Despite being the most common cancer in men across the United Kingdom, for many men, prostate cancer can be asymptomatic, especially in its early stages – which can lead to a delayed diagnosis. However, an early diagnosis is crucial, not only to overall survival, but also to the viability of the different treatment options, which themselves can improve the quality of life outcomes. This is why offering a PSA test (prostate-specific antigen) to gentlemen over the age of 50, or with a family history of prostate cancer, is crucial to identify and treat prostate cancer before a later and more advanced stage.

In 2015, Dave Fenneberg from Essex, who was 65 years old at the time, asked his local GP for a PSA test when he went to have a routine blood test – despite showing no symptoms of prostate cancer. Dave’s results came back with an exceptionally high score of 48 ng/mL (on average, if the PSA is more than 10, the chance of having prostate cancer is over 50%).

Dave comments: “When my results came back, I got a phone call to come in immediately to my local GP surgery, and then the following day I was with a specialist in Basildon Hospital – it all happened quite quickly.”

At Basildon University Hospital, Dave underwent an MRI (Magnetic Resonance Imaging), bone scan and a transrectal biopsy. Unfortunately, a few days after his transrectal biopsy, Dave was diagnosed with sepsis, and subsequently, spent a further four days in the hospital. “I should never have come home after my biopsy. When I came out of the biopsy and the hospital staff asked me to take a seat while I waited for an appointment for the bone scan, when I stood up, the seat was covered in blood,” explains Dave. 

Historically, transrectal prostate biopsies (TRUS) have been the standard practice for prostate cancer diagnosis, which uses a biopsy needle inserted through the rectum to sample the prostate. Yet, the procedure has a high risk of serious infection, sepsis and bleeding, as well as inaccurate identification of suspected cancer cells.

Fortunately, there is now an alternative method, which is increasingly being adopted across the NHS – a transperineal biopsy conducted under local anaesthetic (LA TP), which passes the needle through the perineum instead of the wall of the rectum, and therefore, mitigating most of the risks associated with the transrectal approach.

Following his scans and biopsy, Dave was diagnosed with advanced and aggressive prostate cancer, which was beginning to spread outside of the prostate, on the 9th of December 2015. The oncology team recommended that he should have hormone injections to reduce the aggressive nature of the cancer; LDR brachytherapy – a focal therapy to treat the localised cancer cells – followed by several sessions of radiotherapy to target those cells that were starting to spread beyond the prostate.

Dave said: “Having listened carefully to the oncologist’s recommendation and reading about the treatment options, I was very happy to go along with their advice. Considering the advanced nature of the cancer, it seemed the best way to tackle it with the best chances for a good outcome.  ”

Immediately after his diagnosis, Dave began hormone injections first, which took place over a three-year span between December 2015 and 2018. Then, in August 2016, his LDR brachytherapy procedure took place at Southend Hospital with Dr Ahmed. “My treatment was okay and bearable. I was in and out of hospital within a few days, and found that I was able to get back to normal quite quickly.”

The only side effect that Dave suffered from was the inability to urinate, and because of this, he had a catheter put in approximately one week after the procedure took place. After brachytherapy, Dave then underwent six weeks of radiotherapy – three months after which his catheter was removed.

Since 2018, Dave has had no further treatment for his prostate cancer, and continues to speak to the oncology team and monitor his PSA levels, which has since dropped to 1.8ng/mL in February 2022.

Commenting on his lifestyle now, Dave said: “I don’t suffer from any side-effects following my treatments. I find myself urinating quite often during the day, every couple of hours, but I’m no longer up during the night.”

Now 72 years old and working as a Freemason, Dave emphasises the importance of educating men to get checked and to monitor their PSA scores: “We host sessions every few months where we have someone come in to offer blood tests and general health checks, which is free to all of our members. I always encourage everybody else to get checked.

“I know a lot more about prostate cancer and the tests available now than I did six years ago. You can have high blood pressure, or Type 2 diabetes without knowing, and similarly, you could have a high PSA score and prostate cancer like me, without realising it.”