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Obtaining test reports

User
Posted 06 Apr 2018 at 19:00

I have been diagnosed with prostate cancer 6 on the Gleason scale which I believe is low however I now want to go to private care under a specialist but I am having a nightmare getting hold of my MRI and urologists report and the Hospital wont release them to my insurance company.  They wont even release them to me.  Any advice?

User
Posted 06 Apr 2018 at 21:17
Moose

Has the hospitial sent the reports to you GP ? You are entitled to access to you medical records. I recently asked for a copy of a letter from my GP and was given a obscure form to fill in , when I returned with the form a different receptionist said "what is that for" put the form in the bin and printed a copy of the letter I had requested.

There are times when the NHS locally has better equipment than the private sector.

All the best for your treatment.

Thanks Chris

User
Posted 06 Apr 2018 at 21:40

We didn't have to get involved at all - we just made an appointment with the private consultant and he logged into John's medical records while we were there, had a look at the results and then gave us his view.

Be cautious though - with a G6 you may be suitable for active surveillance or brachytherapy and going private will not necessarily be the best move as you may lose access to a number of support systems including the Clinical Nurse Specialist(s), ED services, etc. But it varies a lot from area to area (one member has found himself with a GP who refuses to even undertake PSA tests because he went private) so worth asking the questions before you commit. We were paying £75 for every PSA test (self-funding rather than private health cover).

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 06 Apr 2018 at 23:49

It depends how proactive you want to be. There have been a couple of examples on here of results being lost and it might also be useful if you go for second or third opinions.

We didn’t make a decision to do it - John’s consultants both just automatically copied him into every letter they sent his GP. In more recent times when we had problems with receptionists that didn’t know what a < sign meant (and consequently gave us duff info re PSA results) John just got into a habit of asking for a print out of the results each time. He has never asked for discs of his scans etc as the two consultants seem to communicate very well without it - they are both able to log into the same online system even though we see each privately at two different hospitals. Interestingly, when we started to query whether my father-in-law’s uncommon PCa behaviour could be indicative for John, the oncologist simply logged into Stan’s medical records ... no data protection debate, no consent forms, nothing.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 07 Apr 2018 at 04:35

I have just done this. Initially the consultant’s secretary told me she would provide everything for my private consultation, yet when I asked for a DVD of my MRI scan, the radiology department refused as it would be for private use.

But they said I could have a copy if I made a request to the “Access to Records Department” of the hospital. I think it’s to do with the Freedom of Information Act, as the fee of £10 is the same price. Several pages of forms filled in, I.D. provided and £10 paid, I am now the proud possessor of my full medical history as far as PCa goes. I have the rest of my medical records on computer via the EMIS Patient Access app.

Interestingly, the clear bone scan report mentioned trauma to my ribs (I thought it was painful when I hit that tree whilst skiing a couple of years ago!) and degeneration to some obscure part of the spine, which I guess is only to be expected in a 62 year-old model.

Phone the hospital on Monday, and I bet you’ll have all the records you need within a few days.

Edited by member 07 Apr 2018 at 07:35  | Reason: Not specified

User
Posted 07 Apr 2018 at 16:48

Rich,

As I have said in the past and will repeat again, I empathize will all men who have PCa, especially those that are young and those whose cancer has advanced. However, regardless of my age, I still face further treatment and I fail to see what this has to do with your ability to interpret scans! As I pointed out, there was a difference of opinion between the interpretation of my scans (and this was between 3 of the leading UK hospitals) and the difference of opinion in my case is not unique in this respect, so it's not so easy to interpret as you seem to believe; ask one of the well qualified people you apparently know, particularly when the cancer is outside the prostate. Ongoing advances in scan technology are helping to identify spread more accurately and this trend is expected to continue (The reason I am awaiting a 68 Gallium PSMA scan).

 

 

Edited by member 07 Apr 2018 at 16:59  | Reason: Not specified

Barry
User
Posted 07 Apr 2018 at 17:12

Moose you are entitled to copes of your medical records. Did they give you a reason for denial? Your private consultant should be able to request everything from the NHS consultant secretary, which may be easiest way.

