My Prostate and Me – Part 2


Some of you may have read my previous post on this subject. I realise that I left it as something of an open-ended, cliff edge item. I had intended to follow-up fairly quickly with the following but for some reason I found I couldn’t  seem to find the time ??? Yet I managed to post on other matters. Go figure.

Since I am on the cusp of the next stage I felt I should bring this up to date, so here goes.

18 Months ago (or so) ….

….. after informing me that I did in fact have Prostate Cancer, Dr Hodgson proceeded to give me the details. The results of the biopsy and so forth. I think I am taking it all on board but in reality the enormity of my situation is quite overwhelming. Its only when he gets up and leaves the room in search of some leaflets that I really feel something. I’m not sure what it is but I have the sensation that something has just come down over me, like a sheet sliding over me. Not heavy but just there.

Dr Hodgson returns and we talk over things for a while longer. The net of this is as follows:

My biopsy has shown that I have Prostate Cancer, this is not good news, however you look at it.

I have a Gleason figure of 6 (3+3) 1% on the left side & 7 (3+4) 8% on the right side. This is relatively good news. Gleason figures in the 1 to 5 range are better. It is later explained to me that 3+4 is better than 4+3 even though they both add up to 7

I am 60 and, apparently, this is a good thing too as, with a following wind,  I have maybe 30 -35 years ahead of me.

My options are :

  1. Surgery – Whip it out and chuck it away
  2. Radiotherapy – External High Energy X-rays
  3. Radiotherapy – Brachytherapy (Nuclear bullets)
  4. Active Surveillance – Regular 6 monthly blood tests to monitor the PSA levels and an annual biopsy unless something changes.

The last was not offered as an option and I had to ask if it was available because I had read about it on the web. Dr Hodgson said that it was an option but he hadn’t offered it as at my age it was more likely that I would eventually have to take one of the other options.

So, I pondered a while then opted for option 4.

My main reasons are a strong fear of people cutting in to my bod. Well that one aside I am also concerned about possible side effects of surgery. After all the Prostate Cancer, isn’t causing me any pain or other symptoms at this time. Whereas, surgery could introduce me to a few negative issues. i.e. infection and damage to surrounding body parts including the bladder. Both of the Radiotherapy options come with potential negative effects which include bladder control which I am not about to give up just yet.

Nope, on the whole, I preferred the idea of Active Surveillance. And that is what we have been doing for the last eighteen months or so. Every six months or so I have had a blood test to measure the PSA and after each test I have had an appointment with a consultant. Each test, other than the last, has shown a slight increase in the PSA. The last showed a 0.1 decrease which in my book is negligible. At the last consultant review we discussed that part of the Active Surveillance regime is a regular biopsy.

And here we are. I am about to go into hospital for a “Template Biopsy”. Instead of grabbing their samples via the back passage, using an ultrasound probe with local anaesthesia, they will knock me out with a general anaesthetic and take many samples using a “template” grid to give them a more accurate idea of what is going on with my prostate. These samples are taken through the skin between the back passage and my undercarriage.

Personally I am really pleased that this will be carried out under GA.
So there you have it. I am about to go into hospital to be shot blasted in the gusset region with 20, 30 or 40 needles.

I will update you on how I get on, if and when I am able to sit down again. And here is a pretty flower for those of you traumatised by the idea of a template biopsy.

Pretty Flower

Pretty Flower

Idiotic Outpatient Appointment Rules


On Tuesday 9th October, 2012 I had just completed an appointment with the consultant dealing with my Prostate Cancer. I left the hospital clutching the details of my next appointment.

Having elected for  “Active Surveillance” the next appointment, to review PSA blood test results, was scheduled for four months time. i.e. 11:10 on Monday 18th February, 2013

A while later, seems like a couple of weeks, I was notified that the appointment had been cancelled and that I would be advised of a new appointment in due course. Time passed, Christmas came and went and no new appointment. Knowing that I had to arrange for a PSA blood test a couple of weeks ahead of the consult and not having a specific appointment I took a punt and arranged for the blood test to be carried out on Friday 1st February.

Well time flies by when you are enjoying yourself and here we are, half way through January and I still had not heard anything regarding a new appointment.

So I contacted the Urology Department at the QA where they explained that the original appointment had been cancelled due to government and/or NHS rules and I had been placed on the Outpatients Waiting List. However, very helpfully she said she would arrange a new appointment for me.

“I have an appointment for you in February” she said.

“Monday 18th” she said.

“That’s amazing”  I replied “My previous appointment was on that day”

“What time ?” I asked.

