My follow up with the consultant involved regular blood tests to monitor the PSA level. My initial appointment in August 2005, showed the reading was <0.1, too small to register. Every six months, a blood test confirmed the reading, until 2012, when a reading of 0.1 showed that there was some sort of activity. The next two readings stayed at 0.1 then it rose to 0.2. The consultants started to talk about radio therapy as an option, but I preferred to ‘watch and wait’, despite their insistence. In February 2013, the PSA reading jumped from 0.2 to 0.58, and this got my attention. The prognosis was that my original prostatectomy had left behind some residual cancer cells. Again, it was proposed that radio therapy was the only serious option, together with hormone treatment, although I could choose to have hormone treatment alone. However, I wasn’t convinced, was unhappy with the lack of empathy of the consultants at my local hospital, so requested a second opinion. I was referred to University College London Hospital.
The first appointment was with a very pleasant lady doctor on Professor Emberton’s team, who talked through the result of a scan I’d had a week or so previously. The scan result was inconclusive, although it showed metal clips had been used internally during my operation in February 2005, which was news to me. My PSA reading was 0.45, interestingly below the 0.58 reading in February. Professor Emberton’s team specialise in ultrasound treatment for prostate cancer, amongst others, but only before surgery, so I was in the wrong department. I was referred to the radiotherapy team, led by Doctor H A Payne.
Doctor Payne and her team are professional and show great humanity when dealing with patients. From my first appointment in August 2013, I was sent for a Choline PET Scan, which uses a radioactive dye to highlight cancer cell activity within the body. This took place on 26 September 2013 and showed damage to a recently bruised elbow, and 3 crushed vertebrae in the middle of my back, from a fall in 1973. There was no sign of cancer activity within the prostate bed. I couldn’t understand this but was assured that the fact of my still rising PSA, which was now 0.47, was of significant concern. The argument was that this indicated that there was some cancer cell activity within the prostate bed and radiotherapy would be aimed at killing the cancer cells; which was what the previous team had been recommending. What was suggested was that, pending my decision on radiotherapy, I should start taking hormone tablets to get the PSA readings down to an acceptable level.
I started the daily dose of 150mg of Bicalutamide hormone tablets on 10 October 2013. My PSA readings started to drop; 31 October 0.16, 13 December 0.04, 15 January 2014 less than 0.01, which was the reading immediately after my operation in February 2005. On January 22, 2014, I signed the consent form for radiotherapy to go ahead. Dr Payne went over the potential side effects: loss of erection, more frequent peeing, difficulty peeing, bowel irritation, and similar alarming subjects. But I had to make a decision. I had seen my brother die untreated – his choice – and I am keen to avoid his fate. So, I thought, this is basically about choosing how I would live and die.
