Following TURP, you still have a prostate. They didn't tell me that.

It is my understanding that samples from my prostate were tested for cancer following the 2010 surgery and were found to be negative. That samples were tested is irrelevant, since my belief, then, and for the ensuing 7 years, based on what I was/wasn’t told, is that my prostate had been removed. The erroneous use of the term ‘prostatectomy’ in the aforementioned Sept. 2010 surgeon to GP letter only served to confuse matters further, and I will return to it later.

I am aware of the medical term ‘radical prostatectomy,’ it’s definition being complete surgical removal of the prostate. In a similar manner the terms vasectomy, appendectomy etc. all define surgical removal, and in most cases full removal. The use of the adjective ‘radical’ is moot, since, as I discovered seven months ago, my surgical procedure was actually TURP [transurethral resection of prostate].  

Let me run through the sequence of events of Sept./Oct. 2017, as I need to add an insight I should have included in my first posting. My second hospital test in Sept. 2017 involved inserting a tv camera via the penis to check my bladder [for cancer]. The doctor’s first words were “hop up on the table and let me check your prostate?” Can you hear the alarm bells ringing in my head? His tests complete, sat at his desk he said, “Of course you know, your prostate can grow back.” Actually no, I’d never been told that, and practically every acquaintance was surprised when I passed on that information. At my next hospital visit, for prostate biopsy, I was informed by a second doctor that the 2010 surgical procedure had been TURP, and that “since men were living longer” revisiting that surgical procedure 8 – 10 years later was common practice.

Let me summarise, Prostate regrowth, TURP as a term, and revisiting TURP were never part of any conversation I had with the surgeon in 2010. Since prostate surgery, whatever the extent, results in what I would describe as a ‘compromised prostate’ surely that fact alone warranted advising the patient on future PSA testing. I was certainly aware of the PSA testing long before 2010, but was not advised at that time to look into it. There’s another vital link in this ‘chain’………….

Let me return to the Sept. 2010 letter. I have yet to be advised whether my GP practice has [ever had] a procedure for advising patients to take a PSA test, following any degree of prostate surgery. The question has been asked. The fact that the Sept. 2010 employed the term “prostatectomy” surely closed that door, while the true term “TURP” would have left it open. I trust that you can see logic in my hospital/GP surgery link, in the future care of “compromised prostate patients.” Since being diagnosed with prostate cancer, I have discussed the letter’s contents with a senior cancer nurse and a prostate cancer specialist, and both have raised concerns about the use of the term “prostatectomy.” The former stated “Things are different now.” What did she mean?

When I compare the amount of advisory medical literature provided in 2017 with 2010, it appears to be akin to an ‘avalanche’ vs. a ‘drought.’ I have read every document of recent vintage,  and view them as ‘let’s cover our backs’ documents, since they [consistently] contain too much information, much of it irrelevant [and as a direct result, confusing to the patient/layman]. I accept that boiling this information down to patient specific facts is a massive and costly task, and one that the NHS cannot afford.  I used to read, decipher and pick apart complex civil engineering contract documents as a work professional.

Post Sept./Oct. 2017, any naïve belief that I retained that the medical profession “knows best, and has told me ALL I need to know” has disappeared. As a patient it is your duty to pursue answers to every aspect of your medical condition and treatment.

The nature of the 2010 question I‘m posing is “Was I one, or one of many?” If the latter, surely that is a cause for concern. Even one ball dropped, is one too many.      

If I understand you correctly you were being treated for urine flow issues and were told you were having TURP which worked for you. As a precaution, tissue removed was tested for cancer and found to be non-cancerous. 

PSA testing would not necessarily have helped with diagnosing your subsequent cancer because all it does is indicate the Prostate is in trouble which could have been explained by the enlargement you already knew you had.

I very much sympathise with your current plight. Being diagnosed with cancer is extremely scary. I agree there was ambiguity in the surgeon’s letter but TURP is a partial prostatectomy and unless you are being told by your GP that this is the only reason you were not monitored for cancer I don’t think you have a cause for complaint. I get the feeling you are looking for someone to blame for your current predicament which won’t change anything in practical terms and is likely to increase rather than reduce your stress at a time when thinking positively is more likely to get you through into better health.