We were talking about the biopsy again, and you mentioned…

Yes.

…one other worry you had?

Yes.

Can you talk about that a bit?

Yes. It only occurred at the time I got the results from the biopsy, when having been expecting it to be benign, it, it turned out to be positive. And my wife and I had made love a couple of times during the interval between having the biopsy and the results. And it suddenly occurred to me after leaving the doctor who told me about this that I might in some way have contaminated my poor wife with semen which was, it had cancer cells involved. And so fortunately I was able to phone my GP, and spoke to his wife, who was also a doctor. And she put my mind at rest, because she said it could not contaminate a woman in any way, prostate cancer cells. Which was a great relief.

And at that consultation did the doctor then discuss possible options that you might choose after that?

Well, the young doctor who told me first, um, the results of the biopsy, mentioned HIFU, which is something I’d never heard of obviously before. And he said that there are three, three options, prostatectomy, which, at my age was an, you know, an indication not to go for that, or radiotherapy of some sort, or this newer HIFU treatment.

Why did he say, because of your age not to go for prostatectomy?

Well, that’s, that’s beyond my knowledge. I think my father was early sixties when he had prostatectomy. My two friends are both similar aged. And I just accepted that. My own doctor in discussion later also said, ‘It is a major surgery and, you know, if theres other ways of going about it they may be preferable.

Did the doctor at that consultation mention the possibility of just monitoring the situation and not taking any aggressive sort of treatment?

They didn’t, they didn’t push that.

Did you feel you had plenty of time to weigh up all the decisions about whether, which treatment you were going to have?

Yes. The natural spacing of the visits to hospital. In the first case, when I had my decision given to me, there was then a natural break whilst the, the two scans were taken. And then very quickly I was then told about radiotherapy. And after that it took another two, about two weeks to meet a, a doctor who would ex-, could explain HIFU.

So you had…

So I had everything else than the HIFU information for quite a long time. So when I then had, well, I, I made actually a questionnaire of items to ask the HIFU specialist. And he explained it very clearly. And I decided that day to go for the HIFU.

And did you feel you were given sufficient information about the nature of the trial?

Yes. I mean any trial is, you’re a guinea pig and, and theres no way out of that. But ones got to balance it against the, what has already gone before. And it appears that around the world about two thousand people have had the ultrasound treatment, and with generally quite good results. And the figures that are claimed for the first five years are f-, are comparable with those of prostatectomy and radiotherapy. And there are certain benefits from the radio-, from ultrasound, which perhaps radiotherapy, in my opinion having thought about it, seems preferable. There is no radiation toxicity in HIFU. And the energy I think is very focused and doesn’t go to other parts of the body.

Yes. I think perhaps my, the history of my father having a benign condition of prostate made me aware that I might have some problem with my prostate at some stage. And in the last ten years my inclination to urinate at frequent intervals in some cases made me aware that I might be getting this condition. And my doctor was not pushing the idea of a PSA test at any stage. I did mention it to him one time, but he said, ‘When things get worse perhaps we can consider it. And recently I m-, I approached his locum when he was away for a spell and mentioned it again. And she said, ‘Well, it’s not difficult to arrange. Quite happy to do it. And I have two friends who just recently have had prostatectomies. And one is our local vicar, and hes been through it and is still recovering from it. And another is a, another friend I’ve known for thirty years and he seems to have come through that well. And by talking with them it made me aware that, you know, I might be getting to the stage where it wouldn’t be a bad idea to, to have it checked up. Throughout our married life I’ve encouraged my wife to have mammograms because, you know, that’s the problem which could affect, could have affected our families years back. And eventually I got round to the idea that I should perhaps have the PSA test. And at that stage approached the doctor and got it arranged.

To date so far have you just had the one PSA test, or has it been repeated?

No, I’ve had a PSA test just recently. And I have to say that, not very alarming, but it was raised to 10.6, on the most recent one I’ve had, which was when I agreed to, to the HIFU [High Intensity Focused Ultrasound treatment]. And I phoned one of the doctors who’s on the, the HIFU scheme and asked him whether I should be bothered by it in respect of the fact that from the time of the test to the time of my treatment it’s a period of two and a half months. And he wasn’t alarmist and he wasn’t quite totally clear to me as to whether I should be worried. He said the PSA tests have a, a factor of 10 per cent, where they can be inaccurate. And I put the point that my PSA was raised by 50 per cent. And when he said that I said, ‘You can read that two ways. It’s risen by 30 per cent or it’s risen by 70 per cent, because the PSAs can be both, wrong in both ways either way. So I don’t know whether that’s a worry. And I don’t think I’m quite clear in my mind yet.

I have to say any information I’ve had about PSA tests has not been as it were explaining to the uninitiated what it means. If I wanted to make it clear to the general population what to worry about with a PSA test, if I could be told that the levels you ought to have are 4, the levels you should be slightly concerned at are 6, and the levels you should be very concerned at are 15 to 30, I’d be better informed about it than I am. I don’t think it’s something which is widely explained to patients.

I don’t really know on what basis doctors read the information from a PSA test. And ones, ones in their hands to say, ‘You need something done or, ‘You could very well not need something done. Theres a certain sort of mystique about it [laugh].