Sep 4, 2024

How visiting hospital with heart palpitations led Graham to a prostate cancer diagnosis and a decision to undergo robotic surgery

On the day before his 50th Birthday Graham, a keen runner and fitness enthusiast, began experiencing ‘heart palpitations and skipped beats’, when they became more severe the next day he called 111 and was sent to the hospital for investigation. At the hospital, Graham was placed on a heart monitor, revealing a condition known as Mobitz Type I, a form of arrhythmia. Graham would need to be monitored and have further tests, but the consultant assured him it wasn’t serious, and that most people can carry on with life as normal, providing the condition does not progress.

Given that Graham was just about to turn 50, the consultant suggested he go for a routine health check, just to make sure everything else was as it should be. So, Graham arranged a visit with his GP to have some general health tests. As a part of these investigations, Graham’s GP performed a prostate exam and noted that his prostate was slightly enlarged. Graham was sent for further tests including a PSA blood test, MRI scan and a biopsy, and was later diagnosed with high-risk, aggressive prostate cancer.

Graham shares his experience of being diagnosed with prostate cancer, his treatment under the care of Mr Vijay Ramani at The Christie Private Care - part of HCA Healthcare UK, his choice to be treated with robotic surgery and his emotional and physical recovery.

“Initially my GP thought my prostate was enlarged because of my age but did a PSA blood test to be sure. Then, when it was high, he thought it could be a result of infection or exercise, which made sense to me as I do a lot of exercise, loads of running, I’d actually done a ten-mile run prior to having the test.

He re-ran the PSA test and two weeks later I got a call, the results were higher this time. My anxiety started to rise; I told my wife but nobody else. I was sent for an MRI scan; the results showed an abnormality and at this point the alarm bells really started going off”.

The moment my “world stopped”

“The next step was to go for a biopsy. Shortly after, the appointment came through to see the consultant and get the results. I was incredibly nervous, but my wife was still hopeful it would be something benign. Sadly, it wasn’t, the biopsy results confirmed I had prostate cancer with a Gleason score of 8. It wasn’t just prostate cancer, but high-risk aggressive prostate cancer.

At that stage your world stops, you can’t think, you don’t hear words, I was numb. You’re trying to absorb the next thing the doctor is telling you, but your mind is going a million miles per hour.”

The challenge of additional tests

Shortly after receiving his diagnosis Graham was sent for an MRI and PET scan to check that his cancer hadn’t spread and was confined to the prostate.

“I thought the worst had happened, but unbeknown to me I needed additional tests to check that the cancer hadn’t spread to other parts of my body, I didn’t even consider this when I was first diagnosed. I was dreading that phone call after the scans, yet I was chasing the phone call. I wanted to know and didn’t want to know at the same time.

Luckily, I got told the cancer hadn’t spread. My wife jumped up for joy, she was so happy that - to use her words - I had ‘regular cancer’. At that point I still didn’t know anything beyond what I had been told by the doctors, I hadn’t read into it, I didn’t want to increase my anxiety. I know some people want to find out as much as possible, but I didn’t.

I then had to make the decision about whether to tell my family, to tell my children, which I did. That was a hard conversation, but it was important to us that they knew”.

Exploring treatment options

A multidisciplinary team of experts had met to discuss Graham’s case. There were two potential treatment options, one would be a combination of hormone therapy and radiotherapy, and the other would be a robotic-assisted radical prostatectomy (RLAP), which is the surgical removal of the prostate using minimally invasive robotic surgery.

After much deliberation, Graham decided to go with the surgical option. His decision was based on his active lifestyle, age, and his family and life commitments. His care would be under the expertise of Mr Vijay Ramani, a highly experienced robotic urological surgeon at The Christie Private Care.

“I found the treatment decision difficult, both options had their upsides and downsides. In the end I decided to go with the surgery. There’s no ‘golden ticket’ of course. Being relatively young I was conscious of the erectile dysfunction and continence issues that can come from surgery, but the idea of having a single procedure, with a shorter hospital stay and a quicker recovery time helped me make my decision. Hormone therapy could take up to two years, and might be the right choice for some people, but it wasn’t for me”.

