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Starting to worry a bit now!

User
Posted 30 Apr 2019 at 18:46

Not on any treatment at all Lyn!, told no hormones until PET scan done in case it makes scan miss nodes that have shrunk etc. That's why I'm getting so mad, I was diagnosed start of the month, no treatment and keep getting cancelled,   if I was on hormones it wouldn't be so bad waiting because I know they stop growth.

 

User
Posted 30 Apr 2019 at 18:48

Originally Posted by: Online Community Member

It's amazing what you wish you had asked at the appointment!

If you have a Macmillan nurse, contact them and ask.

I have even asked them to create another consultant appointment when I had a lot of detailed questions, and they did that (and it caused my case to discussed again in the MDT beforehand, which is a good thing).

I try to make sure I ask everything by writing down a list of questions, and all the consultants have been fine with that. My current onco even takes the list and writes the answers on it. However, if a consultation starts off with some result I wasn't expecting, then I won't have the right questions, and only think of the right questions afterwards.

User
Posted 01 May 2019 at 10:42

Rung the PET scan team today at Notts City Hosp and explained my frustration at being cancelled twice on the day + that I was not being put on any treatment at all until this scan was done + what if any was the back up plan if I'm cancelled again. She was really nice to be fair and said I was booked in for 10th now, I asked if I could be bumped up the priority from any general scans and she said that 10th was earliest as they only scan on certain days! She said I was on a standby short notice list as I said I would come at anytime. As for any backup plan.......there is none!!!

So 29 days after being told I have local advanced  PCa and PET referral I MAY get a scan if the tracer arrives if not I just have to wait again!

Like I said to Lyn I am on NO treatment atm not even hormones because they need to see what the PET scan results are to tailor my treatment.

You couldn't make it up!

 

Edited by member 01 May 2019 at 12:07  | Reason: Not specified

User
Posted 01 May 2019 at 11:23

I was already on HT when they decided to do a PET scan, so I wonder how much that matters?

The scan never happened in the end because long term nonavailability of the isotope, and they switched me to have a full body MRI scan instead.

User
Posted 01 May 2019 at 14:41

I was supposed to start hormone therapy in October 2016 but my oncologist wanted a PET scan done to see what was going on. Promised me it would be within a couple of weeks. Like you he wouldn’t allow HT to start as the scan wouldn’t pick things upon I was on HT.

I didn’t get a scheduled scan appointment until 20/12/16 and had to wait until 21/12/16 as the tracer failed on the 20th.

I had gotten so wound up I had the bicalutamide at the ready to take when I got home from the scan.

When I saw the oncologist he said he hadn’t realised they only scan 2 or 3 prostate cancer patients once a month and apologised about the delay!

It is beyond stressful and I don’t think my oncologist realised how much. Hope you get your scan over and done with on the 10th. Telephone to see if they can prescribe HT to start after your scan on the 10th.

Best wishes.

 

Ido4

User
Posted 01 May 2019 at 15:07

I'm not mad at the PET team at Notts City Hospital they were very good over the phone its the In Health policy of no contingency planning, every other company has a contingency plan in case of a critical failure. I sent the following email today to the complaints Dept of In Health Group, NHS England complaints and my consultant.

" Dear In Health,

                             I would like to make a formal complaint regards the delay in my treatment by your company. I was referred for a PET scan on the 11th April and booked in for a scan on the 17th, this was cancelled on the day, rebooked for the 30th April ( told that was the absolute earliest slot). I was rung 3 hours before scan and told it was cancelled again, same excuse that machine producing tracer broke/failed!? I have rung this morning to explain that I am not happy with the delay and told earliest slot is 10th May 19. I asked what the back up plan was if it 'fails' again and I was told that I would just be cancelled again there's nothing they can do! I find it absolutely amazing that In Health has no back up plan, I would like to know if the building had a fire and could not produce tracer for 2 months what would be your plan? 

I have been told I have local advanced prostate cancer and advised not to have any treatment at all until this scan comes back so that my treatment can be tailored to my needs so you can understand my frustration and anxiety that 29 days after my referral and 2 x on the day cancelations I 'may' get a scan if I'm on a lucky day and the machine works!

In fairness to your staff at the PET scan unit they have been nothing but understanding and helpful, it is In Health who this is directed at because you are paid a lot of money for your contract with the NHS and you are not delivering a robust service.

If my unchecked cancer has spread more then it had from when I had my MRI scan because of your delay in my treatment due to no back up procedures I will take this further."

 

I received this back:

 

 

"I am writing to acknowledge receipt of a copy of the complaint you raised via email to our Complaints mailbox on 1st May regarding the cancellations of your PET-CT scans.

I am sorry to hear you have had reason to complain and would like to reassure you that I have asked our Head of PET-CT, to conduct a thorough investigation into the events. In line with our complaints policy, we will investigate the issues you have raised and hope to be in a position to respond to you in full within 20 working days. If we are unable to complete our investigations within the above timeframe we will write to you and explain the reasons for this and inform you of our expected completion date.

