David

Age at interview: 61
Age at diagnosis: 52
Brief Outline:

In 2002 David was prompted by a poster to ask GP about test for prostate cancer. After a first and second high PSA score he was immediately prescribed hormones by GP. A later biopsy confirmed prostate cancer and he had radiotherapy treatment. David is currently again receiving hormone treatment.

Background:

David is a technical director of an engineering company, married with three adult children. Ethnic background is White.

More about me...

David was diagnosed with prostate cancer in 2002 when he was 52 after being prompted to ask his GP for a PSA test after a publicity campaign drew his attention to this test. His PSA score was 102 and a later test was even higher and he was immediately prescribed Casodex and Zoladex. Later, he had a biopsy and a bone scan at hospital confirming prostate cancer and had subsequent radiotherapy. He found both the radiotherapy and his engagement with the health service staff to be a pleasant experience. He attends the oncology clinic every three months where his treatment continues to be monitored. He was on Zoladex for 3 ½ years before being taken off it and his PSA simply monitored every three months or so. This continued until his PSA crept up again at which point he was put back onto treatment. Over the years he has seen a series of different consultants which in some ways he considers to be a good thing as this means different opinions from different people. Five years after the original diagnosis he was put back on hormone treatment. He decided to have Casodex rather than Zoladex as the latter made him tired and subject to hot flushes. However, a side effect of Casodex which he didn’t fully appreciate at the outset of treatment was enlarged breasts. While at the start of his treatment he was advised that radiotherapy would prevent this becoming a significant problem he declined this as what he understood to be an unnecessary intervention. However, this side effect turned out to be much worse than he expected and during his two year treatment on Casodex considered his enlarged breasts to be a real problem and by this time his breasts had grown so large it was too late to have the radiotherapy. He tried to disguise his breasts physically but then decided to have a breast reduction which he had to pay for privately. While this surgery initially made him feel better he was dismayed to find that his breasts grew quite quickly again afterwards. In addition it seemed that the Casodex wasn’t working as his PSA score was rising again. At the time of the interview he had been back on Zoladex for about 4 months.

Interview conducted in 2011 by Anne Montgomery.

Zoladex made David feel very tired. Casodex led to breast enlargement (gynecomastia) which was a problem. Eventually David had breast reduction surgery.

Zoladex made David feel very tired. Casodex led to breast enlargement (gynecomastia) which was a problem. Eventually David had breast reduction surgery.

SHOW TEXT VERSION
PRINT TRANSCRIPT

But eventually about, this would be about five years after the initial diagnosis, I think, I was put back on eh hormone treatment, but I asked them about the options because I knew from experience that the Zoladex is quite difficult to live with, in some ways, in that it makes you quite tired, so it zaps your energy, and you’re also quite prone to hot flushes which are quite uncomfortable, as my wife knows very well, for other reasons. There was an alternative suggested to me and that was bicalutamide or Casodex, the brand name. I discussed this quite a bit with the registrar at the time, and I was told that the Casodex had the advantage of, perhaps not making me feel so tired, and not giving me the hot flushes in the way that the Zoladex would, but there was a disadvantage that I was quite likely to have gynecomastia, my breasts would grow quite big, and I asked him at that stage, you know, “how big”, and he indicated to me that well it wouldn’t it wouldn’t be too bad, so I was on Casodex for about, about two years, two, I mean I can check all these dates, but I think it was about two years, but during that time my breasts actually did get very big, and to the point where it was really a problem. Now I should say it was offered to me at the time I went on Casodex that I could have had radiotherapy treatment to prevent this happening but on discussing it I opted not to do that, because it was an intervention that I thought, “well this isn’t going to be a life threatening condition so why bother to have some other treatment which is an intervention of a kind”, so I opted not to have it, but of course by the time your breasts grow bigger, it’s too late and you can’t have that treatment, it’s no longer an option. I discussed this with various people and tried different ways of disguising it physically, but in the end I opted to go and have a breast reduction done, I actually thought I was going to have a breast removal done, but I’d been recommended by, yet another consultant, oncology consultant, that the best way of approaching this would be to go and see a plastic surgeon and have it, you know, have the treatment done that way, have the surgery done that way. I did that, I had to pay for it privately, and I actually had to pay in cash although I have medical insurance, they wouldn’t support that, wouldn’t pay for it, even with a, you know we had a long argument about this, even though they will pay for breast reconstruction for women, and this is a very similar situation, they wouldn’t pay for, for this treatment for me, so I paid for that, had it done, just in time for my daughter’s wedding, which was quite good, it made me feel a lot better about standing up in front of people. But to my dismay I found that my breasts grew again quite quickly afterwards, however, at that time, it was also obvious that the Casodex treatment wasn’t working because my PSA score was going up, so I’ve been back on Zoladex now for about four months, and finding things quite hard to be honest (laughs) simply because it makes me very tired, I’ve really got very little energy, and I’ve put on a lot of weight, it’s all in a sort of vicious circle, lack of energy, and the lack of exercise that comes from that then means that my weight has gone up quite a bit, and that makes it worse, so it’s quite hard at the moment, but that’s really where I’ve got to now, that I’m back on Zoladex.

 
So the breast reduction helped but I really should have gone for a mastectomy, but I needed it done before a wedding came up, and there wasn’t an option to have it done that quickly on the health service, I’d probably still be waiting on it in the health service.

 

Having tried Zolodex, and then Casodex, David went back to Zoladex. He is now taking a small dose of the hormone Megace too.

Having tried Zolodex, and then Casodex, David went back to Zoladex. He is now taking a small dose of the hormone Megace too.

SHOW TEXT VERSION
PRINT TRANSCRIPT

This time that I’m on Zoladex I’ve also been put on to a very small dose of medication that’s used, or a drug that’s used for the treatment of breast cancer. I think it’s called Megace, and what I have to do is take a quarter tablet of that every day, and that helps to suppress the effects of hot flushes and so on, and it does work quite well, although you get the strange feeling of feeling hot and cold at the same time, you’re not sure whether you’re hot or cold, (laughs) that’s a very weird, but I do think on balance it’s better. I feel very tired at times, I mean I could just suddenly, about two o’clock in the afternoon, many days, just suddenly feel really exhausted, and I really want to go and lie down, but there’s nowhere to go and lie down, but you recover from it about half an hour later.