PSA test - men

BillN_33

BillN_33

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Just a reminder to you guys to have your regular PSA tests

I know it's not a pleasant subject, but it is really important

Out here, in France, they are pretty hot on that sort of thing and I have just had my regular 2 year echo scan (did my kidneys at the same time as my prostrate), - I normally get a PSA blood test maybe once a year ......... both totally painless and very quick procedures

the reason I also mention this is that a friend of mine has just had his prostrate removed ..... symptoms just came on without notice

maybe not for a photographic forum, but I think that it is worth mentioning ......... if it is not for here I am sure the Mods will take it down
 
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Lost my dad to this horrible disease when he was far too young. Don't ignore any symptoms, far better a few moments to get them checked than finding out when it's too late (and don't just trust the PSA if you still think you have a problem. Request alternative tests as this cancer doesn't always elevate PSA levels)
 
Don't forget to check the veg as well. If the "boys" feel different, get 'em checked out.
 
Test kit in the post? How does one get one of these then.....
 
LASTOLITE said:
Test kit in the post? How does one get one of these then.....
Click to expand...

Bill - ask your doc

http://www.nhs.uk/Conditions/Cancer-of-the-colon-rectum-or-bowel/Pages/Screeningforbowelcancer.aspx

IMHO it is important to be pro active in matters like this - the NHS is under pressure and it is up to all of us to be aware of what is available and when tests should happen

In France there seems to be a database and reminders and appointments are just triggered automatically both through the post and on the docs computer screen - maybe I'm wrong, but it seems that way

I do not think that I am unusual but I have a blood test at least once a year that checks for various things ..... about 10 areas including Cholesterol levels ...... I ask the doc, or he tells me, he gives me a letter/prescription .... I pop along to the local clinic the next morning, usually a maximum of 30 mins wait, sometimes no waiting, they take a blood sample ..... the cost is 40 Euros - 65% is paid by the Government because I am a French resident and 35% from my insurance company ............. I get the report through the post the next day with the results compared against the "norm" and against the last 5 tests. ....... any unusual areas are highlighted........ the doc gets the same report, but I usually email him with the results anyway to remind him

The bowel cancer test is very important - any signs out here and you are in for a Colonoscopy within a couple of weeks - a simple procedure, but out here it is a general anaesthetic event and a morning in the clinic ....... but in the UK I believe that you are semi conscious ......... once you have had the procedure and if minor problems are found, (usually polyps), they repeat it every 2 or 3 years unless the symptoms re-occur through the next test

I do not think that I am at all usual in being aware of what's needed ........ my neighbours seem to treat such subjects as normal ....... the same as a flue jab, (which I never have), reminder came a few weeks ago!
 
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Thanks! will have a chat with Doc's, better to be safe then sorry...would a psa test pickup anything if it was an other form of cancer in your system? I wonder.
 
BillN_33 said:
Just a reminder to you guys to have your regular PSA tests
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The PSA test is a very poor test. The rates of false positive, false negative and irrelevant positive are very high.

There was a recent BBC programme investigating which routine tests were worthwhile, and the PSA test was one that most doctors wouldn't choose to have.

http://www.bbc.co.uk/news/magazine-33855895
 
Alastair said:
The PSA test is a very poor test. The rates of false positive, false negative and irrelevant positive are very high.

There was a recent BBC programme investigating which routine tests were worthwhile, and the PSA test was one that most doctors wouldn't choose to have.

http://www.bbc.co.uk/news/magazine-33855895
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I realise that, my daughter-in-law is a doctor and my son runs a Private Medical Centre

There are many many men with high PSA levels that do not have any cancer indications and enlarged prostrates are the norm the older you get

are you saying, based on the BBC programme, do not have the test then? ........ what is your suggestion as an alternative for general screening?

One of the reassurances of the test even if you have a recorded an increase in your PSA levels is that a further different blood test will help to clarify matters and an echo scan if needed will establish the facts.

Regular testing is important not only for the absolute value but also for an change that may occur ......... prevention is the key ................. just IMHO


you will find it difficult to get an echo scan without symptoms, and then it may be too late, unless you go privately
 
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BillN_33 said:
are you saying, based on the BBC programme, do not have the test then? ........ what is your suggestion as an alternative for general screening?
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It's based on more than one programme, that was just a convenient recent link. Do your own searches to check. I'm not sure the relevance of the knowledge of other members of the family, my mother's a midwife but I wouldn't claim to have any greater knowledge of the delivering of a baby than anyone else.

