Brachytherapy: patient experiences
Men from all walks of life may suffer from prostate cancer. Here, you can read the stories of men who decided that LDR brachytherapy (seed implantation) was the best treatment for their cancer.
Edward Boynton, 62
62-year-old Edward Boynton was the 3000th patient to undergo brachytherapy treatment at The Leeds Cancer Centre at St James’s University Hospital. Mr Boynton, who runs the Nag’s Head at Pickhill, near Thirsk, explained: “When my GP referred me to a specialist about my prostate after a routine health check, I was straight on the phone to a friend who is a retired doctor. He asked me what the Gleason reading was and advised me to ask about seed brachytherapy as an option which would least disrupt my life. I was delighted when they told me I was a suitable candidate to have the procedure and I’m hoping to be back at work within a day or so.
Alan Moore, 58
Alan is a 58-year-old great-grandfather from Derbyshire who was diagnosed with prostate cancer in October 2014. After a routine blood test, he was referred to the Royal Derby Hospital where he was told he had an enlarged prostate and a prostate-specific antigen PSA level of nine (a normal reading is around 0-4). Two weeks after undergoing a biopsy Alan was told he had prostate cancer and his consultant suggested he had his prostate removed. Radiotherapy and hormone treatment were also suggested but Alan was concerned about side-effects. Then one of his consultants suggested low-dose brachytherapy which was being carried out at St James’s Hospital in Leeds. After meeting his consultant Mr Bottomley, Alan’s LDR brachytherapy procedure took place in June last year.
“I was told that after the operation I would feel some discomfort between my legs but nothing too severe,” Alan explains.
“I felt groggy after the anaesthetic but otherwise pretty good. I was told to walk around and get dressed, given pain relief and tablets to keep my waterworks functioning. I was told to drink plenty of water for about three weeks and to keep taking the waterworks tablets and that I might suffer from cystitis. At 5:30 pm that day I was discharged and went home. It was tender but far from painful. I went to work the next day and was singing on stage that Saturday night.”
When Alan returned to Leeds a month later for a follow-up examination and a blood test to determine his PSA level, he was discharged back to the Royal Derby. He was thrilled to be told the treatment had been a success and that his PSA had fallen to 5.7. He still has four-monthly check-ups and last November he discovered that his PSA level had dropped to three. My experience with this treatment was excellent,” says Alan. “And I’m over the moon with the result. Image courtesy of The Daily Mail Scotland. Details courtesy of The Express.”
Tom McGrath, 54
Tom McGrath was a fit and seemingly healthy 54-year old when he changed his doctor to one closer to his home in Wellington, New Zealand. His new General Practitioner ran a comprehensive health check, including the prostate-specific-antigen (PSA) test that indicates the risk of prostate cancer. When the test returned an elevated result indicating cancer the news came as a shock for Tom.
“The scariest thing is if I had not changed doctor I might not even know now that I had prostate cancer,” says Tom.
A biopsy confirmed that the presence of a tumour that was still confined to the prostate gland. Tom and his wife, author Julia Millen, began to assess treatment options. Tom leads an active life with recreational interests of Latin American dancing, mountain biking and ocean swimming. He looked for treatment with the best chance of preserving his quality of life as well as killing cancer. Despite LDR brachytherapy’s long history in New Zealand, Tom said he was not initially told it could be an option for him. He discovered the treatment by reading a book on prostate cancer.
“Many guys go for surgery. I was concerned about hospitalisation and the far reaching effects surgery might have.”
John, an architect from London, was enjoying newly married life and a new job when he was diagnosed with prostate cancer.
“I had recently got married and just changed jobs”, said John. Part of the package for his new job was an annual health screen. When the first screen indicated a slightly raised PSA, John was not concerned. “I was only 45 at the time,” he said.
“In my mind, prostate cancer was an older man’s disease. My father had it when he was in his late 60s.”
However, John was advised to see his GP and have his PSA level monitored.
After a year of regular monitoring, his GP was concerned that John’s PSA remained elevated and recommended that John had a biopsy. “When the results came back that I had cancer, I was in complete shock”, said John. “I had not allowed myself to even think about that scenario.” Adding to his distress, it could not be confirmed at what stage the cancer was and whether it had spread. John’s consultant arranged for a MRI scan, but the results were inconclusive as to whether the cancer had spread outside the prostate. The next decision for John was which treatment to have. ”My local hospital recommended surgery as I was still young and this would remove the cancer completely,” explained John, “but the more I read about the side effects, the more it felt as though my life would never be the same again. My wife is younger than me and we have not yet had children, so the thought that I would become infertile after surgery was another bombshell.”
