Prostate Cancer Screening - (PSA) Testing (1 Viewer)

[pagey]

I suspect the scan is MRI and this was active surveillance, the lowest form of monitoring.
ie Regular PSA blood tests to monitor trend then usually yearly MRI of prostate, any spike in either will usually mean biopsy.

I was offered active surveillance after PSA/MRI/Biopsy, but rather be treated actively than wait given im 53. So next Tuesday Im off to Addenbrookes for brachytherapy.

i tried to get brachytherapy but no deal you do know that you will be known as golden balls now

 

[VXman]

In spite of me having all the classic symptoms my doc has refused on two occasions over the past 3 years when I've asked him. He said: "We don't offer them here as they are inconclusive, unreliable and not cost effective".

He is not wrong from what have heard/read. Yes it can indicate Prostate Cancer but it can also do false positives. The more definite diagnoses (which would be needed as a follow up anyway) would be a finger test or a MRI scan.

Research has shown around 3 in 4 men with a raised PSA level will not have cancer, and around 1 in 7 men with prostate cancer would have a normal PSA result.

Prostate cancer - Should I have a PSA test?

Find out about the PSA test, a blood test to help detect prostate cancer.

www.nhs.uk

 

[seasideBill]

I’ve had several ‘finger up the bum’ examinations over the years and my GP is happy as long as the prostate feels smooth. The only time he’s recommended a PSA test is when I’ve had a change in symptoms. I’ve got an enlarged prostate so share symptoms with prostate cancer. The unreliability of the PSA test is a concern and can set you on a voyage of unnecessary and unpleasant invasive procedures.

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[The general]

i tried to get brachytherapy but no deal you do know that you will be known as golden balls now

Not all trusts offer it

 

[CazPaul]

Having a father or brother who has had prostate cancer doubles your risk.
My father died really young from it, you have to try not to worry.

 

[The general]

have to try not to worry.

And realise it can be treated successfully

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[PaulC70]

He is not wrong from what have heard/read. Yes it can indicate Prostate Cancer but it can also do false positives. The more definite diagnoses (which would be needed as a follow up anyway) would be a finger test or a MRI scan.

Research has shown around 3 in 4 men with a raised PSA level will not have cancer, and around 1 in 7 men with prostate cancer would have a normal PSA result.

Prostate cancer - Should I have a PSA test?

Find out about the PSA test, a blood test to help detect prostate cancer.

www.nhs.uk

He is very definitely wrong when someone with symptoms is asking for one as in this case. The minimum should be PSA then either a repeat after 6 weeks, a finger up the bum plus or minus an MRI.

 

[sedge]

Just wonder what other NICE Guidelines/NHS recommended practice that doctor ignores ......

 

[BillandHelen]

I suspect the scan is MRI and this was active surveillance, the lowest form of monitoring.
ie Regular PSA blood tests to monitor trend then usually yearly MRI of prostate, any spike in either will usually mean biopsy.

I was offered active surveillance after PSA/MRI/Biopsy, but rather be treated actively than wait given im 53. So next Tuesday Im off to Addenbrookes for brachytherapy.

Best wishes for your treatment, I had brachytherapy last August, honestly feel like it’s a miracle treatment, in and out of hospital same day, reasonably quick recovery, bit bruised, no catheter, few side effects, for me it was bit painful to pee (cured by one tablet a day) and up occasionally in the night. Sexual function fully recovered which was a great relief!! Psa level dropped quickly below 1, I’m due my next test at the end of April when hopefully it will show cancer all gone.

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[Red Sonja]

Kevin felt there was something wrong and I rang GP for an appointment. Next day blood test high PSA. Fast track - Appointment on following Monday at hospital. MRI on the Wednesday and all clear on Friday. He has to have yearly blood tests to keep an eye on PSA.

This year when I checked his regular blood test form the PSA test was missing. I asked the receptionist who said "We don't offer these regularly". I pointed out his prior history it was added to form. The receptionist said since Prince Charles was diagnosed they had been inundated with requests.

 

[EuroTrotters]

asked the local GP twice. Only to be told not reliable and expensive

 

[The general]

Only to be told not reliable

Correct to a point but much more reliable after treatment , this info given by prostrate uk

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[Hettie's Crew]

I’ve had several ‘finger up the bum’ examinations over the years and my GP is happy as long as the prostate feels smooth. The only time he’s recommended a PSA test is when I’ve had a change in symptoms. I’ve got an enlarged prostate so share symptoms with prostate cancer. The unreliability of the PSA test is a concern and can set you on a voyage of unnecessary and unpleasant invasive procedures.

