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HIFU Focal Therapy

User
Posted 19 Oct 2020 at 17:19

Hi, I have just been diagnosed with early stage localised prostate cancer.   I have not yet spoken to Oncology or Radiotherapy professors, that's due in a couple of weeks.

I am researching the options and saw HIFU Focal Therapy on the web.  I sent a message to them on Saturday and I had a 30min call today describing the treatment, so, a very prompt response.   From what I've seen, it looks like a no-brainer compared to the risks related to alternatives, including robotic surgery which sounds the best of the rest.  I don't want to wait and see and radiotherapy looks risky, others seem peripheral.

I am 66, otherwise in good health and keep fit, still working, run 8 miles most Sundays and were it not for Covid had entered 5 half marathons this year (all postponed).  I have organ confined prostate cancer Gleason 3+3=6 with a maximum core length of between 1.5 and 2cm. Prostate Cancer has been found on the Left hand Side of the Prostate Gland. (5 of 6 cores taken were positive) The biopsies taken on the Right Hand Side of the Prostate Gland were negative.  I have private health insurance and the Focal Therapy clinic think I should be a suitable candidate.

I am somewhat overwhelmed by all the alternatives, including Nanoknife which HIFU states is not as good as its treatment which they say has a very strong success rate with limited issues prevalent in the alternatives.  

Any views on this would be much appreciated, espePostcially from anyone who has undergone HIFU Focal Therapy. 

Thank you.

User
Posted 27 Oct 2020 at 18:26

Thanks Bill.  I work with my son, I keep fit normally & run half marathons.  I think I'm willing to take a chance on HIFU, despite the longer term risks.  The surgeon I spoke to said that the technology had come on a lot since the early days, and many of the HIFU reviews are dated.  Perhaps recent operations will be more successful. 

I wish you and your brother all the best.

kind regards

Kenny  

User
Posted 10 Nov 2020 at 09:29

Originally Posted by: Online Community Member
We realised too late that the NHS in our area would not support J because he had the op privately so he had no access to a clinical nurse specialist, district nursing, etc., and we had to fight hard for referral to the NHS ED nurse.

NHS is no longer allowed to do this, although it used to be NHS policy - if you'd had any private procedure for an illness, you couldn't go back into the NHS for further treatment. This backfired enormously - lots of people who would normally have had private treatment no longer did, because they'd lose NHS access, and together with the resulting increased load on the NHS, the NHS lost loads of income from its private wards which are run at a profit to pay for other NHS services.

This resulted in a U-turn about 10 years ago, where the NHS is now required to work with private providers, share test results, etc, and patients are allowed to select parts of their diagnosis and treatments to be handled privately while remaining under the care of the NHS. There are detailed rules for clinicians working in the NHS - they are never permitted to mention private procedures to you, unless you have first said that you want to know about them, in which case NHS clinicians are allowed to say what private procedures you might benefit from (although they might not necessarily have expertise to identify all relevant private procedures). This has resulted in many patients returning to private care, reducing load on the NHS and the NHS being able to again make a profit to fund other activities from offering private procedures itself.

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User
Posted 19 Oct 2020 at 21:49

Hi Benny

Sorry to hear about your diagnosis. I considered focal therapy with the legendary Prof E and the team at UCLH at they seemed to be the centre of excellence here in the UK. But that was taken off the table for me even though I had gleason 6(3+3) localised early stage too. In my case following biopsy all four quadrants of the prostate were found to contact small tumours and one near the capsule. Have a look at my Retzius Sparing RARP + Neurosafe for the journey.

I suspect many here will be able to offer more specific guidance having come out the other side of HIFU successfully. 

Cheers

Simon

User
Posted 19 Oct 2020 at 22:34
HIFU is a good salvage option but does not have a great track record as a primary treatment. If you are happy with a treatment that will deal with the problem short term but is less likely to get you to full remission, and you are confident that you would be able (or your insurer would be wiling) to pay for repeat treatments if necessary, I would say go for it.

