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PSA tests - should they be routine.

User
Posted 27 Jul 2020 at 10:42

I think the conclusions of the trial Chris Parker referred to in 2009 may have changed somewhat in that the benefit of screening was underestimated (see https://drcatalona.com/ for some discussions). Doesn't mean he changed his mind about universal screening though. 

I major problem seems to be that many GPs misunderstand the PSA testing controversy and ignore NICE guidelines, mine for example ignored my PSA of 5.68 (but referred me when it reached 32 six years on, when the lab noted "CALL PATIENT"), and the man I shared a hospital room with after my RP was initially refused a PSA test even though he had clear symptoms and various risk factors (he went to a different GP which likely saved his life). 

User
Posted 27 Jul 2020 at 13:14
Of course we are all biased here...

Cheers, John.

User
Posted 27 Jul 2020 at 13:28

I was diagnosed at 56 with localised prostate cancer and have recently received my brachytherapy treatment, shortly after my diagnosis a 72 year old friend who I had told about my diagnosis went for tests, biopsy etc. and was told he had Gleason 4 +4 Prostate cancer where it has moved to his bones he would have loved to have been diagnosed early like me and seeing what he is going through I am glad I was diagnosed early and that all started with a PSA test.

User
Posted 27 Jul 2020 at 15:53

Originally Posted by: Online Community Member

I was diagnosed at 56 with localised prostate cancer and have recently received my brachytherapy treatment, shortly after my diagnosis a 72 year old friend who I had told about my diagnosis went for tests, biopsy etc. and was told he had Gleason 4 +4 Prostate cancer where it has moved to his bones he would have loved to have been diagnosed early like me and seeing what he is going through I am glad I was diagnosed early and that all started with a PSA test.

That is a very good illustration of the GP problem - that is some seem reluctant to "Do their job properly"
Probably because of the "Blame culture" EG It is difficult to prove negligence with this subject. Of course, GP common sense, went out the window a long time ago, in the main they just do what the "Rules" & their computer, instruct them to do.

User
Posted 27 Jul 2020 at 16:11
Almost every time I've had a serious illness the GP has initially diagnosed me with something less severe (flu instead of meningitis, piles instead of colitis, IBS instead of a hernia). With PCa it was only an unrelated blood test that picked it up. Perhaps I'm being unfair, but I get the impression that GPs feel that the public are a feckless bunch of skivers who only go to them to get sicknotes (or worse) and therefore always assume the patient is overstating things.
User
Posted 27 Jul 2020 at 17:42

Originally Posted by: Online Community Member
Almost every time I've had a serious illness the GP has initially diagnosed me with something less severe (flu instead of meningitis, piles instead of colitis, IBS instead of a hernia). With PCa it was only an unrelated blood test that picked it up. Perhaps I'm being unfair, but I get the impression that GPs feel that the public are a feckless bunch of skivers who only go to them to get sicknotes (or worse) and therefore always assume the patient is overstating things.

There is probably some truth in that Peter, of course the other side of the coin, is many badger their GPs, with very minor ailments, such as cut fingers, sprained ankles, pimples & other things, they should sort out themselves.

User
Posted 27 Jul 2020 at 18:22
GPs are self-employed, and GP practices are businesses. There will be as many great doctors as dreadful ones.

Is it still the case that if a patient needs a hospital referral, the cost comes out of the GP's budget?

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

User
Posted 29 Jul 2020 at 12:35

Not sure about screening. I believe there should be more testing.

My GP surgery has those advertising screens and they were displaying a message inviting men over 60 (!) who had symptoms to have a PSA test. I thought that strange, especially as I had no symptoms and was under 60 and was given a test without a problem. In fact my GPs were amazingly good last year, I could not have asked for better. I fear for people being forced to wait for symptoms.

Right now though some tests and some overdue appointments would be very welcome.

Rob

User
Posted 29 Jul 2020 at 13:34
😱
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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