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Is there such a thing as prostate cancer care in UK?

User
Posted 14 Jun 2020 at 16:01

I have lived in West Essex for 11 years. Coming from South Africa at the of 45 I first settled in Enfield, North London. I am 64 years old now, and yet I don't remember getting any information from the NHS about prostate cancer.  I have always been registered with my local GP centre. For the last three years, they have given me good care with regards to my annual health MOT, getting regular testing for bowel cancer, eye examinations etc. but no mention of prostrate examination. Is this normal? Or am I missing something?

User
Posted 14 Jun 2020 at 21:39

Hi, there is no screening for prostate cancer.

User
Posted 14 Jun 2020 at 21:59
There is of course prostate cancer CARE. What there isn't is prostate cancer SCREENING. A screening programme would result in massive over-treatment of men the majority of whom don't need it - they'll die with prostate cancer not from it.

Cheers,

Chris

User
Posted 14 Jun 2020 at 23:12

Ed, you can ask to be checked by your GP - this is available to any one over 50 (or black men or others at higher risk over 45). This will normally be in the form of a PSA test. The GP may try and talk you out of it, but ultimately, you have the right to have one. If you have any symptoms of prostate cancer or benign prostate hyperplasia (BPH), a GP might also do a digital rectal exam.

Some GP's will do a prostate check with a health check or other blood test, but most probably won't and they aren't required to do so unless you specifically ask.

Edited by member 14 Jun 2020 at 23:13  | Reason: Not specified

User
Posted 15 Jun 2020 at 01:08

GP's can have different attitudes towards initial testing by by PSA and or DRE (Digital Rear Examination) I was lucky in as much as my GP at the time whilst arranging a blood test for a quite different problem suggested my PSA was also tested. Just as well in my case as subsequent scans and biopsy found the cancer in the process breaking out of the capsule. On the other hand some GP's are very reluctant to arrange a PSA test and may warn patients about possible over-treatment this may lead to. There have even been a few cases where men in their fifties have been refused the test and have gone to a different GP to authorize one. It is possible to just pay to have a PSA test outside the NHS but this should not be necessary and it's best that a DRE is done too. If the PSA is significantly higher than normal range and infection or other things that might cause it have been ruled out, the GP should refer the patient to a Urology department. A Prostate that feels unusual can also lead to the GP referring the patient to Urology. PSA may be within range but other suspicious symptoms may also lead to referral because in a small number of cases a man can have a type of cancer that only exhibits a low PSA. GP's don't do biopsies and scans, so if there is doubt the man should be referred.

 

Edited by member 15 Jun 2020 at 22:22  | Reason: Not specified

Barry
User
Posted 15 Jun 2020 at 16:37
My friends in America beseeched me to ‘Get your prostate tested’ as they have an annual PSA blood test and DRE paid for by their medical insurers, who must think those tests are value for money.

I took my ‘Full blood count’ form religiously to the phlebotomy department for seven years, only to discover when I was diagnosed with cancer a ‘full blood count’ is far from it, and doesn’t incorporate a PSA test.

I was in my underpants at the GPs for abdominal pain and I asked him, ‘While you’re down there, can you do a DRE please?’

‘Oh, we don’t do that anymore’, which was news to the urologist when my PSA had risen from 2 to 16 and I ended up with stage T3a cancer, currently in remission.

So the answer regarding ‘prostate care’ is no, unless you insist on testing. If you speak to any oncologist or urologist, and indeed anyone here, they will say get regular PSA tests over 50. But then we are all biased...

Best of luck.

Cheers, John.

User
Posted 15 Jun 2020 at 19:00
Assume nothing - it is worth checking at the GP practice whether your doctor has been including the PSA test in the health MOT each year and just hasn't mentioned the results to you because they weren't concerned.

If it turns out that they have been testing your PSA level, ask for the specific readings - far too often, we hear of men being told 'oh, it's normal' - it's just not good enough.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 11 Feb 2021 at 17:38

Hi all,

 What does PSA actually stand for as people use it frequently, but nobody puts the full terminology. 

 One of my over questions on this subject is; You and your doctor agreed to have a regular prostate cancer test, is it up to the doctor surgery to remind you of the appointments or do you have to look after this appointment your self? 

 Wouldn't this be classified as a reasonable adjustment under the Equality Act 2010 or even the Health and Social Care Act 2012?

Regards,

Donald

 

 

Edited by member 11 Feb 2021 at 17:38  | Reason: Forgot to click on the email conversation

User
Posted 11 Feb 2021 at 18:34

PSA = Prostate Specific Antigen

If you've had prostate cancer (have you?) you'll have regular PSA checks for life. In my case the hospital sends me a blood form and I have the test done at my GP's surgery.

Cheers,

Chris

Edited by member 11 Feb 2021 at 18:36  | Reason: Not specified

User
Posted 11 Feb 2021 at 18:54

Originally Posted by: Online Community Member
There is of course prostate cancer CARE. What there isn't is prostate cancer SCREENING. A screening programme would result in massive over-treatment of men the majority of whom don't need it - they'll die with prostate cancer not from it.

Cheers,

Chris

Im sorry Chris but this is just not the way it should be. There is watchful waiting which would mean that no treatment is given following screening but you are monitored.  If you are unluckily enough to have symptoms of prostate cancer it’s often either too late as in my husband’s case which is incurable, or you are looking at radical treatment which can completely change lives. I just don’t subscribe to the no screening view. 

User
Posted 11 Feb 2021 at 19:50

Originally Posted by: Online Community Member

I just don’t subscribe to the no screening view. 

It's available on request, as Andy mentioned, but not as a national screening programme.

The problem is that PSA is a pretty crappy indicator. I was told by my initial urology consultant that...

"as a 50-year-old with a PSA between 4 & 10, there's a 27% chance you've got prostate cancer, so we'll MRI and biopsy."

That means is nearly 3 out of 4 people going through the invasive biopsy process (and risking septicemia) are having it unnecessarily.

PSA is simply not very good as a screening test, which is one reason why there isn't a national screening programme. (Another is the psychological worry factor. Another is potential over-treatment. Another is the cost (of screening itself and the cost of the overtreatment).

On balance, the decision-makers feel that it wouldn't be beneficial, so that's where we are. (Like it or not.)

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

User
Posted 11 Feb 2021 at 19:54
It's a crappy situation, Skye, but there's no good answer. Prostate cancer in a man is an almost inevitable part of ageing; around 70% of 70-year-olds have it, 80% of 80-year-olds, and so on. The overwhelming majority of them will need no treatment and will die with prostate cancer, not from it.

If (as is currently the case) you don't screen, the result is that you'll probably only find those men who start showing symptoms (or, as in my case, if it's found accidentally with no symptoms).

If you do screen, firstly it would be enormously expensive (and unfortunately the economic cost of healthcare does have to be considered), and secondly, you'll treat a lot of men who really don't need treatment because they won't die from cancer. Current cancer treatment centres certainly wouldn't be able to cope with the increased workload of high numbers of millions of additional patients.

Which of these two options is less harmful to society? Rightly or not, the medical powers-that-be in this country have decided that the first is.

Best wishes,

Chris

 
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