Brian Bishop joins OnFocus to discuss his experience with NanoKnife treatment for prostate cancer.
Brian is 77 and lives in Virginia Water since retiring from a career in the airline industry, and was diagnosed with prostate cancer in May 2022. A few months later he was treated by TFTC Consultant Urologist Marc Laniado with a form of focal therapy that uses electric current to ablate cancerous tissues, also known as the NanoKnife.
Clare Delmar
Hello and welcome to On Focus, brought to you by The Focal Therapy Clinic where we address issues facing men diagnosed with prostate cancer that are little known, less understood, often avoided, and too often ignored. Prostate cancer is the most commonly diagnosed cancer amongst men in the UK. And with this sombre fact comes a multitude of challenges and opportunities. I’m Clare Delmar. Joining me today is Brian Bishop, who is 77 and lives in Virginia Water since retiring from a career in the airline industry. Brian was diagnosed with prostate cancer in May 2022 and several months later was treated by Focal Therapy Clinic consultant urologist Marc Laniado with a form of focal therapy that uses electric current to ablate cancerous tissues, also known as the NanoKnife. He’s here today to talk to us about that experience. Brian, thank you so much for joining me today. It’s lovely to have you here.
Brian Bishop
Yeah, good, glad to be of assistance. Hope I can help anybody that…
Clare Delmar
Yeah, well, you’re like a pioneer here in having had the NanoKnife treatment, so we’re very keen, and I’m sure our listeners are very keen to hear what you’ve been through. So why don’t we start by if you could just tell us about your initial diagnosis. What was it in terms of your Gleason scoring? How did you feel and what was the initial treatment offering that you were given?
Brian Bishop
Yeah, okay. I was referred to consultant Marc Laniado by my GP following a routine blood test which came back showing an abnormally high PSA reading. The first consultation with Marc consisted of a physical examination of my prostate and he referred to that as suspicious and referred me for an MRI scan. The MRI scan showed two areas of cancer in the prostate which fortunately was contained, it hadn’t spread from the prostate and he then decided to refer me for a biopsy or book me in for a biopsy. And the results of the biopsy showed that the level of cancer was graded at level three.
Clare Delmar
Okay.
Brian Bishop
It was following that he booked me for the procedure.
Clare Delmar
And just remind me, how old are you, Brian?
Brian Bishop
I’m 77, just approaching 78.
Clare Delmar
Okay, and when did you go through this?
Brian Bishop
It was discovered about May last year.
Clare Delmar
Right, okay, so it was in 2022, in the last year. How were your treatment options presented to you? What were the options that you were considering for treating the prostate cancer that was diagnosed?
Brian Bishop
Okay, well, basically because the cancer hadn’t spread beyond the prostate, the focal therapy would be quicker, carry less risk of possible after effects than other procedures such as prostatectomy or radiotherapy, NanoKnife in particular, because it would be more accurate in targeting the position of the cancer within the prostate. I believe that the cancer was in quite a… certainly one of the cancer areas was in quite an awkward place of the prostate.
Clare Delmar
Okay, and did Marc go through with you, first of all, how focal therapy worked, but secondly, the different ways to undertake focal therapy, the different sort of energy sources that are used to ablate the areas?
Brian Bishop
Well, no, it was described in general terms or he described it in general terms as laser ablation.
Clare Delmar
Right, okay.
Brian Bishop
Which would target the areas of the cancer without damaging surrounding tissue. It would be carried out, obviously under general anaesthetic. And as a hospital day case, the most important thing would not preclude further treatment in the future if I required it.
Clare Delmar
Was that particular point important to you?
Brian Bishop
Yes it was because I didn’t want to sort of close the doors on any future treatment if I needed it.
Clare Delmar
Was any other treatment recommended or it was always going to be focal therapy?
Brian Bishop
He offered me a prostatectomy? Well, he said he would do that if I wanted it or I could have radiotherapy. And he described the possible side effects or after effects of both of those procedures and basically it was a no brainer to have the focal therapy because that obviously carried the least side effects and because of the cancer, he said he felt that it would be very successful.
