Bunkermagnet
Journeyman Pro
I'm 57 now, and had the checks at 50 inc bloods, but I've never had any prostate tests.
I'm not going to pursue it either.
I gotta die sometime
Prostate Cancer
- Thread starter rudebhoy
- Start date
I'm not going to pursue it either.
I gotta die sometime
Jensen
Tour Rookie
With all the publicity about Prostate Cancer, I contacted my GP requesting a PSA test. She advised me that a PSA test could give a false positive, due to whether you have just exercised and other factors.
She advised examining the prostate via the rectum was more accurate. So I had this done, where everything was confirmed ok, not enlarged and smooth.
She then went onto take my blood pressure, which I think she should’ve done first
Had mine checked at 55
She advised examining the prostate via the rectum was more accurate. So I had this done, where everything was confirmed ok, not enlarged and smooth.
She then went onto take my blood pressure, which I think she should’ve done first
Had mine checked at 55
DTChick
New member
Long time lurker, first time poster but this is really important.
I would 100% recommend any man over the age of 50 asks for a PSA test.
After experiencing no symptoms previously, back in April last year my husband noticed a small amount of blood in his urine and a slight discomfort in his bum that we initially thought might be a pulled glute (he played hockey, golf & badminton actively at the time therefore muscle issues, fractures, breaks and injuries were not uncommon).
Went to the GP fairly immediately (well it took him 2 weeks to pluck up the courage to tell me and book an appointment but for a bloke that's pretty good), had a PSA test done which came back high. This triggered physical exams, biopsies, scans etc which ultimately led to his diagnosis of stage 4 metastatic prostate cancer and bone disease. It had spread to his lymph nodes, pelvis, hip, spine and lungs.
From first symptom to diagnosis was 6 weeks.
He’s now 17 months post diagnosis, has had 6 rounds of chemo, 20 sessions of radiotherapy, is on one set of hormones for life, has just started another set as his PSA is rising again and will be starting on bisphosphonates at the end of the month to treat the bone disease which is progressing.
The average survival rate of patients with stage 4 metastatic prostate cancer is 5 years. He is 58.
A PSA test isn’t a conclusive diagnosis. Further tests and exams are always going to be needed to confirm if anything comes back out of the ordinary but early diagnosis is key.
Catch it before it breaches the prostate and treatment and care pathways are so much more straight forward and the prognosis for a successful outcome is FAR greater.
I would 100% recommend any man over the age of 50 asks for a PSA test.
After experiencing no symptoms previously, back in April last year my husband noticed a small amount of blood in his urine and a slight discomfort in his bum that we initially thought might be a pulled glute (he played hockey, golf & badminton actively at the time therefore muscle issues, fractures, breaks and injuries were not uncommon).
Went to the GP fairly immediately (well it took him 2 weeks to pluck up the courage to tell me and book an appointment but for a bloke that's pretty good), had a PSA test done which came back high. This triggered physical exams, biopsies, scans etc which ultimately led to his diagnosis of stage 4 metastatic prostate cancer and bone disease. It had spread to his lymph nodes, pelvis, hip, spine and lungs.
From first symptom to diagnosis was 6 weeks.
He’s now 17 months post diagnosis, has had 6 rounds of chemo, 20 sessions of radiotherapy, is on one set of hormones for life, has just started another set as his PSA is rising again and will be starting on bisphosphonates at the end of the month to treat the bone disease which is progressing.
The average survival rate of patients with stage 4 metastatic prostate cancer is 5 years. He is 58.
A PSA test isn’t a conclusive diagnosis. Further tests and exams are always going to be needed to confirm if anything comes back out of the ordinary but early diagnosis is key.
Catch it before it breaches the prostate and treatment and care pathways are so much more straight forward and the prognosis for a successful outcome is FAR greater.
It seems wrong to “like” a post such as this, so I’ll reply instead.
Welcome to the forum and thanks for the very wise words. You’re absolutely right, of course. If caught early, treatments for PCa are likely to be far more beneficial than they are once the gland has been breached. I did find the comment of another poster, who isn’t going to bother with a PSA test because he’s “got to die some time” to be odd in the extreme.
So again, welcome to the forum, and the warmest of wishes to you and your husband.
Personally, I’m very much in favour taking control of my own ‘destiny.’ If I feel it needs doing I would be unequivocal in my request to get it done.
For my own bowel cancer, I was very keen to take control of the treatment rather than let the disease control the treatment. Thankfully, after a rough ride, I’m currently NED (No Evidence of Disease) but as I act as a patient advocate for bowel cancer sufferers I always nudge patients to choose their own outcomes.
For my own bowel cancer, I was very keen to take control of the treatment rather than let the disease control the treatment. Thankfully, after a rough ride, I’m currently NED (No Evidence of Disease) but as I act as a patient advocate for bowel cancer sufferers I always nudge patients to choose their own outcomes.
Bunkermagnet
Journeyman Pro
Actually, I didn't say "bother" I said "pursue".
It amounts to exactly the same thing. It’s a simple blood test followed by a quick rummage where the sun doesn’t shine by a medical professional. I really would advise you to do it.
