Friday 27 March 2020

Rog T Cancer Blog - A dangerous dilemma for all Prostate Cancer sufferers on active survelliance

I have a dilemma, a difficult dilemma, maybe a dangerous dilemma. I am pretty sure I am not alone in the dilemma. I am sure it is one every man who has been diagnosed with Prostate cancer and is on active surveillance has right now. For those who might be reading this blog and are not familiar with the term, those of us who have a cancer diagnosis, where the cancer is not aggressive, large or spreading, given the potentially life changing effects of a radical prostatectamy, we opt for active surveillance. This is regular PSA tests to monitor the levels, along with biopsies and MRI scans. I had treatment in 2015, but the regime is biannual PSA tests, annual MRI scans and consultations. Although technically this is follow up, for an experimental treatment, the regime is the same as active surveillance. So the thoughts, worries etc I have are the same.

I am due to book a PSA test, having had one in October and with a forthcoming MRI and check up. The only thing is that to have a blood test, I'd have to go to the doctor, get a form, make my way to Finchley Memorial, sit  in a busy room awaiting a blood test, then make my way to UCH for a scan and again for a consult. The thing is, as everything has been behaving itself, with the Covid-19 worries, do I really want to go to a busy hospital, which is likely to be a place where I am likely to come into contact with people infected with covid-19? Do I want to get the tube in to Euston? My hope is that UCH will reschedule the MRI and the consult. Like many things, it is a balancing act, but even if the cancer had started to become aggressive again, can treatment wait until after the crisis has passed? I think the likely hood that there is a problem is low and that the contact with covid-19 would be more risky. Does the MRI machine get completely cleaned after every scan, what if the bloke before was infected?

The NHS is under great strain, so I am very much hoping that the whole thing is deemed not important. Of course in six months, this may bite me on the bum, if the cancer has started to misbehave. I trust my consultant Mr Emberton and UCH to make the right call. I will do what they say, but I cannot say I am not very worried about the whole thing. At the bottom of this blog, I have a little video that sort of sums up my dilemma, and I hope you enjoy it.

I will say this. God bless the NHS. As I've stated many times, the cost of my treatment and my insurance status in the USA would have impoverished me and made me fearful of the future. Perhaps the greatest thing the crisis has done is remind us what a magnificent institution the NHS really is and why we should not be running it on a shoestring.

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For those of you who are regular readers and have read the previous posts on Cancer, here's what this is all about. I write this blog because knowledge is power and if you know what you are dealing with, you have more weapons in the locker to fight it. It is a personal view, I'm not medically qualified. This is for the sole purpose of information for those who are interested.This is the latest installment in my occasional series about how I'm adjusting to living with a big C in my life.  For those of you who aren't, here's a quick summary. I'm 54years old and in October 2011 I  had a prostate biopsy following two "slightly high" PSA tests - 2.8 & 4.1. The biopsy took ten tissue samples and one of these showed a "low grade cancer" which gave me a 3+3 on the Gleason scale. I was put on a program of active monitoring.  In early February, I got the results of the a PSA test - down to 3.5 and an MRI scan which found absolutely nothing, two more tests in 2012 were at 3.5 and 3.9, in 2013 my test was 4.0, Jan 2014 was 3.8, August 2014 was 4.0,  February 2015 it was  up to 5.5  and my latest in August 2015 was down again at 4.6. In October 2015 I had a transperinial Prostate biopsy, that revealed higher grade cancer and my Gleason score was raised to 3+4 (Small mass + more aggressive cancer). On 22nd Jan 2016 I had HIFU (Hi Intensity Focused Ultrasound) treatment at UCHL). My post procedure PSA in May was 4.0 which was down, followed by 3.7 in August, and 3.5 in October  which means that the direction is positive . However in January the follow up MRI revealed "something unusual which requires investigation" After a follow up biopsy, it appeared this was nothing to worry about. My two most recent PSA tests were Ok (3.7 and 4.6) and an MRI scan in March was very positive. My last PSA in October was 4.6, so stable and good news.

  I've no symptoms apart from needing to wee quite regularly and sadly for a few people, if I'm gonna die soon, it won't be from Prostate cancer. Got the picture? 


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