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GP at fault?

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User
Posted 28 Feb 2022 at 12:43

My Diagnosis. I have had pelvic pain since 2013. I had a number of tests including PSA, MRI, sigmoidoscopy and digital rectal examination. The tests were all negative & my PSA was less than one. I thought it must be prostatitis but my GP said no as I did not feel any pain during the digital exam. It was left at that and after 18 months the pains faded but never completely went away. In October 2020 they started to come back but as covid was occupying the medical profession I decided to leave it. In January 2021 I got a PSA test of 3, but my GP did not worry

 I had another PSA in August and it  had gone up to nearly 11 but he didn't tell me and I only found the result when I looked at my NHS app in November. His notes indicated that he didn't regard this as a problem and because I had prostatitis he would not worry about prostate cancer unless it reached 20. At this point I phoned one of the specialist nurses at PCUK who said straight away this was wrong and I should insist on a follow up PSA test and get an appointment with a urologist if it has risen again. 

It had gone up to 13 by November and I got my appointment at the local hospital,. The MRI showed a 'mass' in the prostate. The biopsy followed which came back as Gleason 7/9 and locally advanced. Fortunately negative bone scan and CT. I am on HT with RT starting in may in May.

Could my GP have done better?

User
Posted 02 Mar 2022 at 23:25
Most GPs are fundamentally useless.

Google is usually more use.

User
Posted 28 Feb 2022 at 14:45

I would say your GP was grossly negligent.

Ideally, the PSA of 3 would have been followed up by a retest a few months later, but not doing anything for a PSA of 11 is grossly negligent. You did not have a diagnosis of prostatitis as far as I can see.

Sadly, many GP's, and also their professional body RCGP are largely ignorant of prostate cancer, and this leads to avoidable deaths.

User
Posted 28 Feb 2022 at 17:58
I had a similar occurrence with my GP. Aug 2021 my PSA was 4.7. I had a discussion with a young GP who suggested a retest in a month. That came back at 4.3 so we agreed to just monitor the situation.

4 months later I decided that I could wait no longer and arranged another test. Came back as 6.9! Onto the cancer "pathway"!! Which tl:dr led to RARP in Aug 2020

I suggested to the GP that maybe , in future, he might strongly suggest that any man in my position should get referred to Urology straightaway. He said that he wouldn't do that because they didn't want patients to undergo "unnecessary" biopsies!!

I still wonder if I had been referred in August 2019 whether the cancer would have been caught that little bit earlier and I wouldn't be undergoing EBRT. Nothing I can do about it now but its always in the back of my mind.

User
Posted 01 Mar 2022 at 23:20

Hi,

It does seem strange that he said you didn't have Prostatitis and then he said you did.  Without the full tests.

I wonder if the pelvic pain is relevant.  It's not common 

You might look up the NICE treatment guidelines and see what they say.

I hope your treatment works. Peter

 

User
Posted 02 Mar 2022 at 15:41

So very sorry to hear about your husband. Although my husband is late 60s, his GP was also reluctant for him to have a PSA test with no symptoms. We are now waiting for him to have surgery. I cannot understand why there is such reluctance for regular testing and/or dre. False negatives/positives are surely better than late diagnoses

User
Posted 03 Mar 2022 at 12:35

It really is up to the patient to push for a psa test.......looking at this online community, it is quite scary how many men in their 50s are diagnosed with prostate cancer but the disease itself is still considered to be " an old man's " disease. While breast screening and cervical screening are spoken about all of the time, prostate cancer and screening is hardly out there in the media and rarely spoken about until it actually hits your immediate family. 

User
Posted 03 Mar 2022 at 17:27
To be honest I usually advise anyone I meet who is in "that" demographic to just lie. Tell the GP there is a family history or read up on the symptoms and trot those out.

I don't believe that anyone gets a biopsy before they have had an MRI done. So there is a reasonable filter right there. No-one wants a biopsy but the alternative might not be great.

