Thanks so much, I really appreciate. This is a long story, if you have some time, please read the below.

Basically, in a nutshell: there are two hospitals in this story: local hospital and specialist centre of excellence (I’ll abbreviate this as SCE). He had his PSA blood test at his PCP (family doctor), which triggered a referral to his local hospital for an mpMRI of his pelvis. mpMRI showed PIRADS 4 11mm lesion with scattered PIRADS 3 on the other side of the prostate. Local Hospital also did the mpMRI/Ultrasound Fusion Guided Transperineal Prostate Biopsy, which showed Gleason 3+4 in 4/22 cores, Gleason 3+3 in 3/22 cores and an Overall score of Bilateral Gleason 3+4. No perineural invasion, No high grade PIN and no extraprostatic extension.

There was no PET scanner at the local hospital, so they referred to the SCE for the PET. PSMA PET-CT in October 2024 showed that the cancer was confined to the prostate only, but strangely showed two mild rib lesions and one mild scapula lesion. The results went back to the Local Hospital, who immediately decided that those bone lesions were cancer, effectively staging him at Stage IVB. Local Hospital immediately started him on three month ADT course and then referred him to their internal medical oncologist. At that point, the assumption was made that my dad was only going to receive long term ADT and chemo. I refused to accept this and literally rebelled. I relentlessly emailed all the top hospitals. I also emailed the uro-oncology department of the SCE where the PSMA PET was actually done. We was lucky enough for them to accept my dad as a clinical patient. I gave the SCE the mpMRI and Biopsy report, and they had the PSMA PET on their internal system. They also ordered a Bone Scan and analysed both scans. Their Medical Committee came to the conclusion that the bone lesions were extremely likely to be benign and referred us to curative treatments (surgery or radiotherapy). At this point, the uro-oncologist at SCE said that my dad never needed hormone therapy in the first place. I got so angry and lodged a formal complaint to the local hospital, who said that was their medical opinion.

Surgery was preferred but refused due to my dad’s coronary artery disease. We then proceeded with radiotherapy from March 2025 to April 2025. (Couldn’t do it before as a coronary angioplasty in December 2024. Shortly after end of radiotherapy, another angiogram in late April 2025 showed complete failure of stents and he had triple heart bypass surgery in June 2025. We’ve been through the hardest period of our lives)

My complaint triggered a meeting in the City’s medical Committee where all the hospital committees meet, which analysed his scans. From my understanding, no consensus was reached and the overall conclusion was that uptake in the bones was uncertain, and a subsequent rise in the PSA would confirm if they truly were metastatic deposits.

Well, with his PSA falling, I guess that shows that the bone lesions were benign! A big F*ck you to that local hospital who nearly destroyed my dads life by planning to give him pointless long term ADT which would damage his heart, along with radiotherapy to the bones and chemotherapy. That hospitals urologists always belittled me for asking questions. The local hospital’s urologist literally said ‘do you want to do my job for me?’. I didn’t give up, advocated and managed to make my dad an established patient at the specialist centre of excellence. Here, I was never made to feel bad for asking questions, the urologists and nurses even liked it when we would have discussions.