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.

[Jassmells]

Thanks for all your comments. We have to check it hasn't spread. So clearly I hope it hasn't spread and that he gets to make the choice he wants, if it's spread obviously that's potentially a game changer.

[lovemylover]

My partner is having Hormone therapy and Radiotherapy,
Ha your dad been told it will be surgical, [sorry you might have said already]
Everyone i know or heard about has had a choice on the NHS ,assuming that the treatment would be suitable for whare the cancer is located, and how far advanced it is of course
Sometimes there is watching and waiting option, if it is very slow growing, or radioactive seed implanted

[SweetieBaby]

Sorry to hear about your daughter. That's the balance that I was trying to convey. I've worked in the NHS and the private sector and have had experience of both as a patient and relative.

Sometimes, going privately can give you options of treatment which simply are not available on the NHS, or are heavily rationed.

Eg my dad has serious heart problems which make him a poor risk for major surgeries. When he was diagnosed with an aortic aneurysm the NHS advised to watch and wait. If it started leaking, or ruptured, they would operate if he lived long enough to make it to theatre. Going privately he was 1 of the first patients to have an aneurysm stented. He was in and out of a highly specialised, well equiped hospital within 2 days. Had a world renowned consultant perform the procedure and made a full recovery.

When he was diagnosed with prostate cancer NHS offered no treatment or radiotherapy with nasty side effects as again he was not fit for surgery. Privately, at a leading cancer hospital, he had cutting edge cyberknife radiotherapy. No side effects and only a handful of sessions and he is cured.

But, if I had to choose between NHS treatment at a specialist hospital or private treatment at a local private hospital I would choose NHS every time.

Sometimes going privately offers more choices with more experienced staff. Sometimes it is not appropriate.

It's so important to get advice from clinicians and research options. One big failure we noticed was not being told all options but only the ones offered locally.

There is a big difference between "all that can be done" and "all that we can do".
I wish you and your dad well OP. Don't make hasty decisions and do your research.

[lovemylover]

In my experience, private isnt always best
Different situation, but my daughter has Crohns disease, and was being seen by a private Dr, she was in agony and he just kept prescribing lactulose, eventually she was taken into NHS hospital, where she was told if she had carried on with the treatment she was having she would have possibly lost her life

[InspiredByIntegrity]

Definitely go to the big town on the NHS as you have no insurance. Which Trust/consultants does make a difference. There will be no big delays as he will be on a cancer care pathway.
Next door neighbour has prostrate cancer and he has had brilliant NHS care including the option to go on a trial of a new expensive drug.

[lovemylover]

My partner has been diagnosed with prostate cancer and has had brilliant care with NHS and had every test possible. And non stop and ongoing consultations. Took a long time though to actually find where thre cancer was.eventually found after a perineum biopsy. He is now having treatment.

[CotswoldStrife]

Sorry to hear this, OP. We did briefly look into the private options for the same condition. It was similar to the NHS but they were probably more willing to do a grid biopsy at an earlier stage.

I think the reason that posters are querying the surgery is because it's not clear whether it is the same procedure on the NHS and private but done differently (eg abdominal V keyhole) or that the private procedure would be radically different to the NHS recommendation. If your dad is avoiding the NHS recommendation for fear of the long-term effects of the procedure that is his right, but may not be the most effective treatment.

My DH has had (a different) procedure via private health insurance and the follow-up care was good - but if you are privately paying then you'll probably be billed for any meds needed afterwards as well. The big-city NHS hospital does sound a good option but I do understand that he just wants to get it all sorted now and not mess about with the referrals, etc.

As for the after-care - a PP mentioned that he would likely be transferred to the NHS if anything went wrong and I agree. Private hospitals have nurses and may have a qualified doctor on overnight but not consultants there 24/7 which I think is your concern. I'm not sure he would be immediately transferred back to the NHS for post-operative care otherwise, but I would assume that his NHS treatment would resume at some point.

I hope whatever decision he comes to, it works out the best for him. It is a difficult choice.

[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.

[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

[Jassmells]

Ah ok.

[RNBrie]

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

[Jassmells]

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

[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.

[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.

[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.

[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.

[MadameJosephine]

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

[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.

[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.

[Abitlost2015]

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

[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?

[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.

[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?

[retirednow]

Does he want private as it's less invasive,

[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.