Both George Monbiot (I have been diagnosed with prostate cancer, but I am happy, 14 March) and Bill Turnbull (Former BBC breakfast host Bill Turnbull has prostate cancer, 6 March) have performed a service to men by sharing their shock at discovering they have prostate cancer. Bill wishes he had had PSA testing more often than every five years; George says that this standard assessment is of limited use. I agree with Bill and take issue with George. My prostate cancer was discovered by two private PSA tests taken 11 months apart. My Gleason score was nine out of 10. I was finally clear of cancer last year after 14 years of treatment. I suggest things could have been a lot worse if I had not had these two tests within a year.
George should have mentioned the Prostate cancer risk management programme whose aim is: “… to ensure that men receive information about prostate cancer and the associated risks, and clear and balanced information about the advantages and disadvantages of the prostate specific antigen (PSA) test. This will help men to decide whether they want to have the test.”
It would appear that in both George’s and Bill’s cases, they did not receive clear and balanced information about the test. The implication is that surgeries need to have a notice on the wall that draws men’s attention to their rights under the risk management programme. And, if their GP does not inform them, they should make the first move.
• It is commendable that George Monbiot shares with us his experience of prostate cancer diagnosis. Also his happiness in where it puts him in his life. It is so important to inform and educate men about this disease, to broadcast the news far and wide. Anecdotally, following 15 years of PSA monitoring due to family history, then two biopsies that make your eyes water a bit, I too was diagnosed with this disease. Like George, I am overwhelmed by the love and support from friends, family and the teams of NHS radiologists who irradiate me daily with their linear accelerators. There is almost a social group in the waiting room, where we prepare for our treatment. A dry camaradie exists and humour too, as we fill our bladders to bursting point with water and insert our microenemas, so the radiologists can see what they’re aiming at. (Big shout out for the radiotherapy teams at the Churchill hospital, Oxford.)
Cancer is the great leveller. But there is room for happiness when you do realise, by comparison, how lucky you are. Good luck with your treatment, George.
Flackwell Heath, Buckinghamshire
• I was diagnosed with prostate cancer, with a Gleason score slightly higher than George’s. I opted for radiotherapy rather than surgery, and the seven weeks I spent travelling five days a week to the Churchill hospital in Oxford were an eye-opener for me, since I have never had any contact with the NHS beyond my (very good) general practice and the odd minor operation. At every stage I was dealt with courteously, informatively and sympathetically, often by staff who were not English. There were six radiotherapy machines, each costing about £2m, to which I had free access, along with the ancillary hormone treatment. The true cost of my treatment came home to me when I read in the Guardian last week of the man who has lived in the UK for over 40 years who was asked to pay £54,000 for a course of radiotherapy for his prostate cancer.
Unless there is a change of government soon, this unique healthcare organisation will be irreparably damaged by politicians who despise anyone who is not rich, who use private medicine, and who advocate the discredited use of PFI companies that make profits from selling inferior and overpriced services to the NHS.
• George Monbiot’s response to his diagnosis and forthcoming radical surgery for prostate cancer is impressive and inspiring for others in similar position. But there is a third choice of treatment other than the rather dismal choice between surgery or radiation – namely high-frequency ultrasound, which has fewer side effects and – as with a friend of mine – can be very effective. For some reason it has a lower profile, but is available – and would appear a far less daunting prospect.
• Thank you, George, for that courageous and necessary writing. We admire your brave and clear-sighted approach to your private crisis. Thank you for sharing your thoughts, so that we can emulate your attitude. And we all wish you well in your surgery and aftercare. May the force be with you.
• George is fit and healthy and his prostatectomy should be very successful. I had the same operation nine years ago and I have no doubt that my life was saved by my excellent GP who insisted that I had regular annual PSA tests. Although my Gleason Score was only 4.5, my doctor was concerned by the sudden increase since my previous test and “for peace of mind” (his and mine), he suggested a biopsy. Like George, my cancer was aggressive and the operation was carried out in under a month. Fortunately, the lymph glands were unaffected and apart from the expected debilitation following major surgery, I was soon fitter than before the operation. Erectile dysfunction is an expected side-effect, but don’t worry, George, medication will help that.
All men should have regular PSA tests from age 50 and, if there is a family history of prostate cancer, tests should begin earlier. Delay does kill. I am looking forward to reading George’s next article following his discharge from hospital.
• Thank you, George. I have just been diagnosed too and, at 77, I like the idea of being part of this season’s smart young men. And I like the reasons you give for being happy. They make a lot of sense. My hormone treatment started yesterday and every member of staff was wonderful, kind, thoughtful, skilful and reassuring. Like you, I am happy, but I am also very angry. The idea that the government is determined to sell this national service off to US private business is unbearable.
• George Monbiot has covered everything accurately. His urinary tract infection bad luck turned out to be life-saving good luck. For me a hip replacement pre-op test discovered a heart condition, treatment for which led to the diagnosis of prostate cancer, early developing, responding well to the simplest treatment. Definitely good luck. “All the smart young men have it this season” – no, but all the smart men of any age should be aware of it, speak of it and check for symptoms. I’m old enough to remember when tuberculosis was unmentionable. Let’s not fear to speak of prostate cancer. All the best with the surgery, George.
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