Prostate Cancer: Patient Story – Alan Wilson

Prostate cancer affects 47,500 men in the UK every year, but not all patients experience symptoms – which is why it is important that men over the age of 50 must regularly check their PSA (prostate-specific antigen) levels.

If diagnosed at an early stage, men will be likely to have both better outcomes, as well as a wider variety of treatment options – improving their quality of life long-term. However, whilst having the right support and advice from healthcare professionals is crucial, it is also important that men do their research and find out exactly what pathways are available to them.

This was very much the case for 75-year-old, retired driving instructor, Alan Wilson from Hertfordshire. In 2005, Alan started to experience kidney pain, after a history of suffering from kidney stones. But when he went to his GP to get checked, they were keen for him to carry out a PSA test.

His PSA came back with a score of eight (men with a PSA level between four and ten – often called the “borderline range” – have about a one in four chance of having prostate cancer), so his doctors referred him to his local hospital[1]  for a biopsy test to undergo further checks.

Alan’s biopsy results showed three samples – two of them were clear, but one had signs of prostate cancer – and his Gleason Score was on the borderline of ‘being a concern.’ He comments: “I was shocked as I had no pain, and there was nothing to suggest anything was wrong.”

Due to his results being ‘borderline,’ it was recommended for Alan to monitor his prostate cancer (otherwise called active surveillance or watchful waiting). Watchful waiting is where a less aggressive prostate cancer, that isn’t causing any harm or presenting any symptoms, is observed closely to avoid treatment until it’s necessary.

Alan said: “At the time, they said we can keep an eye on it and make up our mind on what method of correction to take at a later stage, as eventually, I would have to have treatment – you can’t leave it forever.”

Later[2]  on, Alan underwent an MRI scan, which confirmed that his cancer hadn’t spread and it was still contained within the prostate.

Nonetheless, Alan and his urology team agreed it had progressed enough for him to start looking at potential treatment options. Two surgeons at the hospital outlined a couple of treatment options to Alan; one was to have the prostate surgically removed (a radical prostatectomy), which Alan didn’t want to progress with, and the other was to undergo external radiotherapy – which initially was the pathway Alan chose to have.

But it was only after Alan had spoken with a parent of a child he was teaching to drive that he found out about a third option, LDR Brachytherapy: “I mentioned to one of my pupils’ dads that I had got prostate cancer, and he’d said his dad had also just been diagnosed and had a treatment called LDR brachytherapy.”

Following this conversation, Alan went back to his consultant and asked about this other treatment option that he wasn’t offered. It was explained to him at the time that it was a less common treatment option as not as many hospitals offer it.

However, Alan was referred to Barnet Hospital, where he had a telephone appointment with a urologist, Peter Ostler, to discuss LDR Brachytherapy. “I was overwhelmed. He was funny and put me at complete ease both in himself and with regard to the treatment. I asked if the treatment was possible as I wanted to have it.”

To ensure Alan could have LDR Brachytherapy, the urology team needed to carry out further tests to ensure his PSA score hadn’t risen much higher, and that his prostate was still the same. Luckily for Alan, it was shortly confirmed that he was able to go ahead with the treatment.

Six weeks later, Alan went in for his LDR Brachytherapy (LDR-B) treatment. LDR brachytherapy is a targeted form of internal radiotherapy. It is targeted at the site of the tumour, so that the radiation only kills the cancer cells, minimising damage to surrounding healthy cells.

Alan was in and out within a couple of days of having the procedure, and Alan describes that he was amazed at how good he found his experience: “I would say if you get the choice of brachytherapy – to pick it. Luckily now for men diagnosed with prostate cancer, brachytherapy is much more available compared to 15 years ago. It’s so painless, I was back at work within a week. The team at Barnet Hospital were fantastic”.

The only side effect Alan has experienced since having his LDR Brachytherapy treatment is minor incontinence, which, as he describes, “compared to cancer, is quite innocuous really,” and takes tablets to help with this.

For 10 years after his treatment, Alan was getting yearly check-ups and checking his PSA score (with his most recent scoring being 0.02) – and in 2015, he was discharged as his prostate was no longer a concern.

That said, Alan continues to get his PSA checked every year, and recommends that all men over the age of 50 does the same: “It only takes 20 seconds and you walk back out the door – but it could save your life.”