SwingsitlikeHogan
Major Champion
…but on BC it’s important to recognise that about 20% of cancers are DCIS, and DCIS cancers are almost all curable. With all other BCs the important and determining factors are stage of detection and whether spread into lymph nodes.
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stefanovic
Medal Winner
To sum this one up.
There may be no need for a PSA or other test.
Because, if there is something that feels different about your body and it lingers for more than 2 weeks, just go to the doctor.
You might want to contact them before that.
If the doctor suspects cancer you will be referred to the hospital.
In the case of something unusual in your waterworks it's likely to be a specialist urologist, who will indeed stick a finger up your bum.
If the urologist detects a lump on your prostate you will advised to have a rectal biopsy, CT scan and bone scan.
If the results detect cancer the next person you will see is the oncologist.
This may well be your lucky day!
The oncologist is there to save your life.
Not sure if you need to know any more, apart from don't listen to snake oil remedies.
There may be no need for a PSA or other test.
Because, if there is something that feels different about your body and it lingers for more than 2 weeks, just go to the doctor.
You might want to contact them before that.
If the doctor suspects cancer you will be referred to the hospital.
In the case of something unusual in your waterworks it's likely to be a specialist urologist, who will indeed stick a finger up your bum.
If the urologist detects a lump on your prostate you will advised to have a rectal biopsy, CT scan and bone scan.
If the results detect cancer the next person you will see is the oncologist.
This may well be your lucky day!
The oncologist is there to save your life.
Not sure if you need to know any more, apart from don't listen to snake oil remedies.
Quick, mention the BBC.
stefanovic
Medal Winner
We call on UK to step up as new figures show prostate cancer now a bigger killer than breast cancer
We want to stop prostate cancer being a killer. We fund groundbreaking research, drive improvements in treatment, and fight injustice in care.
Why has this happened?
Mainly because men don't go to the doctor until it's too late.
Symptoms to look out for:
Going for a pee more often over a period of more than a week.
Burning feeling when you do go.
Feeling of not emptying your bladder.
It might just be an infection, but infections don't usually last for more than 4 days.
Things to do:
Have a word with the doctor.
If an appointment is not immediately available then ring the PC helpline.
Prostate Cancer UK's Specialist Nurses
If you've been diagnosed or have concerns about prostate cancer, our Specialist Nurses are here to support you and answer questions. We also welcome calls from partners, family and friends and from health professionals.
You could also try ringing your local support group who will provide good information.
Check your risk in 30 seconds | Prostate Cancer UK
It's the most common cancer in men, but most men with early prostate cancer don't have symptoms. Find out about your risk now.
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SocketRocket
Ryder Cup Winner
I keep hearing of Men finding they have aggressive Prostate Cancer who had no symptoms. This happened recently to an ex-work colleague and also to Nick Owens the TV presenter. It seems pretty obvious to me that if Man is having annual health check blood samples they should have a PSA included.
stefanovic
Medal Winner
I for one did not know what the symptoms were, and they probably didn't either.
1st biopsy showed I had cell changes which soon developed into the disease.
Don't like the term silent killer, but potentially that is true.
Posts here suggest the PSA test is not reliable.
In my experience it is reliable within a fairly small margin of error.
Example: PSA is measured at 5.5.
Doctor will probably want a re-test in a couple of weeks.
If it drops below 5, it might be might be okay for now, but still needs watching.
As the PSA can fluctuate, more than one reading above 5 will get you into the system, which can only be for your benefit.
It was mentioned to me at the hospital that some patients had had their PSA measured in the thousands.
1st biopsy showed I had cell changes which soon developed into the disease.
Don't like the term silent killer, but potentially that is true.
Posts here suggest the PSA test is not reliable.
In my experience it is reliable within a fairly small margin of error.
Example: PSA is measured at 5.5.
Doctor will probably want a re-test in a couple of weeks.
If it drops below 5, it might be might be okay for now, but still needs watching.
As the PSA can fluctuate, more than one reading above 5 will get you into the system, which can only be for your benefit.
It was mentioned to me at the hospital that some patients had had their PSA measured in the thousands.
Ethan
Money List Winner
No need to get angry. This is a question based on science on PSA and prostate cancer, and I am sure you realise that your experience may not be the same as others. I would also say, with respect, that personal experience gives a biased point of view. The science is based on millions of cases and tests across the world, and that includes a massive variety of situations mostly based on the most common scenarios, obviously.
Someone mentioned breast cancer above, suggesting it was somewhat different from prostate. In fact it really isn't all that different. If you look at post mortem data for people who die at an old age, you will find a decent number of undiagnosed prostate or breast cancers, sometimes metastasised. We now know that there are a lot of these indolent cancers that were never going to affect the persons life expectancy. The trick is differentiating those from cases that needed treatment. There is another group who have disease at detection with is untreatable. So that leaves a group in the middle who may have disease whose outcome can be, and needs to be, changed. This is where PSA comes in. It clearly rises with cancer, but there is considerable overlap between PSA levels in cases and normals. If you set the trigger level for PSA close to the lowest PSA that is associated with cancer, that means you will flag a lot of people that don't, but will still have investigations that have complications or surgeries that actually are not necessary, and there are deaths associated with both.