Just as a note, HIFU isn't a place or organisation so when you say "HIFU states ..." what you mean is 'the provider I have spoken to who happens to offer HIFU states ..." As a provider of HIFU, they are likely to tell you how great it is while downplaying the alternatives!

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

User
Posted 19 Oct 2020 at 23:17

Hi Benny,

There are pros and cons for all kinds of treatment and HIFU is no different in this respect. It is one of several treatments that come under the heading of Focal Therapy. It is a niche treatment mostly given in the UK as a salvage treatment for failed RT, although we have the partner on this forum whose husband had it (twice), as a treatment for another failed Focal Therapy FLA (Focal Laser Ablation) administered in the USA. A relatively small number of men in the UK have HIFU as a primary treatment if they meet the criteria. Cryotherapy is an even less used form of Focal Therapy administered in the UK. there is a more recent development of HIFU like treatment called TULSA-PRO which may prove better but it's early days, see http://www.profoundmedical.com/wp-content/uploads/2015/05/Phase1ResultsPresentationFUS_London2015_pdf.pdf-

Although you are considering HIFU as a Primary treatment, you may be interested in the HIFU I had for failed RT as here https://community.prostatecanceruk.org/posts/t10960-HIFU--my-experience#post133611

I don't think that as a stand alone treatment HIFU is quite as effective as Surgery or Radiotherapy and long term outcomes including side effects are not yet so well known but the procedure is repeatable (providing the tumour is in a place within the Prostate on which the Ultrasound can focus) and where necessary HIFU can be followed either by Prostatectomy or Radiotherapy.

I recommend you download or obtain a copy of the 'Toolkit' from the Publications Dept of this forum https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit?_ga=2.206109653.795867346.1564408880-1013787081.1564408880

 

Edited by member 19 Oct 2020 at 23:29  | Reason: Not specified

Barry
User
Posted 21 Oct 2020 at 12:35

Hi Benny

It’s a difficult time deciding on options and waiting for treatment in these Covid times I know I have just had primary HIFU at UCLH.

All the advice you’re had here is good and I will not repeat. 
But I can give you a actual example of the difference in side effects etc. of HIFU verses HT (hormone)& RT (radio) as my brother was also diagnosed 12 months ago also Gleason 3+4. He went for HT & RT, where as after researching it I went for a HIFU operation.

I can say that one month on I have almost forgotten it
I have virtually no after effects. I am on my bike again. No wee /bowel problems. 
Whereas my brother wishes he had gone my route . He struggled with the hot flushes etc of HT but his worst problems came with the bowel problems of RT.

My op was one day and a week with a catheter, he had months of treatment and months of discomfort.

UCLH do not expect me to have to return for another HIFU but it is possible as you know. And if all else fails I can still have HT/Rt but for me it is worth the risk. The main risk of course is not following up with check ups as at all costs to not let it get to your bones. (When the pain then is the same whether your old or young).

Bill

 

User
Posted 25 Oct 2020 at 01:41
Hi Benny

My husband had chosen a focal route in an attempt to avoid side effects of a radical treatment after his diagnosis in December 2016 with a large G6 ( 3 +3 ) tumour. It has not been a straightforward journey with the original focal treatment being a focal laser ablation in the USA in 2017 as HIFU was offered but on a whole or half gland basis back then

All well until early 2020 when a reoccurrence was assessed as G3+4. His second treatment as a focal HIFU in London in February this year. Unfortunately again a reoccurrence occurred and he had his third focal treatment (a second focal HIFU) in September. His last scan post this treatment was clear so we are hoping it’s done.

He has avoided the side effects as he wanted so despite 3 biopsy’s and 3 focal treatments he has had no incontinence and has recovered erectile function of completely after a period of rehab needing tablets. He is once again back to full natural erections, though using tablets is no longer the big deal to him it was back in 2017, he doesn’t need them anymore. He is 57. I will bounce my thread if you want to read about his double focal HIFU journey.

