Advanced prostate cancer – Neil Britten’s (UK) experience

Neil Britten, 63, from Buckinghamshire, near London, was first diagnosed with prostate cancer in early 2016. “My PSA then was 16 and it was clear the cancer was already spread to at least one lymph node in the pelvis area. The scans then did not show any other metastases however”, he recalls.

Neil’s cancer treatment started with external beam proton radiotherapy in 2016.

– As a result, my PSA level fell initially, but then it began to rise again. In March 2017 it was confirmed that I had a secondary tumour in my arm. I have a suspicion that this metastasis was there already from the beginning as my arm was not included in the initial scans. I then received SABRE (stereotactic ablative radiotherapy) external beam radiation in September 2017, which also initially resulted in a fall in PSA, but again it started to rise.

It was then suggested that Neil should start hormonal treatment to slow down the progress of the disease.

– My oncologist described a number of palliative therapies that are offered by the NHS in the UK, but none of these appeared to really control the disease and all of these would have had a very unpleasant effect on my quality of life.

Neil had started to do research on his own from the point of his initial diagnosis and had kept up that research throughout.

In April 2018, a Ga68 PSMA scan confirmed there were multiple metastases in his body.

– I had several metastases in the bones; in my spine, ribs, thigh, shoulder, arm as well as my skull, Neil lists.

– Those scan results were definitely not a picture you wanted to see.

New treatment

After the results of the Ga68 PSMA scan, Neil mapped out his alternatives for the future.

– I had read a lot about prostate cancer research and discovered the work that was being done in theranostics, especially with radioactive lutetium-PSMA isotope treatments. I was immediately interested in the results of this new treatment so I thought that it might be something I could try. I discussed this with my oncologist and she agreed I should give it a shot.

Neil also researched for places that might offer this therapy and found two in Europe, one in Germany and one in Finland.

– I was keen not to wait too long for the treatments, as it appeared that my cancer was advancing quite rapidly. I also preferred to be treated as an outpatient instead of staying at the hospital.

Consequently, despite the costs associated with Lutetium-PSMA treatments, he decided to get started as soon as possible.

He chose to start treatment at Docrates Cancer Center in Helsinki, Finland, as it allowed for a speedy start as well as having the option of being treated as an outpatient.

”All the people at the clinic have been very kind and have made the whole experience quite ‘painless’ in both the literal and figurative senses of the word! It is very reassuring to know that I am being advised by people such as Professor Kairemo who are world class experts in their field.”

Getting started with Lutetium-PSMA treatments

Neil started his first round of treatments in June 2018. The fifth round took place in October.

– I hope it will be the last. So far, the results have been very encouraging. It might be a little too soon to be confident that my disease is completely under control, but as far as I know the results have been much better than any alternative therapy that I might have tried, he reflects.

Neil says he found the treatment process very straightforward and convenient. He also got an immediate sense that the clinic is clearly very modern and well equipped.

– All the people at the clinic have been very kind and have made the whole experience quite ‘painless’ in both the literal and figurative senses of the word! It is very reassuring to know that I am being advised by people such as Professor Kairemo who are world class experts in their field.

Travelling abroad for the treatments

When receiving his treatments, Neil would fly to Helsinki each time and liked to stay in small apartments rented via Airbnb in the area near the clinic, which he also felt was trouble free.

– I have found travelling to Finland for my treatments to be quite straightforward. It also helps that everyone at Docrates speaks English really well, better than I speak any Finnish, he says with a smile.

Plans ahead

– I have been mostly asymptomatic all along, so I have no pain associated with the disease, as far as I know. I have not taken any androgen deprivation or chemotherapy at any time so I have not experienced any of the adverse effects of these therapies. The only effects from the Lu-177-PSMA treatment so far appear to be some fatigue and dry mouth. The dry mouth is certainly a nuisance, but I hope it will be temporary and the effects will fade once the therapy is completed.

Some of Neil’s time still goes to thinking about prostate cancer, even in between treatments, but he hasn’t disregarded his other hobbies either.

– I’ve spent quite a lot of time reading about prostate cancer, Neil laughs.

– Apart from that I try to keep active. My favourite pastime is skiing but I have to wait for the snow for that. My wife and I both enjoy travelling, some cycling when the weather is good and going to the movies.

Once the treatments are over, Neil looks forward to getting back to work as a company board advisor.

– My plans for the rest of the year are, assuming that not much further therapy is required, to start working more consistently as I have not been able to make many commitments since about March 2017. When the snow falls I will be skiing in France, but that will not be until 2019 probably.

Neil’s advice for others in his situation

Neil concludes:

– Any sensible person will choose an option that gives you the best quality of life combined with the highest life expectancy.

– I have been very fortunate to find a therapy that seems to have produced good results for me.

Neil would advise anyone with a diagnosis of prostate cancer to arm themselves with as much information as possible and keep up to date with new developments.

– There are new therapies being developed all the time so I suggest that prostate cancer sufferers push for as much information as possible about these advances. After all, it’s our lives at stake!

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