With some New Zealand men risking an early painful death rather than the perceived embarrassment of "a gloved finger" examination, top New Zealand realtor Simon Anderson shares his raw and unfiltered story of prostate cancer, from his shock diagnosis at just 55, to his battle back to health and his discovery of a fresh outlook on life.
Despite "a prick of a year" of gritty medical procedures, unpleasant side effects and a rollercoaster of emotions which at times left the usually confident and sociable businessman "struggling to speak", Simon Anderson feels he needs to say something.
In fact, being in the "people" business as the managing director of one of the longest serving businesses in the Bay of Plenty community, Bayleys and EVEs real estate, Anderson feels it's his duty to
"Every single day of my real estate career has been about people not property. We are very much a family business which looks after people and families in the community.
"When I realised that men in our community - fathers, sons, brothers - could be lost to their families forever simply because we didn't arm ourselves with information about this disease, I felt like I need to say something."
Anderson is talking frankly, bluntly and honestly about his own prostate cancer in the hope it helps to help break taboos and bust some urban myths.
It's about this very common illness that, if detected early enough, has a 98 per cent chance of survival beyond five years.
Having a simple blood test can make the difference between life and death.
If the disease is detected too late, because men skip available testing or fear treatment, only one in four of those men diagnosed will likely still be alive after five years.
Anderson's story forms part of NZME's men's health awareness month with The Hits, Indulge Magazine, Movember and Farmer Autovillage - the last in a series of stories intended to shine a light on key health risks affecting Kiwi males, from mental health and male suicide prevention to physical health risks for men such as testicular and prostate cancer.
Stripping oneself bare in public to expose his very personal experience does not come easy, but Anderson he says it is part and parcel of starting those conversations about urological issues (prostate and testes) that most men find excruciatingly difficult to talk about.
"It's not something I share lightly. I'm a person who very much separates work life and home life. So it is not like I'm gunning to be the poster boy of prostate cancer, but after just experiencing it, I realised how badly Kiwi men need to be more willing to talk about these things.
"Knowledge is power. Prostate cancer is currently a 'taboo' topic that despite how serious it is - as serious as it gets - men treat it like an embarrassing secret. So much so that they avoid having simple checks that could save lives."
With 3800 Kiwis diagnosed with prostate cancer each year, Anderson said it is a no brainer for men over 50 (or over 45 if you have family history) - to take the standard test - a simple routine blood test used to determine the measurement of Prostate Specific Antigen (PSA) concentration in the blood.
"It's a blood test. It's easy. Just get it. If I hadn't had that test, my three daughters could have been facing this Christmas without their father."
Across New Zealand, there are more than 13,500 men living with and beyond prostate cancer,according to the Movember foundation.
Many are dealing with serious side effects from treatment - suffering side issues such as depression, weight gain, temporary incontinence and erectile dysfunction.
"Yes it's messy. One day I am leading business meetings worried about numbers, my staff, what the property market is doing. The next day I am worried about wetting my pants."
A down to earth "country boy" from Otago, Anderson tried to approach the various issues he faced during treatment in a "let's get on with it" way using the same leadership skills that had made him top of his game in real estate.
"I tried to approach things in an almost business like way at first, thinking, okay this is what it is, let's find out what I have to do, talk to who I have to talk to, make a plan and get on with it."
He quickly learned that "getting on with it" was challenging when there was no established dialectic to discuss "all the gory details".
"This means that tragically New Zealand men are suffering a common male disease and a difficult life experience alone and in embarrassment. That to me seems just silly to suffer alone just because you feel awkward.
"When you compare it say to women undergoing breast cancer treatment, equally as terrible and daunting experience, there just seems like there is more public acceptance to talk about breasts. There's pink armies of support for breast cancer sufferers - and I am delighted there are, because there should be. Bring them more!
"There's teas and walks and all the great things in the community - I know first hand as our business over the years has been very committed to supporting these."
He found prostate cancer less culturally acceptable to discuss.
"Imagine yourself at a the cricket with your mates and starting up a conversation about the best pad to wear after prostate surgery. Or going around the golf course weighing up different methods to treat erectile dysfunction.
"Those conversations don't happen. They should. Men need to get over themselves and start talking."
The Bay of Plenty urologists leading the world
As of the country's best known real estate kingpins, who knows and understands the Bay of Plenty better than any, Anderson says he has never appreciated living in the region so much as in the last year.
Living here has given him access to the world's leading experts on prostate cancer - the urology team led by Professor Peter Gilling and Mark Fraundorfer.