The initial enthusiasm for breast cancer screening was based on misinterpreted data, a phenomenon called "lead time bias" which basically means that if you do a study of outcomes of breast cancer, you may find that women detected early live 6 months longer than those not screened. It was later realised that they were also being detected about 6 months earlier than would otherwise have been the case, in other words any deaths that occurred occurred at pretty much the same time regardless.
I recently read a thread on a doctors website and the general view, including some radiologists and some cancer doctors, was that the breast screening programme was ineffective and some of the screening-age women doctors who posted said they did not take part. The Govt stats used to persuade women to go for screening use a selective approach to the data, so whilst not long, it isn't the whole picture either.
Prostate screening has been evaluated over and over and the conclusion has repeatedly been that it is of minimal overall benefit. This is not cost cutting or anti-male bias in healthcare. It simply doesn't work on a population basis. For every person who benefits, and perhaps you did, there is another who does badly needlessly. That poor guy is not your problem, but there are such guys. Test people with symptoms, sure, no problem, because that enriches the sample for cases that will benefit.
I also put my money where my mouth is. I am older than you and don't have PSA tests. I get annual blood tests for something else and one year they did a PSA without asking me, so now I tell them not to do PSA. I have no great issue with anybody who wants a PSA and accepts the risks and benefits, but I think some of the promotion of the screening campaigns is, however well intentioned, unwise.
Ethan
Money List Winner
That is not what is meant by reliable, which is not a useful term for this anyway. PSA may well be quite stable over time.
The question is the predictive value for the risk of cancer, and it is very poorly predictive. There is a large overlap between the normal range and the cancer range, and because at any one time there are relatively few cancer cases, it means that a lot of normals get drawn in and are investigated unnecessarily.
One other thing, the effectiveness of screening for cancers vary. The cervical screening programme, which involves smear tests, is undoubtedly very effective and has contributed to a large improvement in outcomes for women with cervical cancer and pre-cancer. It illustrates the key issue within screening, which is the question 'To what extent will this test select the right people who need further investigation or treatment'. For cervical, the answer is that it selects them pretty well. For breast and prostate, not very well at all.
An analysis of breast screening in the BMJ argued that if 2000 women annually are screened for 10 years, 1 woman will avoid dying of breast cancer, but 10 will have unnecessary surgery of whom most will also have radiotherapy, and 125 will have a biopsy. if my wife decided she did not want tom take part in this, I wouldn't try to persuade her otherwise.
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AmandaJR
Money List Winner
An interesting read from @Ethan as I'm currently taking part in a trial with regard to breast cancer screening. It is examining whether a more personalised screening frequency, based upon risk, is more effective than the current system. I was selected for the Personalised Screening group and assessed to be at high risk of developing breast cancer so currently have an annual mammogram.
Really informative, as always, but I’m still left feeling slightly bemused.
I’ve accepted many times that PSA testing is not the panacea, far from it. But equally, in the absence of alternative screening, it surely must be regarded as a half decent starting point, a trigger which prompts further investigation. I know I’m repeating myself in saying that, and note your response, but please read on!
A PSA test will not cause physical harm, and I wholeheartedly agree that it cannot come close to diagnosing anything. And I would hope a carefully conducted DRE would be likewise harmless. If the combination of those tests raises suspicion, then, in my case and many others, an MRI followed, that presumably being equally harmless to my physical health. It was that scan which confirmed an abnormality.
This brings me to the crux of my question. In the event a man had been through those three stages and an abnormality found, where do you stand on whether that man should then have a biopsy? I am assuming, from experience and my own background reading about prostate biopsies, that it is from this point on where physical complications can occur. In my case, I was knocked for six, for several weeks. I could not believe that taking a number of sample cores could wipe me out like that.
But it was that procedure itself, not the PSA screening, DRE or MRI, which diagnosed cancer and gave my multi disciplinary team an indication, not the definitive answer I hasten to add, of the grading of that cancer, and allowed them to recommend treatment options. It was stressed to me repeatedly that the decision how to proceed was mine. I suspect, having read your reply, that is because even at that point my MDT were not 100% certain what they were dealing with - that only became clear once the remains of my prostate were subject of further pathological examination.
I do accept without contest that PSA screening is not the definitive guide that many think. But where I remain rather perplexed is when we reach the point of an invasive biopsy. Are you saying that, even at the point of an MRI confirming an abnormality, further investigation in the form of a biopsy is resulting in many men having needless treatment?
If that’s the case then it’s not just the PSA test which is the problem, but the entire investigative process. And that really is a concern.
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rudebhoy
Q-School Graduate
Off for the PSA this morning, and the rectal exam is booked for next week. Flying to Rome the next morning, hope the seats are comfy
If you’re feeling it the next day, you’ve been assaulted.Off for the PSA this morning, and the rectal exam is booked for next week. Flying to Rome the next morning, hope the seats are comfy
Tashyboy
Please don’t ask to see my tatts 👍
As was mentioned to me on another thread. If there’s no pictures it never happenedOff for the PSA this morning, and the rectal exam is booked for next week. Flying to Rome the next morning, hope the seats are comfy
