Prostate CA: Sy grows a 'tache and KF grows half a beard

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Re: Prostate CA: Sy grows a 'tache and KF grows half a beard

Postby Steve A » Fri 30.08.2019, 18:55

All the best to you Geoff sounds like they have your situation in hand
I’ve had the finger :poke: but can’t get the blood test done :roll:
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Re: Prostate CA: Sy grows a 'tache and KF grows half a beard

Postby GeoffSmith » Fri 30.08.2019, 19:59

There is new NHS guidance so if you're over 50 and you (manage to get to) talk to your GP then you can get a PSA test. I'm not sure whether it is country-wide but Bristol (after research with UCLA and others reported in January 2017) have introduced MRIs within 2 weeks of an abnormal PSA result. I think that one of the problems in the past has been due to biopsy being the next step in the process - I can understand this as the biopsy is not to be undertaken lightly and can miss cancer sites but the MRI should help rule out false positive PSA results and target the biopsy to maximise the efficacy.
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Re: Prostate CA: Sy grows a 'tache and KF grows half a beard

Postby Saltire » Fri 30.08.2019, 20:18

dapinky wrote:At least you have a GP/Surgery/Whatever that will happily entertain your condition......


:agree: completely. My (also rural) GP surgery operates exactly the same system, so much so that I’ve pretty much given up trying to contact them. Last November I developed a couple of lesions on my legs. Not painful, but unsightly and needing checked. It took me three weeks of daily 08:00 phone calls to get an appointment with a trainee doctor. She prescribed some cream - which had no effect, and said “come back in a week”. This time, it took a month of phone calls.

Repeat twice more, and eventually they decided to do a biopsy, which was straightforward by comparison. When I rang to enquire the results, I was told they were “inconclusive”, and I’d have to see a specialist. And the earliest he can see me is . . . . February 2020. November 17 to February 20 - good job it’s probably not serious :evil:

The NHS is broken. And money alone won’t fix it. Just to cap it all - and back on topic - my GP practice has a page on its website telling you that they won’t give you a PSA test so not to bother asking.

Interestingly, a private GP service has recently opened in Tetbury, the next door town, and it’s heavily oversubscribed.
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Re: Prostate CA: Sy grows a 'tache and KF grows half a beard

Postby Giniw » Fri 30.08.2019, 21:25

Saltire wrote:November 17 to February 20 - good job it’s probably not serious :evil:
Oo
Appalling!
It's bad here, but not to that extent though — yet.
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Re: Prostate CA: Sy grows a 'tache and KF grows half a beard

Postby GeoffSmith » Fri 30.08.2019, 22:12

Saltire wrote:…my GP practice has a page on its website telling you that they won’t give you a PSA test so not to bother asking…

The website of a typical GP's practice near you has a page on PSA testing and link to the NHS PSA pages. The GP's page was posted on 8th March 2016 when (thanks to Wayback Machine) the advice was:
Should I have a PSA test?
Because the results of the PSA test are not as reliable as doctors would like, other tests and investigations are needed to diagnose prostate cancer.
A PSA test cannot identify prostate cancer on its own, and changes in PSA levels alone are not a good reason to start treatment.
If you are thinking about asking for a PSA test, it is important that you first discuss whether it is right for you with your GP so you understand what the results might mean.
The Prostate Cancer Risk Management Programme has information on the risks and benefits of the PSA test to help you decide whether or not to have it.

The advice is now:
Should you know your PSA level?
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If you're a man aged 50 or over and decide to have your PSA levels tested after talking to your GP, they can arrange for it to be carried out free on the NHS.
If results show you have a raised level of PSA, your GP may suggest further tests.


Of course it's always useful to read the GP's crib sheet.
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Re: Prostate CA: Sy grows a 'tache and KF grows half a beard

Postby Saltire » Sat 31.08.2019, 07:03

That’s very interesting, Geoff. I raised it last in Feb or March of this year, and the (verbal) story coming from the practice (which you identify correctly, btw) was that they’d be swamped if all their male patients in the target age group asked for test - so they were encouraging people not to.

Amusingly, I took Bentley (my dog) to the vet yesterday for his regular Cushings disease check up. I had to take a urine sample with me (not mine). They took blood as well at 11:30, and by 4pm the they’d done full bloods, haematology, and urine, and the vet was on the phone discussing the results and recommending treatment. And that costs me less than £30/month to cover all conditions across Bentley’s lifetime. Furthermore, I can ring the vet and get an appointment with a named vet any time to suit me over the next few days. If it’s an emergency, someone is available as soon as I can get there.

Matt Hancock, watch and learn.
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Re: Prostate CA: Sy grows a 'tache and KF grows half a beard

Postby woody » Sat 31.08.2019, 07:11

Thanks Geoff, that is very helpful.
Having had my DRE, I have now been referred to the Hospital for further tests.
My GP found the prostate was smooth, and round(no nobbly bits), but slightly enlarged, and together with the raised PSA levels, he felt it needed further investigation.
I should get an appointment next week, the hospitals here in Nottingham are very good.
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Re: Prostate CA: Sy grows a 'tache and KF grows half a beard

Postby GeoffSmith » Thu 05.09.2019, 21:43

Someone asked me about the relevance of the MRI scan so I thought I should share: These are my own thoughts and may be a load of bollocks…

Until recently, an elevated PSA required a biopsy to investigate matters further: Given that the PSA levels can be increased by a multitude of activities (exercise, cycling, sex [particularly anal sex as the nurse told my wife and I :shock: ] etc.) immediately prior to the test, the risks associated with the biopsy, the possibility of missing a cancer and the irrational nature of some people who have never had to problem solve a Lotus, then I can see why GPs may appear less than enthusiastic about agreeing to a PSA test. I am lucky that Southmead urology are at the forefront and were actively involved in the study with University College London that recommends MRI as the next stage of an investigation into an elevated PSA test. Other health authorities may be implementing similar protocols but perhaps they don't yet fully appreciate the benefits.

My PSA was obviously high and the prostate was smooth but enlarged. I was told that the MRI screened out about 25% of abnormal PSAs (false positives) where no further action was required. As something was found however, the benefit of the MRI is that they knew where to target the biopsy (guided by the ultrasound probe inserted into a suitable dark recess). I had four targeted samples based on the MRI and 9 from across the whole of the prostate. There was one site in each of the sample sets so if I had not had an MRI and if the random samples had been in slightly different positions, my biopsy could well have been a false negative and shown nothing.

If I decide to go down the active surveillance route, they have a baseline PSA, MRI scan and biopsy, so any significant changes in the PSA can be investigated in the first instance with an MRI scan which may do away with the need for a biopsy (there is no denying that the biopsy is not a particularly pleasant procedure, but no worse than a trip to the dentist).
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