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Car mechanic saves lives

User
Posted 04 Jun 2014 at 19:14

Just read in the Evening Standard about a man in Hackney who, having been diagnosed with PCa himself, gives discouints to customers who agree to go for a PSA test. Of the 3000 men that have taken up his offer, 23 were subsequently diagnosed and referred for treatment. The money that he hasn't charged his customers is then donated to PCa research (although they don't specify which charity this is) 

 

It is a good article about a fantastic sounding bloke - name is Errol McKellar.

Edited by member 04 Jun 2014 at 19:15  | Reason: Not specified

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

User
Posted 04 Jun 2014 at 19:14

Just read in the Evening Standard about a man in Hackney who, having been diagnosed with PCa himself, gives discouints to customers who agree to go for a PSA test. Of the 3000 men that have taken up his offer, 23 were subsequently diagnosed and referred for treatment. The money that he hasn't charged his customers is then donated to PCa research (although they don't specify which charity this is) 

 

It is a good article about a fantastic sounding bloke - name is Errol McKellar.

Edited by member 04 Jun 2014 at 19:15  | Reason: Not specified

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

User
Posted 05 Jun 2014 at 19:00

Just wondering what the ladies on here think about the NHS moves to discourage self-examination for B.Ca.

Reason being anxiety & too many cases of benign results.

 

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User
Posted 04 Jun 2014 at 21:15

There really ought to be a national automatic test for men similar to cervical smear tests and breast cancer tests for women. Why not an annual blood test for men after the age of 55. It would save so many lives. Error McKellar....good bloke.

User
Posted 04 Jun 2014 at 21:16
Hi Lyn,

Very good of him but I am astounded by the very few numbers that were referred for treatment, 23 out of 3,000.

My old support group have now given free PSA tests to close on 500 men and have found that on average 12% were recommended to go for a referral, that would be 360 out of 3000. In our last session 123 men were tested and 18% were advised to see their GP.

I accept that of the 360 men which would have been referred in our case most would not have PCa but just 23??

If that figure was broadcast many many men would not bother with a PSA test in the 1st place, my maths can't work out a percentage figure of 23 out of 3000....help.

Life is for living

Barry (alias Barrington)

PS I am now waiting in some trepidation expecting to be shot down in flames.

OK IT's ...0.7666 if that was a true figure, less than 1%, men would be foolish to have a PSA test with the worry it can cause.

Edited by member 04 Jun 2014 at 21:31  | Reason: Not specified

User
Posted 04 Jun 2014 at 22:39
Originally Posted by: Online Community Member

There really ought to be a national automatic test for men similar to cervical smear tests and breast cancer tests for women. Why not an annual blood test for men after the age of 55. It would save so many lives. Error McKellar....good bloke.

Hornets' nest Steve with a very complex set of arguments on both sides. I do not support routine screening of all men but honestly, for each of us that would campaign against it there is another that would argue vehemently for.

TG, I suppose there is a possibility that many of his male customers were young men with souped up fiestas that break down regularly. There is no reason to imagine that all 3000 were men over the age of 50 whereas I imagine that when you arrange tests, you have a targeted approach?

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

User
Posted 04 Jun 2014 at 22:51
Hi Lyn,

45 and over.

User
Posted 04 Jun 2014 at 23:02
I have done some checking. Errol also campaigns to raise awareness and has SPOKEN to 3000 customers about PCa. It doesn't say how many have actually gone on to have the test and been clear, only how many were subsequently diagnosed.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 04 Jun 2014 at 23:33
I get annoyed that so many men are not diagnosed before the cancer has escaped the prostate. I would love to see PSA testing every 3 years for all over 50's. If women can have regular smear tests, and mammograms, surely men are entitled to regular PSA tests. Not only that, awareness of PCa needs to be raised so that the any potential symptoms are recognised and acted upon.

For as long as I remain fit and healthy, this will remain a cause I will fight for.

Paul

Stay Calm And Carry On.
User
Posted 05 Jun 2014 at 00:31

You are behind the times - there is increasing pressure to end routine mammograms due to the high number of false positives and the difficulties caused by over-treatment. Pretty much the same argument as against PCa screening. There is no way a government will introduce screening for men while preparing to end it for women.

One problem with this debate - which we have fairly often on the message board - is that everyone needs to agree a definition of 'screening' - it means different things to different people. Who knows - my idea of informed consent may be your idea of screening!

