Prostate Awareness 14: A Second Operation Clearing Things Up Using HIFU

Mark Emberton operated on me yesterday to clear up some of the illness that was remaining. This time they used the HIFU approach.

Many men now want HIFU and there is a big waiting list. Mark and his team want to help them as quickly as possible. So they volunteered to do additional operations on Saturdays. Hence I was able to get a slot on November 9th.

They did the operation at University College Hospital in London. I checked in at 7.00 am, was released at 2.00 pm and back home at 6.00 pm that night.

Some slight discomfort, but no real pain. The follow up will not involve an MRI. It will be a PSA check in six months. Here is a link to the University College Hospital.


So why was a second operation needed? Previously I had the Nanoknife procedure. This was to treat parts of the illness in areas that could not be reached with HIFU.

The PSA score immediately went down. After a few months, however, it began to rise again. So I had a new MRI, which led to a meeting with Mark in June.

The MRI revealed the parts treated by the Nanoknife procedure had responded well. These were in areas that could not have been treated by HIFU – hence the use of Nanoknife.

The remaining parts could be treated by HIFU and there was an 80%+ chance of success. The approach would be conservative, however, so as not to damage the sphincter.

Mark would do the operation himself. It could be done privately – as with the Nanoknife – or through the NHS at UCH.

The NHS route would take more time, but would be worth pursuing. My GP needed to refer me and it might take many months before the operation. But it was worth exploring the option.

I asked Mark about the risk in waiting. The illness was confined within the prostate and, at the moment, there was no great risk of it spreading. It would not kill me, said Mark, but it did need treating.

The NHS Route

Returning home, I called my GP. He said he would like to say “Yes,” but that it might not be easy to clear the way. The local Health Authority had their procedures, so things might not work out.

Mark sent an authoritative letter to the decision-makers. I contacted his PA six weeks later to ask if I needed to follow up in any way.

Apparently I would soon be notified of an appointment at UCH, so the okay had been given. The first step would be another meeting with Mark, this time at the Macmillan Cancer Centre.

The Macmillan Centre opened in April 2012 and has been well designed. When I visited there were many patients arriving for appointments or treatment. But the space combines both friendliness and efficiency.

Mark explained that there were many men in the queue for treatment. So it could be several months before the operation.

My only concern was the condition spreading. But the risk was minimal. I could be given some tablets to slow the rate if necessary. The side effects would be my breasts growing.

Mark again emphasised that he would be doing the operation. So it was a question of waiting for the appropriate time slot.

The Operation Date

The operation time duly arrived. It was set for the morning of Saturday November 9th. So I arranged to have the pre-op assessment on the preceding Monday. This fitted well, as I was working all week in London.

Colds and coughs can potentially lead to postponements of operations. So I broke one of my rules and took some preventative medicines.

The pre-op assessment went reasonably well, but then came a complication. My blood pressure shot up inside the hospital.

This can be a normal occurrence. Many people experience what became known as ‘white coat hypertension’ when visiting a doctor or hospital. But my readings were much higher than normal.

The pre-op nurse said she would talk with the anaesthetist. If I did not hear from her the next day, then the operation would be going ahead.

No message arrived. So it was all systems go. The surgery reception would be open at 7.00 am on Saturday.

The Operation Day

Took a cab to UCH at 6.00 am. The main reception was open, so sat there until the surgery reception opened.

After a short while there were around 20 people waiting in the surgery. Mostly men and some accompanied by their partners.

The nurses were professional and also friendly. Then a further pre-assessment began. For the first time I had the joys of an enema. That was fine.

My blood pressure, however, was again high. The anesthetist was informed, but gave the go-ahead.

The operation began around 9.00 and took about an hour. I woke up at 11.05.

Mark and I had previously discussed that this time I should have a suprapubic catheter fitted, rather than the urethral one. This is a much more comfortable option.

The only discomfort I felt after the operation was in the urethra. But slowly this began to fade.

Mark came to visit. The operation had gone well, he said. There would be no need for a follow up MRI. The next step would be a PSA in six months.

At 2.00 pm I was ready to leave. There was a slight delay with getting all the medication and forms together.

A car arrived at 2.30 to take me home to the Wye Valley. There were delays on the journey, but got home at 6.00 pm. Checked my blood pressure, which was back to the usual reading.

All went well during the night. On the Sunday morning went for a walk in the sunshine. On Wednesday will return to UCH to have the catheter removed.

Moving Forwards

As an educator, I tend to turn most things into projects. The reaction is normally:

“How can I pass on this knowledge in a way that helps other people to make their own choices?”

I accept that this might be denial, but it is the route I have chosen to take. It seems to have more beneficial consequences.

One side effect is that quite a few London cab drivers have visited their doctors to check for Prostate Cancer. I don’t bring up the topic, but if they ask how I am then, if appropriate, I mention the pioneering treatments.

Virtually every cab driver then starts talking about their health. Many seem to feel more at ease if they are first presented with a possible solution. Only last Thursday I met one who had driven me before and has since asked for a health check.

Since starting this blog I have been contacted by men who have been diagnosed with PC. Some of them have been advised to take immediate action.

My response has been to say that I am not qualified to give medical advice. I can, however, give information and options from a patient’s point of view.

Below is a link to the website Cancer Active. Whilst it tends towards the complementary medicine approach, it aims to give an introduction to many options.

The website contains an excellent interview with Mark. In it he outlines some of the scientific evidence for patients. It is good if more men know the potential options.

Looking ahead, I will have a PSA in six months. If there is any residue remaining, then there will be various options for treating it.

This website was originally set up to raise awareness about the options for tackling prostate cancer. It also focused on positive aspects of living.

You can now find many more pieces about the positive things happening in the world on another website The Positive Approach.

This contains over 700 articles and videos. These highlight the superb work people are doing in education, social enterprise, business and many other aspects of life.

Onwards we go.

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