surgery, getting settled in with his ward mates (and he seems to have stayed for a number of days), the aggressive laxative that sends him running repeatedly to the bathroom in “Poleaxed,” his choice to skip general anesthesia in favor of what I conclude was an epidural injection into his spine (“I arch my back. / A nurse holds my hand.”) so that he can be awake during the procedure to observe but not feel any pain. 

Would I want to be awake and observe someone cutting something out of my body? I think I would, if I didn’t feel the pain. I’m curious about the body and how medicine works.

Unfortunately for Thomas, the cutting goes on behind a screen, so he can’t see the scalpels, retractors, or seeping blood, but his prostate pops out from behind the screen in a jar, “gobbet red,” to be sent to pathology. He mentions his catheter, and later that the drain tube to his wound was yanked out by a nurse like someone starting the motor on a fishing boat — “that starting rope / spinning out of my guts.” He also creates character sketches of his ward mates who are in for surgeries.

The book’s cover photo is of an abdomen with a six-inch, metal-stapled, jagged incision going across. Thomas is credited for the photo, so it could be his body. This was how prostate surgery was done before the Da Vinci robot became a surgical option in Wales that makes only one-inch port holes into the abdomen.

In “Body Beautiful,” the book’s title poem, Thomas takes a visual inventory of his body after surgery: there is a cannula on the back of each wrist, wound drains in his abdomen, a catheter that is sewn to his foreskin to enable the urethra to heal, and the chain of staples across the abdominal cut. (Today the cut urethra is sewn to the neck of the bladder, and the catheter is taped to the thigh to hold it in place as the urethra heals.)

The observations are perceptive and contain enough medical information to convey what’s going on, although I had to guess to fill in some of the blanks. I would have liked to read more about his emotions, especially if there was anger or anguish when he found out his sex life was probably over. I would not be so casual about it. I don’t know how much pain or despair he felt or what physical changes he was left to contend with. Other than being cured of cancer, did he have the customary urinary incontinence for at least three months that surgery causes? It seems likely that he had permanent erectile dysfunction because of the nerve bundle being removed, and because he goes to see a Dr. Zhang for Chinese medicine that might resurrect his erections.

Wry and dark humor appear throughout. For two days he is known as “Nil By,” as in “nothing by mouth.” As he’s being wheeled into surgery, he wonders if now is the time to tell them that he’s changed his mind. I had this thought at 4 a.m. as I was about to head down to the hospital for my prostate brachytherapy procedure where eighteen radioactive wires were going to be inserted. 

He mentions that Robert De Niro was going through treatments for his early stage prostate cancer at the same time, and Thomas found comforting companionship in that.

© 2026 Mark Liebenow