My GP referred me after a PSA test of just 4, no physical exam just referred. The specialist nurse did the DRE and felt a slight abnormality on one side, an MRI was arranged straight away and it showed the slight abnormality which resulted in a further referral for biopsies. The biopsies taken from the abnormality proved negative, nothing of concern other than a slight swelling.
The biopsies from the side that had no abnormality, swelling or image on the MRI proved to be cancerous cells.
My Consultant was very disparaging of GP’s that diss the PSA and insist on doing their own DRE.

 

[PaulC70]

asked the local GP twice. Only to be told not reliable and expensive

Correct to a point but much more reliable after treatment , this info given by prostrate uk

Precisely, EuroTrotters you need a new gp. Whatever their opinion (based on saving themselves money over your health!) you are entitled to this test! 1 in 8 white men and 1 in 4 black men will get prostate cancer!
PSA is an indicator, it's a simple check, if it's raised it can be repeated to ensure accuracy and then if still high you go in the system for other investigations to either exclude cancer or confirm it.

 

[seasideBill]

Precisely, EuroTrotters you need a new gp. Whatever their opinion (based on saving themselves money over your health!) you are entitled to this test! 1 in 8 white men and 1 in 4 black men will get prostate cancer!
PSA is an indicator, it's a simple check, if it's raised it can be repeated to ensure accuracy and then if still high you go in the system for other investigations to either exclude cancer or confirm it.

Information on entitlement is ambiguous…. NHS website states “Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test’”. Prostate Cancer UK interpret that as an entitlement. However, NHS guidelines seem designed to encourage a GP chat for those aged 50+ with no symproms rather than encourage a PSA test for anybody who demands one. I guess funding is proportionate with that approach potentially requiring some rationing on the part of the GP surgery.

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[Hettie's Crew]

Information on entitlement is ambiguous…. NHS website states “Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test’”. Prostate Cancer UK interpret that as an entitlement. However, NHS guidelines seem designed to encourage a GP chat for those aged 50+ with no symproms rather than encourage a PSA test for anybody who demands one. I guess funding is proportionate with that approach potentially requiring some rationing on the part of the GP surgery.

It clearly states here “if you decide you want a PSA test” The GP’s responsibility is to explain, it’s our responsibility and decision to have one.

PSA testing and prostate cancer: advice for men without symptoms of prostate disease aged 50 and over

www.gov.uk

 

[sedge]

asked the local GP twice. Only to be told not reliable and expensive

Pete used to tell chaps whose Drs said that, to slap a tenner on the desk and state 'I'll pay for it myself, then!' since the charity we are trustees of, at that time, was using the NHS hospital Lab for the tests we arranged for men - and we paid them £9 for each one then.

Whatever it costs it won't be as much as www.mypsatest.com charges - and YOUR life is 100% absolutely worth that amount of money to you - if it's not worth it to your GP - change your GP!!!

 

[PaulC70]

Information on entitlement is ambiguous…. NHS website states “Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test’”. Prostate Cancer UK interpret that as an entitlement. However, NHS guidelines seem designed to encourage a GP chat for those aged 50+ with no symproms rather than encourage a PSA test for anybody who demands one. I guess funding is proportionate with that approach potentially requiring some rationing on the part of the GP surgery.

Hettie's Crew beat me to it.

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[seasideBill]

It clearly states here “if you decide you want a PSA test” The GP’s responsibility is to explain, it’s our responsibility and decision to have one.

PSA testing and prostate cancer: advice for men without symptoms of prostate disease aged 50 and over

www.gov.uk

Agreed, but there’s a subtle difference between automatic entitlement like a screening programme and a process that positions the GP as the gatekeeper who might be minded to reassure you in other ways. Research suggests that 3 in 4 men with raised PSA results will not have cancer and that 1 in 7 with cancer will have a normal PSA count. Given the level of unreliability maybe screening by GP rather than patient demand is sensible however frustrating it might be for some?

 

[Odd job]

Our surgery has self referral for a PSA test, quick and efficient. I had a test after a friend was diagnosed with cancer and urged me to go, I didn't think I had any symptoms but had the test done it came back clear with a recommendation to repeat every two years. I was also prescribed Tamsulosin which I did try after much nagging from Mrs. Odd and although I had thought needing the toilet more often was jus old age the tablets have made a big change. I would recommend any man over the age of 70 to try taking it.

 

[trophychap]

All these figures being bandied about with regard to the likelihood of have Prostate Cancer or not let me tell you one. Men in the U.K are dying at the rate of one every FORTYFIVE MINUTES!!!! from Prostate Cancer that is fact.

