Read on:

I was very interested in the article on the Vitality Index although I have yet to find it to see exactly how it is set out.

I am not a doctor but a prostate cancer person.  GP's (or at least the one I had at the time) seem to have no idea of the initial impact on a patient. I will not bore you with the sequence of events before I was passed over to Urologists and Oncologists.  Once with the Urologist the full story of prostate cancer was never explained to me.  I was simply told that I had a PSA of 18 and on a DRE there appeared to be no abnormality.  At my age - 70 - they would recommend keeping an eye on it although I could have an ultrasound scan.  With some reluctance I agreed and as that was negative they felt a biopsy should be done, whilst explaining that only a positive result would be conclusive because a negative result may just mean they have missed the malignant part.  To me this was all mumbo jumbo although I accept it may have been my own fault by not taking in what I was being told.

Eventually I was told I had prostate cancer but there was no discussion envisaged by the Vitality Index.  I was not told of any alternative treatments.  I was sent off to a surgeon who told me I was not suitable for removal of the prostate.  He did not tell me why and I was then referred back to the Urologist.  In turn I was sent to an Oncologist who recommended hormone and radiotherapy.  I asked what that entailed from a practical point of view and was told I would have to attend a hospital (25 miles away - no public transport) every day for 7 weeks and would be on hormone therapy for 2 years afterwards.  No discussion of lifestyle, or anything else.  I would be given a free parking space at the hospital and towards the end of the 7 week period I would probably need somebody to drive me back and forth.

I then set about my own research to find out about the various alternative treatments and their side effects.  From all the material available I felt Brachytherapy would give me the best result but that is not a treatment available with my primary care trust.  I managed to persuade my oncologist that this was a treatment I would prefer for a number of reasons and she was able to refer me out of my area for a consultation with a brachytherapy team. Although I am outside the usual basic criteria for brachytherapy they have agreed to go ahead and stage one has been done.  Stage two which is the actual implant of the seeds takes place on the 17 February.

I have got to this stage by my own persistence and not as a result of sitting down at the beginning and have a complete discussion about the alternatives.  As my partner said with some frustration to one of the doctors "he is a very young 70" and I do not want to live an incontinent and sexless existence.  I have often felt that my numerical age was against me and I was being considered as just another 70 year old.  I was very disappointed to hear one of the speakers at the National Prostate Cancer Conference in London in November waxing lyrical about surgery.  He made the comment that if you haven't had your fun by the age you're 60 he felt sorry for you.  What a sad guy, to think you cannot enjoy a fulfilling sex life into your mature years.

I only witter on like this to show how important it should be for doctors to take into account the individual patient, their lifestyle and the effects that treatment will have.  Quality of life is far more important than the length of life.  I am now being treated by a team that understand that.

(7/2/05)