Please find attached a copy of our complaints leaflet which I hope will help address any questions you may have in regard to this process.

If you have any further queries, please do not hesitate to contact me and I will gladly assist you.

Yours sincerely,"

I will post any updates, the PET scan system sucks and if I can make any part of the system better for others then I will be happy.

 

 

 

User
Posted 01 May 2019 at 17:35
The Choline pet scan tracer has to be bought in from someone with a cyclotron who is not too far away from your hospital as it has a short half life. It is specifically produced for an individual, I think, determined by the body weight of the person. It frequently fails to meet the required standard, (as in my case) but fortunately it was early enough in the day that a replacement was able to be made and staff stayed on to administer mine and operate the scanner. Very few hospital have a cyclotron. The Christie has one at Manchester but whether they would use it for supplying other hospitals is doubtful.

A similar situation applies with the tracer for the 68 Gallium PSMA scan which also has a short half life although it is produced by generator rather than a cyclotron. The machine that was used to supply the London Hospitals that offer this scan broke down immediately before my first scheduled PSMA scan which had to be rearranged on another day so all the London hospitals could not perform the scan during the affected period.

These costly producers of the tracers can only make limited amounts of tracer each day, so it is likely that in general one hospital gets it's supply from the supplier on a Monday, another on a Tuesday and so on. So hospitals can only in the main provide the scan on the day of allocation, hence they only regularly do the scans on their agreed day.

In Australia a leading Professor said that there they only used the Choline scan for abouts six months before abandoning it for the much better 68 Gallium PSMA one. It seems to me that we should be doing the same and have some strategically located generators provided at or close to major UK hospitals in the large towns that would also provide reciprocal back up for those hospitals but apart from other considerations, this would be very costly. Then having said that, there is another scan developed in the USA which looks like it will be even better than the PSMA one but this needs a cyclotron!

I trust this goes some way to explain delays and why scans at your hospital are generally limited and done on a certain day, something that is beyond the control of your hospital.

Barry
User
Posted 02 May 2019 at 09:04

Thanks Barry,

                      This gives me some good background knowledge for when In Health PET Scan boss communicates with me. At least I will sound like I know what I'm on about and he wont be able to fob me off so easy 😌

 

User
Posted 02 May 2019 at 12:16
As I forewarned you earlier, radioactive isotopes ☢️ are notoriously difficult to manufacture, due to their necessarily short half-lives of a few hours or less. You wouldn’t want the likes of Thorium 232 pumping round your bloodstream which has a half-life of over 14 billion years!

However, there seems to be no shortage of Uranium-235 or Plutonium-239 when required for nuclear weapons, so I guess it’s just a question of lack of money invested in the production of these tracers, together with a 20% increase in population and commensurate increase in demand for NHS services.

Why doesn’t the multi-billion pound NHS invest in their own cyclotrons or whatever, (and proton beam machines for that matter), rather than outsourcing them to private companies?

This nuclear medicine, as it is called, is at the cutting edge of technology.

Anyway, I was diagnosed with G7 cancer in January 2018, and I explored all my options until my prostatectomy in June 2018. They say PCa is often slow-growing, and yours probably is, so a few weeks here or there are unlikely to affect your prognosis, but not your nerves!

Best of luck, once again.

Cheers, John.

User
Posted 02 May 2019 at 14:43

Well......just got off the phone with the PET scan UK operating officer for In Health, very nice bloke, apologetic and spent 10 mins explaining about why things get cancelled and future options to make their service more robust etc. Glad I had all your guys input regarding Cyclotrons etc as I found it useful when asking why they had no contingency planning and risk assessments of procedures etc. He asked me if I was available tomorrow afternoon ( pulled forward 1 week early ) and he would have extra tracer made for me and fit me into their schedule. Result! 😄

If it gets cancelled I bet they will be pulling straws on who has to ring and tell me lol

 

User
Posted 02 May 2019 at 17:15
Couldn't be more pleased. If you don’t ask you don't get!

I have found the NHS to be brilliant in my case and with others, but I find you have to be completely proactive to get things done satisfactorily. A phone call to the consultant’s secretary is usually the first port of call.

Best of luck tomorrow, and if successful, the scan will give you and your medics more idea of where you stand.

Cheers, John.

User
Posted 12 Jun 2019 at 15:36

First appointment with chemo onco today. Starting 6 x 3week chemo sessions 27th June then the plan is scan then radiotherapy Nov time. Hormones dont seem to be giving me too many problems, libido diminished but not disappeared, ED clinic booked for 24th Aug as my erections are not as hard anymore, tried some cialis and that helped.

Anyone had any major probs with the chemo?

User
Posted 12 Jun 2019 at 16:50
So, Wart,

You have had a positive diagnosis of PCa?

If you amend your profile to include all your results, the good people here will be better informed to tell you what’s what in their experience as to how it’s likely to pan out going forward.

Best of luck with your treatment.

Cheers John.

 
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