My husband was diagnosed privately but we had to be really proactive to make sure we walked away with copies of everything, including personally taking the biopsy report and the MRI report to the reception to request copies before returning the originals to the consultant as he didn’t have spare copies ready to give us.

We had to request the MpMRI scan on CD and physically pick it up. However we then had a file with

- original BUPA PSA tesult
- NHS PSA result done by GP
- copy of MpMRI report ( had to physically take it off the consultant and get a photocopy)
- copy of the biopsy report ( again had to physically take it off the consultant and get a photocopy)
- scan on a CD
- diagnosis letter to GP was copied to us ( infamously telling A he had 10 days to live)

This made it easier to get second opinions as we researched the options that were given and those that were not given).

Since then we have been given scans on CD plus the typed report on the 2 other scans he has had. They are just in the file should we need to share.

Good luck

Clare


User
Posted 08 Apr 2018 at 04:28

No I am not clever Rich but I have spent considerable time and effort since I was diagnosed in 2007 doing research on PCa. I joined this forum in 2008 with the objective of passing on information I thought might be helpful to members and empathizing with their situations whilst also learning from members. The vast majority of my 3900+ posts have not been about me but about others, based not just on my experience but what I had learnt from lectures, reading published papers and meeting some of the leading consultants in the UK and in Germany as well as from members of forums and other research. (I am also a member of a much wider based forum than this one). On many occasions I have encouraged men to explore various possibilities and to opt for second opinions. This would apply to you just as much as anybody else. You are just piqued because I questioned your ability to interpret scans. I most certainly did NOT advise not getting them for an opinion from a qualified radiologist at some stage. Here is an extract from one of the Law firms which brings cases against Radiologists who misinterpret scans. It confirms what I said about skill and ability.  " Radiology is a skill. Some are simply better at it than others although the reality is that even a good radiologist can fail to see a positive finding on an x-ray, mammogram, MRI, or CT-scan. Repetition also helps sometimes. If a doctor is reading one MRI a month, the doctor is not likely to have the same ability as someone who is regularly reading and interpreting MRIs. These low volume radiologists make up a high volume of medical malpractice cases. "

So in view of all the foregoing, I feel I have no reason to be ashamed and trust that on reflection you will realize this is so. You can then apologize to me as well as you did to Lyn.  You can rant as much as you wish on here but this does not extend to abusing members or writing "well" as though I or any other member is at your beck and call. 

I apologize to the OP that I have felt it necessary to defend myself on this thread against ill mannered and unjustified abuse and will not respond to any further taunts.

 

Edited by member 08 Apr 2018 at 05:11  | Reason: Not specified

Barry
User
Posted 08 Apr 2018 at 05:30
I sympathise Barry. It gets quite unpleasant when you have " fellow" members having a go and getting personal.

I would think that Rich is so very angry at having cancer as is most people but it is not acceptable to take it out on other people. Perhaps Rich you would be better just posting when you have not been drowning your sorrows as this seems to becoming a habit?

As the title of this forum says " We are here to support you" but this doesn't include accepting abuse from members when they don't get the reply they want.

Edited by member 08 Apr 2018 at 06:03  | Reason: Not specified

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User
Posted 06 Apr 2018 at 21:17
Moose

Has the hospitial sent the reports to you GP ? You are entitled to access to you medical records. I recently asked for a copy of a letter from my GP and was given a obscure form to fill in , when I returned with the form a different receptionist said "what is that for" put the form in the bin and printed a copy of the letter I had requested.

There are times when the NHS locally has better equipment than the private sector.

All the best for your treatment.

Thanks Chris

User
Posted 06 Apr 2018 at 21:40

We didn't have to get involved at all - we just made an appointment with the private consultant and he logged into John's medical records while we were there, had a look at the results and then gave us his view.

Be cautious though - with a G6 you may be suitable for active surveillance or brachytherapy and going private will not necessarily be the best move as you may lose access to a number of support systems including the Clinical Nurse Specialist(s), ED services, etc. But it varies a lot from area to area (one member has found himself with a GP who refuses to even undertake PSA tests because he went private) so worth asking the questions before you commit. We were paying £75 for every PSA test (self-funding rather than private health cover).

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 06 Apr 2018 at 23:49

It depends how proactive you want to be. There have been a couple of examples on here of results being lost and it might also be useful if you go for second or third opinions.