Graham Robson, 53
As CEO of V.People, a successful man-management company in Aberdeen, and with four demanding children, Graham really did not have the time to be ill, so when he got the results from a routine medical check-up that he had a PSA level of 6.5 ng/mL he was shocked.
“I had booked in for a BUPA medical check last May just to make sure everything was in working order before I embarked on a 120 mile charity bike ride” said Graham. “I had trained hard for the ride and was feeling fit and healthy so when the doctor said I had prostate cancer, I was totally taken aback.
“My initial reaction was to have surgery and just cut it out, but when I was told that it could take 3 months to fully recover and that there was a strong possibility that I would get erectile and urinary problems after surgery, I realised that my life may never be the same again.”
Deciding that surgery was not an option, Graham was given the alternative choice of external beam radiation, which has a high success rate, but still has the same side effects as surgery. A friend, however, mentioned that he had read about the St Luke’s Cancer Centre in Guildford which was pioneering research into prostate cancer.
“I looked them up on the web and read about LDR brachytherapy, a non-invasive treatment which injects radioactive seeds into the tumour”, said Graham. “I had not heard of this treatment before but it sounded a good option to me.”
Graham went to see Professor Stephen Langley at the Centre. “I was worried how successful the treatment would be and what would happen if it did not work and the centre was, of course, a long way from home.” However, Professor Stephen Langley reassured Graham that LDR brachytherapy had a high success rate with fewer side effects than surgery and that he could be back home and at work again very soon.
“I went in for the brachytherapy procedure in the morning and was out of bed in the afternoon and home the next day. It was that quick and painless”, said Graham.
Max Stinchcombe, 54
Max is a happily married man with two children. He has a rewarding career as a bank manager in Southampton and likes to spend his weekends on the golf course. In fact, it was on the golf course 4 years ago that he first learnt he had prostate cancer.
“I had just had a routine company medical which showed a slightly elevated PSA (prostate-specific antigen) score which I was told could be indicative of the early stages of prostate cancer. My wife was very concerned and insisted that I go to the GP to get it checked out. My GP immediately referred me to a urologist who took a rather painful biopsy.”
The results of the biopsy were due back on the day of an important golf match, so Max left his wife to take the call convinced nothing was wrong. “I will always remember my wife calling me on the first hole with the momentous words – Max, you have cancer”, said Max. “I immediately went into the stereotypic man’s response by denying anything was wrong and carried on playing golf as usual. I even stayed for the prize-giving ceremony in the evening.”
When Max got home he found his wife in tears and he realised the potential severity of his condition. “I decided to take control of this disease and went online to research possible treatment options”, said Max. “I also contacted the Prostate Cancer Charity which had fantastic patient information and were extremely helpful. The treatment I decided I wanted was brachytherapy, a convenient `one-stop shop` which uses radioactive seeds to destroy the cancer cells. Results showed that the side effects from brachytherapy were less severe in terms of incontinence and impotence than traditional surgery and that was very important to me as I was only 50 at the time.”
Max had his brachytherapy at the St Luke’s Cancer Centre in Guildford performed by Professor Stephen Langley. “I was slightly sore and uncomfortable afterwards, but had no side effects and was back at work in 2 days. So far there is no sign of the cancer returning.”
Max actually had to go to the USA 4 months after his treatment. “It was rather amusing”, he said, “as the radioactive seeds were still active and I had to have a letter from Professor Stephen Langley at St Luke’s Cancer Centre to get me through airport security – there was no way I wanted another body search!!”
Chris and his wife Ivy were enjoying early retirement and had just bought a second home in Florida when his GP diagnosed a borderline PSA score in January 2005 during a routine medical. Chris was referred to a urologist who reassured Chris that at this stage no treatment was needed and that he would be actively monitored with his PSA taken every 6 months to record any changes. “I was so unconcerned with the results”, said Chris, “that my wife and I went off to Florida to enjoy our new home and the sunshine and I completely forgot about my next 6 month blood test.”