"If you have to get prostate cancer, the best place in the world to get it is Tauranga," says Anderson.
The dynamic doctor duo are experts in the investigation and treatment of urological cancers (kidney, prostate, bladder and testis), male and female incontinence and sexual dysfunction.
Gilling has devoted his career to uncovering the very best treatments which has put Tauranga on the world map for urology research and the latest surgical techniques including nano-knife, robot-assisted surgery, brachytherapy and cryotherapy.
With a straight up matter of fact manner, Gilling excitedly discusses the science of urology using an anatomical model of the male sexual organs placed centre stage on his desk which he is always eager to dissemble and assemble to illustrate his point.
Undoubtedly revered as an expert in his field Gilling smiles at the suggestion murmured around town that his bedside manner is "blunt".
"In these situations in my experience you need to be simple and very clear as people are often in shock so my approach is to be upfront and direct. But I have patted a few hands in my time too."
He is, in fact, a man who cares deeply about his patients and any perceived bluntness is another reminder that people are not used to straight talk about male body parts.
Gilling is intently aware that it is becoming ever more urgent to break the self-imposed silence that men have sentenced themselves to around medical issues related to the prostate, a silence which results in men educating themselves about recommended tests, avoiding tests, and shying away from talking about it altogether.
"Some men just have an inability to confront what is a common cancer for men."
Gilling says that this denial is driven by unnecessary fear and misinformation.
Research conducted in liaison with Gilling's Virtuoso clinic on Tauranga's Cameron Road canvassed male attitudes towards prostate cancer testing.
The research revealed that a high proportion of men still believed that the only test for prostate cancer was the traditional rectal examination - a gloved finger up the rectum.
The research also found that "terror and embarrassment" prevented some men - particularly in the Maori population the research showed - from taking tests that mean the difference between life and death says Gilling.
"Despite the consequences, men would rather die than get tested that way."
Gilling is wholly supportive of Anderson's choice to come forward with his story.
"It shows just the sort of man he is. All issues around prostate treatment need to come out of the dark.
"Only then you dispel myths. People have misconceptions about prostate surgery thinking you will be left the rest of your life incontinent and with no sex life.
"That is absolutely not true. Modern treatments that we have developed mean, while these symptoms might be temporary side effects after surgery, we have very efficient fixes for them, and are always researching and discovering ever more sophisticated medical modalities (the way things are done). So we fix things and if one thing doesn't work, we will try another."
A shock diagnosis
It was 19 October 2018, just over a year ago that Anderson, then 55, received the news from Gilling that would rock his world and those around him.
Before that diagnosis there was no doubt Anderson was a busy man and had been all his working life.
His three adult daughters were making their way in careers of their own, but still all kept their dad on his toes. Kate, 23 was working as an accountant in Hamilton.
A keen cricketer since primary school at St Thomas More, then Aquinas College, then Waikato Diocesan School for Girls, Kate still plays cricket for Northern Districts.
Annabel, 22 - affectionately called Belle by her dad, was in her third year as a medical student in Auckland, about to head back home to Tauranga for a placement.
Youngest daughter Nikki, was at the beginning of her studies in law and commerce at Wellington, funded by her side hustle of being the Bay of Plenty Cookie Time biscuit sales representative.
While Anderson had his hands full leading his number one team of talented and sports mad daughters who were just setting out on life with all of its complexities, Anderson's other leadership role was just as intense and dramatic.
At the peak of his game in the high octane world of real estate with a booming Bay property market, he is one of the top realtors in the country, then chief executive officer at the Bay's biggest and oldest real estate business, Bayleys and EVES which Anderson he'd help grow over the last 18 years from a small cluttered office in Grey Street, to a slick 500 plus strong operation run out of the heart of Tauranga's business district in the gleaming glass ANZ building on Elizabeth Street.
In between breakfast meetings, business lunches, a sea of black tie dinners and a jam-packed diary that vyed for attention with his ever ringing mobile phone, in May 2018 he had a PSA test that revealed abnormalities.
He had been having them regularly since 40 and had sailed through like a breeze, so he wasn't too concerned.
His doctor, then Gilling's fellow urologist Mark Fraundorfer did an MRI in June and another blood test in August.
When they were inconclusive he had a biopsy on October 8.
Despite the barage of tests, when he went for the biopsy results in Gilling's rooms two weeks later, he was totally unprepared for the news he was about to receive.
