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Men need to be Aware - 4 : Tests, Verdicts and Decisions

by monty2011 on 14 March 2011

It was now July 2008, before leaving my doctor's surgery two weeks earlier a nurse took another blood sample so that the PSA results would be available for the hospital specialist. I was obviously apprehensive but calm and basically resigned to the outcome. Patricia came with me in case there were questions that needed asking that I wouldn't know of, but her with her thirteen years experience of the problem may want me to know about. We sat in the waiting room at the Doncaster Royal Infirmary. My name was called and we were taken in to see the specialist.

He began by introducing himself and asking me a few personal questions, I think more in the line of making me feel more at ease and making sure he was talking to the right patient. He asked how I felt and I told him I would feel better when I knew my situation. He told me that the second PSA blood test had confirmed the result of the first, that was a PSA level of 12.4. He told me that with any cancer the earlier the diagnosis is done, the less grip the cancer has and the more options are available to treat and hopefully remove the cancer. He told me that he would know more about the status of the cancer after I had had a biopsy. He said that if I was agreeable the biopsy could be carried out immediately. He explained that the biopsy was similar to the Digital Rectum Examination (DRE) I had had previously, except instead of the insertion of a finger into my rectum it would be an instrument capable of removing small samples of the prostate gland for examination. Like the DRE the specialist told me there should be a little discomforture but little pain involved. I agreed the biopsy should be carried out and I was led to another room. Again as with the DRE there was the little embarassing moment of being told to lay on my side and draw my knees up towards my chest with my bottom exposed, but you soon forget about that when you are reminded again what the specialist intends to do.

Being told what the implement was going to do during its one insertion got me wondering how big it was. The job it had to do was to remove twelve samples of the prostate gland, this conjures up the thoughts of a claw grabbing at the gland and sticking the sample in a container a dozen times, before doing this the implement has to go through the wall of the back passage in order to get to the prostate gland, so it first injects you with a local anesthetic so there is little pain as it does so, and when the job is completed another squirt, this time of an antibiotic to remove the risk of infection to the damaged area, does it also have a camera so the operator can see what is happening?  that I don't know.  Sounds terrifying doesn't it?    

In reality I felt the insertion not much different to the painless DRE, I felt twelve very minor internal thumps as the specimens were removed and then I was told I could get up and get dressed. All over. Another appointment was made for me to receive the results. From entering hospital to going home, including the wait in the waiting room took less than an two hours.

Mid July I returned to hospital for the results. The specialist informed me that I did have prostate cancer, he believed the cancer was contained within the prostate but I would have to undergo a Isotope bone scan, this meant an injection of a low level radioactive liquid into my arm, a three hour wait for the liquid to circulate and then I was placed into a cylinder for a full body scan. This is intended to locate any other cancer hot spots. Clarification of one area was needed and I had to return for a chest xray to eliminate any fears. It was nearing the end of July by the time the whole picture was known. 

Prostate Cancer is graded between 6 to 10 by something called a Gleason Score. My cancer was graded as 8 and believed to be aggressive. The body scan confirmed that the cancer was contained within the prostate gland. The specialist explained the situation to me by saying if I had a PSA level between 7 and 10 I would be advised to have periodical PSA test to monitor the level. Having a PSA level above 10 I would be advised about possible treatments. In my case I was informed that were I 73 it was possible that natural causes could be the reason written on my death certificate, being 63 it was very likely that prostate cancer would be the reason. I was advised that because of the aggressive nature of the cancer I should seek treatment urgently. I asked the specialist what my options were, he told me I had only three options and they were :- Do nothing, and take the risk,  Have Radiotherapy, but not knowing for two years as to its success or Radical surgery (prostatectomy) the removal of the prostate gland. All treatments had the possibility of undesirable side affects, but I saw the first two options as still carrying a risk to my life, so I chose the prostatectomy. 

I mentioned that Patricia her daughter and I were booked on a holiday in August, the specialist told us to go, have a good time and have the operation in September. The decision was made. 

I would like to say at this point that I could not fault my treatment, advise and concern given out by the Doncaster Royal Infirmary in relationship to my prostate cancer diagnosis. Though an unrelated problem showed a possible breakdown in communication between the hospital and my GP. I believe it was in June, possibly on the same day as I recieved the results of my first PSA test I told my doctor about having a sore throat. My doctor examined my throat but said he was reluctant to prescribe anything until I had been seen by my hospital urology specialist. His reasons were a little too obvious. So I had to suffer a little. When my body scan threw up a query, I thought it was possibly something to do with my sore throat. When my tests were over I returned to my doctor for some treatment of my throat. He said I cannot treat your throat until I know about your cancer results. It was left to me to inform my doctor that  I had known for a couple of weeks that I had prostate cancer and it was contained within my prostate gland. The doctor then started to treat my sore throat caused by reflux. Surely in this day and age patients should have one medical record able to be updated by Hospitals and Doctors surgeries.

I was lucky, my diagnosis was in time to save my life, 10,000 men a year die due to prostate cancer, see to see what you can do to help raise awareness of prostate cancer symptoms.

Next week my report of the prostectomy carried out at the Hallamshire Hospital in Sheffield





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The prostate disease bloggers

Grahamn278 was referred to a urologist with a high PSA in 2008 and prostate cancer was confirmed

monty2011 knew there was a problem with his prostate when he started needing to go to the toilet more often

AgedTenor is 64, loves singing and geology, and was alerted to his prostate cancer by a raised PSA test

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