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BUPA prostate pathway

User
Posted 25 Jan 2025 at 08:53

Hi everyone 

I would interested to know if any one has any experience of the BUPA pathway who offer “straight to tests” all in one day . This is my third episode of going for tests and diagnosis and would rather something quicker then the traditional back and forth to see consultants/hospitals. I suffer from anxiety so anything to shorten the period of uncertainty welcomed 

thanks Tony  

User
Posted 25 Jan 2025 at 09:12

Hi Tony

Welcome to the forum you'll find it hugely informative and supportive - I did/do and it really helps.

I can't answer that specific question about BUPA because my diagnosis from PSA to biopsy result was done in a month by my local NHS. What I can tell you is that having now had a PCa diagnosis the BUPA service for cancer patients has been impressive. Immediate (when I was on the phone to them) release of authorisation number, I can see as many consultants as I want in any location and support and advise for as long as required. I know this won't help your anxiousness but once you know what the situation is you can at least feel comforted that you'll have decent support from them. Good luck in your journey.

Cheers, Adam

User
Posted 25 Jan 2025 at 09:20

Thanks Adam,

I too have found BUPA very efficient in authorising everything . I want to move quickly it’s just that the private consultant I’ve been seeing since 2017 isn’t available until end Feb and the BUPA pathway just sounds too good.

KR

Tony

User
Posted 25 Jan 2025 at 15:36

Hi Tony

May I introduce a note of caution regarding private treatment.

I had prostate cancer treatment from diagnosis to prostatectomy over 14 years ago. The main reason was that I had private insurance cover and therefore could pick a top consultant and speed of diagnosis and treatment. My surgery was successful but the first night spent in a top London hospital (more like a five start hotel, with pretty young receptionists and pot plants galore in the reception area!), and aftercare at my local private hospital in Hertfordshire was beyond awful!. Fortunately my consultant was available on the phone and very supportive during five weeks when my catheter had to remain in place. The night my catheter was removed I had to sleep in a urine soaked bed because they did not have any support for my incontinence and very limited staff. Many consultants earn their lucrative fees doing surgery but often you never see them again!

My wife who had her hip replacement surgery at a top Birmingham private hospital, when her hip dislocated at home a couple of days later in the middle of the night we could not raise anyone other than a night security guy who advised us to call 111. The paramedics came within half and hour and were jolly and very efficient. The hospital fixed her hip and picked up the cost of course.

Make sure that aftercare where you have your treatment is reasonable. Also if your insurance cover is limited you may need a deep pocket if things don't work out.

Good luck.

 

Edited by member 26 Jan 2025 at 21:06  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 26 Jan 2025 at 14:50

I can't answer for the BUPA prostate pathway as no knowledge or experience.

When I had a high PSA, my GP had already referred me to the local hospital before he called and told me. However, I had BUPA cover, so I asked to be referred privately. He was quite firm - twisted knee, strained shoulder - fine to go private. Cancer diagnosis - you want to be on the NHS. I didn't really understand that at the time, but he did do the private referral too. The NHS referral appointment came through first - mpMRI scan, followed next day by an all-day appointment with the urology one-stop shop (which was newly opened then in 2018), so I cancelled the private referral.

Now that I do a lot of support, I completely see where my GP was coming from. The NHS has mandated MDT (Multi-disciplinary team) working for ~20 years. This was specifically to counter the issue of surgeons who run the diagnosis pathway from being over-optimistic about their own treatments, and to ensure patients were offered all viable treatments. It's not perfect by a long way, but many patients do avoid prostatectomies now which were never likely to be successful. Indeed in England, it's around 2/3rds go for radiotherapy and 1/3rd surgery now (Wales is 3/4 and 1/4 respectively).

If you go privately, there's no requirement you will be managed under an MDT, and some patients are only ever under the urologist they were referred to for diagnosis, and there may be no consideration of other treatments. I have seen a number of such patients who did this and went the surgery route, where it wouldn't even have been considered on the NHS because too likely to fail and other options were better.