Good luck

Claret

User
Posted 25 Oct 2020 at 17:00
Benny,

HIFU should probably be thought of as a delaying tactic rather than a curative treatment. Certainly it has many fewer side-effects than surgery or RT, but those are treatments which have good track records as curative fixes for prostate cancer, which HIFU does not.

Of course with a G6 diagnosis a delaying tactic might well be all that's required; "pure" G6 prostate cancer is vanishingly unlikely to kill you. The problem is, of course, that the biopsy is likely to have missed more aggressive cancer cells. HIFU plus regular PSA tests might well work for you, though, as long as you're aware that it may well need to be repeated or a more aggressive treatment option considered in the future.

Best wishes,

Chris

User
Posted 25 Oct 2020 at 18:28

"The problem is, of course, that the biopsy is likely to have missed more aggressive cancer cells."

That's not strictly true; the biopsy may have missed more aggressive cells but it may not have done. 

Edited by member 25 Oct 2020 at 18:28  | Reason: Italics

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

User
Posted 26 Oct 2020 at 20:28
The number of men here who've had their Gleason score upgraded after the pathology examination following RP does rather suggest that it's quite a high probability event for a biopsy to miss things, so I think it's prudent to be cautious about a G6 result being all that's there.

Cheers,

Chris

User
Posted 26 Oct 2020 at 20:51
That may be true based on reading here Chris, but we know that the stories here may not be truly representative. Those who have successful primary treatment with no complications or recurrence tend to drop out quietly, those who successfully remain on AS for many years without any sign of progression also drop out quietly, and those whose G was the same or lower on pathology are not so memorable as those who turned out to have rather more significant disease than expected. As a control group, we are a rather biased lot!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Oct 2020 at 18:05

Hi, to everyone who has replied and offered such great insights.  I apologise for not answering sooner, I hadn't realised that you had responded. 

I had a call on Saturday from my prospective surgeon (Doctors name edited by moderator) (I can't put a link on here but you could Google him, he gets good reviews).  He has completed about 150 HIFU operations he says, in London.  The call lasted about 30mins and I had a big list of questions ready.  I can provide these if you're interested.

I was very impressed with (Doctors name edited by moderator) and did not feel like it was the sales pitch, more a professional assessment.  He initially asked a few questions.  I've been swinging to and fro on what to do, however I have reached a conclusion and that is HIFU, if I qualify (he said it was likely but he will confirm soon).  The comments above endorse the fact that there may be more sinister outcomes, I'm yet to discover.

The upshot is that he did not have my MRI results to-hand, is expecting these from my hospital this week, is discussing my case tomorrow with his colleagues after which he'll get back to me.  I mentioned that it was difficult to get stats on longer term survivors, and also wanted to know whether the technology had improved over the years, which he confirmed was the case.  The stats are impressive, but ultimately it depends on luck.  Don't we know it.

I am leaning towards HIFU as it is the least invasive, and the side effects seem much reduced.  This is important as I have a small business with my son and do not wish to be off work for long.  I am 66 but keep fit and extremely keen to keep it going.  Later on, should there be a repeat (or a new cancer) I can still fall back on HIFU if localised, and subsequently, other treatments.  Also, I have confidence in the surgeon and this I think was pivotal in my decision to-date.

I understand that each individual case is different, with many varied views on treatments.  The nurses from the various sites stress that you should listen to your doctors and would not make any recommendation on the types of treatments available, which of course is understandable.  

I am continuing to go through the motions and will still see the NHS urologist tomorrow, and the oncologist on Monday (fortunately I have private health cover through my business and understand that HIFU is available to me).  I don't want to have reached a pre-conceived conclusion, and will be asking the specialists why I should adopt their treatments rather than HIFU. 

