Prostate Cancer Test

[Random Orbital Bob]

Again, lets not get confused here. The PSA test is not a 100% perfect test by which I mean if you have it and test negative for cancer ie you think you haven't got it....there is a slim chance the test failed to spot it, not good of course. However the vast majority of the time, it works and the result is a helpful early indicator of trouble.

In other words there is a small risk it wont help but a big risk it will......having watched my Father die of cancer and my wife endure chemotherapy and mutilating surgery, I'll opt for any option that helps in any way thankyou very much. I have to say, to me, it's a no brainer!

 

[NickWelford]

By having a PSA test every year, if the level rises appreciably, then it's time to get a further check.

 

[Markvk]

Just had this done, as ive just turned 50 I requested it. The GP had no problems with it but we had an interesting conversation about its relevance. She had just been to a convention on mens health and she had all of her copious notes in her handbag..... VERY big handbag. She said that the evidence now points to the PSA test having very little accuracy..... cant remember the rest of the conversation but ill ask her when I see her next time and see if I can get a link to the info.

Mine came back all good though. just as well, she wanted to stick a finger up my bum if it hadn't.... :shock:

 

[RogerS]

First of. I've been away for some time due to other thing in my life. But as to the test above.

One who has had the test. It's not the pleasant of thing to go through. I have no idea what the push up your back side. But it starts with a camera, and a light. Then they have a thing to snip a bit of your prostate off. not just one snip. But about ten or more bit's. I guess they are taking it from different section. It feels like you have half the NHS up your Azz, working away. Buy the way don't be surprised if you start to water blood aft wards. It's about ten day's before you get the results back, Mine was clear. Look forward to a few day's of being sore. But well worth getting it done.
John933

I think he was referring to the PSA test which is a blood test.

 

[gwaithcoed]

I've just been diagnosed with prostate cancer. The warning signs they tell you about now I was having 30 years ago ( getting up in the night --feeling you can go again soon after) and then I put the poor stream down to age, I'm 78. So I wasn't too worried until just before Christmas I found I was having to squeeze the last drop out.
Went to the doctors and was sent for a blood test which came back high. Prostate check showed problems. Sent to Bangor hospital to see a specialist. Had a biopsy which showed all ten samples to be cancerous, had a bone scan to see if it had spread to the bones, but fortunately it hadn't, had an MRI scan which showed it had spread to the surrounding tissue.
I had to take tablets for 4 weeks and an injection to lower the testosterone.
I now have an appointment later this month to find out when I will have Radiotherapy Which will involve 37 sessions, 5 days on 2 days off. As our nearest hospital giving this treatment is 60 miles away from where I live I am looking at about 4,500 miles of travelling over a 7 week period.
So I beg any of you who are over 50 to get down yo your GP for a check up. As the specialist said when I told him that I had been having these symptoms so many years ago he replied " You haven't just caught it, You've just been diagnosed with it."
When they've finished probing up my bum I deserve a good kick up it for not going earlier

Alan.

 

[Random Orbital Bob]

I'm really sorry to hear that Alan. It' also decent of you to go public on your circumstances. The only "saving grace" about prostate cancer, which is a good one, is that it is very slow growing and can often be managed with exactly the kind of therapy Alan refers to. Apparently many men over 70 have it and don't even realise. So its good that although caught late you're now in therapy as that will significantly improve the prognosis.

But the underlying message is clear again....get the PSA test every single year if you're over 50 because you're almost guaranteed to pick it up early that way.

 

[John15]

Good luck with your Radiotherapy treatment Alan. I found I soon got into the swing of it and in my case at Oxford there were dozens of guys receiving the same so you get to know the faces. The nurses and radiotherapists were all really caring and helpful and smiling which helped a lot.

John

 

[gwaithcoed]

Thank you Bob and John for your words of encouragement. My two Grandchildren age 14 & 15 were very concerned when they were told by there parents so I told them I treat it like they treat their homework and pretend you don't have it until you can't pretend any more.