Unfortunately many Trusts are still doing TRUS biopsies which plays into the concept that biopsies can lead to infection. I'd love to know the stats that back up that claim.

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User
Posted 28 Feb 2022 at 14:45

I would say your GP was grossly negligent.

Ideally, the PSA of 3 would have been followed up by a retest a few months later, but not doing anything for a PSA of 11 is grossly negligent. You did not have a diagnosis of prostatitis as far as I can see.

Sadly, many GP's, and also their professional body RCGP are largely ignorant of prostate cancer, and this leads to avoidable deaths.

User
Posted 28 Feb 2022 at 17:58
I had a similar occurrence with my GP. Aug 2021 my PSA was 4.7. I had a discussion with a young GP who suggested a retest in a month. That came back at 4.3 so we agreed to just monitor the situation.

4 months later I decided that I could wait no longer and arranged another test. Came back as 6.9! Onto the cancer "pathway"!! Which tl:dr led to RARP in Aug 2020

I suggested to the GP that maybe , in future, he might strongly suggest that any man in my position should get referred to Urology straightaway. He said that he wouldn't do that because they didn't want patients to undergo "unnecessary" biopsies!!

I still wonder if I had been referred in August 2019 whether the cancer would have been caught that little bit earlier and I wouldn't be undergoing EBRT. Nothing I can do about it now but its always in the back of my mind.

User
Posted 01 Mar 2022 at 23:20

Hi,

It does seem strange that he said you didn't have Prostatitis and then he said you did.  Without the full tests.

I wonder if the pelvic pain is relevant.  It's not common 

You might look up the NICE treatment guidelines and see what they say.

I hope your treatment works. Peter

 

User
Posted 02 Mar 2022 at 00:15

This is definitely poor practice and negligent. 

My husband went to gp 3 years ago then age 52 and was refused a prostate check up because the GP believed he was fit & healthy. GP said psa gives false negatives and biopsies can lead to infection. No dre given. . Fast forward 2 years and husband psa was over 700 and diagnosed with stage 4 incurable prostate cancer. 

User
Posted 02 Mar 2022 at 15:41

So very sorry to hear about your husband. Although my husband is late 60s, his GP was also reluctant for him to have a PSA test with no symptoms. We are now waiting for him to have surgery. I cannot understand why there is such reluctance for regular testing and/or dre. False negatives/positives are surely better than late diagnoses

User
Posted 02 Mar 2022 at 23:25
Most GPs are fundamentally useless.

Google is usually more use.

User
Posted 03 Mar 2022 at 03:06
Yes, my GP way too slow to pick it up. As patients we tend to think it can't happen to us and shy away from asking for key tests. It's really up to GPs to get in early.

Jules

User
Posted 03 Mar 2022 at 12:35

It really is up to the patient to push for a psa test.......looking at this online community, it is quite scary how many men in their 50s are diagnosed with prostate cancer but the disease itself is still considered to be " an old man's " disease. While breast screening and cervical screening are spoken about all of the time, prostate cancer and screening is hardly out there in the media and rarely spoken about until it actually hits your immediate family. 

User
Posted 03 Mar 2022 at 17:27
To be honest I usually advise anyone I meet who is in "that" demographic to just lie. Tell the GP there is a family history or read up on the symptoms and trot those out.

I don't believe that anyone gets a biopsy before they have had an MRI done. So there is a reasonable filter right there. No-one wants a biopsy but the alternative might not be great.

Unfortunately many Trusts are still doing TRUS biopsies which plays into the concept that biopsies can lead to infection. I'd love to know the stats that back up that claim.

User
Posted 18 Oct 2022 at 12:24

I had a PSA test, unbeknown to me in 2011, which showed a reading of 3. Nothing was done at this time by my GP. I continued to go to my GP regularly to complain of urinary issues, again no PSA was done. In August 2021 I had to insist I wanted a PSA (at age of 56), which my doctor reluctantly did and suprise suprise my result the following day was 57! So on to the NHS Fastrack scheme where it showed Stage 4 locally advanced Prostate cancer. 

 
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