I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

Cancelled appointment

User
Posted 29 Jan 2019 at 23:37

Hi , feeling a bit unsettled! My partner’s appointment at the hospital following a raised P.S.A , albeit a minute rise has been cancelled and he has also been told his  Consultant  who he had a lot of faith in has retired  and there  is  now a locum in his place. What do the forum think about this ? Should we be concerned?

User
Posted 30 Jan 2019 at 11:00

It always unsettles me a bit when I read of people being concerned their psa has reached a level like 0.034.  At my hospital I wouldn't know as the lowest they do is 0.05.  

If mine did go above 0.05 I'd be wanting another psa test fairly soon to establish its trajectory and then to discuss further treatment such as RT perhaps after a scan.  So yes I can understand your concern although at 0.034 it's pretty low and I'd imagine another psa test being taken before considering further treatment.  As others have said in your other post they regard 0.2 as recurrence so you could have a debate on your hands about when treatment starts, although in my opinion a good treatment will start early.

Also if it is rising the surgeon probably isn't the best person to see and you might ask to see an oncologist if they're truly maxed out.  I've never seen my surgeon since the pre-op discussion, his clinics are done by doctors as well.  In conclusion it might not be that critical with such a low psa but I'd recommend you keep on the case to get an appointment with someone.

User
Posted 30 Jan 2019 at 11:43

Originally Posted by: Online Community Member

Hello Lynne , thanks for your reply. He should have had an appointment with his consultant , but he has now retired and he was supposed to see a locum . From what I can make out they are overwhelmed and unable to see all the patients at the moment. We have heard another person we know of has actually had his surgery cancelled so you can understand our concerns !Lynn is going to phone them and try and find out more information and pin them down to another appointment As you say he should at least be havimg his psa checked 3 monthly as it is showing an upward trend. If they have not got a consultant to look at the results though we are in trouble !

 

He should be able to have his future PSA tests at the GP practice - if it rises significantly, he could either press the urology department for an appointment with the locum, or ask the GP to refer him to an oncologist. They are unlikely to be concerned unless it goes over 0.1 and then continues to rise. Anything under 0.1 could be normal cell regeneration or machine noise. 

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

User
Posted 30 Jan 2019 at 23:18

Originally Posted by: Online Community Member
Indeed - I was at the BMA headquarters recently and there is a huge wall display showing the shortages nationally for all disciplines; only being made worse by the number of overseas doctors & other medical professionals that have left the UK because of uncertainty about post-March 29th. There are more doctors leaving the profession here than there are qualified or student doctors to replace them.

”Hold my hand while we jump off this cliff” 😉

Bri 

Show Most Thanked Posts
User
Posted 30 Jan 2019 at 01:06
Cancelled or postponed? Did they say they have closed his case and handed his care back to the GP, or just that this particular appointment is cancelled and another will be sent in due course? Was he due to see the surgeon now anyway or did you request an extra appointment / rereferral?

I would make sure he has another PSA test 3 months after the most recent one and then decide what to do.

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

User
Posted 30 Jan 2019 at 10:19

Hello Lynne , thanks for your reply. He should have had an appointment with his consultant , but he has now retired and he was supposed to see a locum . From what I can make out they are overwhelmed and unable to see all the patients at the moment. We have heard another person we know of has actually had his surgery cancelled so you can understand our concerns !Lynn is going to phone them and try and find out more information and pin them down to another appointment As you say he should at least be havimg his psa checked 3 monthly as it is showing an upward trend. If they have not got a consultant to look at the results though we are in trouble !

User
Posted 30 Jan 2019 at 11:00

It always unsettles me a bit when I read of people being concerned their psa has reached a level like 0.034.  At my hospital I wouldn't know as the lowest they do is 0.05.  

If mine did go above 0.05 I'd be wanting another psa test fairly soon to establish its trajectory and then to discuss further treatment such as RT perhaps after a scan.  So yes I can understand your concern although at 0.034 it's pretty low and I'd imagine another psa test being taken before considering further treatment.  As others have said in your other post they regard 0.2 as recurrence so you could have a debate on your hands about when treatment starts, although in my opinion a good treatment will start early.

Also if it is rising the surgeon probably isn't the best person to see and you might ask to see an oncologist if they're truly maxed out.  I've never seen my surgeon since the pre-op discussion, his clinics are done by doctors as well.  In conclusion it might not be that critical with such a low psa but I'd recommend you keep on the case to get an appointment with someone.

User
Posted 30 Jan 2019 at 11:43

Originally Posted by: Online Community Member

Hello Lynne , thanks for your reply. He should have had an appointment with his consultant , but he has now retired and he was supposed to see a locum . From what I can make out they are overwhelmed and unable to see all the patients at the moment. We have heard another person we know of has actually had his surgery cancelled so you can understand our concerns !Lynn is going to phone them and try and find out more information and pin them down to another appointment As you say he should at least be havimg his psa checked 3 monthly as it is showing an upward trend. If they have not got a consultant to look at the results though we are in trouble !

 

He should be able to have his future PSA tests at the GP practice - if it rises significantly, he could either press the urology department for an appointment with the locum, or ask the GP to refer him to an oncologist. They are unlikely to be concerned unless it goes over 0.1 and then continues to rise. Anything under 0.1 could be normal cell regeneration or machine noise. 

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

User
Posted 30 Jan 2019 at 13:13

Thank you for your comments.  We just want to be on top of any developments and it does nothing for your confidence when they havent even appointed a consultant to replace the 2 who have left!!

