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Former Tauranga mayor Tenby Powell looks back over the past six months and realises the signs were there - the signs of prostate cancer.
He just didn't realise it at the time.
In fact, Powell put much of his wakefulness and lower stomach pain in recent months down to stresses from ongoing issues at Tauranga City Council.
It's an understandable situation. The council's elected members' team has been plagued by high-profile conflict that boiled over when Powell resigned suddenly last Friday.
It was a move he had not planned on but became something he "had to do". It happened on what was his last day before going on medical leave for cancer treatment.
On Monday, Powell had a robotic-assisted radical laparoscopic prostatectomy at Grace Hospital. He's now on the mend, getting plenty of bed rest.
"With this procedure, you leave your dignity at the door," he said.
Powell's brutal honesty continued when he described the impact of diagnosis and treatment.
"A catheter wasn't on my discovery to-do list. And regarding incontinence, never did I think that would have incontinence pads on the shopping list."
When asked if he was sure he wanted to be so open and personal about his experience, Powell said: "This is what people need to understand, it is what it is."
And that's the point.
"I started this whole thing, this public life because I wanted to make a positive difference. That's what it was all about. If I can do this for men and encourage them and motivate them to get checked ... this is anything but an exclusive club."
Prior to his diagnosis, Powell said he had been "pretty active" in climbing Mauao often and running 15 to 16km pre-lockdown.
It was a routine prostate-specific antigen (PSA) blood test that turned everything upside down.
"My message to men 50 and older is: Go and get checked. Get your bloods done. The PSA test is very important."
Powell had continued to be inundated with hundreds of messages of support since his departure as mayor on Friday.
Such feedback had helped spur his motivation to share his health journey.
"I'm happy to talk about this. If you said to me six months ago, this is where you would be now, I would have laughed. Looking back though, the signs were there; the getting up in the night, pains."
Powell said it was important to accept vulnerability and he was keen to "turn lemons into lemonade" to do what he could to help others.
"The message is you are not alone. There are many of us out there willing to talk," he said.
"The number of people who are very high profile in this city, and country, who have reached out to me to say they know what I'm going through has been staggering."
Humbled, Powell was now focusing "on what's good in life" and getting "back in the bush" hiking. He's not sure when that will be just yet, but that day will come.
"It's different for everyone. Some say they are back to work in three weeks and for others it can take three or four months. Everybody's different."
Powell said he was fortunate, at 60, to be relatively young and fit but to push his recovery beyond its limits would be a mistake. For now, he was sticking with bed rest and taking things easy.
"It's about coming to terms with these changes in a mature and open way."
Reflecting on the events that led to his sudden resignation last Friday, Powell said he remained concerned significant plans under the proposed Long Term Plan due to be signed off next year could fail. He hoped acting mayor Tina Salisbury would remain in the role.
"Tina has every ability, if she has the right support around her, to become a very good mayor. I think it's important for the city to wrap around her. In my view, we need a progressive council."
However, Powell's focus now was health and family. Support from wife Sharon Hunter had been "amazing", as has support from friends and former colleagues, he said.
Before the conversation with Powell ended, he had already received 14 messages from friends around New Zealand checking in on him.
Powell was comforted by such support but adamant his cancer journey should not be done solo.
He hoped men, and the wives or partners of men, would heed his call to get tested. Early detection greatly enhanced recovery.
About 3100 men a year are diagnosed with prostate cancer in New Zealand.
Of those, about 650 men died. Mãori men are 72 per cent more likely to die of prostate cancer.
It needn't be that way, Powell said.
"There will be many men out there wondering if they should get tested. They should."
Symptoms of prostate problems
Usually the first sign of trouble with a prostate is with passing urine. A man may notice one or more of the following symptoms:
- trouble getting the flow of urine started, especially if in a hurry
- trouble stopping the flow of urine ("dribbling")
- the stream of urine is weak, or it stops and starts
- needing urgently to pass urine at any time
- feeling a need to pass urine more often during the day, even though not much comes out
- getting up at night to pass urine more than once
- feeling a need to pass more urine, even though none comes out
- pain and/or burning when passing urine; this may be a sign of infection
Source - Prostate Cancer Foundation NZ