Interview 20

Age at interview: 71

Age at diagnosis: 69

Brief Outline:

Diagnosed with prostate cancer 1998. External beam radiation and short hormone treatment.

Suggests that screening and testing should be available on a regular basis.

What's your opinion about doing routine testing for PSA for men?

Well I think it is invaluable, in spite of the fact that there is contrary opinion now that it's not a good indicator of the level of malignancy or level of tumour that one can have. I think it's essential and certainly I would argue from my case that it's the change in the reading that is significant and therefore if it's done routinely one would see or recognise the change in the system. However if it's only done once and then not again for another couple of years or so then there is no comparative effect, but if it's done regularly then this to me is utterly vital.

I think it would be a really good idea to provide screening for prostate cancer on a regular basis because it is the change in the PSA level that would indicate that something is going wrong. And it's, it's no good to my mind going to your GP and him saying that you know it's a fact of life that the prostate is enlarged, and you know we'll wait and see, and not do anything about it, because there are things that one can do about it and it would be advisable I think.
 

Describes how his monitored PSA levels raised enough to cause concern.

I really didn't discover a problem myself because my condition was what I would describe as benign. I go to France annually and when I am there I have a check-up with a doctor in France. And over a three, I think, a three or four year period the doctor noticed that my PSA, this is the Prostate Specific Antigen test that she does routinely, that it had gone up from something like 2 or 3 to 7.

May I just ask, before the doctor did the test, the PSA test did she explain what it meant and what the implications were?

Oh yes, yes I mean she said that anybody over the age of 50 and certainly I'm more than that, ought to have an annual PSA test which she does routinely for elderly people, men anyway in her practice in France.

But at that stage did she explain that if the PSA level was unusually high and if cancer was found what the options would be, did she explain at that stage?

No, no at that stage there was no question of discussing whether my condition was cancerous or not. It was a matter of monitoring the PSA level and to see whether any malignancy would occur. And I understood it to be a routine test, a sort of monitoring test and if the situation warranted it, like the PSA went up some alarming amount then other tests would follow, because it would be an indication that that the prostate was malignant.

Considers that it was harder for his family than himself.

I think it was hardest on my family and people around me rather than on me. I was at the centre of this, it was happening to me and I was pretty sanguine about the whole business I suppose. I felt relieved in a way that the cancer had been diagnosed early and that I would have an opportunity to treat it and recover if one can speak about cancer in that state. But my family were very, it was very difficult for them because I don't, I'm not somebody who discusses my particular complaint with anybody, I suffer alone, I don't spread it about. This was very difficult for my family I suppose.

Advises that the PSA test is extremely worthwhile.

Oh have it [a PSA test] by all means and then go through with the procedures because no matter how embarrassing or painful or otherwise it is eventually you must realise that this is a life threatening situation and you know it's worthwhile I think pursuing this, earlier rather than later because timing is of the essence. I mean left too late then the medical profession can't do anything for you but caught early enough and in time there's every hope that you can deal with the problem. 

States that he was informed watchful waiting is not recommended for those of African descent.

It [watchful waiting] was presented or discussed as an option but the consultant then suggested that this was not an appropriate procedure for me because she was involved in some, in setting up some research and the preliminary indications were that men of African descent, that their particular prostate cancer in them, the prostate cancer in men of African descent was more active and aggressive than it would be in Asian or people of European descent and therefore if there was another route, another treatment available she'd prefer to do that rather than the watchful waiting. So there is some indication around that in the male of African descent that the prostate is much more aggressive.