Paul Davies had understandably let his usual habit of having regular PSA checks lapse over the COVID-19 pandemic. In 2023, Paul restarted his PSA checks. Although his score was only just over 4, his GP was concerned about how quickly it had increased since before COVID.

“There was obviously a huge backlog of people waiting for prostate investigations at that time, so after a friend recommended Alan Doherty, I decided to seek a private assessment. One of the nurses on his team arranged a high-quality multi-parametric MRI for me.”

The results came back quickly. “My wife and I went to see Alan for a consultation, and we both knew immediately, just from looking at the scan, that I had a number of tumours of considerable size in my prostate gland.” 

Paul was 66 years old at the time. “My overriding memory is how kind Alan was at a traumatic time for us. My father had died of prostate cancer back in the 1980s in great pain, having been diagnosed very late with the disease,” Paul explains. “I’d helped to nurse him and that was my model of what my future might be.”

MRI-guided biopsy for clearer insights

Alan suggested a biopsy, but Paul didn’t have health insurance to cover the costs. “He really was compassionate and gave us the time and space we needed to decide what we wanted to do next, supported by really nuanced advice.”

After consideration, Paul decided to go ahead. “Alan prefers to perform the biopsy transperineally and under general anaesthetic. He said he didn’t want me jumping about! He used the detailed MRI images to guide where he took the cores from. Thankfully, the whole thing was totally painless.”

Since then, Paul has started working with a support group for men with prostate cancer and realises how rare his experience was. “The number of men I speak to who’ve had transrectal biopsies and have been in pain during the procedure and left with side effects is awful. Biopsies can also be imprecise if you don’t have a good MRI to guide you. I’ve spoken to men who got an all-clear when they actually had cancer. It’s all made me appreciate being in Alan’s care even more.”

A calm and measured multi-disciplinary approach

Paul was diagnosed with a Gleason score of 3+4, “So not the end of the world.” 

He remembers that Alan’s advice was to not rush into anything. “Although he’s a surgeon, I didn’t feel railroaded into having anything invasive done. He said to take a beat and to think about what comes next. He put me in touch with a patient who’d had focal therapy and one who’d had a radical prostatectomy as well as with a radiographer.” 

It was a great way to explore the options, and Paul appreciated the whole team’s calm and measured, multi-disciplinary approach: “The radiologist and nurse specialists all got together and discussed several treatments that might be right. Everything was explored, including active surveillance. I had a good 45-minute phone consultation with Alan too, grappling with the choices.”

“The fact that Alan had performed over 3,000 radical prostatectomies at the time and was known nationally for his good outcomes meant I eventually went for that option. The memory of my dad loomed large. I just wanted to do what I could to get clear, particularly with the tumours near the margins of my prostate that were at risk of spreading.”

Paul had the operation in January 2024. “I saw Alan beforehand, obviously, but I also had the same anaesthetist that I’d had for my biopsy, so I had huge confidence in the team.”

Side effects keep improving

Paul left hospital a day earlier than expected. “I had a little incontinence and leakage for six or seven weeks following the operation, as many men do. My mental health wasn’t in a great place at that time. But I had great physiotherapy at a pelvic health clinic in Harborne to help me recover. That included using ultrasound to show me my pelvic floor muscles and how exercises could make a difference. It takes a bit of practice, but I regained bladder control quite quickly after that.”

In a follow-up appointment, Alan confirmed that detailed pathology had revealed higher-grade cancer than was expected during the diagnosis, confirming that a radical prostatectomy had been a good decision. He’d been able to use a nerve-sparing technique on one side of the prostate area and a partial one on the other side. 

“Your erectile function rarely goes back to usual, but after some trial and error with medications, Alan recommended taking a low, constant dose of Tadalafil, an alternative to Viagra. That really does help,” Paul shares. “To be honest, I was pretty low about the fact that all that hadn’t recovered when I went to see Alan about a year after my operation. But two years on, I’m happy to say there’s a slow but constant improvement.”

Helping other men make good decisions

Paul has been putting his lived experience of prostate cancer to great use. “I joined a ‘Tackle Prostate Cancer’ group near me in Solihull. Talking to men who’d been down different paths was a real eye-opener, from big gaps in treatment cycles to having no time for reflection and little conversation around which treatment might be best,” Paul shares. 

The ‘Tackle Prostate Cancer’ group is designed to support and advise men at tough times. “Sadly, ‘treatment regret’ is pretty common, with men making rushed decisions at a time when they’re very anxious, with only the briefest of consultations and using online information, some of which can be very misleading. I’m now the chair of trustees, helping the organisation grow and offering invaluable group and one-to-one mentorship. I go into workplaces to raise awareness with male employees and am also focused on helping black communities where the chances of prostate cancer are higher.” 

“I’ve started working with HR departments too, to create a more supportive protocol for men going through the prostate cancer diagnosis and treatment process. We got a big grant from ‘Movember’ and are focusing on the Midlands and North-East right now, which are the areas that have the highest incidence of men being diagnosed with the later stages of prostate cancer.” 

“I’ve made firm friends in the group and built networks that have really supported me.”

If you’d like a symptom check or a second opinion, we offer a FREE initial consultation with one of our highly experienced nurse specialists, in person or remotely.  Just call 0121 7566705, and our friendly team will get you booked in.

If you’d also like to find a support group near you, visit https://tackleprostate.org and search in your local area.