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[Hettie's Crew]

Agreed, but there’s a subtle difference between automatic entitlement like a screening programme and a process that positions the GP as the gatekeeper who might be minded to reassure you in other ways. Research suggests that 3 in 4 men with raised PSA results will not have cancer and that 1 in 7 with cancer will have a normal PSA count. Given the level of unreliability maybe screening by GP rather than patient demand is sensible however frustrating it might be for some?

100% do not agree with your comments. Read the other way around 1 in 4 men with raised PSA will have cancer, that’s enough to justify blood tests.
“Screening by GP” ? What exactly? DRE because it’s free to the GP, my cancer area of the prostate felt perfectly normal to DRE, it didn’t show up on MRI scan and was only diagnosed with biopsies.
The only reason I have ended up having treatment is because my GP practice is good enough to do PSA tests and referral to services.
Having worked in the NHS for 36 years GP’s are not high on my list of people I admire. My practice is a welcome exception.

 

[seasideBill]

100% do not agree with your comments. Read the other way around 1 in 4 men with raised PSA will have cancer, that’s enough to justify blood tests.
“Screening by GP” ? What exactly? DRE because it’s free to the GP, my cancer area of the prostate felt perfectly normal to DRE, it didn’t show up on MRI scan and was only diagnosed with biopsies.
The only reason I have ended up having treatment is because my GP practice is good enough to do PSA tests and referral to services.
Having worked in the NHS for 36 years GP’s are not high on my list of people I admire. My practice is a welcome exception.

I don’t think you understand my point. I’m not against testing, far from it, just presenting what I see as the dilemma of the situation for medics and why so many struggle to get screened.

 

[PaulC70]

I don’t think you understand my point. I’m not against testing, far from it, just presenting what I see as the dilemma of the situation for medics and why so many struggle to get screened.

There is no dilemma for medics, it is up to men to ask for this test, as you say there is no national screening for prostate cancer, none!
That alone is a travesty, it's only just slightly less deadly than breast cancer which has a massive screening programme!
The only "dilemma" for GPs is the cost for them, there should be no struggle to be screened for a health condition!

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[seasideBill]

The only "dilemma" for GPs is the cost for them, there should be no struggle to be screened for a health condition!

I don’t think it’s 100% clear cut….don’t underestimate the anxiety and distress of a false diagnosis and consequential unnecessary tests and invasive procedures like biopsy. A GP will assess you in the round and recommend the best course of action. Even Cancer Research UK takes the view that screening wouldn’t have a significant impact on deaths. A reliable test would obviously be a game changer, but it doesn't exist.

https://publications.cancerresearchuk.org/sites/default/files/publication-files/Infographic_‘PSA%20without%20symptoms’%20update_print_A4.pdf

 

[PaulC70]

I don’t think it’s 100% clear cut….don’t underestimate the anxiety and distress of a false diagnosis and consequential unnecessary tests and invasive procedures like biopsy. A GP will assess you in the round and recommend the best course of action. Even Cancer Research UK takes the view that screening wouldn’t have a significant impact on deaths. A reliable test would obviously be a game changer, but it doesn't exist.

https://publications.cancerresearchuk.org/sites/default/files/publication-files/Infographic_‘PSA%20without%20symptoms’%20update_print_A4.pdf

I don't underestimate it at all, but that's part of the GP's role to talk everything through and counsel the person. Its a basic tenet of medicine / care ie informed consent.

 

[Nirvanauk]

There is no dilemma for medics, it is up to men to ask for this test, as you say there is no national screening for prostate cancer, none!
That alone is a travesty, it's only just slightly less deadly than breast cancer which has a massive screening programme!
The only "dilemma" for GPs is the cost for them, there should be no struggle to be screened for a health condition!

Don’t know if I agree with your last sentence as there would be no cost to them.

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[PaulC70]

Don’t know if I agree with your last sentence as there would be no cost to them.

yeah I see what you are saying and I should have explained more clearly, I didn't mean specifically financially, though there is a cost (each GP appt is approximately £40 and they don't always recoup all of this from the NHS) but also the cost in time, referrals etc etc.
Here's an example.
I live in Bedford, my GP has done my psa twice, after a referral Im due to have my prostate treatment tomorrow at Addenbrookes at Cambridge (hence 2 days on the lovely CCC site) On one of my letters Addenbrookes have informed me that my gp practice has asked them NOT to ask for any blood tests via my GP (half a mile from my front door) so if I need any relating to my treatment I have to do a 65 mile round trip???

 

[Carpmart]

Thanks for posting. I’ve booked a test in July at an event near me.

 

[3 cabbages]

Man at the Doctors getting his prostate checked. Dr says "Now Ken, dont get an erection when I stick a finger up." Man says " I'm not Ken"
Dr says "No, that was me talking to myself."

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