Per Fagerlund, 75, from Gothenburg had his PSA value measured when he was 68. PSA is a protein in the prostate. If the value increases, it may be a sign of cancer – a cancer which at an early stage cannot be discovered in another way.
“The doctor at the local health centre felt that it was unnecessary to take the PSA test during the annual medical check since I did not have any symptoms. So I had to insist.” Per then had the value measured once a year.
“About three years ago, the value shot up. In 2013 they took a biopsy, tissue samples, which proved that I have cancer. But the tumor was so small – four millimetres – that nothing needed to be done, said the doctor.”
In March 2014, a new biopsy was taken; this showed that the tumor measured approximately nine millimetres. Afterwards Per got a urinary tract infection and had difficulty urinating. The infection was cured with antibiotics, but the difficulty in urinating persisted, and Per had to have a catheter.
“This was not funny, and I obviously wanted the doctors to find out what was wrong and do something about it. But they were not interested, I felt. As regards the cancer, I was to wait for a call.”
The call took a long time coming – and Per Fagerlund decided to seek alternatives.
He came across the privately-run Docrates Cancer Center in Helsinki, one of the world’s top cancer hospitals, on line.
“I emailed Docrates and immediately got an appointment for magnetic investigation.”
Magnetic investigation is the foremost method for investigating the local spread of prostate cancer – but the investigation is not a routine one in Swedish health care of prostate cancer.
“My tumor was seen to be a T3, a third-degree tumor, which was growing through the prostate capsule. It was, in other words, on the verge of being really serious – and it was important to start treatment urgently.”
Per underwent radiation treatment five days a week for eight weeks. After the radiation, the medical team at Docrates suggested that Per should take hormone treament to minimize the risk of relapse.
Then – after completion of treatment at Docrates – Per got a call to see an oncologist in Gothenburg. That was in November – eight months after the second biopsy when the tumor was seen to be growing.
“The doctor admitted that they misjudged my cancer and said it was a good thing that I had received treatment.” In the weeks Per was having radiotherapy, he lived in an apartment hotel.
“The staff at Docrates helped me to book it. I was a walking distance away from the centre of Helsinki and the hospital. I took the opportunity to work in peace and quiet, and to roam around Helsinki, which is a fantastic city in the summer.”
Per is full of praise for the hospitality shown by Docrates:
“I met the same professional and friendly staff all the time. I had a personal doctor and a contact person who really cared. Everything was run swiftly and efficiently but no sight was ever lost of ‘bothering’. With such treatment, you begin feeling in a better mood – you feel safer and more hopeful.”
“They were never stressed but took the time to explain how the treatment was progressing, and the schedule was spot on. If they said 12 o’clock, they meant 12 o’clock and not 12.15.”
In Gothenburg Per saw seven doctors when seeking treatment for the prostate problems.
“Each contact was new; each time the records had to be read and questions asked. Then no informative dialogue can be fitted in – which means that the patient must take important decisions on his or her own.”
“When the next visit is planned, they say ‘we’ll call you’, which can mean a wait of a few weeks or a few months. Swedish healthcare is generally of a high quality. The staff are both knowledgeable and helpful. But the forms of organization they work within often result in them being forced to prioritise organisational problems over the patient’s medical problems”, concludes Per Fagerlund.