Whilst I am anti-screening, I will continue to fight for improvements in testing with informed consent (for example by doing something about GPs who tell a man he is too young for PCa, refuse to test someone with symptoms, refuse to refer a man whose PSA is "not that high" or advise a man that he is better off not knowing.

 

Edited by member 05 Jun 2014 at 00:37  | Reason: Not specified

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

User
Posted 05 Jun 2014 at 04:53
Hi Lyn,

Thanks for clarifying that, spoken to 3000 men rather than giving 3000 men a PSA test......not quite so expensive either and in all fairness no more than most of us do. Allister and his ilk probably gets the message about awareness across to 3000 men on a monthly basis. However this man is certainly doing "the cause" no harm nor probably his business....good old cynic that I am!

Ref National screening I am on side with you Lyn and it is interesting to see what Professor Richard Ablin, the discoverer of PSA in 1970 has to say about it as a diagnostic tool, I quote........

Prostate expert who won't have PSA test

Richard Ablin, professor of pathology at the University of Arizona College of Medicine.

"When I discovered the prostate specific antigen (PSA) in 1970, we soon realised it could be hugely helpful to prostate cancer patients.

The protein is specific to the prostate gland - it's not found in any significant amount in any other organ. So if a man with prostate cancer had his prostate removed, our discovery meant we could measure his PSA afterwards to see if there was cancer remaining which hadn't been detected.

However, the PSA test began to be used to diagnose prostate cancer. This was a huge mistake.

The PSA is not cancer-specific - it's simply a protein produced by the prostate, so a high level can just mean a man has prostatitis (an infection) or an enlarged prostate - sometimes troublesome but benign.

Also, 'normal' PSA levels vary dramatically from one man to the next: there's no threshold at which point we can reliably diagnose cancer. The test also cannot differentiate between a slow-growing 'pussycat' prostate cancer and an aggressive 'tiger' cancer. It's about as effective as a coin toss.

Nevertheless, it was taken up as a way to check for prostate cancer and, as a result, millions of men have been overtreated, often with unnecessary, highly debilitating side-effects. I would have a PSA test only after treatment for prostate cancer, or if I was at risk of the disease (for example because of family history), and was using it in combination with other tests, such as digital rectal examination, to diagnose it."

The emphasis must be in discovering a non invasive test that can not only determine once and for all whether a man has Prostate Cancer BUT whether it is a pussyfoot cat or a tiger. One day, not too far off, that will happen.

Life is for living

Barry (alias Barrington)

PS The search to determine the "tiger" and thus the most aggressive PCa which needs to be treated urgently is currently the main campaign on The MEN UNITED v PROSTATE CANCER site which is asking for funding / donations to carry out this research.

Edited by member 05 Jun 2014 at 06:47  | Reason: Not specified

User
Posted 05 Jun 2014 at 10:11

I had understood that the modern supersensitive assay machines calculate the ratio between Free PSA and Total PSA giving a good differentiation between benign prostatic hypertrophy and actual prostate cancer. Not a test to decide if the cancer is a 'pussycat' or a 'tiger', that still comes from direct pathology, but good enough to decide if a patient is at risk even when total PSA values are within normal limits.

Often, waiting until a man experiences the physical effects of his cancer means that it has already reached critical mass and has spread outside of the gland. In my case I had no physical effects at all and I had my blood test for a quite different reason. The Dr ticked the PSA box on the hospital blood test form, luckily, and my illness was discovered whilst looking for something else. Once removed it was seen that the tumour in my prostate was about to 'breach the capsule' so had it not been found when it was things would have been much worse for me.

At least if there was some form of national screening test many, many more men would be diagnosed at an early stage rather than later when for many it is too late. The alternative, waiting for an improved test, may mean waiting for years or perhaps never.

I also hear of a new urine test for Prostate Cancer which is said to be more accurate than the blood test for PSA and gives an idea of the size of the tumour.

http://www.dailymail.co.uk/health/article-2573395/The-10-prostate-test-New-cancer-check-twice-accurate-no-need-embarrassing-examination.html

 

Edited by member 05 Jun 2014 at 10:21  | Reason: Not specified

User
Posted 05 Jun 2014 at 11:10
Is a monitoring of PSA helpful?

I first went to me GP 4 years ago with a change of urinary habits, although I have forgotten what exactly. I got the finger up the bum, a PSA measurement, and put on tamsulosin. When I went last year, not emptying my bladder in the morning, I had a PSA test. The level had gone up, and set off on my journey to having the robotic RP.

