Michael
Michael first asked his GP for a PSA test in April 2005 after learning that four friends had radical prostatectomies. His PSA readings increased over four years and a biopsy revealed prostate cancer in October 2009. He had brachytherapy in April 2010.
Michael is a retired police officer who is married with one adult daughter. His ethnic background is White British.
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Michael was prompted to ask his GP for a PSA test after four golfing friends had radical prostatectomies. He had 5 PSA tests over four years and these readings were always above 2. Eventually it became clear that his PSA was rising and that he should be referred to a consultant although he thinks he should have been referred earlier. He had ultrasound and MRI scans and a biopsy and was diagnosed with prostate cancer on 19 October 2009 with a PSA reading of 5.4 and Gleason score of 3+3 = 6 and T2 staging. While Michael was not shocked at the diagnosis, being prepared for it by the rise in his PSA, he was shocked by his surgeon’s insistence on choosing a date for a radical prostatectomy. When a specialist nurse told him about treatment options he was impressed by brachytherapy as it seemed to be pain and risk free; offer little risk of hospital infections; no invasive surgery; and a high success rate. He researched it further on the internet and soon felt like an expert. He feels extremely fortunate that his prostate cancer was detected early due to regular PSA tests giving him the option of brachytherapy; this has criteria to be met including agreement from his PCT. He thinks choosing treatment is very important for a man with prostate cancer and that it is very difficult for those without internet access. Before his treatment his oncologist suggested that he should consider active surveillance but he did not want the ‘ticking time bomb to carry on ticking [and wanted] the detonator removed’.
Michael was prescribed a finasteride to shrink the prostate in preparation for treatment on 20th April 2010. He is a great believer in the skill of the surgeon and anaesthetist and was not frightened. While his treatment was straightforward he developed paraphimosis which was exceptionally painful and distressing. He returned home the next day as he felt he could recover there more easily. Four days later he decided to play a full four-hour round of golf and during this time had to urinate three times which alerted his friends to a problem. However, as up to this point he had only told his wife about his prostate cancer he steadfastly refused to tell anyone else, in particular, his daughter. He continued to improve and was prescribed alfuzosin to control his urine flow. In August he returned to hospital and while his PSA reading seemed a disappointing 2.5 he was encouraged by his consultant that this was to be expected and he was discharged for six months. While he is delighted with his NHS treatment he is very unhappy with NHS attitude to PSA testing, comparing this to other national screening programs e.g. bowel cancer, breast and cervical cancer. He thinks that men should be made aware of the risk of prostate cancer and should not wait to be invited for a PSA test but rather should seek one regardless of whether they have symptoms or a family history.
Interview conducted in 2010 by Anne Montgomery