Prostate cancer found during kidney transplant evaluation

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Malcolm Butterfield shares his story of his battle against prostate cancer

By Amanda Dale

A prostate cancer test saved Malcolm Butterfield's life in more ways than one.

Mr. Butterfield underwent a PSA (Prostate Specific Antigen) test as part of a series of checks ahead of preparing for a kidney transplant.

The managing director of KPMG Advisory was diagnosed with renal failure last year and opted to undergo a transplant rather than a lifetime of dialysis. His 27-year-old son Rayman volunteered to be the donor.

"My son is giving me this gift. He decided he would give up one of his kidneys for me, so he is really the hero in all of this," says Mr. Butterfield.

"Without that kidney I would be on dialysis for the rest of my life."

Mr. Butterfield, a partner at KPMG, underwent extensive medical tests at Brigham and Women's Hospital in the US to see if he would qualify for transplant surgery.

He says: "I had a PSA test when I was in Bermuda but for some reason, when I had one at Brigham a few weeks later, it had shifted slightly. Not to a level that was alarming but to a level which got their attention.

"The doctors said we had to make sure there were no malignancies in my body ahead of a transplant, because the anti-rejection drugs are like jet fuel to cancer.

"The PSA test is not definitive though, it's just the first step in diagnosing cancer, and so I had a biopsy done. When the results came back, [Bermuda urologist] Dr. Charles Dyer confirmed I had early stage prostate cancer."

Mr. Butterfield, a married father-of-three from Smith's, says: "It was a double blow to be told I was in renal failure and then a few months later to find out about the prostate cancer.

"But we took it as a blessing in disguise because if we had missed the diagnosis for prostate cancer I would have really been in trouble.

"Without the PSA test and biopsy, can you imagine had they done the transplant and then found out I had prostate cancer?

"Either way I would have been toast because the anti-rejection drugs would have caused me issues."

The 57-year-old opted to undergo a prostatectomy.

"I couldn't afford not to, because I had a kidney transplant on the cards," he says.

Since surgery, he has had a PSA test every three months to make sure he "zeros out" before the transplant procedure.

"It's important to get that negative PSA result in order to have the transplant. Subject to my next follow-up in July, I will be ready for my kidney transplant at the end of September."

Since the removal of his prostate Mr. Butterfield has not suffered any side effects, such as urinary or erectile problems.

"At the end of the day, even with those phobias and fears, the question is: life with or without prostate cancer?

"Death is the end result if it is left undetected and you do nothing about it."

He says: "I would encourage all men to have regular PSA and DRE (Digital Rectal Examination) tests. Men tend to shun away from the DRE but if they don't do this there are a lot worse issues they may have to face.

"It is always better to know than not to know."

He agrees with the Bermuda Cancer and Health Centre's recommendation for all men over 40 to have an initial PSA test to establish a 'benchmark' reading.

"As soon as you get into the habit of getting checked, early detection is the saving grace," says Mr. Butterfield.

"The longer you wait and there's something going on, the more likely it is that you are going to have issues.

"I still think there are far too many males who think they are beyond detection. Black men also have to pay more attention than Caucasian males because for some reason they have a higher incidence of this disease."

Mr. Butterfield says: "Everyone seems to have a different story when it comes to prostate cancer, and mine is very different.

"But when you're in a card game and you're dealt a hand, the important thing is how you play your cards."

The Bermuda Cancer and Health Centre is offering a free PSA test tomorrow (Saturday) for any man over 40 who has not been checked in the past year or who has no medical insurance.

The walk-in clinic has been organised in partnership with the Bermuda Hospitals Board and takes place at 46 Point Finger Road from 10 a.m. to 3 p.m. just bring identification.

For more information visit www.chc.bm or call 236-1001, extension 1020.