If I was unaware of the prostate history in the family, I could have ignored the symptoms and the consequences don't bear thinking about. There are too many cases where diagnosis is too late. How can awareness, more targeted testing be achieved so the ridiculous number of PCa deaths can be significantly reduced?

Stay Calm And Carry On.
User
Posted 05 Jun 2014 at 12:23
I think you have hit the nail on the head, 6f2. Considered approach, understanding risk factors & what is being monitored and what the implications might be - this all combines to give men the best chance of early detection and successful outcome.

The problem with a generic screening programme is the significant proportion of men who despite a higher than expected (or rising) PSA would decide not to go on to have a biopsy, the proportion that would have the biopsy but then go into denial and decide against any form of treatment (and I am NOT including active surveillance in that category) and those whose other medical conditions mean that knowing they have cancer would simply cause distress but make no difference to their life expectancy.

I have two friends who have decided against biopsy simply because they think they would rather not know. That is despite John's diagnosis. We also had a new member on here fairly recently who posted that he had agreed with his GP not to go for biopsy as his other conditions meant PCa is low down the priority list. I know the wife of a man whose bladder cancer is advanced and he now has a high PSA identified because someone ticked an extra box on his blood test form - he decided to have the biopsy but now he knows he has PCa and won't have treatment because the bladder cancer is incurable.

What is the point of routinely screening men like these if they or their medics already know they would not act on the result even if it suggested there might be a problem?

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

User
Posted 05 Jun 2014 at 13:13
This is a never ending discussion that has been going on over various sections of the forum for as long as I can remember.

I can only repeat the views of the Professor who discovered PSA. His view is that it should never be used on its own as a diagnostic test because it is too unreliable. Having said that my Support Group has now tested nearly 500 men in this area without any correct GP to patient consultation taking place as to what the possible outcome could be. I have severe reservations about that but the uptake has been unbelievable with waiting lists now over 100 and at the very least I suppose our adverts for the free PSA testing days have raised awareness throughout South Dorset.

I still feel however that there is an urgent need to find a one off non invasive test that can determine the difference between the pussy cat and the tiger, the latest estimate I believe is that there are 27 types of PCa of which thankfully most are of the pussy cat variety.

PSA in itself is to me a total enigma, I was diagnosed over 15 years ago, had RT and here I am now 15 years later being diagnosed as terminal with spread to my liver, lungs, groin, bowels and soft tissue in the pelvic region.........YET MY PSA IS 0.29 !!

Life is for living

Barry (alias Barrington)

PS

Lyn, I hope Errol McKellar is doing a good business!

Edited by member 05 Jun 2014 at 16:59  | Reason: Not specified

User
Posted 05 Jun 2014 at 13:25

Second attempt at a posting....the first simply logged me off, so here goes.

 

I think the point is that the vast majority of men, and particularly younger men, would rather know. If a Doctor told his patient that he had early signs of PCa and that treatment was readily available to treat it and prolong his life by many years then surely most men would opt to have the treatment.

 

I could possibly understand someone faced with the knowledge that their cancer has grown and spread to a point where treatment would provide a worse standard of life than not having it, deciding to enjoy the time they have left with their family, but the object of the exercise would be to identify PCa early enough so that treatment can be acceptable, curative and life prolonging at an early age.

 

User
Posted 05 Jun 2014 at 13:35
As far as I can see, a rising PSA is a reasonable indication that PCa needs to be investigated. Should men be encouraged to keep a diary of their peeing habits for one week, once per year, to detect otherwise unnoticeable changes, or patterns that might indicate a problem, and have a base from aged 30 as a guide to changes in PSA.

Anything that increases early detection and treatment is better than what is in place now, which is haphazard to say the least.

Paul

Stay Calm And Carry On.
User
Posted 05 Jun 2014 at 19:00

Just wondering what the ladies on here think about the NHS moves to discourage self-examination for B.Ca.

Reason being anxiety & too many cases of benign results.

 

User
Posted 05 Jun 2014 at 19:51
I don't self examine and I would not go for a mammogram. I don't want to know, I wouldn't want to have to make treatment decisions and I am far too busy keeping John and my dad on the straight and narrow, trying to handle my mother in law and loads of other carp - no time to have someone tell me that I might not be superhuman :-)

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

User
Posted 06 Jun 2014 at 16:04

All the more reason to go and have the check up. They can ill afford to lose you....

 
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