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Booking a PSA test

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User
Posted 06 Sep 2022 at 23:18

I had 2 PSA tests, the first was borderline and the second was lower. That was in 2019 before covid. My father had prostate cancer and was treated about 10yrs ago he was clear after a year or so. I decided to ring my surgery to book a PSA test today after seeing Gaby and her husband on the BBC news this morning and hearing him say that you should get tested because if you have the symptoms it could be too late. So I rang the local surgery getting through to a receptionist after about 25 minutes and they said you couldn’t book a test unless you have symptoms and spoken to a doctor. I had spoken to a doctor 3 years ago and thought I could just book a test to make sure nothing has changed. “No we don’t have a screening program for prostate cancer” was the reply from my surgery.

Women have breast and cervical tests on a regular basis. A PSA test is nowhere near as invasive as what a female has to go through. Why is a PSA test not part of a screening program for men?

User
Posted 07 Sep 2022 at 09:57
No no no, DRE is a great indicator for advanced PCA only.

No amount of DRE training will let you feel a 1mm lesion through an ass hole!

Regular PSA is the best indicator we have that further investigation is required.

User
Posted 07 Sep 2022 at 15:45
I'm of the opinion that a PSA test is a good "starter for 10". That, with a supplemental DRE, should be enough to make a crude determination as to whether further investigation is necessary. Unfortunately too many GP's are not competent to undertake this procedure with any degree of accuracy and certainty.
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User
Posted 07 Sep 2022 at 00:38

If you are over 50 you can have a PSA test. As you have a first degree relative who has had prostate cancer your concern is more than legitimate. Your GP is just being lazy in these post COVID times.

The test is way too inaccurate for screening the population. Even breast cancer and cervical cancer screening is debatable in its value.

However a history of PSA Tests so you can see if it is increasing is much more useful than a single test. And of course to have a history of tests you need to get tested.

Just checked the NHS site, I thought you could have the test on demand. That is not quite true. You can have it after discussing it with you GP. So phone the receptionist say you want an appointment with your GP when she asks why? Say it is personal between you and the GP.

Once you are talking to the GP they will almost certainly take the blood their and then rather than call you in again.

https://www.nhs.uk/conditions/prostate-cancer/psa-testing/#:~:text=If%20you're%20aged%2050,GP%20may%20suggest%20further%20tests.

 

 

Edited by member 07 Sep 2022 at 00:45  | Reason: Checked NHS site

Dave

User
Posted 07 Sep 2022 at 02:15

It seems nowadays the DRE properly done is considered a better indicator of whether the Prostate needs further investigation. I did post details on this but Dave must have missed it. Disappointingly, nobody commented so I will repost the link https://community.prostatecanceruk.org/posts/t28462-Initial-PSA-and-DRE-in-Screening#post272076

For many years the initial PSA test was what led to a man having test/scans but it often led to wasted expensive MRI scans and biopsies and often treatment when a man with cancer wants it treated, even though the cancer may never develop to the extent that it might not develop to need treatment. This has led to men being overtreated and thereby experiencing unnecessary harm. It has also placed a great strain on hospitals treating such men. Conversely, the PSA test fails in some men to raise concern where treatment would be beneficial. The rejection of a national PSA screening program applies in a number of other countries besides the UK due to the above.

It would be interesting to learn how GPs would react if asked for a DRE if a man was in a higher risk category.

Edited by member 07 Sep 2022 at 02:17  | Reason: to highlight link

Barry
User
Posted 07 Sep 2022 at 02:33

Thanks Barry, yes I missed the earlier post. I definitely agree PSA is not good for screening, but a history of PSA tests does add value (though as noted, more value in tracking post treatment). 

The PSA test does save on the embarrassment factor which is a big obstacle to diagnosis. A PSA leading to DRE and then to the costly tests would be better, but of course once the PSA is high even if the DRE is clear the patient will want the whole gamut of tests.

Dave

User
Posted 07 Sep 2022 at 07:29

I do notice that when being interviewed on TV the men always mention the "simple blood test" but very few mention having a DRE.

Thanks Chris 

User
Posted 07 Sep 2022 at 08:49

If it was not for PSA then my doctor would not have referred me. DRE, my DR said my prostate was normal.... Thank god for guidelines.

Edited by member 07 Sep 2022 at 14:34  | Reason: Not specified

User
Posted 07 Sep 2022 at 09:57
No no no, DRE is a great indicator for advanced PCA only.

No amount of DRE training will let you feel a 1mm lesion through an ass hole!

Regular PSA is the best indicator we have that further investigation is required.

User
Posted 07 Sep 2022 at 15:45
I'm of the opinion that a PSA test is a good "starter for 10". That, with a supplemental DRE, should be enough to make a crude determination as to whether further investigation is necessary. Unfortunately too many GP's are not competent to undertake this procedure with any degree of accuracy and certainty.
User
Posted 07 Sep 2022 at 23:38

A recent research paper has shown that prostate cancer nearly always has no symptoms until incurable.

The LUTS symptoms usually referred to are symptoms of enlarged prostate.

Enlarged prostate is nothing to do with prostate cancer. Actually, some researchers now say enlarged prostate slightly reduces the chances of getting prostate cancer, and that therefore the LUTS symptoms are likely to be slightly more prevalent in men without prostate cancer, and those without any symptoms are therefore slightly more likely to have prostate cancer.

You are entitled to a PSA test from age 50, symptoms or not. This is part of the NICE guidelines.

If you are refused a PSA test, ask the doctor to record the reason for refusal in your medical records. When they think about why you might have asked for that, they sometimes change their minds.

Another option is to have a look on https://mypsatests.org.uk for a local charity PSA test event. They will alternatively send you a postal test (£26) if you think you can collect almost 1cc of blood. I did hear (about 3rd hand) they had 60,000 requests for postal PSA tests in the days just after Bill Turnbull died.

Edited by member 07 Sep 2022 at 23:39  | Reason: Not specified

 
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