Alan

 

[mikefab]

I'm a urologist currently working on a PhD related to prostate cancer and thought perhaps I could provide some useful information.

The following link might be helpful https://www.gov.uk/government/publications/prostate-specific-antigen-testing-description-in-brief. The leaflet summarises the risks and benefits of having a PSA test and the false negative and false positive rates, which leave a lot to be desired.

The false negative rate is 15% (IE the test is normal but the patient actually has PC), the false positive rate is 75% (patient has a raised PSA despite no prostate cancer and may go on to have a biopsy).

You can find some more useful documents on the Prostate Cancer UK website: this is a high quality resource based on good scientific evidence http://community.prostatecanceruk.o...MP-information-and-PCUK-s-position#post143877

Essentially you will see from these leaflets that PSA is a pretty crude test but it is the best we have. An abnormal PSA test will often lead to a prostate biopsy being recommended which carries risks in itself and is also not a perfect test with a significant false negative rate. Depending on the study you look at transectal prostate biopsy will only detect about 70% of prostate cancer cases, or to put it another way, 30% of people with a negative prostate biopsy may have cancer. We need better tests.

Why don't we screen the population as a whole with the PSA test? It would not be that effective. We would need to test 781 men to save one life. And 27 men would have to undergo radical treatments such as surgery or radiotherapy (with significant side effects) to save that one life too.

So PSA testing may result in early detection of PC and access to some of the newly emerging treatments or the opportunity to undergo definitive treatment such as surgery or radiotherapy before the disease has spread. But PSA testing may result in unnecessary further tests or worry in the absence of PC so this is very much a personal choice and you are entitled to get a test if you wish.

I hope this information is useful

Mike Fabricius

 

[finneyb]

Thanks for that Mike, useful - particulary ' We would need to test 781 men to save one life. And 27 men would have to undergo radical treatments such as surgery or radiotherapy (with significant side effects) to save that one life too.'

After reading Margaret McCartney I view all health screening with a critical eye - it's not like an engineering test or accountancy audit that produces a definitive answer. Personally, I am waiting for symptoms before testing, with the exception of AAA screening ( Abdominal aortic aneurysm) that has no symptoms and a rupture results in an 85% chance of a fatality. It is non invasive ie ultrasound and available to men over 65 years, I go for mine in two weeks http://www.nhs.uk/aaadecisionaid

Brian

 

[BearTricks]

They've painted themselves in to a corner with parking charges. They're taking enough flak from the funding end that removing parking fees would be another blow that they can't handle, but at the same time the fees shouldn't have existed in the first place.

 

[Graham Orm]

Don't ask for the PSA test around these parts. When I asked I was told the results from PSA tests are inconclusive without other symptom, giving false positives, and are therefore a waste of time, and not available, period, without other reasons to give it.

I'm 59 and no reason to think anything is wrong and believed theses tests were good, but have to wait until there is reason to have it.

Phil
Somerset.

That's entirely your choice Phil, not the doctors. He's trying to save his surgery money.

 

[Graham Orm]

I'm a urologist currently working on a PhD related to prostate cancer
Mike Fabricius

Thanks for the educated input Mike. Interesting reading.
As I've already said, the test was compulsory for my brother as part of an insurance plan. It saved his life as far as I can see. I'll continue to err on the side of caution. (Especially as it's in the family).

 

[mikefab]

I'd suggest that anyone over 50 who wishes to have a PSA test takes a copy of the PCUK consensus guidelines or Public Health England Prostate Cancer Risk Management Programme guidelines to discuss with their GP if the GP is refusing access to the test. The threshold age becomes 45 if you have prostate cancer in your family or black ethnicity. The GP or practice nurse should have a discussion with you regarding the risks and benefits of testing before you decide whether to proceed.
Repeat testing following a normal result should also be an option and the frequency of this needs to be agreed with the GP in the light of individuals' risk factors for developing PC.

