We know that having tests for prostate cancer can be stressful and worrying. That's why, with the help of volunteers like Phil Watson, we’ve updated our fact sheet: How prostate cancer is diagnosed. He talks to us about his own diagnosis with prostate cancer in 2011, aged 61, and the experiences he had of having a range of tests before treatment.
What made you go to the doctor in the first place?
I was getting up in the night several times to go to the toilet and I’d been having trouble starting whenever I tried to urinate. I’d put off going to the doctor for a little while because I was embarrassed.
What happened when you went to see your doctor?
I told him about the problems I’d been having urinating. He explained that they were likely to be caused by either a urine infection, an enlarged prostate, or prostate cancer. And that there were a few tests that I could have to find out more.
What tests did you have?
Firstly, I was given a small container to take to the toilet and urinate into. The doctor tested it and said that I didn’t have a urine infection. The doctor then did a digital rectal examination (DRE), where he felt my prostate through the wall of my back passage. I found it slightly uncomfortable but it wasn’t painful at all and was over in about 20 seconds. The doctor couldn’t feel anything abnormal – there weren’t any hard or lumpy areas and my prostate didn’t feel enlarged.
The doctor then explained that I could have a blood test to measure my prostate specific antigen (PSA) level. He explained that prostate cancer cells produce PSA, so if the PSA in your blood is high, it could suggest that you have prostate cancer. But normal prostate cells also produce PSA and other things can raise your PSA level. So the test on its own can’t usually tell whether you have prostate cancer or not, but it can indicate whether you might be more likely to have it. I booked an appointment to have a blood test. The nurse put a needle in my arm and collected a small tube of blood. My blood was then sent to the hospital to be tested.
What were your PSA blood test results?
About a week later, a receptionist from my doctor’s surgery called me to tell me that I needed to make an appointment with my doctor. My first thought was, “I’ve definitely got prostate cancer”. I was devastated and very distressed. When I went to the appointment, my doctor explained to me that my PSA level was slightly raised and it was something we should keep an eye on.
What did you decide to do?
My doctor explained that I could have more tests at the hospital to find out what was going on. But that there were pros and cons. The doctor gave me a lot of information and I felt that I was able to make an informed decision that I was happy with. I wasn’t keen to have hospital tests straight away. So we decided to regularly monitor my PSA level to see if it changed. In the meantime, I was given medication to help with my urinary problems. I had blood tests every few months to check my PSA level and I felt happy that we were keeping a close eye on things. My PSA level was slowly going up so about 18 months after I originally went to see the doctor, we decided that I should go and have more tests at the hospital to see if I had prostate cancer.
What tests did you have at the hospital?
I met a doctor at the hospital who specialised in urology. I had another PSA test and DRE and then I was given an appointment to come back and have a TRUS prostate biopsy. The doctor explained that he would use a thin needle to take small samples of tissue from the prostate. First, he put an ultrasound probe into my back passage to create an image so he could see where he was taking the cells from. I found it quite uncomfortable. The doctor injected local anaesthetic to numb the area so that I couldn’t feel anything. He then put a needle next to the probe and inserted it through the wall of my back passage into my prostate to take the samples. It took about 10 minutes.
What were your TRUS prostate biopsy results?
The results came back negative – there was no sign of cancer in the samples. But the consultant stressed that I could still have cancer and my other tests indicated that I might. So I continued to have my PSA monitored for about a year. It was still going up so we decided it was best for me to have another biopsy.
What happened next?
This time, the doctor at the hospital thought that I should have a template biopsy, where more samples are taken from the prostate. It was done under general anaesthetic, so I was asleep and couldn’t feel anything during the biopsy. Afterwards, I couldn’t urinate and had to have a catheter for about a week. It was quite uncomfortable and a huge relief when it was removed! This time the results came back positive – I had cancer. It was upsetting and frightening. Even though I had been monitored for a couple of years, I was still hoping that I didn’t have cancer.
What treatment did you have?
I had localised prostate cancer – so it was contained inside the prostate. But the results from my prostate biopsy and MRI scan suggested that the cancer could be close to breaking out of the prostate and spreading into the area around it. So we decided that my best option would be to have surgery to remove my prostate. A couple of months after surgery, my PSA had fallen right down and it’s still undetectable now. I do have some side effects from the surgery, but they’ve been manageable. I’m mostly just thankful I’m alive! And the urinary problems I originally went to the doctor with have gone away. I now feel fitter and healthier than I have done in a decade.
What are your top tips for other men having tests for prostate cancer?
If you’re worried about something, get it checked out. Initially I was quite embarrassed about going to see my doctor. But I overcame my embarrassment because I realised that my health was more important to me.
Take someone with you to your appointments.My wife came to many appointments with me, especially the ones where I would be given results or information. It was really helpful because the stress of going to an appointment meant that I didn’t always remember exactly what was said.
Read about the tests in advance. I found Prostate Cancer UK’s information about diagnosis really helpful – it gave me a good idea about what to expect.