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Sorry about the serious question on a Sunday night. Guessing there’s a fair chunk of you that are of a certain age - north of 40 shall we say - lucky you if you’re younger 😉. Something I saw online earlier made me think ‘oh, maybe I should get checked out’ being ‘that’ age. Always dismissed the whole get checked out thing but this resonated and made me read up a bit more. So who else has and who will after this post? (like the ‘who’s got a will’ one I did a few months ago). And no they are not connected - well hopefully not anyway!
Not me, since you ask.
You mean the finger and camera up your arse test? Why yes, why wouldnt you. The anticipation is much worse than the actual tests
Is this a PSA thread?
Or some other more digital format?
Leffeboy - obviously everyone’s had that done for pleasure yes?
Married to a urology nurse, I am 45 and my dad has had prostate cancer. I keep getting badgered to get tested but have not had it done yet.
Apparently riding a bike can increase PSA levels.
I've had it a few times, it's bloody horrible, but not as bloody horrible as prostate cancer, get it done. Last time I had it done was by a nurse practitioner, worst bit was when she was finished, she asked if I would mind the trainee having a good old root around too. Oaft.
I was diagnosed with benign prostate enlargement at 48 - my PSA tests are normal / no blood in wee etc but it means that I sometimes need to go for a wee a few more often. I went to see a consultant, but most of the procedures on the NHS are only available if you're 50+, they offered me a private procedure for £8k that 'might' make it a bit better but could also have side-effects. 5 years later nothing's changed. The PSA test also produces lots of 'false positives' so its not that reliable.
What's the deal with getting checked under NHS anyway? Do you have to ask, or are you supposed to be invited at a certain age, and is it postcode lottery? As mid 40s (that sounds depressing saying that), not heard anything. I've never been invited for anything from my GP except recently they've said they want me to get my blood pressure checked as they have no record of it, despite having checked it every single time I'm there the dozens of times I've been over the last 5 years for one thing and another.
deadkenny, my dad died at 52, prostate cancer, I basically explained this to my GP when I hit 30, that I wanted checked, he did it there and then. I go back every couple of years to get it done.
Stuff in the BMJ the other week - very much equivocal about benefits (catching an important cancer) vs risks (overdiagnosis & hazards of biopsies/"unnecessary" treatment)
Chat to your GP if you're concerned/interested
https://www.bmj.com/content/362/bmj.k3581
https://www.bmj.com/content/362/bmj.k3519
I get my bloods done every year. Prostate is one of the tests (blood test).
Me.. sort of. Had a bleed from old chap a few years back. Went the hospital to get checked out , as it was unusual . They checked the prostate too and whilst it was uncomfortable , I’d rather be safe than sorry.
A few seconds of discomfort but the piece of mind when I was told I had a “ small smooth prostate “ was worth it.
no harm in an MOT. Lost a friend this year of cancer that originated from the prostate.
Go and get done. It’s all good.
Had mine checked earlier this year, I’m 34.
PSA test isn’t worth a ****, father had low PSA but still had cancer.
There's been a couple of folk close to me, not relatives, who have had prostrate cancer at some level or other. Has made me realise that getting it done is now a priority. 50th birthday looming too.
Had mine checked earlier this year, first thing on a Monday morning. PSA was a bit high so had to go back for more bloods but all ok. Was 41 at the time, no invite from go - had to request it.
Got an appointment for bloods tomorrow at 11:10am as it happens*. No finger up the exit hole just yet, but we'll wait to see how tomorrow pans out.
*The reason why I really can't be bothered with riding bikes, or pretty much anything else at the moment.
Had some blood tests as a result of another potential issue and PSA was high. Had finger test and then an MRI and CT scan and a biopsy. Went along to find results expecting to be told nothing found, but received news that I had intermediate prostrate cancer which was complete shock. Fortuntately they found it early enough so whole range of treatments are available. Get tested guys!
Had a high PSA level show up in a routine exam, had MRI which showed some ambiguous areas so had a biopsy(*) of which came back all clear. Now my PSA level is higher still though no change on MRI, so wondering exactly what to do next .... Prostate cancer is really a poorly studied area (fnarr fnarr).
(*) trans-rectal - basically someone shoving a thing like a stable gun up your bum and firing away.
A very emotive subject...
Firstly, the PSA test is NOT a screening test (like breast or cervical screening)..this is because, a screening test is performed in asymptomatic people.
If you’ve no symptoms, the PSA blood test is actually, pretty useless. Recent data and teachings suggest we do more HARM than good by ‘testing’ asymptomatic men.
(If you have symptoms... poor urine stream, dribbling, peeing loads at night...then the test is much more useful).