Clare Delmar
Right. So you felt that you had a pretty substantial briefing on the sort of trade off, if you will, between sort of getting rid of the cancer but also preserving your sexual health, your urinary health, even your mental health. You felt that you really had a balance?
Brian Bishop
Very much so and he described everything in detail and I had absolutely every confidence in him.
Clare Delmar
Yeah, that’s very important. And so did the actual procedure meet your expectations? How did it all go?
Brian Bishop
Yeah, very much so. The post procedure MRI scan showed complete eradication of the cancer. A blood test three months after the procedure showed that my PSA level had returned to normal. Obviously I was delighted with the result and I could see that Marc was also delighted with it as well – win win all around basically.
Clare Delmar
As you said before, when you’re describing how it was presented to you, you went in as a day case patient, is that correct?
Brian Bishop
Yeah, I checked into the hospital at 07:00 in the morning and I was home by about 07:30 at night.
Clare Delmar
Yeah. And I mean, did you have a sense of this being something that was not at all experimental but something that was actually very leading edge in terms of prostate cancer treatment?
Brian Bishop
Marc told me that it was a fairly new procedure. I didn’t actually know the difference at that stage between NanoKnife and say HIFU, but I was told afterwards that he was using the NanoKnife procedure because of the position, the awkward position of the cancer in the prostate and he felt that that would be more accurate.
Clare Delmar
Okay, so that’s interesting. So you knew about that that had to do with the location of the lesions…
Brian Bishop
That’s right.
Clare Delmar
…and optimising the accuracy?
Brian Bishop
Yeah, that actually came to light when I got onto my insurance company to give them the procedure code and they questioned the code. I was thinking at that stage it was the HIFU, but they questioned the code and said that they required more information from the consultant, which he gave them. They then agreed to fund the procedure. From there on it, everything was successful. One of the cancer areas was very close to the urethra and he didn’t obviously want to damage that, so that’s why he felt that the NanoKnife procedure would be more accurate in dealing with it.
Clare Delmar
Okay, so you really went into this with a pretty full sort of base of knowledge?
Brian Bishop
Yeah, very much so. And in fact, even on the day of the procedure, I think he had a couple of consultants observing in the theatre, observing the procedure as it was so new, they wanted to witness the procedure being carried out.
Clare Delmar
So you became a celebrity?
Brian Bishop
I knew nothing about it, of course, at that stage, but I certainly didn’t object. I feel the more consultants that can carry out this procedure, the better.
Clare Delmar
Absolutely. No, and it’s very generous…
Brian Bishop
Particularly, as it turned out, so successful.
Clare Delmar
Yeah. So it sounds like you would recommend this procedure to other men with a similar diagnosis. What would your advice be to…?
Brian Bishop
Absolutely, yeah, 100%. Well, if you’re deemed suitable for the procedure, it really is a no brainer. I think, to go down this line first is the only way if you want to minimise your possible after effects. I mean, the procedure was minimally invasive, it was quick, as I say, a day case in hospital, totally painless. I’ve actually come out of a dentist after a filling and felt more discomfort than I have with this, so totally painless. And in my experience, I’ve had no lasting after effects whatsoever.
Clare Delmar
And also, you felt very confident in Marc and the advice he gave, and you went in sort of fully understanding why and how it was going to work?
Brian Bishop
That’s right. I mean, that’s important to any patient, I think, to have confidence in your consultant.
Clare Delmar
Yeah, no, absolutely. Well, first of all, I just want to say thanks for sharing this information and it’s wonderful news that this all went so well for you and hopefully we’ll get a chance to talk to you again. But it’s been extremely generous of you to join us and I want to thank you once again, Brian.
Brian Bishop
No pleasure. And I hope it helps anybody in the same position that I’ve been in the future.
Clare Delmar
A transcript of this interview is available in the programme notes on our website, along with links to more information on NanoKnife and additional interviews and stories about living with prostate cancer. Please visit www.thefocaltherapyclinic.co.uk and follow us on Twitter and Facebook at The Focal Therapy Clinic. Thanks for listening and from me, Clare Delmar, see you next time.