I have gathered a great deal of information on the subject, including very helpful comments on this site and others. The experience of Saturday's conversation and review of the surgeon thereafter has only served to confirm my thoughts that HIFU, if possible, is the way forward for me.  I'm keen to get something done now, asap, but I suppose that's natural.

Then again, by this time next week I may have changed my mind, albeit I don't think so.

I wish everyone all the best, and thank you again for taking the time to respond, it's greatly appreciated and valuable to me.

I will update you as I progress.

Kind regards

Kenny

Edited by moderator 27 Oct 2020 at 19:28  | Reason: Doctors name mentioned

User
Posted 27 Oct 2020 at 18:26

Thanks Bill.  I work with my son, I keep fit normally & run half marathons.  I think I'm willing to take a chance on HIFU, despite the longer term risks.  The surgeon I spoke to said that the technology had come on a lot since the early days, and many of the HIFU reviews are dated.  Perhaps recent operations will be more successful. 

I wish you and your brother all the best.

kind regards

Kenny  

User
Posted 27 Oct 2020 at 18:31

Hi Chris, thank you for your reply.  Yes I am concerned that only 12 biopsies were taken.  I hope I'm lucky, stay lucky!

Putting on a brave face to my immediate family, have not told friends, playing it down somewhat - especially to my 3 children - but the truth is I'm a bit stressed & have a knot in my stomach.

Thanks for your help & best wishes.

Kenny  

User
Posted 27 Oct 2020 at 19:21

Hi Kenny,

I read your post with interest but mention that it is a forum rule that you should not mention the name of your consultant, so you may find moderators delete any such reference. I think you and other would benefit from the thoughts of the man widely regarded as the top HIFU specialist in the UK , also his comparing with other forms of treatment etc. I don't understand the wide margins between various aspects so you have to scroll so much, https://www.canceractive.com/article/professor-mark-emberton-on-high-intensity-focussed-ultrasound-or-hifu

 

Edited by member 27 Oct 2020 at 19:24  | Reason: to highlight link

Barry
User
Posted 28 Oct 2020 at 09:00

Thanks Simon.  I'm sorry to hear that your diagnosis was more severe than originally thought, but I hope you're doing well now.  Thanks for giving me the heads up that it may not be plain sailing.  I dare say I'll find out soon.

Best wishes,

Kenny

User
Posted 28 Oct 2020 at 09:02

Thanks Chris, I'll find out soon.  Thanks for the heads up.

cheers

Kenny 

User
Posted 28 Oct 2020 at 09:05

Thanks, that's very positive and the way I am approaching this illness.  I count myself lucky to have discovered PC relatively quickly, and due to a chance comment to my doctor.  Best wishes, Kenny 

User
Posted 28 Oct 2020 at 09:11

Hi Claret

Thank you for sharing your and your husband's experience with multiple HIFU courses.  I wish you both well.

I am still going through the motions and don't know for sure whether HIFU is a possibility, it looks like it is and I hope so, as my mind is made up.  I am however meeting the urologist professor this afternoon and will listen to what he has to say.

Kind regards,

Kenny

 

User
Posted 31 Oct 2020 at 07:24
Well I had the standard RT at Addenbrooks, with no real problems.
User
Posted 31 Oct 2020 at 08:06

Well that's good Bob but it was only after two years of having RT and then a gradually increasing PSA that it became clear that I would need further treatment.  I hope yours works for longer but I don't think this is going to help Kenny finalize his decision.

Barry
User
Posted 31 Oct 2020 at 17:27

Cheers for the kind words Kenny

I’m almost a year on now and pending quarterly PSA blood tests almost back to normal. Continence pretty much where it was pre surgery. Might have a drip if I force wind or have an exceptionally large sneeze without squeezing pelvic floor....mostly that second nature now. Nights are perfect and only get up once for a pee usually. Sex life as before...in fact in some respects better now as don’t need condoms or the pill. 

Pelvic discomfort when sitting on a hard chair all but resolved.

One of things to be mindful with Prostate Cancer is it tends to be multifocal. Sometimes small tumours can be missed with imaging/biopsy. 


