Hi , feeling a bit unsettled! My partner’s appointment at the hospital following a raised P.S.A , albeit a minute rise has been cancelled and he has also been told his Consultant who he had a lot of faith in has retired and there is now a locum in his place. What do the forum think about this ? Should we be concerned?
It always unsettles me a bit when I read of people being concerned their psa has reached a level like 0.034. At my hospital I wouldn't know as the lowest they do is 0.05.
If mine did go above 0.05 I'd be wanting another psa test fairly soon to establish its trajectory and then to discuss further treatment such as RT perhaps after a scan. So yes I can understand your concern although at 0.034 it's pretty low and I'd imagine another psa test being taken before considering further treatment. As others have said in your other post they regard 0.2 as recurrence so you could have a debate on your hands about when treatment starts, although in my opinion a good treatment will start early.
Also if it is rising the surgeon probably isn't the best person to see and you might ask to see an oncologist if they're truly maxed out. I've never seen my surgeon since the pre-op discussion, his clinics are done by doctors as well. In conclusion it might not be that critical with such a low psa but I'd recommend you keep on the case to get an appointment with someone.
Hello Lynne , thanks for your reply. He should have had an appointment with his consultant , but he has now retired and he was supposed to see a locum . From what I can make out they are overwhelmed and unable to see all the patients at the moment. We have heard another person we know of has actually had his surgery cancelled so you can understand our concerns !Lynn is going to phone them and try and find out more information and pin them down to another appointment As you say he should at least be havimg his psa checked 3 monthly as it is showing an upward trend. If they have not got a consultant to look at the results though we are in trouble !
He should be able to have his future PSA tests at the GP practice - if it rises significantly, he could either press the urology department for an appointment with the locum, or ask the GP to refer him to an oncologist. They are unlikely to be concerned unless it goes over 0.1 and then continues to rise. Anything under 0.1 could be normal cell regeneration or machine noise.
Indeed - I was at the BMA headquarters recently and there is a huge wall display showing the shortages nationally for all disciplines; only being made worse by the number of overseas doctors & other medical professionals that have left the UK because of uncertainty about post-March 29th. There are more doctors leaving the profession here than there are qualified or student doctors to replace them.
Cancelled or postponed? Did they say they have closed his case and handed his care back to the GP, or just that this particular appointment is cancelled and another will be sent in due course? Was he due to see the surgeon now anyway or did you request an extra appointment / rereferral?
I would make sure he has another PSA test 3 months after the most recent one and then decide what to do.
Thank you for your comments. We just want to be on top of any developments and it does nothing for your confidence when they havent even appointed a consultant to replace the 2 who have left!!
The poaching of trained/qualified medical staff from other countries has been going on for many years and at an increasing rate in the UK and it's high time that more incentives were in place to attract, enable and retain indigenous people in the medical profession. A wake up call is certainly overdue but regardless of what may be in train or planned it will take years to overcome the deficiency, regardless of what happens after 29th March 2019.
My mother was in a nursing home over a decade ago and the home owner had just returned from a staff recruiting trip to Poland. Asked why she had done this she said she could get a qualified nurse from there for the salaryof an unqualified helper in the UK. Just one example of the situation. It's no surprise to me that the Polish are now wanting at least some of their medical staff to return to cover shortages in Poland.
I think shortage of staff in a profession that requires greater training and expertise than ever before and with increasing demands on it, will result in more delays and cancelled appointments along with complaints from patients that they were not being given sufficient time and satisfactory service.
The poaching of trained/qualified medical staff from other countries has been going on for many years and at an increasing rate in the UK and it's high time that more incentives were in place to attract, enable and retain indigenous people in the medical profession.
I am not sure Barry but I think the main problem in relation to doctors and physiotherapists is that there are more vacancies than places at university for new ones to train & join the sector?
If air traffic controllers were put under the pressure our doctors and nurses were, there would be an outcry at the risks this entailed.
Indeed. Also, our daughter is a physio and when someone leaves, the Trust delays advertising the vacancy for months to save some money so her team is constantly understaffed.
It is about probabilities. When the PSA falls low post op and then rises by small amounts, that is a classic behaviour of small clusters of cancer cells left in the prostate bed so salvage RT would be offered, usually with HT.
If the PSA stays high after RP (over 0.2) and / or rises rapidly, that is the behaviour of mets or micromets so salvage RT is unlikely to work. In that case, HT is likely to be the main holding treatment with or without chemo - this would not be curative. If a scan can pinpoint one or two mets then some targeted treatment might be offered in some areas of the country.
It seems that if you do have a recurrence on your hands, Lynn falks safely into the first group.