An online guide to your Fast Track Prostate Clinic
Helping you understand what happens at our clinic
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Overview
Hear from our urology surgeon who gives you an overview of the service and explains the positive outcomes from early detection.
Video transcript
Hello, I’m Christos and I’m a surgeon here in Urology team at Bradford Teaching Hospitals NHS Foundation Trust. You’re going to meet some of our specialist nurses as part of this pathway, but I want to use this opportunity to explain what to expect at the prostate fast track clinic.
You have been referred by your GP to the prostate fast track clinic and you have been placed on the prostate fast track pathway. The prostate fast track pathway makes sure that you are seen within 2 weeks of the referral being sent to the hospital by your GP.
This is an educational guide about what to expect when you are on the prostate fast track pathway.
Your GP has referred you as they are either concerned about a blood test you have had called a prostate-specific antigen which is more commonly known as a PSA test; or if they have felt something on your prostate when they examined you. It could be a combination of these things and they are concerned there may be a possibility of prostate cancer.
Once the referral has been received by the hospital you will be sent an appointment asking you to attend the prostate fast track clinic. When you attend this appointment the urology team will carry out a full assessment and ask you about any symptoms you have been having. Any urgent scans or procedures required could happen later on that day or will be arranged with you within the following 7-10 days. These could be an MRI scan of your prostate or procedures such as prostate biopsies.
Our aim is that within 28 days of your first clinic appointment, we will have given all the results of any scan or procedures you might have. This is so that if required, a treatment plan can be discussed with you.
I hope you find the rest of this guide helpful.
Meet our team
Here is a quick guide to some of the people in our team you might meet as part of our service. For more information, visit our team page.
Understanding the process
Our guide to the appointments, locations and timescales involved is really important. The urgency of the checks means that if you don’t attend an appointment you will drop out of our system and be referred back to you GP. So please do pay close attention to what Claudia has to say in this film.
Video transcript
Presenter: Claudia
When your referral, to the prostate fast track clinic, is received by the hospital it is reviewed by the clinical nurse specialist team. Following this review you will be contacted and given details to attend an outpatient appointment at either the Bradford Royal infirmary or at St Luke’s hospital. The appointment date will be within 2 weeks of your referral information being received at the hospital.
On arrival at the outpatient department you will need to first check in with the reception team, which is clearly signposted, before you are welcomed by our experienced team.
When you attend for all of your appointments please can you make sure that you have a full bladder as you may be asked to provide a sample of urine.
When you are seen in clinic we will carry out a bladder scan with ultrasound technology before or during the consultation once you have emptied your bladder.
You may receive a questionnaire in the post prior to your appointment which you can complete at home before coming to your appointment. Please remember to bring this with you when you attend your clinic appointment. If you have not received a questionnaire in the post you will be asked to complete one before your consultation. The questionnaire asks about symptoms you have been experiencing when passing urine and erectile function habits or problems.
A consultation will be carried out and this will include going through your answers in the questionnaire. A full medical history will also be taken including confirming current medications you may be taking which are either prescribed or non-prescribed. We ask that you bring a current list of all your medications with you are taking to your appointment. Please let us know about your non-prescribed medications such as herbal medication or supplements which you take.
A clinical examination will follow which includes examination of the prostate through your back passage.
The consultation will be carried out by one of our experienced urology team. This may be a clinical nurse specialist, a urology registrar or a urology consultant who is in clinic on the day of your appointment.
Following the consultation and examination we will discuss with you the need for further investigation for prostate cancer.
Due to the nature of the prostate fast track pathway, investigations and treatment all happen within a strict timeframe. We ask that you attend all the appointments offered to you unless you have other very significant reasons for being unable to attend. Should any exceptional circumstances occur that prevent you from attending then you must urgently let us know using the contact numbers on the panel next to this film.
Once an appointment is accepted if you do not attend and do not contact us to change the appointment it will lead to you automatically being discharged back to your GP. This will delay any tests or procedures which are recommended and needed as part of the prostate fast track pathway.
MRI Scans
We’ll explain what happens at the first appointment in the Urology clinic, the types of checks, including MRI scans, that might be needed. We’ll also discuss the decision making about a biopsy, so you know what to expect.
