Graham Pipe, a recent patient at the Focal Therapy Clinic who underwent HIFU treatment with Consultant Urologist Tim Dudderidge following a diagnosis of localised prostate cancer, joins OnFocus to discuss the process he went through to seek an alternative treatment which would maintain his active lifestyle. Age 70 and recently retired from a career as a Chartered Building Surveyor, Graham describes himself as Young at heart who loves travelling abroad and is married 47 years to the love of his life, who is a model.
Clare Delmar
Hello and welcome to On Focus, brought to you by the Focal Therapy Clinic, where we address issues facing men who are 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 Graham Pipe, a recent patient at the Focal Therapy Clinic who underwent HIFU treatment with consultant urologist Tim Dudderidge following a diagnosis of localised prostate cancer. Age 70 and recently retired from a career as a chartered building surveyor, Graham describes himself as young at heart, who loves travelling abroad and is married 47 years to the love of his life, who is a model. Sounds like a perfect candidate for focal therapy. How wonderful to have you here, Graham. Thank you so much for joining me today.
Graham Pipe
Thanks, Clare. It’s just good to be able to be able to talk to you and share my experience because I hope it’s going to help other guys.
Clare Delmar
Absolutely. So, let’s kick off. Why don’t you start by telling me and our listeners what was your initial diagnosis and the treatment recommendation that you were given at that time?
Graham Pipe
It was through my local NHS hospital after I found I had a raised PSA. I then had the usual MRI and then a transparennial biopsy, which was, to put it mildly, the most unpleasant experience I’ve ever had, far worse than anything that I experienced having the actual cancer removed.
Clare Delmar
Can I just ask you quickly, is that because it was under a local anaesthetic as opposed to a general?
Graham Pipe
It was a local – I wasn’t told what was involved. I didn’t know what was involved until I actually arrived there and having signed all the papers as usual, I went into the room and then I discovered what they were going to do.
Clare Delmar
Wow
Graham Pipe
Yeah, it’s not the mostly pleasant experience in my life.
Clare Delmar
Yeah. Okay, so then do continue. What happened after you actually had the biopsy?
Graham Pipe
Obviously after the healing, which took quite a few weeks, I had a phone call with the diagnosis, which was then followed up by a letter and pretty flat, the phone call was just very factual and included a lot of medical descriptions that I didn’t fully understand, even though I had sort of Googled and investigated quite a lot. But I did ask questions so I could then understand what they were saying. But the only recommendation given both by phone and the letter was a radical prostatectomy or radiotherapy. I did ask if there was any other choices, but they said that this was what they would recommend.
Clare Delmar
Okay, so then why did you seek an alternative approach and how did that lead you to the Focal Therapy Clinic?
Graham Pipe
I’ve known guys who’ve had prostate cancer. One of my wife’s cousins died of it when he was in his forties because it had spread to his liver or bladder. I had a biopsy probably about 10-15 years ago, which proved fine, but it was always in my mind. So I was very much aware of the problems relating to it and the very unfortunate and very common side effects. Me being me, no way did I want any of the side effects of either incontinence or impotence. So if there was anything that I could do, any procedure that was available and recommended, I wanted to look at. So before the diagnosis, I’d already found the focal therapy clinic. So that’s what set me on that line, because I still feel young, though my body occasionally tells me I’m not. I didn’t want to go around being incontinent or impotent for the next few years. So to be honest, that was my main driving force. I wasn’t concerned about the procedure at all.
Clare Delmar
And so when you raised those concerns with your urologist that initially gave you the diagnosis and the treatment recommendation, was there a response to that? Did you have any kind of offer of counselling or any opportunity to discuss your concerns?
Graham Pipe
No. The only bright part of it was, and I wish I knew her name they assigned me a clinical nurse who phoned me, and she was actually really good, really lovely. She hadn’t heard of these focal therapies. She worked at the same NHS hospital. But she did find out about them and came back to me and actually said that, yes, I could be referred to one of the few hospitals that actually do these procedures. But it was far too late then because I had already agreed to go with Tim Dudderidge at the focal therapy clinic.
Clare Delmar
Okay, so let’s move on to when you first engaged with Tim. I mean, in addition to him offering you a different approach to your diagnosis and subsequent treatment, how did he build your confidence in focal therapy?
Graham Pipe
I was thinking about that because I first of all spoke to Brian Lynch on the phone. He was fantastic. Tim phoned me 24 hours later. Now that’s something I’m not used to in business or many other ways to have that prompt attention. What I found with Tim, who already – me being me – I researched him thoroughly to make sure he wasn’t a charlatan. He ticked all the boxes as a fellow professional, not a medical professional. What I particularly found helpful with him was obviously he was knowledgeable. Obviously he knew what he was talking about, but he had that relaxed confidence in him. There was no bravado. There was no hyping it up. He was a man who just knew that he knew what he was talking about and had nothing to prove to himself or me. That might sound strange, but it’s that that instilled the confidence in me, that he knew what he was doing. So when he said that, yes, I was an ideal candidate for focal therapy and that he could say there was a very high likelihood that my urinary problems would go and I would not have them again. And that my impotence… I would not have any impotence at all. I believed him. Obviously, there was that small amount of doubt, but up to that point, as you would appreciate, I was very fearful and worried because I thought, well, will I be a suitable candidate? Could I do? So when at the consultation he said yes, we can, you’ve got an excellent chance of full recovery and beyond, lots of my worry went.