It was later in September 2005, when he was back in the UK, that Chris had a second PSA test and his urologist was concerned as his PSA level had risen to 10.9. A biopsy was taken which confirmed that Chris had localised prostate cancer and the urologist recommended that he underwent an immediate radical prostatectomy. However, Chris was not keen on the side effects from radical surgery and also the long post-operative recovery period.
Luckily, Chris has American relatives and he decided to ask them for advice. They suggested that Chris enquired about brachytherapy (or seed implantation as it is called), a procedure routinely carried out in the USA. Chris mentioned this to his urologist who agreed that he was a suitable candidate, but that this treatment option was not available in Devon. Having researched brachytherapy on the internet, Chris and his wife Ivy decided that this was definitely the treatment they both wanted as the risk of impotence was minimal compared to surgery and their physical relationship was very important to them.
Chris eventually decided to pay privately for brachytherapy and his treatment was carried out at Guy’s Hospital in London in November 2005. “I decided to stay in for a couple of nights as it is a long way back to Devon, but I could have gone back the same day as the procedure if I had wanted. Although I was uncomfortable for a few days after the procedure, I have no physical side effects and my wife and I can just go on with enjoying our lives.”
It has been six years since Brian underwent brachytherapy for localised prostate cancer but he can still remember the shock of being told he had cancer. “I was fit and healthy, played golf regularly and travelled the world with my job”, said Brian. “I had just changed my GP and the new practice offered me a health screen which my partner said was a good thing to do. Everything was normal apart from a slightly raised PSA but I was told that it was probably nothing to worry about. However, the GP thought it best if I was referred to a specialist for a routine biopsy.”
Brian was devastated to be informed that he had prostate cancer at what he considered was a young age. “I was in complete shock, I thought it was an old man’s disease” said Brian. “It was so unexpected as I felt fine and had no real symptoms. I immediately went home and onto the internet.”
At first, surgery seemed like a good option, but it meant a three month recovery period which was not ideal for Brian’s work. “Although I am quite squeamish about surgery”, said Brian, “it was my concern about the possible long term side effects that made me look closely at the other options.”
Compared to surgery, prostate brachytherapy offered a fast recovery period with minimal side effects and seemed to fit in well with Brian’s busy lifestyle. The procedure was carried out at Mount Vernon Hospital six months after his diagnosis.
Brian stayed in hospital for one night and was back in the office two days later. “Although the actual procedure was quick and pain free, the main problem for the first ten days or so after the implant was the regular need to visit the toilet and the pain which accompanied it. Although this took some time to clear completely it steadily improved over the following months.” Brian was back on the golf course within four weeks and travelling long haul not long after. “Although I carried a card with the date and details of the procedure, the seeds have never set off the airport security alarms.”
There have been none of the side effects often associated with surgery and Brian continues to lead a very active life. “My PSA count is almost zero and the shock of discovering I had cancer is in the dim and distant past. At one time I couldn’t discuss my illness with anyone outside my immediate family but now want others to know, that if caught in time, prostate cancer need not be life threatening and can be successfully treated.”
Chris, a web site developer and composer from London, was diagnosed with prostate cancer in October 2007 after he consulted his GP following some urinary problems. “My father has a benign enlarged prostate and suffered similar symptoms, so I assumed that was what I had,” said Chris.
However, an above-normal PSA score and resulting biopsy confirmed that he had prostate cancer. Unfortunately, Chris suffered an adverse reaction to the biopsy and was poorly for six weeks. “Not only was it a shock to hear I had cancer,” said Chris, “but I was fit and well when I went to see my GP and to be so ill after the biopsy was not pleasant, although I understand it is a very rare occurrence”.
More worryingly, Chris’s consultant decided to do an MRI scan to make sure the cancer had not spread. The results came back showing a slight shadow in one seminal vesicle and, more alarmingly, in the bones, although they could not be absolutely certain the shadow was cancer. Mercifully, a nuclear bone scan came back clear within a few days, but the question remained over the seminal vesicle.
Chris was, therefore, told that his only options were radical surgery or external beam radiation (EBRT) and warned of the possible side effects of impotence and incontinence. “You can imagine how I felt,” explained Chris, “Things just seemed to be going from bad to worse.”