He had no family history of prostate cancer and a former Otago rugby player, who boxed, played twilight cricket and golf, he'd had no real symptoms other than a few more colds that year that he couldn't get over easily.
"I always thought I was bullet proof. I walked into his office to get my results, and remember smiling, joking, saying 'so am I stuffed?'
"Before I even had a chance to sit down Gilling replied 'yes you have cancer.' I went into shock. I thought no way, I am gone. My number's up. I am going to die."
His first question was: "How long have I got?"
The answer wasn't simple.
Prostate cancer is graded firstly by a Gleason score, which ranges from 6 to 10.
The higher the Gleason score, the more active the cancer and the more likely it is to spread.
Then the ISUP grading system (named after the International Society of Urological Pathology) grades the cancer between 1 and 5 depending on your Gleason score.
The lower the grade, the less likely the cancer is to spread.
Anderson's Gleason score was 7 and his ISUP score two, meaning while most of the cancer found in the biopsy looked likely to grow slowly, there were cancer cells present that looked more likely to grow at a more moderate rate.
While there were several treatment options mooted, Gilling recommended a Robotic Prostatectomy to avoid the risk of the cancer returning later in Anderson's life.
Only available privately and with modalities used in Tauranga the most advanced in the world, Gilling planned to use a robotic device to remove the prostate which allows more advanced surgical tools.
This is advantageous, explains Gilling, to have the best chance of saving the two bundles of nerves attached to the prostate that help a man get erections.
During surgery the robot uses tools to first pare back these nerves, then remove the prostate, and then re-position the nerves back in place.
Anderson initially booked the surgery straight away, but then deferred it to February because that coming Christmas the whole family was gathering together on Boxing Day to spread his father's ashes.
His beloved dad had died two years earlier from an aneurysm at 86.
"Gilling said deferring it was fine - and it would have been too much for mum to deal with all at once."
When breaking the news to his daughters, he adopted the protective parent role he was used to and deliberately downplayed it.
"I said, look I have a bit of a problem but am sorting it, no worries. They seemed to take that okay. But there was no dressing it up for Belle, as being a medical student came back with all the questions."
That Boxing Day, the family including his mother, two older sisters and older brother gathered in Chatto Creek in Central Otago to spread his father's ashes.
With all the family around him, Anderson said it was at that point that the reality of the situation grabbed hold of him and he "broke".
"I thought I could handle it well, and planned to tell them separately, so that it would be less of an impact on them. I didn't want things to be any upsetting for them than it already was spreading dad's ashes.
"So I planned a walk with them. But it all got to much - I struggled to explain it, the emotions all came flooding to the surface. I could not even talk.
"It is the first time in my life this has ever happened - I really had been bullet proof until then. But it really then grabbed me, the fear of facing death, of leaving my daughters alone.
"I guess it is what a lot of people go through in these situations, just raw grief and tears.
"And then you sort of process it with everyone, it is definitely better letting those feelings out because then when I got back to Tauranga I realised I couldn't fix this like I fix things in real estate, I had to put myself in the hands of other professionals and just take it one day at a time."
Anderson says he got through the subsequent months of surgery, discomfort and uncertainty feeling the fierce love of his three daughters who were determined not to let this potentially fatal disease take away their beloved dad.
And he equally was determined to battle not to leave them alone.
Solid support came from his other "close knit" family, at Bayleys and EVEs to which he has devoted 18 years of his life, helping grow the business to be arguably one of the most successful real estate companies in New Zealand - which he says he did by leading its people to be "loyal, committed, family and community focussed".
These same people who he had devoted so much of his own self to, did not hesitate to rally around their leader in the most life and death deal he had to negotiate.
While surgery in February was successful in removing the prostate, he was not out of the woods as there was still uncertainty of if the cancer had metastasised to other organs.
Continual tests every three months for the rest of the year were to be a further "tense waiting game".
When he spoke to NZME for this interview during men's health awareness month, he had already had the all clear on the 3 month test which showed undetectable levels of cancer.
Last week, he had had the nine month test and was awaiting the result as he shared his story, occasionally checking his phone to see if it had come in.
The all clear on this one would give him 12 months of "breathing space".
On the bench
Anderson feels grateful he could take a proper amount of time to recover.
He returned to work just a month after surgery, but still feeling unwell, uncertain what the future had in store, compounded with the sense of responsibility of leading people as chief executive, he realised it was too much at the time.
"I talked with our chairman Bruce Cameron after the month back at work and said 'I'm not good'."