We didn’t make a decision to do it - John’s consultants both just automatically copied him into every letter they sent his GP. In more recent times when we had problems with receptionists that didn’t know what a < sign meant (and consequently gave us duff info re PSA results) John just got into a habit of asking for a print out of the results each time. He has never asked for discs of his scans etc as the two consultants seem to communicate very well without it - they are both able to log into the same online system even though we see each privately at two different hospitals. Interestingly, when we started to query whether my father-in-law’s uncommon PCa behaviour could be indicative for John, the oncologist simply logged into Stan’s medical records ... no data protection debate, no consent forms, nothing.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 07 Apr 2018 at 02:04

Rich,

What training have you had in interpreting scans - it's not that easy? If professionals with a lot of experience sometimes draw different conclusions or are unsure, what chance do you think you have? Other things like arthritis for example to the untrained eye could be taken as mets. Some hospitals make a charge for scans on a disc while others provide for free. It may apply only to NHS hospitals but the Royal Marsden said they could 'call over' scans from UCLH so did not require to see my disc in order to give an opinion. The main reason for having scans on a disc and histology, I believe to be for obtaining a second opinion for those who wish to seek one.

Barry
User
Posted 07 Apr 2018 at 04:35

I have just done this. Initially the consultant’s secretary told me she would provide everything for my private consultation, yet when I asked for a DVD of my MRI scan, the radiology department refused as it would be for private use.

But they said I could have a copy if I made a request to the “Access to Records Department” of the hospital. I think it’s to do with the Freedom of Information Act, as the fee of £10 is the same price. Several pages of forms filled in, I.D. provided and £10 paid, I am now the proud possessor of my full medical history as far as PCa goes. I have the rest of my medical records on computer via the EMIS Patient Access app.

Interestingly, the clear bone scan report mentioned trauma to my ribs (I thought it was painful when I hit that tree whilst skiing a couple of years ago!) and degeneration to some obscure part of the spine, which I guess is only to be expected in a 62 year-old model.

Phone the hospital on Monday, and I bet you’ll have all the records you need within a few days.

Edited by member 07 Apr 2018 at 07:35  | Reason: Not specified

User
Posted 07 Apr 2018 at 14:00

Hi Lyn

Im more wanting a second opinion from a specialist then I would decide if I go private but I wouldn't want to jeopardize access to NHS because I've annoyed someone going for a private opinion.  Im not so keen on active surveillance, my fathers PSA went from 7 to 70 in a month under active surveillance , sadly it got him.   

User
Posted 07 Apr 2018 at 14:16

My NHS consultant even mentioned the name of the specialist who I saw privately during my “Dear John, you’ve got the Big C” appointment and unbeknownst to him I had already booked a private consultation with the same guy, as I had already twigged what was what.

I joked: “I’m surprised you haven’t got a big box of tissues here on your desk when you give men the ‘bad’ news”. I am sure some people are emotionally wrecked though.

No doubt your NHS Consultant will be doing loads of private work on the side himself, so I bet he would have no problem whatsoever with a private second opinion. As Matron has suggested, there may be difficulties subsequently with follow-ups in some regions if you have surgery privately. I don’t know why, because you would have saved the NHS a fortune.

NHS surgery is just as good as private, but I find the NHS menus and wine lists somewhat lacking.

User
Posted 07 Apr 2018 at 16:48

Rich,

As I have said in the past and will repeat again, I empathize will all men who have PCa, especially those that are young and those whose cancer has advanced. However, regardless of my age, I still face further treatment and I fail to see what this has to do with your ability to interpret scans! As I pointed out, there was a difference of opinion between the interpretation of my scans (and this was between 3 of the leading UK hospitals) and the difference of opinion in my case is not unique in this respect, so it's not so easy to interpret as you seem to believe; ask one of the well qualified people you apparently know, particularly when the cancer is outside the prostate. Ongoing advances in scan technology are helping to identify spread more accurately and this trend is expected to continue (The reason I am awaiting a 68 Gallium PSMA scan).

 

 

Edited by member 07 Apr 2018 at 16:59  | Reason: Not specified

Barry
User
Posted 07 Apr 2018 at 17:12

Moose you are entitled to copes of your medical records. Did they give you a reason for denial? Your private consultant should be able to request everything from the NHS consultant secretary, which may be easiest way.