However, a friend who had had brachytherapy suggested that he seek a second opinion and Chris’s GP referred him to a London brachytherapy centre where a more sensitive transrectal ultrasound scan showed that his cancer was confined to the prostate and Chris was told that he was a suitable patient for LDR brachytherapy.
In April 2008, Chris underwent the brachytherapy procedure and was home the next day. “I’m experiencing some urinary symptoms, but they are only what I was led to expect and I’m confident they will improve. In general, I can just get on with enjoying my life and work,” said Chris.
Paddy Kelly, 52
Paddy Kelly is an airline pilot with a leading airline. He had never even heard of the prostate until a routine medical check and blood test by his GP in December 2005 revealed high PSA (prostate specific antigen) levels. Paddy’s PSA was 27 ng/mL. The normal range is between 0–4 ng/mL. A high PSA level such as this is often caused by prostate cancer.
Paddy was referred to a urologist in Ireland who took eight biopsies (samples of tissue from the prostate). “Not a pleasant procedure”, Paddy remembers. The results, however, came back clear and Paddy was put on a “wait and see” policy even though he had other urinary symptoms. Not reassured by this diagnosis Paddy requested a second opinion in the UK and, in February 2006, 14 more biopsies were taken, this time under general anaesthetic. Once again they came back clear, but his PSA score was still too high. Paddy also had a bone scan, which came back negative. His doctor gave him a course of antibiotics in case it was just a urinary infection.
“I was becoming increasingly concerned”, said Paddy. “My mother had died of cancer and my sister had breast cancer, so I decided to go online and do my own research.”
Luckily, Paddy came across the St Luke’s Cancer Centre in Guildford run by Professor Stephen Langley, a urologist specialising in prostate cancer. “I read that Stephen performed a different type of biopsy which was more accurate and so I made an appointment to see him. This time the results of the biopsy were all too clear – I had bilateral prostate cancer with a Gleason of 6/7 and needed to make a decision about treatment without much delay. This was now June 2006, 6 months since my initial PSA check.”
Paddy was given hormone treatment and external beam radiation before receiving LDR brachytherapy in December 2006, a treatment which places radioactive seeds in the prostate to destroy the tumour. “The short term side effects from the hormone treatment and EBRT were not great but apart from feeling a little uncomfortable from the brachytherapy I had no other long term side effects from this treatment. It was so convenient – I was back at work almost immediately.”
Paddy was advised not to have surgery to remove the prostate as incontinence is a common side effect; “That is something I simply cannot afford to suffer from as a pilot. My career is very important to me”.
Paddy now has a PSA level of 0.08 and is optimistic that he is clear of prostate cancer.
David Robb, 68
David Robb was a 68-year-old retired secondary school teacher from Peebles, Scotland when he was diagnosed with prostate cancer last Summer.
After two years of health checks following minor symptoms of LUTS, his PSA (prostate-specific antigen) level had risen from 3.8 from his first check in January 2017, to a score of 4.2 in July 2019.
David refused to undertake a rectal exam and a blind biopsy, which are the basic processes in Scotland, until the doctors had performed a scan to identify accurately what they were looking at: “The MRI scan identified a lesion of 1.6mm, which the doctors said was almost definitely cancer. I then got a biopsy which was graded at a 4+3 Gleeson score.”
The confirmed cancer was fortunately contained on one side of the prostate and at an early stage of progression, and the Nurse Practitioner reassured David that it should be treatable without too many problems.
During all of this time, David had rapidly educated himself on prostate cancer, which allowed him to remain fairly calm during diagnosis: “I’d done a lot of reading on this; the various criteria used can give you all sorts of false pictures. The size of the lesion, 1.6mm, if it had been 1.4mm, would have been graded T1a cancer, not T2a cancer. If you do your research, it’s not as bad as it might first appear, so I wasn’t in a panic. I was more worried about the quality of life after treatment”.
Following the diagnosis, David was referred from the Borders General Hospital where the biopsy was conducted, to the Western General Hospital in Edinburgh for a follow-up appointment and treatment.
With concerns around the side effects and recovery associated with surgery and hormone therapy, David researched the various treatment options available. As a fiddle player and dance instructor in a ceilidh band for over 30 years, his social life played an important factor in his final decision about what treatment route to go down.
“Early December 2019, I met with the radiotherapy consultant first, Duncan McLaren, who discussed various options including classic radiotherapy plus hormone therapy, and brachytherapy. I wasn’t happy about having to do hormone therapy due to the repercussions, so brachytherapy made more sense. It seemed to be the best option in the short term for me to carry on with my normal activities.”