Histology showed that in my case had I waited a few more months it’s likely it would have breached the prostate capsule although pre-surgery imaging and biopsy told a different story.

Good luck with whatever route you take. There are no guarantees with any path. My view was try and buy as much quality time as possible in the hope that if their is a reoccurrence that science and immunotherapy will have matured a little.

Please shout me anytime if you have any questions as very happy to help where I can.

simon

Edited by member 31 Oct 2020 at 17:31  | Reason: Not specified

User
Posted 09 Nov 2020 at 15:53

Hi All,

9th November 2020.  For interest, here is an update on my situation.  I had a meeting with the consultant surgeon in London (I am in Scotland) on Friday evening.  The upshot is that the cancer is bigger than was thought, is close to the sphincter and whilst I could still have HIFU, I am recommended to have robotic surgery, and soon.  The suggestion was that the NHS did insufficient biopsies (12) and the surgeon seemed unhappy with other aspects of the report.  

I have decided to progress the robotic surgery, privately, which is now scheduled for next month.  This is on PMI which I am fortunate to have, as a client added me to his group scheme.  I have 'enhanced cancer cover' with Aviva.  However, the consultant states that the equipment is unavailable at the hospital Aviva covers me for (Princess Margaret) and the operation would need to be conducted at Princess Grace (both are in London).  Aviva only partially covers the latter and the shortfall is described as being very large. I have asked Aviva if they will cover me anyway given that the equipment is unavailable for the Princess Margaret hospital, and I am at present awaiting a reply.

On the NHS I would have a long waiting list for robotic surgery, and whilst keyhole is a possibility sooner, I have considerably more confidence in the London surgeon and with robotic.  For domestic and work reasons (I'm still working from home with my son) I have discounted radiotherapy.  Anyway, I am anxious to have the operation conducted soon.  I am recommended to have a spinal block and a full general anaesthetic. 

Has anyone else had a similar experience with hospitals being covered / not covered?  I don't know if there's a precedent and if such latitude exists from Aviva, I really hope so.  I hope to find out soon and will update on this forum.

Best wishes to everyone and thank you for all your constructive, educational and very helpful responses to-date.

Kenny

User
Posted 09 Nov 2020 at 17:22
Not sure about all of that but we didn't have PMI so the op cost £18,000. One of the issues you might need to think through is the aftercare - will the Scottish NHS system pick you back up and provide things like continence / ED support, regular PSA tests and access to a urologist or will you be forever destined to travel down to London for reviews and appointments? As a point of reference, every follow up PSA test cost us £180 until it was handed back to the GP practice to arrange.

We realised too late that the NHS in our area would not support J because he had the op privately so he had no access to a clinical nurse specialist, district nursing, etc., and we had to fight hard for referral to the NHS ED nurse.

It might be different in Scotland?

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

User
Posted 09 Nov 2020 at 17:51
Lyn, I think this is very much a case of a postcode lottery. As you may recall, I had all my treatment privately, and then retired, losing my medical insurance. My consultant simply transferred me from his private list to his NHS list and all my post-treatment care and follow ups continued exactly as before. The same thing happened with my kidney cancer: private treatment then NHS follow up.

Best wishes,

Chris

User
Posted 09 Nov 2020 at 19:09

Hi LynEyre

Thank you for your comments, Chris you too.  I had not even thought about aftercare.

It's a minefield. I could write a long, boring and contradictory blog on the subject...  wait a minute....?!  

Probably conjecture but I came away from the NHS doctors (1st keyhole lap, 2nd radiotherapy) with the feeling that they were in competition - no doubt conjecture on my part.  However the consultations were recorded and I listened carefully afterwards.  The RT doctor couldn't get his CD player to work, I used my phone.  There were a couple of things that on reflection irked me, and the London doctor (Harley Street) was polite but quizzical on the NHS surgeon's HIFU comments, which he explained were quite erroneous.  The keyhole lap surgeon did say that if I were 50 he would strongly recommend a prostatectomy, if I was 75, HIFU but as I'm an ostensibly fit 66 year old, he said I was in the middle and good luck with the choice.