Video transcript
MRI scans explained
Presenter: Nicola / Harry
As part of the prostate fast track pathway, you will be seen by the urology team in the prostate fast track clinic. They will ask you specific questions regarding your prostate and any symptoms you might have been experiencing. They will explain the investigation process for possible prostate cancer and answer any questions you may have. A full explanation will be given about any further investigations or procedures which need to be carried out at your first clinic appointment.
Depending on the symptoms you’ve been experiencing and the examination in clinic, you might be referred to have a magnetic resonance imaging scan, or you might know this as an MRI scan. The MRI scan helps us get a detailed picture on how the prostate looks and will show suspicious areas that might be prostate cancer.
If you are being referred for an MRI Scan please tell us, when you are at your clinic appointment, if you have clips in your head, a pacemaker, insulin pump, cochlear implant or spinal cord stimulator.
If the decision is made for you to have an MRI scan we will try to arrange for it to be done on the same day you are seen in clinic. Remember to confirm your mobile number or the best number to contact you on. Please keep your mobile phone to hand or stay close to the telephone number you have given if you have been told that it will be a same day appointment, even if later in the day.
Unfortunately it is not always possible to have an MRI scan on the same day as you attend your clinic appointment. If it is not possible for you to have an MRI scan on the same day you attend your clinic appointment this will be done within 7-10 days of you being seen in clinic. You will be contacted by telephone to give you the details of the date and time of your MRI scan appointment. The MRI scan is carried out in the Radiology department at the Bradford Royal Infirmary.
You will be asked to fill out an MRI safety questionnaire on arrival in the department. Before the scan you will need to be free of any metals including any external jewelry.
It is recommended, when you attend your appointment, for your MRI scan, that you wear loose comfortable clothing. If this is not possible then you will be given a hospital gown to wear.
Once all your details and safety checks are confirmed, you will be taken into the room to have your MRI scan. You will be asked to lie down on the scan table and will be provided with headphones and a safety buzzer that you can use at any point if you need assistance.
MRI Radiographer: It is important to lie as still as possible on the scan table. The main reason is because any movement can blur the images and make it difficult to make a diagnosis.
For this particular MRI, the scan typically lasts 20-30 minutes to complete. We will speak to you through the headphones as much as we can throughout the scan to help keep you as updated as possible. The noise in the scanner can feel very strange and sometimes feels repetitive but it is nothing to feel worried about.
The scanner is an open ended tunnel but it does make some patients feel claustrophobic when they go inside the scanner. If you are really not able to tolerate the scan we can discuss options with you to see if any of those suggestions could help you try the scan another time.
Once the scan is done and you feel fine you are able to collect your belongings and leave the department. You can get home as usual and the images will be looked at by one our radiology doctors.
If after reporting your MRI scan the Radiologist feels a biopsy of your prostate would be necessary then you will be contacted by telephone by a member of our administrative team. They will give you the date, time and location you will need to attend for this appointment.
When you attend this appointment you will have a discussion about the biopsy. If you agree, to have a biopsy, you will have the biopsy at that same appointment.
Please be aware our administration team cannot give you the results of the MRI scan over the telephone, you will have plenty of time to discuss the results at your biopsy appointment.
What happens next?
You’ll want to know what’s involved in assessing your results and giving you the outcome in a timely manner. In this film, Sarah also explains what happens next should prostate cancer be detected.
Video transcript
Presenter: Sarah
Once we have received the results of your MRI scan and if you have also had prostate biopsies we will make an appointment for you to see the urology team at St Luke’s Hospital. At this appointment we will discuss your results with you and anyone who you would like to attend the appointment. This is usually around 2 weeks after the scan and biopsies have been carried out.
You will receive your clinic appointment the same way you have previously this may be by post, email or text message. At the appointment a Urology consultant will discuss the MRI scan and biopsy results in depth and you will have the opportunity to ask any questions. If the prostate biopsies confirm prostate cancer the consultant will also discuss any treatment you may need.
There are different treatment options depending on the grade and stage of your prostate cancer, this is identified in the biopsy results which will be discussed in the clinic appointment.
You can find more information regarding prostate cancer on prostate cancer UK or Macmillan websites.
The clinical nurse specialist team or Prostate navigator are also available and happy to answer questions at any point throughout the prostate fast track pathway.
