Stephen Sayer’s prostate cancer experience


It began in the bleak days of the early part of 1997 when I was a young man of 51 years old.  It was, of course, my first awareness that I was suffering from cancer; cancer of the prostate, an organ of which I was then but vaguely aware and certainly very ignorant.  I have since become very conscious of it.  Cancer, and the treatment of it, forces you to take a close, introspective look at whichever organ of your body is suffering from the disease.

There had been no symptoms - none of the things that, in my ignorance, I assumed would be warning signs: no blood, discomfort, no slowing of flow.  So the discovery of the problem was a great surprise, out of the blue, made through a PSA test carried out as part of a routine medical which the office required.

Then came the visit to the eminent Harley Street oncologist and the taking of biopsies.  Not a pleasant experience, given the invasion of privacy involved and the significant discomfort of the probe extracting cells from the sensitive organ.  Confirmation of the disease was immediate - from the doctor undertaking the test - ‘I’m sorry but there is clear evidence of cancer’.

Decision time

The next step was the somewhat nerve-racking and lengthy discussion about the possible courses of treatment.  Fortunately my wife attended this consultation; living with cancer is something that a closely united husband and wife do together.  The burden is certainly shared - or at any rate it has been for us.

The debate came down to this. Should I have a radical prostatectomy or should I go for radiation?  I opted for radiation as being less invasive and carrying less risk of incontinence.

There then followed a series of tests.  The bone scan, was certainly the most extraordinary - I never expected to have the opportunity of viewing my own skeleton!  Other scans determined the best angle of delivery of the radiation particles.  The entry points into the body were marked by tattooing - the only tattooing I have undergone despite modern fashion.  The treatment itself was painless - with short bursts of radiation being fired at you by a nuclear accelerator which was aimed at the entry points using lasers.

This was done every day, weekends excepted, for six weeks, and I was able to continue working throughout.  It proved very effective, with my PSA level being reduced to 0.25.  Check-ups followed, at first at three month intervals, then six month and finally twelve month intervals.  All proved satisfactory until 2003.

Set back

From 2002 onwards the blood tests had shown a slow but steady increase in PSA level.  By May/June of 2003 it had risen to 3.8 and I insisted upon further investigation.  The biopsies confirmed the presence of two tumours.  It was unclear whether this was a recurrence of the old ones or the appearance of new ones.

I was referred to a new specialist urologist, described as a leader in this field.  It was his view that the hoped for step of a radical prostatectomy should not be undertaken.  The risks were simply too great.  Hormone therapy was rejected, largely on the grounds of the unpleasant side-effects and uncertainty about long term efficacy.  But this last option could only be rejected because of the presence of a third option : cryosurgery.

Cryosurgery

It was carefully explained to us that there were risks attached and no guarantees could be given.  The procedure was developed in the States and successfully used both there and in Germany.  It was therefore ripe for use in the UK.  The Cromwell Hospital was about to set up a new unit providing the treatment.  Would I be interested and would I like to go to the USA or have it done in London?

Yes I would, and I would like to have it done at the Cromwell Hospital in London, close to where I live in Fulham.  And thus it was.  The operation was undertaken, over 2-3 hours, in July and I was able to return home two days later.  The operation involved freezing, warming and re-freezing the prostate to kill the cancer cells.  The freezing was achieved by delivering gas through a dozen or so needles.

The best news of all . . . regarded as cured

The side effects have been difficult, and not insignificant (pain, incontinence, urgency and tiredness) but are now finally fading and a return to work becomes possible.  And the best news of all - with a PSA level of 0.27 I am regarded, within the limits of medical uncertainty, as having been cured.

Financial cost

As a result of the operation I have been left with a large debt - some £16,000 was the total cost and the most disturbing feature was the failure by BUPA to pay for it.  Unlike the insurance company of another of the guinea pigs, which has paid without demur, BUPA has refused to pay on the grounds that it was experimental.  The last thing I feel was part of an experiment.  On the contrary I was the beneficiary of very sophisticated medical procedures.