Clare Delmar
And how long has it been since you actually had your treatment?
Graham Pipe
Well, I suppose the dates in my memory indelibly. That was the 28 August 2021.
Clare Delmar
How are you now?
Graham Pipe
Absolutely fantastic. I have absolutely no incontinence of any description and I’m fully sexually active without any side effects of any sort. I had the annual MRI, which Tim arranged, because the hospital wouldn’t do it for me. And that was completely clear and all the margins were clear. My PSA was low, so I’m now onto just a six month check up and surveillance again with Tim. I’m absolutely fine and I’m very happy indeed.
Clare Delmar
Yeah, that’s good news. I just want to pick up on what you said about the monitoring through MRI and the PSA testing. So if I just can step back. I mean, your journey clearly has been a blend of both NHS and private care through the focal therapy clinic. How would you describe this experience? Because it’s something that a lot of men will be facing and contemplating and don’t fully understand, and I’m just wondering if you can offer just some either some red flags or some things that people ought to be looking out for and be mindful of.
Graham Pipe
The difficulty is my experience, obviously, with the NHS, whenever it was for all the time, except the clinical nurse, was very poor – communication and everything else. So that obviously will affect my view. And I’m sure there’s many, many hospitals who just wouldn’t do this.
Clare Delmar
Okay.
Graham Pipe
There may be a history to that, which actually I’m aware of, but once I got involved with the focal therapy clinic, everything changed. Tim was fantastic. He had two staff, I think Kirsten and Natalie, that I dealt with, were incredibly helpful, guided me through all the procedures and everything else I needed to do. And the communication was superb, which is high value to me. And everything went really very well indeed. I was very happy with that. I knew that the procedure itself and even after the procedure, I’m not likely to get much pain. But the only thing I wasn’t looking forward to was the catheterization, which I actually hated. Again, not painful, just demeaning, and horrible. Who wants to go to bed with a bag strapped to their leg, for goodness sake? I got through that, obviously. But I would recommend that, assuming that, as in most cases, the initial contact will be with the NHS, that you ask the consultant or whoever is giving you the diagnosis lots of questions and to ask them to explain it in layman’s language so you can understand whether or not there’s a serious problem or whether it’s a less serious problem. Because I was presented with a less serious problem, which became clear once I started researching it.
Clare Delmar
But how do you mean? Can you explain that when you say you were presented with a less serious problem?
Graham Pipe
There’s something called the Gleason scale. They gave me the figures. So while he was talking to me on the phone, my wife was busy googling it. And actually the Gleason scale was actually quite good, but they didn’t say that. And then being presented with the radical options, obviously it was considered, as it would appear to them as being a very serious thing with no other option. You need to ask questions including, of course, if a radical procedure is recommended, as in my case, that you then ask if there’s any other alternatives and mention is focal therapy an alternative? Would you be able to refer me if you don’t do it? There’s only six or seven hospitals currently in over 130 NHS trusts which I believe are actually offering these procedures. So I would recommend they ask about that. And keep pressing it. And then they will be able to find out when talking, for example, to the the focal therapy clinic, whether or not they are a good candidate, so to speak.
Clare Delmar
Yes, I mean, the criteria for actually selecting patients for the procedure is quite rigorous, as you know, and involves quite a lot of discussion, involves an MDT. And you’ve obviously been through it. So I think it’s an interesting question about what you would recommend to other men who have a similar diagnosis. And you’ve very helpfully put out asking questions. Is there anything else you would suggest? You mentioned, for example, that your wife was involved in your conversations, even in some of the research that obviously drove you to achieve what you finally did undergo. Is there anything around partners or other aspects that you think you would want to recommend to someone in your situation?
Graham Pipe
My wife and I communicate a huge amount about virtually everything, but a lot of men don’t like to talk about this.
Clare Delmar
That’s an important point.
Graham Pipe
I want to encourage all men to be honest about it because if they can’t deal with this before they have a procedure, then it’s too late for many of them, with a dramatic effect on their lifestyle.
Clare Delmar
Well, that’s extremely helpful and I really want to thank you for coming today and chatting to us about it. Would you be willing to chat to other patients who might contact us, having listened to this interview?
Graham Pipe
Of course I would. Yes. Because obviously I’ve got my own experience and I’m a firm believer in what Tim and his colleagues do for obvious reasons.
Clare Delmar
Well, first of all, it’s great news to hear that you’ve had such a wonderful recovery and I want to thank you once again for joining us and we look forward to possibly speaking again in the future. Thanks again.
Graham Pipe
I look forward to that. Thank you.
Clare Delmar
A transcript of this interview is available on the programme notes on our website, along with links to more information on diagnosis and treatment for prostate cancer 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.