15th August 2012 – I wish I could get away with blagging results to my clients!

Ah well - had my meeting with the Urologist and he confirmed that the MRI says the cancer is organ contained. 
He is not recommending Active Surveillance despite the fact he staged it as T1c and it has a Gleeson 3+3=6. 

He wants to do a Nerve-Sparing Radical Prostatectomy via keyhole, he had a preference for that over radiation. However when I asked what nerves he will save he said left side only and used the excuse that he couldn't guarantee clearing all the cancer if the left in the right bundle of nerves.

Am not happy as I queried this as it goes against everything i have read. This procedure was invented by Dr Patrick Walsh in the USA and if my cancer is not in the outer aspect of the capsule then I don’t see why he couldn’t save both sets of nerves. He really didn’t explain this well.

Suspect there is something I am not being told or he doesn't have all the information. I asked for my prostrate volume and he said it was 33. If this is correct then Epstein's research (|Epstein is a leading doctor in the USA at the famous John Hopkins Institute )  would say my PSA should have been around 3.3 and it was 5.3 - that would indicate an aggressive cancer not a low risk. Also the Density would be 0.16 again indicating aggressive. Also my freePSA was only 8% which would also tie into these findings. He wasn’t interested in any of this side of things.

Could be that this is why they don’t recommend AS and want to do surgery - but it all didn’t add up. I asked him if I could have a second opinion and he said he would arrange it for me with another urologist in Shrewsbury.  I will be quizzing the new consultant. In the meantime, my  present urologist said he would put me down on Active Surveillance - not happy with AS though as its like having a ticking time bomb inside you. Dont know how long I can live knowing that cancer is growing silently inside me. He gave me a PSA test form and told me that I needed to go to my GP with the form on or about 5^th October and have another blood test.

Was a little annoyed as the urologist couldn't give me any idea of how much cancer was on the MRI's and locations. Hopefully things will get better with the second opinion person. The most frustrating thing is all the sitting around and waiting.

Another upsetting aspect of the meeting with the urologist was the speed of the meeting. All very clinical and no time to think. It was as if I was being asked to make a decision there and then to satisfy some NHS target. When I told him I needed time to think and I wouldn't make a decision there and then it was as if he wanted me out asap to get on with the next person. 

If the next person is anything like this then I will immediately go private under Bupa. I think my heart is already telling me to do that.

The next day I received a letter from the hospital confirming a booking with the urologist in 12 months time  - so I suppose that’s the last time I will ever see this urologist.

Apart from 15mins doing a DRE and initial consultation, and 10 mins telling me what an MDT team had already decided as he didn’t have my notes – that was the sum of his involvement. I wouldn’t employ him if he was in my profession.