David Robb was a 68-year-old retired secondary school teacher from Peebles, Scotland when he was diagnosed with prostate cancer last Summer.
After two years of health checks following minor symptoms of LUTS, his PSA (prostate-specific antigen) level had risen from 3.8 from his first check in January 2017, to a score of 4.2 in July 2019.
David refused to undertake a rectal exam and a blind biopsy, which are the basic processes in Scotland, until the doctors had performed a scan to identify accurately what they were looking at: “The MRI scan identified a lesion of 1.6mm, which the doctors said was almost definitely cancer. I then got a biopsy which was graded at a 4+3 Gleeson score.”
The confirmed cancer was fortunately contained on one side of the prostate and at an early stage of progression, and the Nurse Practitioner reassured David that it should be treatable without too many problems.
During all of this time, David had rapidly educated himself on prostate cancer, which allowed him to remain fairly calm during diagnosis: “I’d done a lot of reading on this; the various criteria used can give you all sorts of false pictures. The size of the lesion, 1.6mm, if it had been 1.4mm, would have been graded T1a cancer, not T2a cancer. If you do your research, it’s not as bad as it might first appear, so I wasn’t in a panic. I was more worried about the quality of life after treatment”.
Following the diagnosis, David was referred from the Borders General Hospital where the biopsy was conducted, to the Western General Hospital in Edinburgh for a follow-up appointment and treatment.
With concerns around the side effects and recovery associated with surgery and hormone therapy, David researched the various treatment options available. As a fiddle player and dance instructor in a ceilidh band for over 30 years, his social life played an important factor in his final decision about what treatment route to go down.
“Early December 2019, I met with the radiotherapy consultant first, Duncan McLaren, who discussed various options including classic radiotherapy plus hormone therapy, and brachytherapy. I wasn’t happy about having to do hormone therapy due to the repercussions, so brachytherapy made more sense. It seemed to be the best option in the short term for me to carry on with my normal activities.”
David also saw a urological surgeon that same day, but due to his concern over becoming incontinent with a tougher recovery process associated with radical prostatectomy, David went back to Dr. McLaren having settled on low-dose rate brachytherapy (LDR-B) as his preferred treatment option.
On the 14th of February 2020, David received the brachytherapy procedure at the Western General Hospital.