The day of surgery

“I had never had an operation or an anaesthetic before, so I was super nervous, but Mr Ramani and the team were excellent, they provided lots of reassurance and really put my mind to rest. I also felt confident being treated at The Christie Private Care, it has an excellent reputation and many people travel for care there, so I feel lucky to live so close.

Because of my heart condition I needed to have my heart checked by a cardiologist to ensure I was fit for the operation. Not only were my arteries and heart in good condition, but they were pristine, so I was proud of that”.

A rapid recovery

“Because I had minimally invasive surgery, I was in hospital for just two days following the operation. Some people can go home the next day, but I didn’t feel ready to walk upstairs, sort my catheters out, and just be at home really. I needed to be around the medical team a little longer, to look after me, and give me the confidence that I was doing things right. The team were really understanding about that and kept a close eye on me, which I was really grateful for. When I did go home, I managed quite well, but having that extra day in hospital felt right for me.

I was a little sore after the procedure, but within days I was starting to feel better, and my stomach swelling was going down. I looked down and saw just how small the incisions were, it was truly amazing. I’d read that robotic surgery enhances your recovery period, and that was the case for me. Quite quickly I could swing my legs out and before I knew it I was able to bend down, and manage my own catheter. I like to think that because I was healthy and fit before my operation that also contributed to my quick recovery. So that was a positive”.

Post-Operative Care and Clinical Nurse Specialist support

Graham praised the support he received from his Clinical Nurse Specialist (CNS) Emma, who supported him throughout his treatment and continues to today. The consistent and personalised care from the team helped Graham navigate the physical and emotional challenges of his recovery.

“Emma gave me so much advice and support throughout, in the hospital, after hospital, and still today. It got to a point where I felt bad for bothering her, but she always insisted it was no trouble at all and that’s how I felt. I first met Emma when I came for my pre-op, it was great to have her as my CNS, I had a name and a face I could always go to, and still can. Not only has she been a great support to me, but to my wife Alison too. She really has gone above and beyond”.

Emotional impact and adjusting to life after cancer treatment

“Despite having had the surgery, it still hadn’t really hit me at that point what had happened. The enormity and the magnitude of it, I felt like it had happened to someone else – it was still quite surreal.

One of the strangest feelings was that I felt embarrassed by the diagnosis. Partly because of the intimate nature of it, but also because people see me going out and running; I’m fit, I’m active, I’m only 50, this shouldn’t be happening to me, but it has.

Work have been brilliant about me being off and haven’t put any pressure on me to come back, but I like my job and was keen to return as soon as I was able. But being diagnosed with cancer did really knock my confidence, made me question am I good enough to go back to work, everybody seems to know everything. I struggled with that.

The other thing is that people think, because you’re back in work, that everything’s ok now. Physically, mostly, I am. But they don’t see the back story, and that takes a bit of getting your head around. But I don’t blame them, because if I saw somebody who was working again, walking, jogging, getting on with everyday life, you would think everything is ok. But with hospital appointments, work, homelife, my own wellbeing…you’re juggling a lot really!”

Ongoing physical recovery and looking to the future

“I had my first post operative PSA blood test results in March, which were clear. Then I had my second set of results in June, which were also clear, so it’s good news so far. It’s a very anxious time having the test and waiting for the results, it’s a complete rollercoaster. I don’t think people can understand that part of it unless they have been through it.

Physically I have recovered great and a lot of that is down to Mr Ramani and the benefits of robotic surgery. I’m back to running and I’m back in the gym. I took it slowly, gave it a couple of months.

The timescales for the continence and erectile dysfunction were explained to me, but I still found it difficult. I wanted to have the world’s best recovery, be back to where I was within two weeks, but I know that it’s going to take a bit longer than that. There’s been changes already, so I told myself ‘hold your horses, things are going well, be positive’. My biggest concern was continence but mine has been good, I’ve not needed pads and generally have good control, even when running.

Overall, I am doing well. A new me is emerging, I’m developing as a person. And in some ways, I am better than before”.

Learn more about cancer diagnosis, treatment and care at HCA Healthcare UK here.

This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.