If you have no symptoms and no family history of prostate or breast cancer then the the statistics suggest there is very little value (or negative value) in PSA screening.

Analysis of the data suggests that general population screening for PSA has a negative value, resulting in more unnecessary interventions/surgeries and more stress-related conditions than not screening the general population.
 
Alastair said:
It's based on more than one programme, that was just a convenient recent link. Do your own searches to check. I'm not sure the relevance of the knowledge of other members of the family, my mother's a midwife but I wouldn't claim to have any greater knowledge of the delivering of a baby than anyone else.

If you have no symptoms and no family history of prostate or breast cancer then the the statistics suggest there is very little value (or negative value) in PSA screening.

Analysis of the data suggests that general population screening for PSA has a negative value, resulting in more unnecessary interventions/surgeries and more stress-related conditions than not screening the general population.
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so you are basically saying unless you have a family history of prostate or breast cancer the test is of no value or even a negative value

I did not say I had any greater knowledge than anyone else - I said that I was aware of what you had reported because it had been discussed with me by my son and daughter in law .............
 
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Uk based, over 50, I've never been invited in for any tests whatsoever. Never even heard of a PSA test, assuming its prostate.
 
Not the diagram I'm looking for, but this illustrates the stats well enough - screening 1,000 men avoids results in (on average) slightly less than one death avoided due to prostate cancer whilst just over 100 have the stress of a false positive, andthis graphic doesn't include those that would have died with prostate cancer not of prostate cancer (slow-growing benign tumours that do not impact longevity)..

psa-infographic.jpg


http://www.cancer.gov/types/prostate/psa-fact-sheet
http://prostatecanceruk.org/prostat...st#what-are-the-pros-and-cons-of-the-psa-test
 
BillN_33 said:
so you are basically saying unless you have a family history of prostate or breast cancer the test is of no value or even a negative value.
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Not quite, if you have a family history of prostate/breast cancer the numbers suggest screening is appropriate.

If you have symptoms (regardless of family history) the test will have diagnostic value alongside the other diagnostic options available.


The distinction between the test itself and a general population screening programme is important.
 
Alastair said:
Not the diagram I'm looking for, but this illustrates the stats well enough - screening 1,000 men avoids results in (on average) slightly less than one death avoided due to prostate cancer whilst just over 100 have the stress of a false positive, andthis graphic doesn't include those that would have died with prostate cancer not of prostate cancer (slow-growing benign tumours that do not impact longevity)..

psa-infographic.jpg


http://www.cancer.gov/types/prostate/psa-fact-sheet
http://prostatecanceruk.org/prostat...st#what-are-the-pros-and-cons-of-the-psa-test
Click to expand...


so a general screening test "kills" more than it saves .......... interesting .......... I suggest that the Mods take the post down ........... and I'll tell my local MD
 
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BillN_33 said:
so a general screening test "kills" more than it saves
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Not if you read the diagram correctly.

On average 5/1000 men die from prostate cancer if you don't screen.

On average somewhere between 4 and 5 men per 1000 die from prostate cancer with screening. Or only very slightly less than with no screening at all.


Another interesting link on the subject of screenin, http://understandinguncertainty.org/node/1279
 
There is always an alternative medical point of view: http://www.medscape.com/viewarticle/824024
STOCKHOLM — For the first time, updated results from the European Randomized Study of Screening for Prostate Cancer (ERSPC), the largest randomized prostate cancer screening trial in the world, show a significant survival advantage with prostate-specific antigen (PSA) screening for men from 50 to 74 years of age.

The new data come from a follow-up of 13 years, and were presented during a late-breaking abstract session here at the European Association of Urology 29th Annual Congress. An initial analysis of the ERSPC results, reported in 2009, provided the first proof that PSA screening saves lives from prostate cancer.

This update "offers the most robust data yet in support of the effectiveness of PSA-based early detection efforts to reduce prostate cancer metastases and mortality," said Matthew Cooperberg, MD, MPH, associate professor of urology, epidemiology, and biostatistics at the University of California, San Francisco
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Keep up the good work Bill :)
 
The conclusions given by the ERSPC are not quite as the press release given above would suggest..