Apparently the London surgeon (described as a Top Doctor on the web) and his multidisciplinary team discussed my case last Thursday and arrived at what appears to be a more in-depth conclusion than was the case with the NHS.  Who knows, but I have much more confidence with the London doctor and his team.  Ultimately it will boil down to luck but I am trying to make a judgment that I won't regret later. 

Update: Aviva has now responded - the lady has been immensely helpful I must say, but unfortunately there is likely to be a large shortfall (maybe £10k+ and I don't know about aftercare).  She has suggested another surgeon and hospital who are covered and I'll start the process again.  Before emailing me, Aviva kindly checked with the 'new' surgeon's secretary and I can still be scheduled for December.  I'm very keen to move forward quickly although it's clear that the cancer has been there for years - again, sheer luck that through a chance remark to my GP that it came to light.

I also have an old critical illness cover policy which expires next February, after 17 years.  Maybe this will be successful, I'll believe it when I see it but in any case I am lucky to have PMI through a client's group scheme (I'm a consultant - a very old one). 

Onwards and upwards!

Best wishes,

Kenny 

User
Posted 10 Nov 2020 at 07:13

Hi Kenny

I had my biopsy done at the Princess Grace. And main surgery at London Bridge (Guys Cancer Centre). Both have the latest Da Vinci Robotic Systems and very modern. Rooms were bigger at Guys but Princess Grace had all the Sky TV channels (useful for first 24hrs) or take a Media usb thingy for Netflix :-)

Critical illness definitely worth tapping up. Very policy specific I suspect but a few of them only pay partially for say low grade Gleason 6. Anything above that normally a stronger case. You might find you need to submit post surgery histology results for them to take a final view on claim settlement. In 40% cases the cancer grade is upgraded post surgery (mine went from 3+3 to 3+4). I submitted all my case data from day one in chronological order with a covering letter. More information the better usually.

Best of luck for London and wish you an excellent outcome. Keep us posted!

Simon

Edited by member 10 Nov 2020 at 07:15  | Reason: Not specified

User
Posted 10 Nov 2020 at 08:33

Hi Simon

Thanks - that's great advice.  I am calling the new alternative today to get things going.  The operation would be at the Royal Marsden Hospital in Fulham London.

I'll keep you posted & good luck with everything.

kind regards

Kenny

User
Posted 10 Nov 2020 at 09:03

Cheers Kenny

The Marsden have all the best stuff being the UK centre of excellence. 

It would be choice in the PCa ever returned.

Cheers

Simon

User
Posted 10 Nov 2020 at 09:21

Thanks Simon, that's reassuring.  I've been mulling over this morning if I was maybe making a mistake in going for the Royal Marsden over Princess Grace (although I know much depends on the surgeon).  Today I'll try to get the process started.

Best wishes,

Kenny

User
Posted 10 Nov 2020 at 09:29

Originally Posted by: Online Community Member
We realised too late that the NHS in our area would not support J because he had the op privately so he had no access to a clinical nurse specialist, district nursing, etc., and we had to fight hard for referral to the NHS ED nurse.

NHS is no longer allowed to do this, although it used to be NHS policy - if you'd had any private procedure for an illness, you couldn't go back into the NHS for further treatment. This backfired enormously - lots of people who would normally have had private treatment no longer did, because they'd lose NHS access, and together with the resulting increased load on the NHS, the NHS lost loads of income from its private wards which are run at a profit to pay for other NHS services.