I would also add that it is not a matter of waiting for symptoms as prostate cancer is only likely to be symptomatic once it has become quite advanced. However of course please note that lots of men will have lower urinary tract symptoms (waterworks problems) as a result of a benign enlargement of the prostate or bladder instability which are separate problems to prostate cancer.

These are tricky decisions for individuals to make, as the evidence we have shows that population based screening would not be effective based on the number of invasive investigations required (with associated risk of complications) and the number of radical treatments required to save one life. However, this may feel rather different when an individual is considering their own position rather than what is best applied to a population. The best we can do at the moment is equip people with the facts to make their own choices, and to wait for better tests and risk assessment tools to be developed.

Mike Fabricius

 

[Alexam]

Just to clarify for anyone going for the biopsy, it is not that bad at all. A little uncomfortable during the process and in my case there was hardly any blood discharge in the week following, so don't be put off if you need to have this done. My results were clear but my PSA continues to rise and another biopsy may well be needed, but with previous knowledge, I am not concerned.

A nice nurse was holding my hand and chatting to me whilst the uncomfortable bit was going on, which certainly helped. All on NHS. A great service.

Malcolm

 

[whiskywill]

Free in Wales,

Not entirely, yet. Although it has been free for a few years in most of Wales, whoever is paid to make the stupid decisions, in their wisdom, sold the contract for collecting parking fees to a private operator at the University Hospital in Cardiff and that is yet to run out. So we still have to pay there, and maybe in some other Welsh hospitals.

 

[Harbo]

Our local hospital is also opposite the local jail and when parking was free it was full of prison visitors!
Even now with the current high charges, it's still very difficult to find a space without driving around for hours!

It's also near to a large garden centre which soon became a "free car park " but they have now installed barriers and you pay £4/hr unless you are a customer.

Rod

 

[mikefab]

They hit staff with some pretty high rates for parking too - and that's if they determine that the staff member qualifies for a permit at all!

 

[dexter]

Over here in rural France the onus is up to you with regards to tests after seeing your GP.
I'd been feeling under the weather and went to see my GP on Tuesday, She examined me and did a urine test there and then which was negative for the obvious suspects. After a bit more prodding and poking she said I should have a blood test and ultra sound test. She wrote out her test requirements on two pieces of headed note paper and handed them to me. "What do I do with these?" Said I. "For the blood test you can contact your local district nurse and she will come to your home and take the sample and send it away for you or you can go directly to the blood test unit in La Souteraine and arrange a test with them directly and they will send the results to me. For the ultra sound you can contact the X-ray unit at the hospital or the X-ray clinic and arrange for them to do the scan, they will give you the results and then you bring them back to me." All in all I was in with her for about half an hour and that cost the standard fee of 23 euros.
Unfortunately, I'm not yet affiliated to the French healthcare system, ( not the easiest to get into) and so have to have private cover with a 120 euro excess but I don't mind for the time being.
The blood clinic is only 10 miles away in my local town and so I went straight there and arranged a test for yesterday morning. I arrived for the test and was asked if I wanted the results posted to me or did I want to pick them up after 5pm. I opted to pick them up and arrived dead on 5pm to be presented with them at a cost of 48 euros. The receptionist told me that the results had also been emailed to my GP that afternoon.
Looking at the results which seem to be very comprehensive, there is also a PSA test result shown as a percentage which, despite searching the Internet for a simple explanation I can't find anything other than medical gobbledegook which doesn't help my stress levels! What is it they say about a little bit of knowledge!
I should have my scan next week should I try to understand those results, now there's the rub!
Dex

 

[Wuffles]

Free in Wales,

Not entirely, yet. Although it has been free for a few years in most of Wales, whoever is paid to make the stupid decisions, in their wisdom, sold the contract for collecting parking fees to a private operator at the University Hospital in Cardiff and that is yet to run out. So we still have to pay there, and maybe in some other Welsh hospitals.

I did not know that, thanks.

I don't live in Wales but I picked my Dad up from a hospital in Swansea and was stunned at the enormous multi story car park available to park in for free. I thought it was a trap, if it were Bristol it'd be a trap for sure.