"Despite showing a clear prostate cancer mortality reduction, the findings are not sufficient to justify population-based screening. We still need further quantification of harms of screening and better strategies to overcome overdiagnosis and overtreatment for both more targeted screening and assessment of prostate cancer risk, such as multivariate risk stratification. In the meantime, well-informed men suitable for screening should have access to PSA-testing if they wish after careful consideration of the pros and cons. Various decision support tools are available online developed for communication of the pros and cons for men considering screening to discuss with their doctors. Multiparametric magnetic resonance imaging holds promise in evaluation of screen-positive men and is being tested in large scale trials."​

http://www.erspc.org/
 
BillN_33 said:
The bowel cancer test is very important - any signs out here and you are in for a Colonoscopy within a couple of weeks - a simple procedure, but out here it is a general anaesthetic event and a morning in the clinic ....... but in the UK I believe that you are semi conscious ......... once you have had the procedure and if minor problems are found, (usually polyps), they repeat it every 2 or 3 years unless the symptoms re-occur through the next test
Click to expand...

You believe right, at least in my experience (and believe me, I have experience :( ) They say semi-conscious but I think there are only three that I recall anything at all about, most of the time I sleep right through them.
I get a colonoscopy every three years due to a genetic testing programme and a family history of bowel cancer. I think it was the fourth one that showed some polyps, a including a couple of large ones. I am sure that if left, they would have become a serious problem. They were removed, I was tested yearly for two years and now they are happy to go back to three yearly.
Thanks for the thread, Ive just realised Im two months overdue.
 
Alastair said:
The conclusions given by the ERSPC are not quite as the press release given above would suggest..

"Multiparametric magnetic resonance imaging holds promise in evaluation of screen-positive men and is being tested in large scale trials."​

http://www.erspc.org/
Click to expand...


I have the X-rays of my scan .............. plus other bits and pieces from other tests
 
Madmoggy said:
I think it was the fourth one that showed some polyps, a including a couple of large ones. I am sure that if left, they would have become a serious problem. They were removed, I was tested yearly for two years and now they are happy to go back to three yearly.
Thanks for the thread, Ive just realised Im two months overdue.
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same here, but not too bad, but three small ones removed .... I even got coloured photos and I could have had a video ........... not just images on a memory stick but real prints, (wedding photographers take note!!)

the day before preparation is quite interesting .......... again talking to a few guys out here ............ polyps are quite common as is a two or three year check

We should just treat all this stuff, tests etc., as a normal "preventative" situation ....... modern medicine is just progressing so quickly that much can be done if problems are found ........... but we all have a duty to ourselves and families to take responsibility for our own health
 
Simple screening always makes sense and provides an opportunity to discuss treatment options or no treatment.
 
The PSA test is poor as a screening tool for prostate cancer, largely down to specificity and sensitivity. The infographic posted by @Alastair explains this well. You could have a normal PSA (and a normal prostate exam) and still have prostate cancer. Even TRUS + biopsy might not find cancer if they've not been taken from the right areas. MRI is more useful but we still don't have a good easy screening tool for prostate cancer.
 
So heads in the sand then everyone! :rolleyes:
 
crofter said:
Job done,poo in the post and on it's way to whichever unfortunate soul has to examine it.
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I think that you can buy a test kit on Amazon and do your own analysis .......... trust the internet!!!
 
I had a PSA test some time ago as part of a Well Man clinic.

I mentioned at the time that my flow rate was poor and I could sometimes be stood there for ten minutes waiting to finish. I was sent for tests and put on Tamulosin to control it but that has very little effect.

I have since had MRi scans that revealed the extent of the damage. My doctor explained that his prostate is the size of a grape (that is how it should be) whereas mine is the size of a tangerine. He is around 30 while I am 61.

I was then sent for a biopsy (I won't go into how that is taken) and they have found a non malignant growth. I am now waiting for a second biopsy date to find out what that growth is.

Don't argue and bury your heads in the sand about how effective the PSA test is because at the end of the day it WILL pick something up that CAN be treated. Also if your flow rate is getting slower I also urge you to see your doctor immediately and get it sorted ASAP.

