Stockholm 3 – What to do if you have a high risk score – The private route

If you are visiting the page you will have had the results of your Stockholm 3 test, possibly followed by a DRE or prostate volume measurement, which together indicate that there is a high risk of your having prostate cancer.

Although this is worrying you do have time to consider your options and what you wish to do. If you start on a private pathway, you can always revert back to the NHS at any stage.

This page discusses private options and how to navigate the variability in the quality of the diagnostic and treatment pathway across the country in the private sector.  In fact this variability has resulted in Prostate Matters, working with A3P to develop a Premium service for Stockholm 3 patients with a high-risk score. The intention is that this eventually will be available across the UK.

We suggest you study this page first and the visit the Premium Diagnostic Service page, link at the bottom of the page.

Get referred to a privately to a Urological Surgeon

If you are a Self Pay patient, you can contact a Urological Surgeon of your choice, have a consultation, and start on the prostate cancer diagnostic pathway.

If you are privately insured your Insurance Company will require a referral from your GP to the private Urologist.  Many Insurance Companies understand the difficulty of getting in touch with your NHS GP so will have their own GPs available on-line. Normally you can get an appointment with one within 48 hours. It is probable that either the Insurance Company nominated GP, or your NHS GP will never have heard of Stockholm 3.

To overcome this obstacle we have developed a pro forma letter that is signed by a Consultant Urologist for you to send to the GP. It is a Word document which you can edit. If you use the Insurance Company GP, he or she will arrange for pre-authorisation.  If you get the referral letter from your NHS GP you will need to get authorisation to see the Urologist from your Insurance Company.  You should be aware that different plans have different levels of cover and restrictions, so getting referred to some of the London private hospitals may not be covered by your policy or you will need to pay ‘top up’ fees. Check with your insurer.

Regardless of which route you choose, NHS or the private route, (and you can switch between them) the first step on the diagnostic journey will be an MRI. Be aware  MRI and its reporting vary in quality especially in regional private hospitals and imaging centres. Be aware most private hospital chains focus on musculoskeletal problems rather than cancer. This is not the case with the larger London based private hospitals (Cromwell, HCA Hospitals, The London Clinic and King Edward VII) which all treat cancer.

In the regions there is an exception and that is the GenesisCare private clinics which specialise in cancer diagnosis and treatment. However they only offer radiotherapy not radical Prostatectomy or Focal therapy as far as we can ascertain. The major London private hospitals tend to offer all or most treatments depending on the Urological Surgeon who takes you on your diagnostic journey which results in you requiring treatment.

Therefore in the regions GenesisCare will offer good MRI and reporting. For other private hospitals outside London, be referred to a Urological Surgeon who has an NHS post in regional hub NHS Trust or a London teaching hospital. It is worth enquiring which radiologist will be reporting your MRI and their NHS base.

Also remember the large regional NHS hubs/Trusts nearly always have a private wing you could choose if you wished. The quality of their MRI and reporting will be good.

Below is a link to both London and regional (mostly GenesisCare) cancer clinics. Note the London clinics can offer Focal therapy and RALP surgery depending on the Urological Consultant you are initially referred to.

Treatment options you might be offered if necessary are far from the same in every private hospital and will depend on the Urological Surgeon you choose to be privately referred to. This is discussed in more detail later in this section.

As to the time to complete the diagnostic process, not many private hospitals complete the diagnostic pathway in 28 days.

You can read about the steps on the diagnostic  pathway by following the link below the link below. The link page will open in a separate window, so you can study it and switch back to this page.

The results of an MRI, which, when reported will give an indication of the significant cancer lesions and their position in the prostate. Results from this MRI and report will determine whether you need a biopsy.

You can read more about the MRI and how it is reported and scored by clicking on this link.

Finally, there is also a link to pages explaining  prostate biopsy and what the results mean if it is determined that you need one.

 What if, following biopsy results, I need treatment?

The major London private hospitals tend to offer all or most of the treatments depending on the Urological Surgeon you are referred to. These include the London Clinic, King Edward VII, The Cromwell, and HCA hospitals. 

Outside London, some private hospitals may offer Radical Prostatectomy and GenesisCare Clinics Radiotherapy.  Not all offer Active Surveillance and very few offer focal therapy which has the least side effects for suitable patients. Focal therapy centres are are few and far between and travelling may be difficult. With this in mind, Remember you can always ask to be referred to a different Urologist after MRI results are reported and you have had biopsy results or ask for a second opinion. If you would like to explore the possibility of being referred to a hospital with Focal Therapy facilities, the charity Prost8 will help you with this.  Typically if you are diagnosed after biopsy with a Grade Group 1 (Gleason 6) or Grade Group 2 a or b  which equates to Gleason 3 + 4 = 7 you may well be suitable for Focal therapy and in the case of Gleason 6, Active Surveillance as an alternative. In some cases with an isolated lesion it may be possible to treat Gleason 4+ 3 = 7. More likely though you will need external beam radiotherapy or a Radical Prostatectomy

If you want to learn more about  the treatment options for prostate cancer, including which Urologists at what private hospitals offer them , the treatments section of the website gives a comprehensive description of all the options. See link below.

A new premium private service for diagnosing prostate cancer

Because of the variability in both quality and options, in conjunction with a3p Prostate Matters is developing  a premium diagnostic service for prostate cancer for Stockholm 3 patients with a high risk score. We intend that eventually this service will be available across the UK .

Click the link below to find out more: