PSA test for prostate cancer

For people that don't know what that is can you explain a little bit what it [a TURP] is?

Yes from the bladder to the outlet the, there is this tube that takes the urine and it has to go through the prostate gland. Now if the prostate gland it becomes, as it does with most elderly men, begins to enlarge to it traps the outlet, consequently it's very hard then for an elderly person to pass urine. So it's a very common thing to have this, what they call a TURPS, it's like a rebore and they bore the hole through the prostate gland and that allows then a freedom of passing water, passing urine. And that's what the TURPS is. I don't quite understands what TURPS means but...

Trans-urethral resection.

Is it okay yes [laughs].

And how long were you in hospital for that operation?

Five days, yeah I went in on the Thursday and I was out on the Sunday.

Do you want to say a little bit more about the operation, can you remember?

Yeah they just did the test on the Friday, ran various you know blood pressure, blood tests and so on and then on the, on the Saturday I went into, into surgery and I was offered the opportunity of having either a local anaesthetic or a general, so I opted for the local anaesthetic which was that epidural is it called in, yeah and just went dead from the waist downwards. And I was in surgery for about half an hour and chatting to the, the what's the man, anaesthetist just chatting generally because I didn't want to know what was going on. And then came out and had, when I came back into the ward I had a blood pressure machine fixed to me, I also I had a catheter. These were removed the day afterwards and then the day after that I was discharged from hospital. I had to be very careful, no driving for three weeks, but I was okay. Healed very quickly and my waterworks problems cleared up.

So after that you found it much easier to pass urine?

Oh yes, yes until about ten years later when it started all over again. And that was the mistake I made was that it could happen again, I thought that's it, it's finished, I don't have any more problems. But I did of course.
 

After the operation I recovered quite well and everything else. And I had an appointment to go back and see the consultant after six weeks. And I had a PSA test done with my general practitioner, and that is to look at, 'Is there still any prostate cells that are left, even though I've had a radical prostatectomy?' And the good news from that was that the, the PSA s-, result was less than 0.01. So it was virtually unreadable. And that's, that is tremendously good news because that means that hopefully the problem has d-, then disappeared. So I went to see the consultant. He asked me a number of questions about how I was feeling, how my continence was feeling, impotence, talked about impotence, and talked about, about the result. But he also talked about the pathology of, of my prostate, which he'd taken out, and unfortunately the Gleason score which was first at 7 had moved to 9. And so that was, that was slightly disappointing, on the good result of having a very low PSA count, was that the, the tumour that is now removed was very aggressive. So I'm now under a regime of, of seeing him again in three months. And he said he will continue to see me three-monthly until, until we decide that things are clear.

So you'll have three-monthly PSA tests and then go and see him?

Yes. The situation now is I've, I've already put a date in my diary to go to see the GP to get a PSA test. And I've got another date to go and see him early November.
 

What do you expect the PSA to remain now?

The PSA should come down to may be 1.2, 1.4 and stay around there. If it starts to rise again I'm in trouble. 

Have you been told that or have you just read that?

Oh I know that and I've been told that effectively, not in those words, far more delicately put but the only way of keeping track of things is to, for me to have a regular PSA reading and that will continue for 5 years.

Will that be done every 6 months or every?

In the first year I believe it's going to be every 3 months and then it will go to 6 months. I have, I'm a firm believer in the PSA test for obvious reasons. I might well go and have a private PSA test every 3 months just to make sure because it did screen me, it did discover my cancer and I can't understand why after I've had my cancer it's sufficiently good to screen me for the future, why couldn't I have been screened beforehand and logic just tells me, I'm a very logical person, medical opinions may say one thing but logic tells me everything I've gone through that the PSA test is a good way to screen for prostate cancer.

I've got to go back and see, see the consultant in six weeks. So instead of seeing him in six months, three months, he said, 'No, I want to keep an eye on you.'

Hmm.

'Six weeks time'. So I said to him, I said, 'You're joking.' I said, 'Well why not give me three months?' He said, 'No, oh [laughs]' he said, 'No way. Six to seven, I'll see you in six weeks' time.'

And did the consultant explain to you what they can discover from the PSA test, in relation to the prostate?

Yes, they, they, yes they did. From the test they, they can determine how the cancer's behaving, whether the, it's going in, oh how you call it, the'

Remission?

Remission, yeah. I must emphasise here at this point, whenever my PSA is in remission they take me off the medication.

When the cancer's in remission?

Yeah. They take me off of it. Sometimes I off, I'll be off of it for 6 months. The last time I can remember being off of it, is about, for, for 14 months.

Ahh.

Yeah. 

That's interesting.

Yeah. So, in that time I'm off of it, I'm off medication. 

And then what happens?

Until it started behaving badly, I would say.

And they can tell that from looking at the PSA test?

Yeah from the blood tests, they can tell whether the figures is going up.

Hmm.

And when it reaching double figures, say about, hmm, for the last time when it was 7, he said, 'Ah, that's nothing,' they're not worried about that. That's nothing to them. But to me, I don't want it to go that high. So he said, 'Well come back and see me in such and such a time'. And from that it went up to 17. He said, 'Right, I'm going to put you on medication.'

Back on the Zoladex?

Back on the Zoladex and the flutamide tablets. Well some, from day one that's what's the medication I was on. So they never change, change me on any other medication.