Interview 54 - Prostate Cancer
He was diagnosed with prostate cancer in 1997 and had a radical prostatectomy. Five years later his PSA started to rise again so in 2003 he had some radiotherapy and hormone treatment.
A retired doctor, married with 3 children. Ethnic background: White British.
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His doctor discussed his results with him and gave him a firm steer towards having a prostatectomy.
His doctor discussed his results with him and gave him a firm steer towards having a prostatectomy.
Then I went back to see my surgeon and of course he by then had my Gleason score from the biopsy. It was a semi-formal interview, we are on friendly terms anyway and he said, “Well let's look at all these results together” and he said, “Well, the PSA is excellent, 7.2 and the bone scan looks splendid” and he said, “Nothing to worry about in the shoulders we've decided. And the MRI, nothing to be seen, and it seems to be the tumour is actually confined to the gland.” And he and I said, “That's excellent.” And he said, “You're now 67 and you haven't got any relevant history but I'd like you to have a cardiologist's opinion but if that is alright I think we should go ahead.” Now we discussed, a formal talk on you know, radiotherapy versus surgery or even watchful waiting and he said that in his view this would not be a good one for watchful waiting. And then I thought well, we've been through everything but what about the Gleason and I said, “Now what about the Gleason score?” And he smiled and said, “Oh, I wasn't really going to talk about that, don't let's think too much about that” and wrote it on a bit of paper and handed it to me, you see, and it was 8 which as you know, really puts you in a very high risk group. And so I said, “No, perhaps you'd better not talk about that any more but don't let it interfere with what we ought to do.” It would, of course, rule out radiotherapy as the principal form of treatment.
So in his opinion surgery was really the only option?
In my opinion and his opinion. We were absolutely at one about that.
Did you feel that all the options had been well presented to you at that stage?
Yes, I mean I knew the options and we went through them very thoroughly but very quickly. I mean it was not a long interview but everything relevant was said. It was going over very old ground between us because we'd had similar talks about, you know, very many patients between us before.
The prostatectomy was not as painful as he had expected it to be.
The prostatectomy was not as painful as he had expected it to be.
I found that you know, the hospital staff, the nursing staff, everybody was very kind and considerate and I felt extremely well and I had no worries about it. But people went out of their way to give me information which they, nothing was hidden, everything. I met the anaesthetist who gave a large number of anaesthetics for prostate surgery and I think, probably, at that time was giving more anaesthetics for prostate surgery than any other anaesthetist in the country. So we had a very friendly talk about it and you know, the problems with anaesthesia in prostate surgery, such as they were, and so I felt very reassured. Well, there was no pre-med, which I hadn't realised, so there were little things that slipped passed, I didn't realise that so far as he was concerned he didn't like his cases to have pre-med so I went down to the theatre quite wide awake. Then had the induction and the anaesthetist said to me, 'Well, this is just like champagne which you'll have drunk rather too much of it, it's a very pleasant feeling.' And I didn't altogether care for the feeling induced, of the feeling brought on by the induction, and I said, 'That champagne is bloody awful champagne' and if I hadn't come round those would have been my last words.
But was that with an injection?
That's right, yes. And then I woke up in intensive care.
And how was that?
Well, I found it much better than I expected. Everybody had talked to me about pain when you wake up and there wasn't a nurse who hadn't come in and sat down and said to me, 'Now I do want to warn you of that' and my surgeon had warned me of this and the anaesthetist. So when I went to sleep I was fully expecting to wake up in considerable pain but I woke up in discomfort, no more. And I had my, I could regulate the amount of analgesic I was getting so that if I had wanted more I could have had more but I didn't want any more. And then there were a massive number of drips going, of course, and oxygen, just the usual intensive care procedure. And a very, very pleasant male nurse was specialing me; he couldn't have been better and very efficient, I thought, forever regulating this and that and putting things into my line, what it was I have no idea.
So how long did it take for you to move back to a regular [ward], were you in a private room or regular ward?
I was in a private room and I was just over 24 hours in the intensive care and then went upstairs. I was still having problems with blood pressure and blood oxygenation because I'd bled during the surgery and I had a fair number of units of blood. But even when I got back to the ward, to my room, my haemoglobin was 7 so I had obviously had quite a biggish bleed.