As for the poo stick thing that is nothing to do with your prostate but every thing to do with bowel cancer. Get that checked too.
 
Harriers9 said:
I had a PSA test some time ago as part of a Well Man clinic.

I mentioned at the time that my flow rate was poor and I could sometimes be stood there for ten minutes waiting to finish. I was sent for tests and put on Tamulosin to control it but that has very little effect.

I have since had MRi scans that revealed the extent of the damage. My doctor explained that his prostate is the size of a grape (that is how it should be) whereas mine is the size of a tangerine. He is around 30 while I am 61.

I was then sent for a biopsy (I won't go into how that is taken) and they have found a non malignant growth. I am now waiting for a second biopsy date to find out what that growth is.

Don't argue and bury your heads in the sand about how effective the PSA test is because at the end of the day it WILL pick something up that CAN be treated. Also if your flow rate is getting slower I also urge you to see your doctor immediately and get it sorted ASAP.

As for the poo stick thing that is nothing to do with your prostate but every thing to do with bowel cancer. Get that checked too.
Click to expand...

Hope all works out well for you :)
 
Harriers9 said:
Don't argue and bury your heads in the sand about how effective the PSA test is because at the end of the day it WILL pick something up that CAN be treated.
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It's not about head in sand, you had symptoms (flow rate) and so did @BillN_33 's mate. Neither case was picked up by general screening. And in neither case has a PSA test been mentioned so far. I would personally not take up the offer of a PSA test. PSA is less accurate than breast screening, and breast screening is so bad that only 8% of positive results from screening actually have cancer. General population screening is a very blunt tool in many cases, the research to improve this is around targeting the diagnostics - pre-screening before testing.

By contrast, the bowel cancer screening test is supposed to be far more accurate. And there's a strong case for wider availability of ultrasound in GP surgeries as a diagnostic tool.


Good luck with getting things sorted Philip.
 
Re the effectiveness of the PSA test. I had one in 2005 which came back with a raised result and had two biopsy tests on my prostate, the first one was inconclusive, the second one was clear. My GP immediately referred me for a further consultant appointment, who sent me for a kidney/bladder ultrasound scan. the scan showed that my right kidney was cancerous, but at an early stage. It was removed in less than a month and I'm still here, so in my case the PSA test saved my life. It's better to have one and get a raised result which is a false alarm than not have one and be told "Sorry you have left it too late."
 
I thought that my posting would be helpful, but I am now not sure,


My experience was quite simple, (in France) - at 65 years a PSA test, resulting in a low recorded PSA level, (1.6ng/ml) - but the Doc decided I should have an echographie, (an echo scan), because of my age ...... as part of a general check up .........

(I was never aware about the PSA when we lived in the UK - It was mentioned to me by a friend in the US maybe 10 years ago who was surprised when I said I had never had a PSA test - he could not believe it)

another PSA test 2 years later - normal - (in France if it is less than 4 ng/ml - it is considered OK, taking my age etc., into consideration)

3 years later another PSA test - raised level to 4.6 ng/ml - doc immediately said usually no worries but we need to be sure and I want you to have an echo scan - 4 days later echo scan on kidney's, bladder and prostrate with also the usual empty you bladder check ..... prostrate weighted, (calculated weight), measured and all that stuff ...... simple procedure this echographie does not take long and totally painless ..... the size of my prostrate had increased since the last echographie ......... that's what causes pressure on the bladder

All OK

One of benefits of regular testing is that it shows any change that may have occurred

The test is very cheap, quick and easy, but of course no one test on it's own is enough ....... but the cost of cancer treatment and care is very very high and regular testing of the over 60's and because the PSA test is cheap and easy must have significant merit for any health system which is under constant financial pressures

I am no expert in matters like this, all I did was to flag it as my experience as I thought that it would be useful, and also, at my age, I'm 69 years old, for the past few years friends of mine have experienced the usual problems ...... some OK, some bad

As I said to Alastair, my daughter in law and my son are connected with the medical profession and as such I discuss all matter like this with them and get their views: from them I am aware of the opinions concerning false positives, the information available and the official guidance given by the UK NHS etc., probably more than most....... but I am surprised that Alastair, who I presume is not an expert, wants to "rubbish" the tests and effectively advise against any "general screening" particularly for anyone over the age of 60 years. He also sees my discussions with my son and daughter in law and knowledge gained on this matter as akin to any knowledge he has from his mother regarding the delivery of a baby.......... which again I just do not see as logical.


