Private or NHS for prostate cancer?

[Jassmells]

Hi there
Just as the title says - what would you do - does anyone have experience of private?

My dad (just diagnosed) wants to go private. I understand his reasons for this but I am concerned re the aftercare and coming out of "the system."

Does anyone have any experience of going private for prostate cancer please and how did you do with aftercare?

No private bashing please - his decision I'm the one with concerns re coming out of NHS thanks.

[retirednow]

Sorry your dad is poorly, what treatment is he having done.

[Jassmells]

Not entirely sure yet. NHS immediate option is removal of prostate in traditional manner full abdominal surgery. Private equivalent would be much less invasive.

Some further tests required though.

[CMOTDibbler]

Does your dad have private insurance, or is he thinking of self funding?
If he has insurance, then he'll be fine with follow up, but self funding everything could be an issue- though I'm sure they deal with transferring people all the time.

[Jassmells]

Not insurance no. He can afford it (to a point) I'm just concerned whether the aftercare would be as good (I have read reports where whilst surgery is better aftercare is weaker privately) and I'm worried he will get stuck in private and not be monitored as closely or unable to get back where he needs to be NHS wise.

[retirednow]

Has he been given two different surgery options. What about private bed in an n.h.s. hospital.

[Jassmells]

As above the NHS op would be far more invasive. I understand his reasons for wanting private. It's the after care -long haul I'm worried about.

[IhaveChillyToes]

Look up private surgeons who also work in NHS if he wants private

[madamy]

Is it the same consultant both privately and on NHS? If so, he could ask to be transferred to NHS post-op so that he'll then have all follow up etc as standard.

[retirednow]

Does he want private as it's less invasive,

[MadameJosephine]

The decision about the type of surgery should be based on clinical evidence, not cost. Has he spoken to his NHS consultant about why they would prefer a more radical surgery?

[welshweasel]

The nhs does cancer care extremely well. I am a surgical consultant with lots of experience of treating cancer. If I or my family were unlucky enough to get cancer, I’d go nhs every time, despite us having private health insurance.

[SweetieBaby]

I worked in urology within the NHS. My dad had treatment for prostate cancer as a private patient so I guess that I have seen some of each side.

As a private patient, dad was able to have a greater choice in the treatment options. We discussed the stage of his disease and what treatment he preferred. He was able to opt for a particular treatment which is not widely available within the NHS. The NHS gave him limited choices, some of which he was not eligible for due to pre existing conditions and so, for him, he was lucky to have a minimally invasive treatment at a world renowned cancer hospital which has cured him.

There isn't one answer though. You have to get advice from the doctors and do your own research if possible. Cost may also be a factor. My dad's treatment cost about £30 000 in total. Could you get a referral to a specialist NHS cancer hospital eg the Royal Marsden?

[Abitlost2015]

Don’t go private without insurance. If he needs to be in intensive care after the procedure it would be very very costly.

[ShovingLeopard]

What would be the waiting time on the NHS? And why are they pushing the more invasive technique?

These would be my first two questions. Waiting times for NHS give me the fear. It could be that the NHS has not yet adopted the procedure the private surgeon can do. It can be awfully slow in taking up new treatments.

[Jassmells]

NHS option partly due to being a mediocre, semi rural trust. He could go next door to big city hospital and have same consultants as would do it privately.

[MadameJosephine]

Then surely it’s a no brainer, go to the bigger hospital where the specialists are and get their expertise for free?

[madamy]

Well he could ask his GP to refer him to big city hospital to see those consultants in the NHS. We get patients referred in for robotic prostatectomy from our local smaller trust where they only do radical open surgery.

[Jassmells]

@MadameJosephine that would be my option. He's concerned re the speed of transfer between trusts etc slowing it all down and not ending up with whom he believes to be the best consultant. In all fairness he wants the best person for the job, I totally get that but it doesn't take away my worries about aftercare.

[SweetieBaby]

Abitlost - not necessarily. Private hospitals do offer fixed price surgery sometimes. So, if extended stay or ICU isn't envisioned but then becomes necessary, the patient only pays the original cost.

That being said, many private hospitals don't have ITU or emergency care so if any serious complications occur the patient is transferred to the NHS.

It is very difficult. It's naive to think that every cancer patient within the NHS gets the best available treatment. NICE has made sure that in some cases, particular treatments or drugs are not available on the NHS. So, in this instance, cyberknife treatment is one example. It would also be naive to think that just by dint of going privately you will get better treatment than that which is available within the NHS.

[Schoolchoicesucks]

I second the pp ^^ go to the large NHS trust and have the most suitable op on the NHS - whether that's invasive, keyhole, robot or whatever - but based on clinical need rather than cosy.

[Jassmells]

@Schoolchoicesucks I don't think there's anything cosy about this situation.

[RNBrie]

I think Schoolchoicesucks meant cost and cosy was an unfortunate typo.

[Jassmells]

Ah ok.

[Yvest]

If he doesn’t have insurance then NHS but with insurance 100% private in a top cancer centre. Quite simply, privately the choice of treatment options is often wider with the consultants able to access drugs which are unavailable or limited on the NHS. I’d never, chose NHS cancer care over the option to see the consultant I choose, where I choose in the hospital I choose with the access to the most cutting edge care and trust me, my DH has an advanced rare cancer and none of his treatment would be given on the NHS yet his consultant is a world renowned expert who all works on the NHS but told us that he can’t do what he’s doing within the structure

[Couchpotato3]

Bear in mind that private = guaranteed consultant of your choice doing the op. NHS = no such guarantee and depending on the procedure, may not be a consultant at all. I'm not saying lower grades of surgeons aren't completely competent, and everyone has to start somewhere, but if you have the choice, why would you not opt for private if you can afford it? Your Dad could transfer back to NHS at any time if he ran out of cash or preferred NHS follow-up.