Richard Melville – The long wait

After four years of waiting for radiation, Richard Melville finally got it through a private-public hospital partnership. He tells us how the delay in treatment has affected his quality of life.

Richard Melville (71) lives in Randburg, Gauteng with his caregiver and spiritual son, Richard Taylor (34).

In May 2021, Richard noticed he had slow urinary discharge, so he went to casualty at a private hospital. Various tests were done (prostate-specific antigen level test and digital rectal exam). Since he is a pensioner and doesn’t have medical aid, he was referred to Helen Joseph Hospital (HJH).

Richard was admitted to HJH, and a urinary catheter was inserted. He was discharged and told to come back for a biopsy. “The biopsy was such an embarrassing experience. Not only for myself but for everyone involved. The consulting room door was open, three doctors were sitting and laughing, while 

I was lying on a bed while a doctor was pushing rods into my anus. Really, it was disgusting,” Richard recalls.

Richard was told he had prostate cancer and would be sent for external beam radiation at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). In the interim, he was sent to Chris Hani Baragwanath Academic Hospital (CHBAH) for a radionuclide test, an imaging technique to create images of internal organs and tissues. This showed that the prostate cancer was still localised. He was put on three-monthly goserelin injections which suppresses testosterone, as well ascalcium tablets, bladder and prostate medication, and pain medication. 

Four-year wait for radiation

Richard consulted with an oncologist at CMJAH and asked if brachytherapy was an option. He was told the hospital doesn’t offer it. Surgery (prostate removal) was never discussed or even mentioned. Richard was informed that there was a long waiting list for radiation and he would be contacted when they could accommodate him. 

He was to carry on with the injections and catheter, and come for yearly checkups. 

For four years Richard waited for radiation and never received communication to update him. The only communication he encountered was when he went for his checkups.

Depression

During these years, Richard became depressed and frustrated, especially with the pain. At his lowest point, in 2023, he felt the need to go to church on Christmas Eve. This was a turning point as this church soon became his support system; a community that loves and supports him. The minister, also a prostate cancer survivor, has become a confidant to Richard. 

Grief support was offered to Richard as he lost his mother, in June 2023. He was taking care of her all the while waiting for his own treatment to start. This only added to his depressive state.

During his early days at church, Richard met Richard, a young man involved in kids ministry and a father-son relationship formed. Since Richard was living alone and needed a caregiver, he offered young Richard to stay with him. This has made a huge impact in Richard’s life, not only for brotherhood and company, but young Richard automatically took the role of caregiver, driving him to his appointments and being the son he never had.

In August 2024, an attempt was made to remove the catheter at HJH. “It was taken out and I was given 12 glasses of water but only three drops of blood came out,” Richard says. “So, a catheter was put in again.”

The big star of hope

In December 2024, at his annual checkup, Richard saw his file had a big star on it. “The nurse gave me my file and told me to not sit with the other patients but in a separate section with nine other patients. We were told that we were selected as part of the second pilot project with Busamed Modderfontein Private Hospital, where we would get radiation in January.”

Richard was extremely happy and relieved that something was finally happening. 

Before radiation could start, Richard had to have a planning scan. During this scan, his catheter blocked and caused immense pain and he asked if they could change it. “They refused and wanted to call an ambulance to take me to CMJAH. I was crying from pain. Eventually, the hospital manager realised the absurdity of the situation and allowed the catheter to be changed and pain treatment given, with the cost covered,” Richard explains. 

Radiation

Richard started radiation in February 2025; he had a total of 20 sessions. He picked up a bladder infection and was treated for it. He says since radiation, he has a burning sensation at the tip of his penis and pain below his rectum and testicles. In March, he received a letter stating he had finished treatment and was to take it back to the state hospitals. 

After radiation, Richard experienced extensive pain so went to see the oncologist as CMJAH who told him that he only wants to see him in a month’s time, and it’s more than likely prostatitis (inflammation of the prostate gland) but he must go see the urologist at HJH. 

Ongoing pain 

Richard suffered throughout the weekend and went to HJH even though his appointment was only in three months’ time. “I was told I can’t see the doctor and must come back when it’s my appointment. I was so frustrated that I walked into his room. He confirmed it was prostatitis and gave me a script for 20 paracetamol tablets to take two, three times a day. That would only last three days!”

Out of desperation and unable to walk due to his feet burning like they were on hot coals, Richard went to a private GP. Richard was diagnosed with a bladder infection and given medication to treat it as well as morphine to manage the pain. 

A month later, Richard had a checkup with the urologist at HJH and asked if he still had to continue the ADT injections. 

The urologist suggested he have two more, prescribed more bladder medication, and gave him a referral letter for the pain clinic, and the catheter was kept in.

A listening and caring ear

“The consultation at the pain clinic was the first time any doctors had given me time to explain how I was feeling. We had a two-hour conversation with two doctors and a nurse; they asked many questions, almost like a survey, and listened to every single concern of mine,” Richard says.

“I was taken into a room where a pain test was conducted with needles and hot and cold water. It was explained that the radiation had irreversibly damaged my nerves causing radiation-induced neuropathy in the lower half of my body.”

Various pain medication was prescribed and vitamin B12, and an anti-depressant to help Richard with anxiety and low mood. Since taking these, Richard has a better quality of life. He has checkups at the pain clinic and gets his catheter changed every six weeks at urology at HJH. He prefers the silicone catheter as the latex one causes infection though he still has a burning sensation every time he urinates.

Appreciation

Richard is waiting to have a bone and CT scan at CMJAH to see if the radiation worked, as well as PSA level results from HJH. It has been explained that the pain is likely due to the catheter being lodged into the prostate gland; a prostate gland scrape would be needed. He still struggles with pain but is grateful for young Richard and how the church has uplifted and carried him through this time.

Young Richards says, “Meeting Richard has been a life-changing experience. To know all the pain and anguish he goes through and apart from being there for him, hugging him, and sharing encouraging words, there is nothing else I can do. That’s not easy to accept. It has taught me a few things about myself, especially learning patience when dealing with state hospitals.