Interview 22

Age at interview: 67

Brief Outline: Had repeated urinary infections. He suspected this was due to an enlarged prostate, so asked for a PSA test, but the GP refused until he had an appointment with a consultant. In 2005 PSA was "normal" for his age, 4.5 ng/ml. Symptoms treated with antibiotics and Flomax.

Background: Occupation' Clinical researcher (health care). Marital status' widower. Number of children' 2. Ethnic background' White British.

He is adamant that the PSA test gives men a chance of surviving prostate cancer .

Now I am a retired nurse amongst other things and I was in charge of a male genitourinary ward and this was in the 60s. What a lot of people don't appreciate without the PSA test, which is really wonderful and fantastic, we would have to go back to the old ways, you didn't know you had prostate cancer until you broke a major bone and what a hell of a way to find out. A PSA test, no matter what people say about it, it is purely an evaluation, it is no more than taking your blood pressure to see if you have a problem with your heart and arteries, it doesn't mean you're going to have a heart attack, it doesn't mean to say that you're going to die. If you go along and you have your urine tested it doesn't mean to say you've got diabetes but it's a damn good idea to find out if you have because at least you can control it and you can live with it. Women have repeated scans for breast cancer and the amount of women who die from breast cancer has been reduced. Having a PSA test does not mean that you won't get cancer and it doesn't mean you won't die from cancer but at least you're given a chance.

His local radio station provides information about prostate cancer and puts people in touch with others who can answer questions.

Have you been aware of anything in the newspapers or magazines about the PSA test?

Oh yes, yes I've seen quite a lot. The Mail on Tuesday runs health pages and there have been several items over the last few months regarding prostate cancer in men. Three Counties local radio in this area have had awareness days on there, they also produce a very good action pack. May be other local BBC radios do the same thing, I'm sure they do and so therefore contact your local radio. And they also put people in touch with other individuals who can answer questions.

Suggests that information about the PSA test found on the internet may be hard to understand so it may help to discuss it with a male nurse.

Well if I have a question about the PSA I'll get on line, look on a website, have a poke around, if necessary pick up a phone, ring a urologist and say tell me.

Have you always used the Internet for health matters?

I use the Internet for most matters. I find it, I mean before I was trying to work out how to spell raison d'etre, I couldn't work out, couldn't get a French dictionary so I went on the website and said French phrases and there it was.

So for the PSA test it's been really helpful?

Anything I've used on there, anything at all you go on there. I think the problem is that PSA test information on the website, you have to have some scientific/medical background because it can be gobbledegook and so if somebody goes on there it might be worthwhile to print it off and find a friendly nurse. Now you have to remember that modern nurses, that's nurses trained probably after 1980 onwards, female nurses don't have a lot to do with genitourinary conditions and male nurses don't have a lot to do with gynaecology so if you want to ask this find a nice friendly male nurse, buy him a pint, they always like beer, sit down and have a chat about these things.

He remembers nursing men in the 1960's when they died a painful death from prostate cancer and argues that the PSA test is useful.

Did you know very much about prostate cancer and the PSA test before you developed these symptoms?

I didn't know much about the PSA test because it's something that's come since I stopped clinical; prostate cancer yes, I've known about that for many years. I recall as I say in the past, that prostate cancer in terms of men, the only time we knew about it was someone would be admitted with what we would call a spontaneous fracture then, I believe they're now called non-traumatic factures which is the same difference. The men would come in and nearly always it would be a fracture of the thigh bone, the femur. When you knew about that this man's life would be thrown upside down, back to front and there'd be so little you could do, absolutely nothing. It wouldn't, the cancer didn't respond to radiation, it didn't respond to, it only responded to stilboestrol so it was it was quite a hard job. 

It wasn't uncommon at night in the hospital, you would have men that had prostate cancer, and it could take 11 or up to 20 years to kill them, and some of the latter part of that they'd have really bad pain in their bones which is one of the worst types of pain and no matter how much diamorphine, heroin you gave them it wouldn't, it wouldn't stop it. And it was dreadful to see them and their family suffer and that's why I say, now we've got something, may be it isn't the best, may be we're just on the threshold, but now we've got something we can find out before we fall over in the street and when you get up you say, 'Oh god I've got prostate cancer'. What a way to find out. This way at least it's scientific and it gives individual patients an opportunity to ask the questions based upon the evidence. It's pretty silly to ask questions after the event. It's like saying should Lazarus have asked, 'How do I come back to life?' when he was dead or somebody said, 'How do we resuscitate him?' And I think the question is when you think of it these days, when I started nursing and it's 1960, if you had a cardiac arrest you died. Now in 2005 the amount of people who are resuscitated and live is round about 60 to 70%, without all that research and all the insight and all the help from doctors, nurses, scientists and patients we would still be in a situation when you said if you had a heart attack you died and I'm sure anyone who sees this interview would say if I was asked to go for blood pressure tests, cholesterol tests, tests on my heart I wouldn't think they're thinking going to die, they're thinking how can they save my life so why not have a PSA test and save your life too?