Dont die of embarassment

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Heckler

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Am of the age now where more checks need to take place. Men are always, or should be, aware of prostate probs. But the thought of that certain "snap" as the doc puts his rubber gloves puts most men off. Anyway, last year, I went for a cholestrol test and I asked the practice nurse to do a PSA test as well. 3 days later and a letter from the practice, drop in for a chat with the GP. Hmmm! Anyway to cut a long story short, the dreaded prostate cancer has got me. I am well on the way with hormone treatment and start radio therapy next month for 7.5 weeks. Prognosis good and the consultant is talking about 3 years down the line when I can come off hormone treatment as well. If all turns out as expected, I will count myself lucky!
As the heading says, dont die of embarrassment, if you are 60ish, go to your GP and discuss prostate tests. I nearly didnt! ( Iasked the consultant what would have happened if I hadnt asked for that test, he said you would have come to see me in a years time with back pains because it would have spread to your bones! I t hasnt thank goodness) The first question I get asked is what are the symptoms? Well I didnt really have any, maybe get up at 4.00am ish for a pee now and again, the only thing I could say is that I did used to have an "urgency to piss" a serious urgency!! I put it down to being a county councillor, normally I dont drink tea during the day, the prob arose, so I thought, because the girls in the counci offices, would always say "cup of tea councillor?"
Going on from there, please, Im not asking for sympathy, I am OK. Please dont regale me with anecdotes or ask have you got this or that symptom, I would rather not have info that will prey on my mind everytime my body does something.
Am writing this so that perhaps more of us will do as I did, and get themselves checked and catch the thing in its early stages.
I repeat, dont die of embarassment!!
Stu
 
Very sorry to hear about your cancer.

The point of this reply is to point out that benefit of screening well men for prostate cancer is not yet established. This may seem counter-intuitive, and I'm not the right person to explain why, in the population as a whole, it might do more harm than good.

Those who are interested might like to look at the Cochrane review of the subject, a summary of which is available here.

It has been argued, with some justification in my view, that people involved in screening and treatment are not in the best position to give a balanced account of the pros and cons. The question has been more exhaustively explored with breast cancer - Gotzsche and others have recently published this in the British Medical Journal
 
I agree that this is a very complex matter and wishful thinking often takes the place of reason, by which I mean, we all want screening to be successful and tend to assume it must be. The scientific/economic approach can seem insensitive but all that is desired is the best result for the most people.

In fact, if Skipper_Stu had consulted a doctor about his symptoms it is not unlikely that an examination and test would have been recommended, and the subject of random screening, which is what Freestyle refers to, would not have arisen. All I can recommend is that people take the advice of their doctors.
 
[ QUOTE ]
what is a PSA test?

[/ QUOTE ] Prostate Specific Antigen. It's present in all men.

There is a very large study callled PROTECT (can't be arsed trying to remeber what it stands for) looking at the outcomes of different treatments and the possible benefits of screening or not. I only know about it as a subject in the study. We will know a great deal more in a few years time.
 
So, the benefits of screening didn't show up in 2 poorly conducted trials. No reason to think that a PSA test is a bad idea.

Can't see how it could do any harm!

---------------------------------------------------------------------------------------

Authors' conclusions

Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of mass, selective or opportunistic screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multicentre randomised controlled trials that will be available in the next several years are required to make evidence-based decisions regarding prostate cancer screening.
 
I am with you on this one, although I did not have to wait till 60 for the test - symptoms at 58! Fortunately the tests showed no cancer just a 2.5 times normal prostate which gives similar symptoms. Hormones to shrink it. PSA came down OK but 2 years later shot up again. Another test (joy!) taking even more samples, still negative. Great relief.

However, during that period two close colleagues were diagnosed, both by "accident" that is went to the docs for one thing and had a PSA as a matter of course.

So my advice is the same as yours, any doubt ask your GP. In my experience reaction is quick.
 
A useful post.
There is not a general correlation between moderately high PSA results (above 4.0) and prostate cancer but it is wise to check it out with a biopsy. The curious thing about this condition is that even though cancer may be detected there may be no treatment. The management is called "watchful waiting". There must be very few conditions where a similar strategy is adopted but it is within the medical ethic that treatment should make the patient better not worse and the treatments for prostate cancer generally have unfortunate side effects.
Good luck skipper _stu
 
"the treatments for prostate cancer generally have unfortunate side effects."

The side effects aren't half as bad as they can be for an untreated prostate cancer!
 
Exactly my experience even if the collection of samples for the biopsy is unpleasant, particularly second time around. You are right there are various ways of dealing with it, depending on the circumstances, of which one is wait and see. That is why it is really important to see a specialist who can explain the alternatives. Web searches throw up extensive material which helps provide background when you do get into the discussion with a specialist.

There are echoes in this thread with a recent one on Liveaboard about the use of warfarin. Applies to a similar age range, which is also a significant age range for cruising yotties. So relevant as managing these conditions is crucial to getting the best out of declining years!
 
Thanks, thats handy, although it seems that the love of a faithful partner is just as effective, and slightly more fun. Indeed I am minded to ask my wife to help protect me from cancer tonight,

Seriously, it is a good thing that people are willing start posts like this, so thank you for that and good luck to all.

R
 
I agree with Freestyle. Nobody is checking my PSA without good reason. I have seen a number of men rendered seriously ill following trans rectal biopsies subsequent to PSA testing (as painful as it sounds) and a number of men whose quality of life has seriously suffered following therapy for Ca prostate, which may or may not have shortened their life, picked up on screening. The Times medical correspondent is fanatical about pursuading men to get screened, but the evidence (as referenced above) just does not match up. And the evidence for breast screening is not much better, again as recently debated in the BMJ. But that is a whole new can of worms.......
 
My view is get the PSA test.If nothing shows up ok,if it does well take advice.I know the score I found out by accident,had the opp.years latter PSA levels went up to 99,following medication am down to 0.01.Still sailing and am glad I found out in time.GET TESTED.
 
By way of my support for testing.

I have a Medical MOT every two years.

Last but one test the PSA was under 1. which was great

Then the MOT late last year, the PSA was just over 7.
Retook the PSA the following weekand results were 6+

Had an ultrasound scan (rather than the digit up the rear).
Prostate normal size, BUT several small nodules on it.
Antiboitics for six weeks.
Another ultrasound scan. Nodules gone, appear to have been an infection. PSA was 1.1.

Will monitor and do another test in a few months.

Rather that then finding out too late!!!!!

Surgery is an option, but can result in erection problems.
Careful surgery can avoid this (damaging/removing nerves).

Better to do the blood test etc rather than find out too late.
 
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