Chris Dobbs was 56 when he was diagnosed with prostate cancer in 2011. He spent a lot of time deciding what treatment to have, and found information about a focal therapy clinical trial online.
I was diagnosed with prostate cancer in 2011, at age 56. I didn’t have any symptoms, so it was just chance really when an email came round at work offering PSA testing at a local rugby club. I found out that my PSA was a bit high and was told that I should see my GP, but at that stage, I didn’t even really know what PSA was.
My GP was brilliant, and referred me to different specialists to hear about the possible treatment options – surgery, radiotherapy, brachytherapy and focal treatment. I also did my own research online, and read more about focal therapy clinical trials.
I rang the trial team at University College London Hospital (UCLH), and they spoke to me about a High Intensity Focussed Ultrasound (HIFU) trial they were running. My GP referred me to the trial team, and I had a multiparametric (mp)MRI scan to confirm that I was eligible.
The trial team talked to me about my prostate cancer, they showed me the scans and the pictures, but also told me how they analysed them, told me the pros and cons of the trial and went through the protocol fully. I became more and more comfortable there as time went on – I was treated very personally.
I liked the sound of HIFU, because of the possibility that I could get rid of the cancer, with potentially fewer side effects than a radical treatment, and still have a back-up option afterwards – it still wouldn’t be too difficult to have a full prostatectomy later if necessary.
I spent one night in the hospital for the treatment. I had to have a catheter for a week, but I was (gingerly!) back on my bike after 12 days! I had some side effects, but not many – I was at my former level of activity really quickly.
After the HIFU, my PSA went down from 11 to one point something, but it’s really been very up and down ever since. Six months later it started to rise slightly again. Eventually, the doctors thought it was rising a bit too fast for comfort, so two and a half years after my first treatment, I had another MRI scan. It showed that there was still some residual cancer growth in an area of the prostate that was always going to be hard for the HIFU to reach.
At this point, I could try another round of HIFU, or opt for cryotherapy. This had a good chance of clearing up the residual cancer without worsening any of the side effects I’d already experienced. Of course, I could have chosen to have a full prostatectomy now, but my mindset was the same as before – I wanted another try with focal therapy and another attempt to avoid additional side effects.
Six months after the cryotherapy I had an MRI, and three monthly PSA tests again. Once again, my PSA dropped after treatment, stayed level for a while and then started to rise again. At this point, after another year or so, I was advised that I really needed a full prostatectomy. I’d had two bites of the cherry with focal therapy, but now I needed to go all in – or all out, rather! I’d always known that this was the deal with focal therapy though, so I wasn’t surprised.
This time, I joined the RAFT trial at Guy’s hospital. This trial is testing how well robotic surgery works for men who have previously been treated with a focal therapy.
In terms of how my experience has left me feeling about focal therapy… I still wouldn’t do anything different. I could have had a prostatectomy on day one, but who knows how that would have turned out, or what side effects I’d have had to live with? And then I’d have had fewer options if there was any cancer left after that. Having said that, the robotic surgery turned out to be excellent and after a few months didn’t worsen any side effects I already had. My PSA is undetectable now.
I knew that the focal therapies were experimental, but everything was explained to me really clearly. I was happy with the principals of a clinical trial, and for me, the process was very worthwhile. Medical advances are happening in every field – treatments are just getting better all the time, but only because of research.
I hope that the results from the trials I’ve been part of mean that one day everyone will be able to access the treatments I’ve had as standard.