David also saw a urological surgeon that same day, but due to his concern over becoming incontinent with a tougher recovery process associated with radical prostatectomy, David went back to Dr. McLaren having settled on low dose-rate brachytherapy (LDR-B) as his preferred treatment option.
On the 14th of February 2020, David received the brachytherapy procedure at the Western General Hospital.
Speaking about how he felt after the procedure, David highlighted how he only had paracetamol overnight after the treatment and has not needed painkillers since. “I haven’t felt any pain after urination settled down into a more normal routine on the second day – I don’t have any great urgency and have never had any accidents since. It’s entirely under control as far as I can see, and it’s done everything I wanted it to do.”
Since his recovery, David has been able to go back to normality and play in his ceilidh band without any problems (now cut short by coronavirus). He compares his experience to the alternative of surgery, saying: “I think if I was to have had surgery, I might still have had continence issues and certainly sexual problems. I’ve had a completely different experience from some people I know, and everyone around me is amazed. My wife, who is a retired nurse with 39 years’ experience, is totally impressed. The staff at the Western General were brilliant”
David is keen to make more men aware of the importance of getting themselves checked early and regularly: “I’ve encouraged both my brothers – and three sons over the next 10 years- to get their PSA checked. I don’t think the current policy discouraging people to take a PSA check is the right one. I think what people should do is take the PSA test after having educated themselves about what it implies and what it doesn’t imply, and do it sooner rather than later. Don’t cut down your options by delaying diagnosis.”
More critically, David heightens how patients should stay informed and do their research “You have to be a patient who can understand what they’re saying to you. I became obsessed with needing the right information as a patient to make the correct decisions. You don’t have to be a medical expert, but you need to understand what the terms and procedures mean in order to make what is the best choice for you, including your lifestyle afterwards – you hope to live for years” he concludes.
Kevin Darragh began his prostate cancer treatment journey back in December 2012. He initially visited his doctor in Feilding where he had a digital examination taken of his prostate. Following this, on the 1st February, he was referred to a second doctor in Palmerston North. There he had a repeated digital examination and more biopsies were taken.
After all the examinations were complete, Kevin was diagnosed with prostate cancer in 2013 and was given 3 treatment options; surgery; radiotherapy and brachytherapy.
“I researched a number of other treatment options with my wife and we both felt that surgery would be horrendous and radiotherapy too time-consuming.”
After researching and discussing treatment options with those close to him, Kevin decided on brachytherapy and on February 22nd 2013 had his initial consultation in Palmerston North. Shortly after, on the 28th March, he had a phone conversation with an additional Doctor in Tauranga followed by a visit to the centre on July 8th to undertake the planning for treatment which took place on 24th August in Tauranga by Professor Mark Fraundorfer.
He recovered from his procedure within a couple of days and was back to a normal lifestyle. “The worst part of the procedure was the night before both the planning and procedure – which was emptying my bowels.” Kevin’s prior medical history requires the regular use of blood pressure tablets, which makes him urinate often and this was something the treatment exacerbated. “The journey home was difficult as we needed many stops. I take a pill that makes me urinate quite often and the procedure made it temporarily worse. However, this settled and the recovery time was just a couple of days”. Besides these initial side-effects, the brachytherapy has had no major effect on his personal life.
Now semi-retired as of April 2013 and not as a result of prostate cancer, he is a strong advocate of brachytherapy and would recommend that other men consider the treatment as an option. “It was relatively simple and painless. I didn’t have to use drains or have any bed rest, within a week my life was pretty much back to normal.”
In many ways, Kevin found having four doctors helpful and appreciated the opinions given to him. Since completing his procedure he has visited his Doctor every 6-12 months for check-ups until he retired and still has annual PSA checks which are monitored by his GP and Professor Fraundorfer.
Bill Morris, 51
Four years ago, ex-policeman Bill Morris went to his GP because he noticed he had started to need the toilet during the night. His doctor gave Bill, then aged 51, a PSA test which highlighted that his PSA level had increased from a baseline of 1.8 – established previously in Wellman health checks – to 3.2.
While this is still a relatively low score (the average score for Caucasian men aged between 50-59 is 0 – 3.5), and a physical examination didn’t reveal anything untoward, Bill was referred for further investigations.
