As it stands, not all men across the United Kingdom have access to the latest biopsy techniques and treatment options for prostate cancer, which are often postcode dependent due to availability and nursing shortage. However, giving patients control over their choice is key; as the side effects of the different treatment options can vary and may have an impact on a gentleman’s lifestyle, and therefore, quality of life post-treatment.

Every man going through treatment for prostate cancer should be given an equitable opportunity. This is something that Camberley-based John Whitehouse realised, soon after he was diagnosed with prostate cancer in 2012.

John had no symptoms of prostate cancer, and only went to get checked because he was offered a private health check through his company at the time. During this check, John underwent a Prostate Specific Antigen (PSA) test, which is a blood test that can help detect the potential risk of prostate cancer by measuring the amount of PSA in the blood. Generally, the higher a man’s PSA level, the more likely it is that he has prostate cancer, though this will vary by age, ethnic origin and also simply from individual to individual. For example, ‘normal’ levels for a 50-59 year old are up to 3.0 ng/mL, and for 60-69 year olds up to 4.0 ng/ML.

“My results showed that I was right on the cusp, I was 59 years old at the time and my PSA score was 4.0 ng/mL. The doctor that did the health MOT felt that I ought to get double-checked, as she felt it was a bit on the high side for my age,” explains John.

John then went to his GP a month later to get another PSA test, and his score had marginally increased to 4.1 ng/ML. He was then referred to Frimley Park Hospital to undergo an MRI test, an ultrasound and a biopsy in March 2012, which was when John was told he had prostate cancer.

John says: “When I was told that I had prostate cancer, I felt like a startled rabbit as I was totally unaware. You get given a sea of information to digest and asked to give an answer to fairly quickly, which if you’re unqualified to do – like a majority of us men – you feel that you have got to rely on the doctor’s expertise.”

After being diagnosed at Frimley Park Hospital, John was referred to St Luke’s Cancer Centre at Royal Surrey Hospital in Guildford, where he had further ultrasounds and another MRI test: “It was a far more detailed examination at St Luke’s, and the consultant advised that the cancer was localised in my prostate. I then started the clinical resolution of my prostate cancer with the urology team there and discussed my treatment options.”

John’s treatment options included external beam radiotherapy (EBRT), a radical prostatectomy and LDR brachytherapy, which he researched heavily, in addition to speaking to the hospital consultants, and his family and friends: “I used to work in Tewkesbury, and four guys at work also had prostate cancer. But locally, they were only offered external beam brachytherapy. My colleagues advised that I would have to go to hospital every day for around 8 weeks, which I didn’t fancy doing. Also, there is the potential for external cell damage due to the radiation, which was a concern.”

John also decided that he didn’t like the sound of a radical prostatectomy due to the longer timeframe of recovery, and instead, spoke to Professor Stephen Langley at St Luke’s Hospital who has been a long-standing advocate of LDR Brachytherapy and has treated over 5000 men:

“Professor Langley was very confident that I was a suitable patient for LDR Brachytherapy, and he showed me lots of data and supporting documentation around the success rates to suggest that LDR Brachytherapy was the best route to go down. I also felt that the process of putting smaller doses of radiation into the tumour over a longer period of time would be a much better, and targeted treatment option, where the chances of damage would be lesser. So, I elected with his support to go with this treatment option and that’s exactly what happened.”

On the 20th of July 2012, John went in for his LDR Brachytherapy procedure at St Luke’s: “It was a Friday morning and there were three of us having LDR Brachytherapy. The other two gentlemen went first, and they both came out of the procedure after around 45 minutes, and said ‘there was nothing to it’ and ‘it was painless,’ which was reassuring to hear.”

It was then John’s turn, who had an epidural before the LDR Brachytherapy procedure, which the other two gentlemen also had, as their local anaesthesia: “The urology team explained the procedure to me and then I had the epidural, which was painless. I was able to speak to the consultants throughout which was comforting, as well as watch on the monitors where the radiation was being put in. The whole procedure was around 40 minutes long. Afterwards, I had a CT scan and they took my catheter out and wanted me to urinate on my own before being discharged.”

John was sent home the next day, and experienced no side effects and was able to return to day-to-day life quickly: “I was off work for two weeks, but I was able to walk around the house and do normal activities. I also didn’t have to take paracetamol for pain or aches.”

Follow up checks occurred regularly to monitor John’s PSA levels following his LDR Brachytherapy procedure: “My PSA dropped after the procedure and then it bounced back up again, which apparently is quite normal. It then dropped back down and has remained at 0.1ng/mL for the last nine years, but I still go for two PSA tests a year.”

Following John’s LDR Brachytherapy procedure, he says that he would recommend the treatment option to other men: “It was successful and worked for me, I’m happy with my overall experience. It’s a very easy procedure. I was very well cared for by the teams at Frimley Park Hospital and the Royal Surrey Hospital who gave me confidence and reassurance throughout the whole process.”

Furthermore, since his diagnosis, John now encourages his family and friends to get checked: “There is no point in hiding it. I spoke to my family, friends and colleagues about getting a PSA test, which most of them did.”

However, John realised that he was lucky to be in the right place at the right time, with the right team to provide him with the best options. Since moving away from Camberley, it has become apparent to John how much treatment options vary depending on where you live: “One of my friends was diagnosed with prostate cancer just before Christmas, and wasn’t offered LDR Brachytherapy, and instead, he had a radical prostatectomy, and the recovery time is quite protracted – he was off work for around three months.

“It’s a pity that they don’t offer LDR Brachytherapy across more centres. Especially if you catch prostate cancer early enough, it’s a great treatment option and shouldn’t be based on where gentlemen live. Prostate cancer is the most common cancer in men, so more should be done to improve the outlook and accessibility for men across the United Kingdom.”

ENDS