This resulted in a U-turn about 10 years ago, where the NHS is now required to work with private providers, share test results, etc, and patients are allowed to select parts of their diagnosis and treatments to be handled privately while remaining under the care of the NHS. There are detailed rules for clinicians working in the NHS - they are never permitted to mention private procedures to you, unless you have first said that you want to know about them, in which case NHS clinicians are allowed to say what private procedures you might benefit from (although they might not necessarily have expertise to identify all relevant private procedures). This has resulted in many patients returning to private care, reducing load on the NHS and the NHS being able to again make a profit to fund other activities from offering private procedures itself.

User
Posted 10 Nov 2020 at 10:08

Yes, surgeon skills very key. High volume and good stats are the things to look for. My surgeon was doing 3x the ops as many others with great stats. Obviously like every case they are not always great outcomes. If I’d have left things another few months I would have certainly been in a different place irrespective of who was doing the work.

 

User
Posted 10 Nov 2020 at 10:17

No issues switching between NHS and private here. In fact most of the staff I have seen take the view that private work takes the load off a very busy system.

Edited by member 10 Nov 2020 at 14:30  | Reason: Not specified

User
Posted 10 Nov 2020 at 13:44
Hi Andy, I know that you are correct in theory but we have a current member who had private RP in the neighbouring city and his geographic NHS trust is refusing to provide any support or clinical service at all, as is his GP, so in practice not all NHS trusts are complying. Also, we know that men living in Wales who opt to travel to England for radical treatment can have difficulties afterwards so NHS Scotland might also have its own rules? I wasn't sure, just thought it was worth flagging up as a question to ask.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 10 Nov 2020 at 14:02

Hi Simon et al

I've just had an update: the original surgeon from London where I concluded that Princess Grace was too expensive, not being covered by my PMI.  The surgeon now says he could do the operation at the London Clinic.  I would need to see if Aviva would cover me there.  At the moment, I have an appointment with the alternative surgeon where the operation would be at Royal Marsden.  But does anyone reading this have any ideas about the degree of modern equipment at either hospital?  

cheers

Kenny

User
Posted 10 Nov 2020 at 22:43
I am sure that all the London teaching hospitals have excellent surgeons and equipment. When I had a check up with UCLH recently, I took the opportunity to ask how they had coped with treatment since Covid and was told they were able to keep up by using other well regarded hospitals such as Princess Grace. When it comes to highly specialised treatment, I think it makes sense to go a centre specialising in that treatment. However, many hospitals now do Robotic Prostatectomy and providing you get a well experienced surgeon, I would have thought you could have it at a major hospital nearer home.

I started my HT at the Royal Marsden (Sutton), in 2007 within the NHS but had my RT in Germany in 2008 in a trial. The Marsden were a bit miffed but subsequently took me back under their wing as a NHS patient and referred me to UCLH for HIFU in 2014, also as a NHS patient. So I didn't have a problem reverting to the NHS, although some did I understand.

Barry
User
Posted 17 Nov 2020 at 02:02

My husband used BUPA and a different ( but near) London private hospital and I just checked and both the consultants I am familiar with operating privately there accept Aviva. One however was above BUPA rates so top up payments needed and one within so no top up. We do get a very small bill for each MRI as the bill is slightly over BUPA rates but nothing else.

During lockdown our GP has done the PSA testing with no quibble at all with a well PPE’d up phlebotomist . They also sorted COVID and urine testing on the NHS pre procedure. So other than reluctance to give a PSA ‘number’ ( preferring to tell him his PSA is ‘normal’  ( not sure who he compares with. Following his three focal treatments) ) the GP has been fine with support as needed despite his BUPA primary care

 

Kind Regards

Clare

User
Posted 17 Nov 2020 at 06:30

Hi Clare

I experience similar with my PSA bloods done by my GP. They are fantastic and the result is always out the same day as sent to local hospital lab. Unfortunately they don’t yet automate and email the result so the usual is either make an appointment or phone for result. I hate getting the number  over the phone due to risk of error and prefer to see it myself.

Path I find works well is to call and ask for a printout of my blood report and pop up in person to pick it up. Seems to work well and I can file something tangible :-)

Simon

 
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