My husband was diagnosed privately but we had to be really proactive to make sure we walked away with copies of everything, including personally taking the biopsy report and the MRI report to the reception to request copies before returning the originals to the consultant as he didn’t have spare copies ready to give us.

We had to request the MpMRI scan on CD and physically pick it up. However we then had a file with

- original BUPA PSA tesult
- NHS PSA result done by GP
- copy of MpMRI report ( had to physically take it off the consultant and get a photocopy)
- copy of the biopsy report ( again had to physically take it off the consultant and get a photocopy)
- scan on a CD
- diagnosis letter to GP was copied to us ( infamously telling A he had 10 days to live)

This made it easier to get second opinions as we researched the options that were given and those that were not given).

Since then we have been given scans on CD plus the typed report on the 2 other scans he has had. They are just in the file should we need to share.

Good luck

Clare


User
Posted 08 Apr 2018 at 00:18
Originally Posted by: Online Community Member
Hi Lyn

Im more wanting a second opinion from a specialist then I would decide if I go private but I wouldn't want to jeopardize access to NHS because I've annoyed someone going for a private opinion. Im not so keen on active surveillance, my fathers PSA went from 7 to 70 in a month under active surveillance , sadly it got him.

Sorry Moose - back to your thread! I really don’t think that anyone gets annoyed about second opinions these days, even private ones! It is more that if you opt for private treatment, in some areas that means that referral routes for follow up treatment are closed down. Perhaps not such an issue if you have private health cover but my guess is that there aren’t many private incontinence nurses around if you can’t be referred to an NHS incontinence service. But it really does vary by area and I know that some men on here have been able to have the best of both worlds so don’t let it put you off seeking that second opinion.

One of the things that might be useful would be to find out which type of prostate cancer your dad was diagnosed with. Presumably you have adenocarcinoma (otherwise you would have been unlikely to be suitable for AS up till now) but there are at least 27 types and knowing how your dad’s PSA could have risen so suddenly (because that is an exceptionally rare thing that happened with his score) might help you to determine with the doctors whether or not it has any relevance to your situation.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 08 Apr 2018 at 04:28

No I am not clever Rich but I have spent considerable time and effort since I was diagnosed in 2007 doing research on PCa. I joined this forum in 2008 with the objective of passing on information I thought might be helpful to members and empathizing with their situations whilst also learning from members. The vast majority of my 3900+ posts have not been about me but about others, based not just on my experience but what I had learnt from lectures, reading published papers and meeting some of the leading consultants in the UK and in Germany as well as from members of forums and other research. (I am also a member of a much wider based forum than this one). On many occasions I have encouraged men to explore various possibilities and to opt for second opinions. This would apply to you just as much as anybody else. You are just piqued because I questioned your ability to interpret scans. I most certainly did NOT advise not getting them for an opinion from a qualified radiologist at some stage. Here is an extract from one of the Law firms which brings cases against Radiologists who misinterpret scans. It confirms what I said about skill and ability.  " Radiology is a skill. Some are simply better at it than others although the reality is that even a good radiologist can fail to see a positive finding on an x-ray, mammogram, MRI, or CT-scan. Repetition also helps sometimes. If a doctor is reading one MRI a month, the doctor is not likely to have the same ability as someone who is regularly reading and interpreting MRIs. These low volume radiologists make up a high volume of medical malpractice cases. "

So in view of all the foregoing, I feel I have no reason to be ashamed and trust that on reflection you will realize this is so. You can then apologize to me as well as you did to Lyn.  You can rant as much as you wish on here but this does not extend to abusing members or writing "well" as though I or any other member is at your beck and call. 

I apologize to the OP that I have felt it necessary to defend myself on this thread against ill mannered and unjustified abuse and will not respond to any further taunts.

 

Edited by member 08 Apr 2018 at 05:11  | Reason: Not specified

Barry
User
Posted 08 Apr 2018 at 05:30
I sympathise Barry. It gets quite unpleasant when you have " fellow" members having a go and getting personal.