This will depend massively on where you are in the UK. My hospital now runs a one-stop-shop for urology cancers with the MRI done the day before. Some even do the MRI on the same day. Of course, there are still hospitals doing every test one-at-a-time with 3 or more week wait in between. You can ask your GP to refer you somewhere else in such cases. Some places run the RAPID diagnostic pathway.

If you do go private, I would try to ensure you are going to be under an MDT.

If you go NHS and have private cover, you can tell them that you would be interested in private procedures and then they can advise if any particular private diagnostic or treatment option might be relevant, but still stay under the NHS MDT. Clinicians are not permitted to mention private procedures during an NHS appointment unless you've explicitly asked them to do so.

User
Posted 26 Jan 2025 at 16:59

Are you considering tests privately and then use the NHS for treatment?  If so I'd check the NHS is happy about that as I get the impression some areas can be a bit awkward about it.

What Andy has written above is a side I'd never thought of.  Although you might decide that if the MDT puts Surgery in the options, they might not, you could choose a private surgeon.   If so you need to ensure you have a follow up programme without undue restrictions or that the NHS will take you in. 

I looked up private surgery 8yrs ago and noticed they offered 5yrs, I think it was, of post-op follow up as an additional cost. 

Actually I'm now on my 9th year of follow up on the NHS as my psa started to rise after 5yrs.  So it was back to 3 montlhly psa tests.    I think my NHS follow up in Lancashire has been as good as it gets.  I have a named Macmillan Specialist Nurse who I can ring anytime, although since diagnosis I've not rung at all.  At this time I have 3 treatment options open as offered by the Consultant Oncologist although I'm hoping to go another 3yrs and perhaps longer without treatment.   I'm now on 6 monthly psa tests and telephone interviews as my psa is rising very slowly.

All the best, Peter

Edited by member 26 Jan 2025 at 17:05  | Reason: Not specified

User
Posted 26 Jan 2025 at 19:48

I only have experience of private cancer treatment with Genesis care centres. They have MDTs , when I had my first private SABR treatment the MDT team strongly recommended adding Bicalutimide to the treatment. This week the Lutetium consultant said he wouldn't get the treatment proposal past the MDT.

11 years ago my NHS/private surgeon said he could offer me a better service on the NHS than private sector and I went down the NHS route.

There are some services missing from the private sector that are standard on the NHS. There are some treatments available privately than are not sanctioned on the NHS.

I would still be inclined to initially go down the NHS route.

Thanks chris

Edited by member 26 Jan 2025 at 20:20  | Reason: Not specified

User
Posted 27 Jan 2025 at 00:22

Hello, I think there is a view to avoid hormone treatment if possible due to the well published side effects, but it is a question my list for discussion at my next meeting. I have feeling that it might be being kept in reserve as time progresses other flare up might arise as the lymph node involvement could suggest a pop up anywhere and especially with the scan being undertaken with a PSA of 0.2

Edited by member 27 Jan 2025 at 00:23  | Reason: Spelling error

User
Posted 27 Jan 2025 at 13:44

For bog-standard external beam radiotherapy, hormone therapy typically halves the recurrence rate. This varies considerably by your diagnosis risk though. Someone with low risk disease might be treated without hormone therapy as it might not be considered worth it, whereas a Gleason 9 or 10 patient is more likely to be asked to do the full 3 years. Some hospitals have switched to using just Bicaluatamide for hormone treatments up to 2 years. The new PACE-B 5 treatment SABR is done without hormone therapy.

You always have the option to say no, of course, but you should do that in the full understanding of what impact it's likely to have on your chance of a cure, and that if treatments fail to cure, you would be on hormone therapy life-long. For men who are really worried about the hormone treatment, a tactic is to start on it and see how it goes. Most people do manage OK. If you don't, you can stop and might have already got some benefits.

User
Posted 27 Jan 2025 at 13:46

Many thanks, I will be raising this. 

 
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