Unfortunately, a biopsy did reveal an incidence of prostate cancer. A clinical nurse specialist gave him information on a full range of options including active surveillance, prostatectomy, external beam radiotherapy and brachytherapy.
“My wife and I did quite extensive online research, but I also spoke with a friend who had received brachytherapy treatment about a year before I did and found his experience of huge value. Because of my age and the fact that we had caught the cancer at an early stage, we felt brachytherapy would have the least impact on my life as it carries less risk of impotence and incontinence – and there is no need for pre-operative hormone treatment. I also didn’t want to risk active surveillance,” Bill comments.
The brachytherapy treatment was carried out at St James Hospital, Leeds, by Dr David Bottomley, Consultant Clinical Oncologist. “I had a reasonably quick recovery and was back at work after a week,” Bill adds. “Other than that, it didn’t impact on my work life at all. I would recommend brachytherapy to others simply because of the recovery time and my lack of problems after the operation.”
Indeed, now 55, Bill maintains a physical job as a caretaker and gardener at a day care centre.
“My advice is that all men over the age of 50 should get themselves checked out. I’ve spoken to a lot of men and there is actually no standard approach to the PSA test across primary care. What I do believe is that without my GP’s proactive approach, the chances that I might have not been diagnosed when I was would have been high. To give men the most control over and greatest choice of treatment options, I can’t recommend getting checked out enough.”
Chris James, 67
Chris was diagnosed with prostate cancer at the age of 67, having previously been treated for testicular cancer in 1976. His treatment pathway took many turns and below is his story.
In 1976 Chris successfully underwent an orchidectomy followed by external beam radiation therapy (ERBT) to remove his testicular cancer. Fast forward to 2016 and Chris began experiencing urinary incontinence, with an increased urge to go at night time. Having experienced similar symptoms during his first cancer diagnosis, he visited his GP to get checked. Following standard tests, his GP referred him to the Urology department at Guy’s Hospital, London. It was here that Chris had an MRI, blood tests and further PSA tests taken. He was diagnosed with prostate cancer, albeit non-aggressive.
“For the initial treatment, I was put on active surveillance due to low PSA levels and carried on with this method for over half a year. As my symptoms became worse though, I sought advice from my Urologist on alternative treatment options and was told active surveillance at this stage was in fact the best course as a biopsy could lead to complications.”
Chris continued on active surveillance for another 3 months and then sought out a second opinion. “After seeing a different Urologist, I was advised a biopsy should be the next step and agreed to have this done,” he explains.
“Due to the EBRT treatment I had for my testicular cancer, there was a lot of debate from my clinicians on what the best treatment option might be. A second dose of radiation is not typically advised due to higher risks of complications. So it was recommended we should try a prostatectomy to remove the prostate and the cancer. This was attempted in May but failed due to adhesions. My mood quickly dropped after this procedure and left me feeling confused on what would happen next.”
During Chris’ recovery, he was visited by his Urologist where he was told about Brachytherapy. “I was reassured that, although brachytherapy was the second option in my case, for a lot of men it is a successful first option,” Chris says. And, following researching the treatment with his wife and thanks to help of a Macmillans’ brachytherapy booklet, he felt comfortable with the low risk and was happy to go ahead with the procedure.
“In November, I underwent the brachytherapy treatment. My recovery was good and within a couple of days, I was up and moving. That said, with the rollercoaster of the year that I’d had, I was fatigued and struggled to get my head around the second cancer diagnosis and the complications I had with treatments. Fortunately, largely thanks to the quick recovery from the procedure and the success of the treatment, this changed after a couple of months. It was even noted in my local ukulele club that I had my ‘spark’ back and I was able to start volunteering again at my local bereavement centre.”
Following his experience, Chris urges that men get as much advice on their treatment options as possible. “Men do have different lifestyles and different priorities and it is really important to assess all available options to you before you make a decision. After the variety of different routes and advice I was given, I would strongly recommend that other men speak thoroughly to their clinicians and nurses from the outset about the range of options that are available as well as the likely outcomes and potential side effects of each.
“Fortunately, my story has a positive outcome, but it wasn’t without its complications which is why transparency and raising awareness is so important to me.”
