Why a treatment summary is not the same as a first-visit history
A first-visit history answers "what brought you here?" It starts with symptoms, risk factors and the patient's own account. A previous-treatment summary answers a narrower question: "what has already been done to this cancer, and what happened?" The receiving urologist or oncologist is not trying to reconstruct your original diagnosis from scratch. They are trying to work out whether the cancer is controlled, whether it is progressing, and what options remain.
This distinction matters because prostate cancer care is cumulative. A biopsy result from three years ago, a course of radiotherapy, a period of active surveillance, or a radical prostatectomy all change what a clinician can offer now. If you send a general narrative, the key facts can be buried. If you send a structured treatment summary, the clinician can see the sequence and the response at a glance.
The goal is not to write a long letter. It is to give the treating team a clear, dated record of decisions already made, so their assessment starts from your current position rather than from the beginning.
What a previous-treatment summary should contain
Start with the confirmed diagnosis. Include the date of biopsy, the Gleason score or grade group, the number of positive cores, and any imaging that staged the disease, such as MRI, PSMA PET or bone scan. If the diagnosis was made elsewhere and the pathology slides are available, note that. The receiving hospital may want to review the original slides rather than rely on a report alone.
Then list each treatment in order. For surgery, give the date, the type of operation, the hospital, and the postoperative pathology report including margin status and lymph node findings. For radiotherapy, give the dates, the technique, the total dose and the target area. For hormonal therapy, give the drug, the start and stop dates, and the reason for stopping. For active surveillance, give the dates of each PSA test and repeat biopsy, and what triggered any change in plan.
Finally, record the results. PSA values with dates are the single most useful tracking item. Note any imaging after treatment, any rise or fall in PSA, and any symptoms such as urinary, bowel or sexual function changes. If a treatment was stopped early or changed, say why. That reason is often as important as the treatment itself.
- Confirmed diagnosis: biopsy date, Gleason score or grade group, positive cores, staging imaging.
- Each treatment in order: type, date, hospital, technique, dose or drug, start and stop dates.
- Results: PSA values with dates, post-treatment imaging, symptom changes, reason for any change in plan.
- Current status: latest PSA, current symptoms, current medications, and the specific question you want answered.
How to present cancer control and function goals separately
Prostate cancer decisions often involve a trade-off between cancer control and function. The receiving team needs to know which goal matters most to you now, because that changes how they read your history. If your main concern is a rising PSA after radiotherapy, the team will focus on imaging and salvage options. If your main concern is urinary continence or erectile function after surgery, the team will focus on those outcomes and what can be done.
Write these as two short statements. First: "My main cancer-control concern is..." Second: "My main function concern is..." For example, a patient may write that the priority is understanding whether a rising PSA means the cancer has returned, and separately that he wants to know how any further treatment might affect continence. This is not a treatment request. It is a clear statement of what you want the review to address.
Do not merge the two into a general sentence about "quality of life." Specific goals produce specific answers. If you are unsure how to phrase them, write them as questions: "Has the cancer been controlled?" and "What are the likely effects on urinary and sexual function?" The treating clinician can then answer directly.
Records that support the summary, and what to ask about them
The summary is the index; the records are the evidence. For a prostate cancer review, the most useful records are the original biopsy pathology report and slides, the operative note and postoperative pathology if surgery was done, radiotherapy planning and completion records, and all PSA results in date order. Imaging reports and, where possible, the images themselves help the receiving team assess staging and response.
Different hospitals have different requirements for accepting outside records. Some may ask for slides to be re-reviewed; others may accept a report. Some may want imaging on disc or via a link; others may prefer a specific format. These are administrative questions, not clinical ones, and they vary by hospital. Ask the specific hospital what it needs before you send anything.
If a record is missing, say so in the summary rather than leaving a gap. A missing operative note or an unavailable PSA series is useful information. The receiving team can then tell you whether they need it, whether they can proceed without it, or whether a repeat test would be helpful. Do not delay urgent local care while gathering records for an overseas enquiry.
What the receiving team still has to confirm
A records-based review can clarify your history and identify options worth discussing. It cannot confirm final eligibility for a specific procedure, guarantee an outcome, or replace an in-person assessment. The treating hospital decides suitability after reviewing your records and, where needed, examining you and ordering its own tests.
For prostate cancer specifically, the receiving team may want to confirm the original pathology, repeat PSA testing, arrange imaging, or assess your general health before recommending anything. These are clinical decisions for the treating clinicians. Your job is to provide an accurate, dated summary so their assessment is based on correct information.
If you are considering robotic-assisted radical prostatectomy, the relevant question is not whether the technology exists, but whether it is appropriate for your cancer and your goals. Radical prostatectomy removes the prostate for selected prostate cancers, and robotic instruments are controlled by the surgeon. Whether that operation is suitable for you is a decision the treating team must make after reviewing your full history.
A practical way to send your summary
Keep the summary to one or two pages. Use dated headings in reverse order, with the most recent event first, or in chronological order if the sequence is complex. Put the diagnosis and current status at the top. Attach the key records as separate files with clear names, such as "2023-05 biopsy report" or "PSA results 2021-2024."
If you are working with a coordination service, a short initial enquiry is enough to start. You do not need to send a complete medical archive at first contact. The team can review your summary, identify what is missing, and suggest the relevant next step. A proxy consultation is optional and is not a prerequisite for every appointment or operation.
The practical next step is to write your one-page treatment summary, list your two main questions, and send a brief enquiry. The hospital, not the coordination service, decides whether to accept your case and what treatment to recommend.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.