My “classic and ideal” prostate cancer treatment

Richard Burdekin is a 70-year-old retired managing director from Shropshire, who worked in the grocery sector. Mr Burdekin had what has been described as the “classic and ideal treatment” for prostate cancer. He explains what happened and the choices he made.

“I’ve had an annual medical every year since the age of 40. I am fortunate as this was provided by my company and as a Scuba diver, it included the tests I need in order to dive and to teach diving. Equally, I’m the sort of person who wants to have as much information as possible and to know what is going on inside my body.

“When I was 65, I was told that my PSA had risen marginally. A year later, it had risen again and the doctor advised me to see a specialist. He recommended Mr Doherty. A biopsy showed there were some cancer cells present in my biopsy, but no significant tumour was evident, so I was advised to come back six months later. It followed that for 18 months, I would have “active monitoring,” having regular checks, knowing cancer was present but it had not developed sufficiently to move to treatment. The medicals I’d had over the years meant there was a 27 year history of PSA tests, so it was clear to Mr Doherty what was happening over time, rather than just having one or two readings.

“By the time I was 68, we looked again at the options. My Doherty explained his focus is on nerve-sparing surgery: safely removing all cancer while reducing the risk of nerve damage as this the main cause of the main long term complications, incontinence and erectile dysfunction. It made sense to me to have surgery at a relatively early stage because with less cancer spread, it would be easier to avoid the nerves. Why delay something that was going to be my preferred treatment choice in any case?

“Mr Doherty described the robotic system for a prostatectomy, when the surgeon works through small ‘keyholes’ rather than a larger incision across the abdomen. While I could appreciate the benefits of this in terms of the short term recovery from surgery, I could also see the drawbacks. However skilled the surgeon is, the field where they are operating is not open to them to directly see and to touch. One of my hobbies is listening to music and it seemed to me, keyhole surgery is like standing outside the room, listening through an open door. Outside, you can certainly hear the music, but it would not be the same experience as being there in the room, surrounded waves of glorious music, with every detail perfectly clear.

“I had my operation close to Christmas 2012. The first couple of weeks were exactly as I had been told to expect: there was some pain and discomfort and I had to wear a catheter. However everything had gone to plan and you feel providing you have a plan, it is just a case of following it. The recovery went well – I was swimming again within weeks of surgery and by three months, was fully continent. By six months, I was feeling pretty well and by a year, felt fully back to normal in all respects, including the manly side of life. My post-operative PSA results were very good and Mr Doherty put me onto annual review, so there is that sense of putting the experience of cancer behind you.

“In all our discussions, one thing that struck me about Mr Doherty was his willingness to be open and to explain things really clearly, which in my experience is not always the case, but it is really helpful if surgeons do communicate well. But through discussions with Mr Doherty, you become very clear about the choices you are making. It was very evident to me that open surgery had advantages over robotic and also that removing the cancer before it spread further would allow for the best opportunity of successfully sparing the nerves.

“When more recently, I developed a trapped nerve in my shoulder, I was clear that I wanted to explore different opinions before deciding what to do. I was losing all the function in my left arm, but the first two spinal surgeons I saw advised against surgery due to the risk of nerve damage. I then saw a neurosurgeon who was in favour of operating, but recommended open surgery rather than keyhole. Like Mr Doherty, he explained if the nerves were clearly visible, this would be the safest way for him to operate; to reach and shave part of the bone which had grown over the nerves, causing the compression.

“In terms of prostate cancer, I wish there could be more positivity, both among men and the medical profession. Doctors can be too quick to point out the downsides of the PSA and men are happy hear this negativity and then avoid going to see a doctor. While PSA is certainly not perfect, it is the best test we have and gives you the greatest chance of identifying prostate cancer and having early, effective treatment.

“Mr Doherty described my case as a classic example of how prostate cancer should be treated. I do hope many others can benefit from the same early diagnosis and optimal treatment.”