As usual in many cases in life, dammed if you do and damed if you don't seems par for the course
 
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BillN_33 said:
I thought that my posting would be helpful, but I am now not sure,
Click to expand...

It is helpful Bill, my view is that everyone should take advantage of tests available to check for serious conditions ... yes some indications may eventually prove erroneous but IMO it is better for a harmless mistake to occur than to end up wishing that you had had it done.
 
BillN_33 said:
Bill - ask your doc

http://www.nhs.uk/Conditions/Cancer-of-the-colon-rectum-or-bowel/Pages/Screeningforbowelcancer.aspx

IMHO it is important to be pro active in matters like this - the NHS is under pressure and it is up to all of us to be aware of what is available and when tests should happen

In France there seems to be a database and reminders and appointments are just triggered automatically both through the post and on the docs computer screen - maybe I'm wrong, but it seems that way

I do not think that I am unusual but I have a blood test at least once a year that checks for various things ..... about 10 areas including Cholesterol levels ...... I ask the doc, or he tells me, he gives me a letter/prescription .... I pop along to the local clinic the next morning, usually a maximum of 30 mins wait, sometimes no waiting, they take a blood sample ..... the cost is 40 Euros - 65% is paid by the Government because I am a French resident and 35% from my insurance company ............. I get the report through the post the next day with the results compared against the "norm" and against the last 5 tests. ....... any unusual areas are highlighted........ the doc gets the same report, but I usually email him with the results anyway to remind him

The bowel cancer test is very important - any signs out here and you are in for a Colonoscopy within a couple of weeks - a simple procedure, but out here it is a general anaesthetic event and a morning in the clinic ....... but in the UK I believe that you are semi conscious ......... once you have had the procedure and if minor problems are found, (usually polyps), they repeat it every 2 or 3 years unless the symptoms re-occur through the next test

I do not think that I am at all usual in being aware of what's needed ........ my neighbours seem to treat such subjects as normal ....... the same as a flue jab, (which I never have), reminder came a few weeks ago!
Click to expand...

Madmoggy said:
You believe right, at least in my experience (and believe me, I have experience :( ) They say semi-conscious but I think there are only three that I recall anything at all about, most of the time I sleep right through them.
I get a colonoscopy every three years due to a genetic testing programme and a family history of bowel cancer. I think it was the fourth one that showed some polyps, a including a couple of large ones. I am sure that if left, they would have become a serious problem. They were removed, I was tested yearly for two years and now they are happy to go back to three yearly.
Thanks for the thread, Ive just realised Im two months overdue.
Click to expand...

When I had a endoscopy and colonoscopy a few months back they didn't offer me any sedation for the colonoscopy as they said it won't be a long procedure and it wasn't to painful. If I go again I want sedation, it hurt! They numbed the throat with some spray for the endoscopy which wasn't too bad.

I suffer with chronic epididymitis and have an enlarged prostrate, so luckily for me I have a regular check up with my urologist along with the regular blood tests. They keep an eye on me.
 
Had occasion to visit my GP a couple of months ago and was advised to have the FUTB (DRE) test. Prostate found to be very hard. Had a PSA blood test and it came back at over 100(!) which started the alarm bells ringing as it is a pretty sure sign that there is something serious going on. Was referred for an urgent hospital appointment (which turned out to be four weeks later). Had another FUTB test and because of the high PSA result a biopsy was by-passed and a bone scan and CT scan followed which, happily, were clear. Was then decided that a biopsy was needed after all/

Had the biopsy today - results in a couple of weeks.

I'm writing this to reassure anyone who is a bit concerned (as I certainly was) about having a biopsy. It was nothing compared to how worried I was and the biopsy procedure itself is all over in minutes.

I am 74 years old, fairly fit and haven't had any major health problems. Indeed, apart from getting up in the night occasionally to have a pee, I have had zero symptoms of anything wrong.

BTW - FUTB = finger up the bum!
 
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