I would think that Rich is so very angry at having cancer as is most people but it is not acceptable to take it out on other people. Perhaps Rich you would be better just posting when you have not been drowning your sorrows as this seems to becoming a habit?

As the title of this forum says " We are here to support you" but this doesn't include accepting abuse from members when they don't get the reply they want.

Edited by member 08 Apr 2018 at 06:03  | Reason: Not specified

User
Posted 08 Apr 2018 at 10:15

The moderator removed some of the more unpleasant insults around midnight :-/

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 08 Apr 2018 at 12:57

Here is a scan of someone with seminal vesicle involvement

https://goo.gl/images/qrfFw8

Edited by member 08 Apr 2018 at 12:57  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 May 2018 at 19:31

Thanks LynnEyre

I have filally got all the reports and made a private appointment at the Royal Marsden Cancer Hospital here in London which will happen next week.

One thing I have found difficult with the NHS specialist's is they wont recommend any specific treatment for my age and type of cancer.  They just run through all the options and tell me the decision is mine.  I have since found out that this is because if they recommend a specific treatment and it fails then they are libel.  I am hoping the private specialist will stare me in the right direction.  The NHS specialist tells me the full proof option is a radical Prostasectomy which I wonder is a bit radical at 54 with a Gleason of 6.

I would love to hear about the results others have had with Brachytherapy, Cyber knife, radiology any other treatment methods etc

 

I know there are pros and cons with all.  Grateful for your thoughts.

Cheers

JRLT (Moose)

User
Posted 02 May 2018 at 21:32

Moose,

I think what you reported the NHS specialst saying, "the full proof option is radical Prostatectomy " needs some clarification. No method is foolproof because regardless of treatment and how well it is administered, which is a factor, there is a possibility that some cancer cells may have escaped. There are reasons for this on which I will not elaborate at this point, but it applies to some extent with all forms of treatment. Early diagnosis and treatment maximizes the likely success of treatment but for some men with early and restricted cancer it means that some men following this route will radically treat a cancer that would never become a problem, so that is the judgement based on uncertainties. a man has to make. Clearly, in a younger man there is longer for a cancer to develop over a normal lifespan, another consideration. For many years surgical removal was regarded as the 'Gold Standard' but there have been great advances in radiotherapy and little difference between these two therapies in terms of outcomes now. One reason why surgery can compare well is because surgeons often pick the cases where they feel the chances of a good result are high. In more difficult cases surgeons direct you to an oncologist for Radiotherapy so this skews against the success of radiotherapy. For men at an early stage there is the possibility of other treatments if you are prepared to consider these and perhaps travel. Focal treatments such as HIFU, Cyrotherapy, FLA and Nanoknife are other treatments but except through trials, these last two may require going abroad. If you want Proton Beam radiation, (about which there is a question on whether it is significantly more effective than other forms of radiation), you will have to go abroad.

I don't think it's only a matter of consultant's trying to protect their backs why they will not in many cases suggest a treatment. There are pros and cons to all treatments, and side effects in the short and long term can vary between these even between individuals. So a consultant may not give the same weight to options and drawbacks as any particular individual would. Hence the decision is often left to the patient without a strong steer from his consultant.

Barry
User
Posted 02 May 2018 at 21:56

Surgeon sounds like he has an ego the size of a small planet :-/

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 May 2018 at 22:45
A’s surgeon said something similar after his G6 diagnosis but failed to be transparent on all potential side effects of surgery and impact on the quality of life of a sexually active 54 year old.

For us after research rushing into surgery seemed like an over treatment given the side effects.

It seems surgeons recommend surgery ..

User
Posted 02 May 2018 at 23:12

Originally Posted by: Online Community Member

One thing I have found difficult with the NHS specialist's is they wont recommend any specific treatment for my age and type of cancer.  They just run through all the options and tell me the decision is mine.  I have since found out that this is because if they recommend a specific treatment and it fails then they are libel. 

Cheers

JRLT (Moose)

 

Personally, I find it hard to accept that. NHS specialists have no problem recommending a treatment for most medical conditions and don't worry about being sued. Prostate cancer is different to most other illnesses, in that if you are suitable for curative treatment then you are probably suitable for all options. Each option has its pros and cons though; how can a specialist guess which side effects you are most willing to live with, or what your approach to risk is? 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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