Walsh, 50, was diagnosed with cancer last year after an earlier blood test, carried out in 2017 as part of a regular health check, revealed an abnormal result. Further tests were carried out before prostate cancer was confirmed.

“I remember sitting in the doctor’s office with my wife, Connie, and being in shock,” he says.

“I could not believe [the diagnosis] as there were no symptoms and I felt very healthy. In fact, I had just completed an Ironman triathlon one week before [the diagnosis] so I didn't think it could be true.”

Walsh leads a fairly healthy lifestyle, exercises frequently and considers himself fit – having competed in long-distance races since 2015 – so he never expected to find himself suffering a major health scare.

Common cancer among men

“Prostate cancer is the third most common cancer for men in Hong Kong after colorectal and lung cancer,” Dr Edmond Wong Ming-ho, Walsh’s urologist at Hong Kong Adventist Hospital – Stubbs Road, in Happy Valley, says.

“In its early stages, the cancer is confined so there’s no symptom.”

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Wong recommends that all men aged 50 and above go for a prostate-specific antigen test – a blood test used primarily to screen for prostate cancer.

While the causes of prostate cancer still are unclear, the American Cancer Society attributes it to “changes in the DNA of a normal prostate cell”.

These gene mutations can be inherited from a parent or acquired during a person’s lifetime.

Up to now, the best medical suggestion for prevention follows the general advice for staying fit and healthy – do regular exercise, drink less alcohol and avoid sugar and processed foods.

The prostate is a gland, located between the bladder and the penis, which helps to make the reproduction function easier. It secretes fluid that nourishes and protects sperm.

Like every organ in the body, the prostate deteriorates with age. If enlarged, in a condition known as benign prostatic hyperplasia, and left unchecked, the growth can be cancerous.

The good news is that most early-stage prostate cancer can be cured with surgery or radiation, with a success rate of more than 90 per cent.

“I was very lucky,” Walsh says. “If not for my company’s annual medical check, I would not have discovered it. Early detection gave me a much better chance of survival.”

Less invasive, more accurate surgery

Walsh has the hospital’s minimally invasive, robotic surgery system, or robotic prostatectomy, to thank for his swift recovery.

Traditional prostate cancer operations require making a large 12cm (4.7-inch) to 14cm incision from the pelvic bone.

However, robotic prostatectomy relies on several small incisions for more precise surgery, which also enhances results after the operation

“Traditional surgery can leave patients in greater pain afterwards,” Wong says.

“On average, they used to have to stay in bed for up to four days and in hospital for two weeks. Now [with the new technology], they can be back to work in a week.”

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However, the road to full recovery is still tough. Patients can suffer side effects following surgery, such as a period of urinary and sexual difficulties, but fortunately these often can be overcome with medication or rehabilitation.

Also, patients often have to face mental and psychological challenges – often overlooked after surgery – in addition to dealing with the physical wounds and problems of rehabilitating muscles and ligaments.

“I can deal with [the pain], but the psychological effects are more difficult,” Walsh says.

At the time he says he often found himself asking questions such as, “Why me? Is this the beginning of the end? What if it can’t be cured? What if it comes back?”. He says: “The worry never goes away.”

Yet Walsh’s reaction is not uncommon among cancer patients.

Wong says: “Breaking the bad news is always difficult. Most [patients] come to the doctor’s office expecting the worst and hoping for the best.”

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As such, it is important for doctors to be “sincere, compassionate and empathetic” and to give patients ample time to digest the diagnosis before starting the conversation about possible treatments, he says.

Personal fight against cancer

Walsh’s positive attitude was just as important to his recovery as his physical conditioning. He was determined to return to taking part in sports

A week before his diagnosis Walsh had qualified for an important triathlon competition – last year’s Ironman 70.3 World Championship, which was being held in South Africa on September 1.

Yet lying in his hospital bed after his operation, at the end of June last year, he didn’t think he would be fit to take part in the race – comprising a 2km swim, 90km cycle and a 21km run – as it was little more than two months away.

“I remember emailing the organisers to cancel my entry, trying to get my money back,” Walsh says with a laugh. “Luckily they ignored me.”

Deep down, Walsh had not given up wanting to take part and worked hard to recover from the prostate surgery.

“When I attempted to run in August [last year] I could manage only one lap around the running track and was exhausted,” he says. “But I persisted.”

Walsh gradually increased the distances and later also resumed swimming and – finally – cycling.

His perseverance paid off and he was able to take part in the event in South Africa.

Walsh says he used his training for the event and – ultimately – competing in the race as personal goals while fighting prostate cancer.

“The race was challenging and difficult, but I didn’t finish last,” Walsh, who is now in good health, says.

“With 1km to go I burst into tears. I knew I had not only done the race but beaten cancer.”