"He saw I was struggling and said 'we need you back to lead us, and you will be back, so just for now you are on the bench so go take the time you need'. For that, I thank Bruce for his observation."
Anderson felt grateful that the company he helped grow was now paying it back, allowing him the time he needed to properly recover.
Having been used to years going at "100 miles an hour" he got used to a more leisurely few months at home.
He spent gardening and planting trees on his rural Pyes Pa property planting a gully with flax and natives to put life into the soil around him wherever he could.
His daughters gifted him a boisterous labrador puppy called Beau, who became Anderson's guiding light and loyal companion as he navigated this unknown territory of cancer treatment which, although included some pitfalls, he says he has found a new balance in life which he actually prefers.
"I look back on the early years in real estate - I used to be going in the office at 4am when people were just coming out of the Bahama Hut.
"That is what you do when you are growing a business initially but then this is not sustainable long term. I now make sure I get enough sleep and rest and am in bed by nine most nights."
His former diet of beers and pies has been swapped out for smoothies and eggs.
"I try now to make sure my body is getting the right nutrition it needs. I was lucky my three girls seem to know everything there is to know about food and diet so they helped me figure it out. It is not all green tea - I still love a beer too, it is about balance."
Having stared down the barrel of death, Anderson he is more than ever focused on the present moment, and has completed mindfulness courses.
"I have slowed down and am appreciating things more, like what I have actually achieved and done. I don't worry about the small stuff and details that don't really matter."
Time away from the real estate business he loves also allowed Anderson and the team to rethink and redevelop a leadership structure and strategy for the company to keep it growing 2020 and beyond, competitive and ready for the ever changing real estate market.
In October, the board announced new executive appointments and welcomed Anderson back on deck as Managing Director.
He has set a goal of a family holiday with his daughters at least once a year.
They visited the Philippines in August, travelling to Dauin on the island of Negros where they spent 10 days diving with turtles, sea snake and an assortment of fish.
nderson also went to the Rugby World Cup in Japan with a group of mates and managed to fit in three diving in Panglao on the way home.
Anderson says he finds his zen in this fishy kingdom.
"What I love most about being under water is you can't hear your cellphone ring."
While the recent trip has Anderson daydreaming about another life running a dive centre in Panglao, he says in reality he would never leave the Bay of Plenty that hold such a special place in his heart for both family and his real estate business where he lives and breathes Bay of Plenty land and houses.
"The Bay has been so good to our family we won't leave here. Its provided us an amazing job good education for my girls, access to some of the best sporting venues in New Zealand apart from a rugby stadium and some good mates. Maybe I'll just set up the dive centre here!"
As December approaches, he's looking forward to all the events that get him among the people in the Bay community he loves.
With his favourite season Christmas around the corner, he is looking forward to a traditional Bay of Plenty Christmas with pohutukawa and pavlova
If you do get it, have the treatment early and the odds are very much in your favour so you can stick around. And your family and this community wants you to stick around."
The day Anderson spoke to NZME he was waiting for the results on his nine month blood test.
The tense wait was tangible as each time the phone bleeped he glanced down to check.
Even though he enjoys a break from the phone ringing when diving in the ocean, he also loves his phone and always has it near as it is the heart and soul of his people business connecting him with everyone as he does deals, and the way he keeps in daily contact with his three girls.
"I have been given a second chance at life really to focus on what really matters, and for that I am grateful."
Local company Farmer Autovillage is getting behind the Movember Foundation's campaign this month to raise awareness about men's health. Since 2003, the Movember Foundation has been a global leader, committed to changing the face of men's health. Movember tackles all aspects of men's physical and mental health, tackling prostate cancer, testicular cancer, mental health and suicide prevention. Movember has funded more than 1250 men's health projects around the world, shaking up men's health research and transforming the way health services reach and support men.
Who is Simon Anderson?
• Born in Clyde Hospital in Alexandra in Central Otago, one of five children. • Three daughters Kate, 23, Annabel (Belle), 22, Nikki, 19. • Educated at Lincoln College. Graduated with an Agricultural Commerce Degree in Valuation and Farm Management. • Played rugby for Otago as an outside back from 1986 to 1989, then played three seasons of club rugby in Cape Town, South Africa, as a flanker. • Worked for BNZ in Otago, transferring to the Bay of Plenty in 1999 as senior rural manager. • Joined Bayleys in 2002 to develop and manage the country sales team in the Bay of Plenty. • Appointed as chief executive of Realty Group, which owns the Eves and Bayleys real estate brands, in 2016