“11:10”  she replied

“Bizarre” I responded. “That’s when my original appointment was scheduled”

“Oh I can’t give you that time” she jumps in. “The diary is showing a conflict with your original appointment even though it has been cancelled.” “I’ll have to give you another time. How’s 11:20 ?”

Obviously I accepted the new time and she said she would mail me confirmation.

So in summary, the new rules meant that my appointment had been shifted by 10 minutes, had cost me a telephone call and cost the NHS/QA  three appointment letters.

WHY ?

I can only imagine that they are applying the same petty bureaucratic rules that stop me from being able to book an appointment, to see my GP, greater than a month ahead of time.

My Prostate and Me – Part 1


Here I am in my 60th year. I have made it through most of my adult life without suffering anything worse than the common cold and the occasional bout of flu. A couple of years back I was diagnosed with hypertension and have been taking tablets ever since to keep things under control. All has been well until earlier this year when I was asked to provide a blood sample as part of the regular monitoring. This time my GP said he noted that I hadn’t been checked for prostate cancer so he added it to the list of things for the lab to check out. Part of their preventive maintenance plan I guess. He told me to call in a couple of weeks to find out the results. and me being me, I forgot all about it and did nothing.

Until ……

Some time later I decided to go and see the doctor about a couple of moles on my shoulder. During the exam I mentioned the blood test and asked about the prostate element. After he pulled up my notes and following some chin rubbing he said “Your PSA is up a bit, perhaps we should book you in for an examination”.

Don’t you think that someone might have said something when my blood test came in ?

After all “No news is good news ….. Right ?”

Did they check the other stuff pertaining to my blood pressure ?

So I was left to go and make an appointment. While I am at the reception desk he calls me back in to the examination room. “Since you are here we might as well do it now” he says. A few minutes later he’s got a rubber glove on and I’m laid down on the couch, facing the wall with my knees tucked up under my chin.

After what can only be described as a “strange and unusual experience” he informs me that his exam was inconclusive, that he really isn’t an expert and feels it would be better if I was examined by someone with more experience. Personally I would rather that he had chosen someone else to practice on.

A week or two later I am up at The QA (Queen Alexandra hospital, Portsmouth) and I’m laid down on a couch, facing a different wall, with my knees tucked up under my chin. This time it is the lovely bubbly Vanessa with the rubber glove. This time I’m told that because I am tall, my prostate is quite high up and perhaps this is why the GP couldn’t feel my prostate. There then ensues a discussion about the length of my GPs fingers, me saying I hadn’t noticed from my position at the time if he had pianists hands and comparisons with Elton Johns chubby pudds. Meanwhile back on the couch… Vanessa thinks that we, I, should have another blood test to compare with my earlier one and that, based on that comparison, a decision would be made as to the need for a biopsy.

An appointment date is set and I am left to arrange a visit to the vampires at my GPs practice. I manage to fit in a  fortnights French holiday in between times, get the blood drawn and await the results.

On Thursday, July 26th, I have a short but bubbly telephone call with Vanessa who informs me that my PSA is once again elevated, that it is probably nothing, but why don’t we, meaning I, have a biopsy just to be sure. You can guess how enthusiastic I am about that. I haven’t been sitting idle, wasting my time. I’ve been on the interweb and found out how these biopsies are performed.

An appointment is made for Tuesday, July 31st. All too soon I am sitting in the Urology Dept waiting room and my name is called. They hadn’t warned me, but en-route to the torture chamber, they ask me to provide a urine sample. If I had known I would have made sure that I had plenty to drink. Needless to say I could not perform. Not a drop. “Stage Fright” says Vanessa.

Once again I find myself with my trollies down round my ankles, laid down on a couch, facing yet another wall, with my knees tucked up under my chin and my bum hanging over the edge. Now that’s an image to scare the kiddies don’t you think.

So the procedure gets underway, cold lubricating gel and the ultrasound wand is put where the sun doesn’t shine, anaesthetic is applied and the numerous biopsy samples are taken with the device clacking away with the sound of an industrial stapler. Job done, my bum is wiped and a man-sized pantyliner applied and I am packed off home, advised not to do anything strenuous. As if.

Thursday, August 30th, and I am once again at the QA. The Urology Dept. waiting room isn’t any more attractive. My name is called and introductions made. This time I am seeing Dr Dominic Hodgson. Where is the lovely Vanessa ?  After the pleasantries I am sitting waiting for Dr Hodgson to give me the “All Clear”.

So it’s all a bit surreal when he tells me that the biopsy has shown that I do in fact have Prostate Cancer.