Russel Stewart, 69
In the United Kingdom, Prostate Cancer is the most common cancer in men, with more than 47,500 diagnoses every year. With celebrities including Stephen Fry and Bill Turnbull announcing their own prostate cancer journey in recent years, the ‘Turnbull/Fry’ effect led to more men getting themselves checked for early warning signs and potentially saving themselves from adverse outcomes by getting an earlier diagnosis.
Their stories resonate with that of Russell Stewart, a 69-year-old retired Sergeant in the Royal Engineers Bomb Disposal, and Police Sergeant from Newcastle. Despite having suffered slight issues with incontinence since his 50s, for which he was on long term medication, Russell never considered he was showing any signs of prostate cancer. However, around the same time in 2017 that Bill Turnbull and Stephen Fry were going through their own diagnoses, Russell went to his GP to get himself checked.
“I’ve always been a bit of a workaholic, but retirement gave me a bit of time to think. I did some research and found that if you were over 50 and wanted a PSA test, you should be able to get one. I didn’t have any problems, other than the incontinence which I largely had under control, but I went to my GP who thought I had a slightly enlarged prostate, but with no concern.
“Around August 2017, I went for a blood test, and my PSA reading was 5.76. From my research, I knew that they expect most males to be between 2-4, but as you get over 50, if it’s slightly higher it isn’t necessarily something to be concerned about. However, my doctor suggested we tested my PSA level every 3 months for a year to monitor the results.”
Between August 2017 and June 2018, Russell’s results kept fluctuating. However, by June 2018, his score had risen to 7.33 – which was the point when his doctor referred him to the Queen Elizabeth Hospital in Gateshead for diagnosis. Russell underwent a TRUS biopsy, which showed there was a small cancerous lesion contained within the prostate, which the consultant said was both treatable and curable.
Together with the multidisciplinary consultancy team at the hospital, Russell began to explore the various options available for treatment, which included undergoing a radical prostatectomy or low dose-rate brachytherapy. “I never felt I had any definitive guidance or pressure from the hospital as to what I should do, instead, my options were presented to me and I was given the choice,” Russell comments.
With such an important decision ahead, Russell researched his options for around 6 weeks as he continued to ask questions on each of the procedures to ensure he was as informed as he could be. From his research, he interpreted that the potential side effects of brachytherapy, compared to surgery, would be less intrusive and have less impact on his lifestyle, which involves lots of walking and working with gun dogs. He settled on brachytherapy as his preferred treatment option in August 2018, adding that “The team at the hospital was fully supportive of my choice and my consultant said I had made the right decision – but I wasn’t pushed in any direction.”
After his final consultation in September, Russell underwent the brachytherapy procedure at the Newcastle Freeman Hospital on the 11th of December. Russell highlights that since the operation everything has settled down, and his recovery process has been remarkable.
“From a personal perspective, my problems with urination and bowel movements have gone from good, to better, to even better over time. I’m better than I was before the operation, and I haven’t had any issues since which I’m quite pleased with.”
Another factor Russell had read about from other men’s personal experiences was the loss of sexual function. Some treatment options, such as radical prostatectomy, can have more adverse side-effects than others, including erectile dysfunction, which can be a big concern for many men when they’re diagnosed with prostate cancer. However, this worry shouldn’t stop men from progressing with treatment, as not all treatment options affect a man’s sexual ability.
Russell recalls a conversation he had while waiting for one of his appointments, where another gentleman was discussing his treatment options for prostate cancer. “He had a high level of cancer which had grown outside of the prostate but had decided to watch and wait. His reasoning was because he didn’t want to lose the ability to have sex, yet he was in his late 60’s. It’s true that my prostate cancer was not as advanced and brachytherapy was an option available to me, but I think it’s important men understand that there are choices available to them that can be minimally invasive.”
3 months later, Russell continues his consultation visits to make sure everything is okay. Since his operation, his last three PSA test scores have been under 1.
Discussing his prostate cancer experience, Russell applauds the process from diagnosis to the operation: “It couldn’t have been any better. I don’t think I would’ve had better or faster treatment in a private situation than with the National Health.”
Like Bill Turnbull and Stephen Fry, Russell is keen to make more men aware of the importance of getting themselves checked early and regularly. “I appreciate men are reluctant to speak about it, but it needs to be talked about. For the sake of having a blood test, which is so accessible and doesn’t cost anything, it could change your life.”