Question re ADT

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Hi everyone, can anyone help with this. We saw the urology consultant last Monday, confirmed Gleason 9 (4+5), no spread to lymph nodes or bones found on CT or bone scan. Prescribed Bicalutamide for 21 days, and told to contact my GP to arrange ADT injections (three monthly) starting a week after starting the Bicalutamide. Contacted GP and booked appt for today. Husband had a call from the GP earlier who asked what injection he should be having as they hadn’t heard anything from the urology department advising treatment plan. He hasn’t had anything in writing either. The doctor said she’s happy to prescribe 11.25 mg of Prostap today.  My husband has called the urology dept, no answer, left a message for his named nurse, but no call back.  He doesn’t want to delay the treatment as he first became aware of his high PsA in January (details in biog),  and just wants to get on with it.

Is this lack of contact concerning, should he go ahead today with the first injection ?

  • Hello  

    I would be very happy with the GP prescribing Prostap today. (I was on Decapeptyl and had no side effects from any injections).

    My concerns, however would be there should be a "shared care agreement" between the GP and Hospital. This should be in place and a copy should be available under "Documents" on the NHS App - The GP should also be maintaining a register of injections given to give you regular reminders when the next one is due.

    Do let us know how you get on.

    Best wishes - Brian.

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  • Many thanks for the quick reply. I’m glad you came back with that response. I’ll suggest he speaks to the practice nurse and suggest they contact urology re a plan, and I’ll get him to chase up with urology as well. It is frustrating that they give you a named contact in urology to call if you have questions, which you inevitably do at the start of treatment, but you just get a message service and no call back. 

    thanks again for your advice. 

  • What Millibob says. Proper detailed arrangement/shared care needs to be formally in place. Otherwise danger of falling between two stools scenario. 

    Good luck, Dave 

  • Hi  . Interestingly I was given a choice of locations for the first injection and I chose the hospital closest to me. The urologist had given me a prescription which was collected from a local pharmacy and the injection was delivered by a MacMillan specialist nurse, after she had filled me in on my diagnosis and treatment aim. All subsequent injections have been at the GP with them supplying the drug. Maybe that’s just the way this trust does things, maybe others have different ways of doing it…? I just thought it a bit of an odd way to start, relying on the patient to pick up the box. Particularly as the first pharmacy I tried couldn’t supply both drugs I needed.

  • He had the injection earlier, all went well. I think you are correct in that every trust does things differently. Our GP has Prostap in stock so it’s just the case of the GP writing the prescription and turning up for the injection. GP is good for us as it’s three miles away, where the hospital is more like 25 miles. 

  • Yes, we are going to chase up and get this in place asap.