User
Posted 30 Jan 2019 at 13:19
Indeed - I was at the BMA headquarters recently and there is a huge wall display showing the shortages nationally for all disciplines; only being made worse by the number of overseas doctors & other medical professionals that have left the UK because of uncertainty about post-March 29th. There are more doctors leaving the profession here than there are qualified or student doctors to replace them.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 30 Jan 2019 at 13:31

Originally Posted by: Online Community Member
I was at the BMA headquarters recently ...

 

Should point out that I am not a doctor - I just deliver training there on a regular basis :-/ 

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

User
Posted 30 Jan 2019 at 22:32

Thanks Lyn, my other half phoned the hospital and after a bit of to and fro ing he has  now been given an appointment with a consultant so alls well that ends well 

User
Posted 30 Jan 2019 at 23:18

Originally Posted by: Online Community Member
Indeed - I was at the BMA headquarters recently and there is a huge wall display showing the shortages nationally for all disciplines; only being made worse by the number of overseas doctors & other medical professionals that have left the UK because of uncertainty about post-March 29th. There are more doctors leaving the profession here than there are qualified or student doctors to replace them.

”Hold my hand while we jump off this cliff” 😉

Bri 

User
Posted 31 Jan 2019 at 00:45

The poaching of trained/qualified medical staff from other countries has been going on for many years and at an increasing rate in the UK and it's high time that more incentives were in place to attract, enable and retain indigenous people in the medical profession. A wake up call is certainly overdue but regardless of what may be in train or planned it will take years to overcome the deficiency, regardless of what happens after 29th March 2019.

My mother was in a nursing home over a decade ago and the home owner had just returned from a staff recruiting trip to Poland. Asked why she had done this she said she could get a qualified nurse from there for the salaryof an unqualified helper in the UK. Just one example of the situation. It's no surprise to me that the Polish are now wanting at least some of their medical staff to return to cover shortages in Poland.

I think shortage of staff in a profession that requires greater training and expertise than ever before and with increasing demands on it, will result in more delays and cancelled appointments along with complaints from patients that they were not being given sufficient time and satisfactory service.

This is a more recent drive to recruit medical staff from the EU :- https://www.telegraph.co.uk/news/2017/01/11/nhs-recruit-hundreds-gps-poland-lithuania-greece/

https://www.express.co.uk/news/politics/781366/Brexit-news-Poland-Britain-UK-NHS-recruitment-doctors

 

 

Edited by member 31 Jan 2019 at 12:43  | Reason: Not specified

Barry
User
Posted 31 Jan 2019 at 00:48

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member
Indeed - I was at the BMA headquarters recently and there is a huge wall display showing the shortages nationally for all disciplines; only being made worse by the number of overseas doctors & other medical professionals that have left the UK because of uncertainty about post-March 29th. There are more doctors leaving the profession here than there are qualified or student doctors to replace them.

”Hold my hand while we jump off this cliff” 😉

Bri 

 

Did you like it? 

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

User
Posted 31 Jan 2019 at 00:50

Originally Posted by: Online Community Member

The poaching of trained/qualified medical staff from other countries has been going on for many years and at an increasing rate in the UK and it's high time that more incentives were in place to attract, enable and retain indigenous people in the medical profession.

 

I am not sure Barry but I think the main problem in relation to doctors and physiotherapists is that there are more vacancies than places at university for new ones to train & join the sector? 

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

User
Posted 31 Jan 2019 at 06:27
Also fewer people choosing to enter the profession (and leaving) because people are wising up that loadsamoney does not compensate for insane hours, too much responsibility and lack of basic resources 😫

If air traffic controllers were put under the pressure our doctors and nurses were, there would be an outcry at the risks this entailed.

User
Posted 31 Jan 2019 at 09:37
Indeed. Also, our daughter is a physio and when someone leaves, the Trust delays advertising the vacancy for months to save some money so her team is constantly understaffed.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 31 Jan 2019 at 13:59

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member
Indeed - I was at the BMA headquarters recently and there is a huge wall display showing the shortages nationally for all disciplines; only being made worse by the number of overseas doctors & other medical professionals that have left the UK because of uncertainty about post-March 29th. There are more doctors leaving the profession here than there are qualified or student doctors to replace them.

”Hold my hand while we jump off this cliff” 😉

Bri 

 

Did you like it? 

 

oh yes

User
Posted 12 Feb 2019 at 16:31

Hi all, we went to Lynns appointment and saw a very young but excellent houseman who tells us that now it is a waiting game until his next appointment ,  scheduled for 3 months as you had all thought it would be. However I mentioned to him about the rise maybe being due to lab variations or re growth of healthy prostate tissue at the neck of the bladder but he ruled both of these out . He says we will know more at next blood test in 3 months for p s a  levels -. levelling or rising. If rising a lot next time they will take action or if  3 successive rises are found .  I   would like to know if it rises but the focus is Still to small to be located what treatment is likely to be carried out. Has anyone any advice to give ?Thanks 

User
Posted 12 Feb 2019 at 17:03
It is about probabilities. When the PSA falls low post op and then rises by small amounts, that is a classic behaviour of small clusters of cancer cells left in the prostate bed so salvage RT would be offered, usually with HT.

If the PSA stays high after RP (over 0.2) and / or rises rapidly, that is the behaviour of mets or micromets so salvage RT is unlikely to work. In that case, HT is likely to be the main holding treatment with or without chemo - this would not be curative. If a scan can pinpoint one or two mets then some targeted treatment might be offered in some areas of the country.

It seems that if you do have a recurrence on your hands, Lynn falks safely into the first group.

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

 
Forum Jump  
©2019 Prostate Cancer UK