Of course, if you test every man in the world, you WILL pick up many cases of prostate cancer. However, many of those cases will NEVER have been problematic (i.e you might have prostate cancer, BUT....heart disease etc will be the death of you)...also, you will end up doing further tests on many men (biopsy of the prostate etc) that can have side effects or problems.
If a bloke asks me for ‘prostate screening’, I will certainly highlight the flaws of the test, and let them decide if they feel having a blood test with little useful outcomes (in the general population) is of use...
DrP
I had the physical test at a medical a few weeks back. The GP explained at length the PSA test, the numbers etc,. and I decided not to have the PSA test. Having a finger up your arse for a few seconds is hardly traumatic is it, absolutely nothing to it. Even the finger test is not perfect as can't feel all the way round anyway.
Had my annual Well Man clinic chat a while ago and my Doctor also explained the efficacy of the PSA test and suggested I look at the International Prostate Symptom Score (I-PSS, hee hee) to give an initial indication of whether the finger test was required. Test below:
I-PSS... just scored 13.
Yes. The Finger. Mildly embarrassing.
The Grid Of Needles. Effing painful. Could hardly walk for a fortnight.
Had a PSA test recently and tweeted about it. Someone posted this back at me.
What's not clear to me is if the same 7 people die under both conditions or a different 7 - I realise it's statistics but it's an important point...
The consultant who did it to me had a "wonderful" technique so I didn't know the finger was coming until it was "IN"! Crikey!
He told me that if there had been a problem I would have hit the ceiling.
I had to go for a pint on the way home.
I'm 45, I had the PSA test a year or two ago. I requested it, Dr explained the pros and cons (which I'd already researched) and agreed to get one done. He was very reluctant to make it a yearly even though and suggested 5 yearly. At least I have a base number to compare in future.
My motivation for asking for the test was that I know three fit/active/healthy guys in their early 70s and in all three cases the first symptom they experienced was aching limbs when the cancer had spread to their bones. All three dead now. Their PSAs were massive.
Based on a sample of three you're very lucky if you get clear early symptoms of prostrate cancer so a PSA test has to help in spite of the significant flaws.
I can see why a frail 85yo wouldn't benefit from testing, for an active 70yo, I'm less sure.
wwaswas,I think you're right to be a bit suspicious of those statistics. What's the definition of 'survive the cancer'? 'Survive' might mean reach 5 years alive which isn't a long live for a healthy 65yo. It might equally mean "Died of something else" in which case was the PC a significant contributory factor? Also what does 'screening' mean? Screening every 1 year? Every five years? Every month? Screening with just a PSA test, or with a range of tests? Why pick 45 as the starting age for screening, would 10 years later be a better sweet spot? So I'd say those statistics are *very* misleading. (Although the underlying message has some truth, I'm sure.)
Dicking a frail 85yo about to treat a cancer that will take a 4 or 5 years to kill him is needless. But then that logic gets applied to 70yos who are still rock climbing and kayaking around the Scottish Islands. My experience of PC is that it's not just dying, it's the five years being inactive with poor quality of life while you're waiting to die. Not a problem if you're an inactive 85yo, a big problem if you're a 70yo living life to the full.
PSA tests are ok as long as you remember to refrain from bike riding or getting jiggy for three days before the blood is drawn. (Both will raise the hormone level).
One on it's own is not much use (unless a big number is reported) the medics are more interested in any upward trend or sudden rise in the value. Protocols seem to be changing in that needles into sensitive parts are further away in the diagnosis path, you'll still have a consultant stick a digit in you to check on size and smoothness though. MRI should be used to check on your prostate not just the check for spread before you go under anaesthetic for a template biopsy. The trans-rectal test and bladder pressure test are probably the worst of the tests. Oh and having your flow analysed by a woman in her 60's with another watching rates pretty low on the dignity scale!
I'm on long-term monitoring for an enlarged prostate with low-risk cancer. 6 monthly blood tests with follow up meetings with the urology practice nurse for the foreseeable future.
Had the 'digital' test about 5 years ago as I was starting on meds. I now get PSA tested each year and it's been between 1 and 2 (the meds can cause it to go up). Bit difficult refraining from riding a bike sometimes though.
The 'digital' test wasn't bad, just that you feel like you are about to 'poop' yourself.
Dicking a frail 85yo about to treat a cancer that will take a 4 or 5 years to kill him is needless. But then that logic gets applied to 70yos who are still rock climbing and kayaking around the Scottish Islands. My experience of PC is that it’s not just dying, it’s the five years being inactive with poor quality of life while you’re waiting to die. Not a problem if you’re an inactive 85yo, a big problem if you’re a 70yo living life to the full.
The statistics make perfect sense to me on a population level. For certain individuals, prostate screening has a clear benefit. But the decision to offer it has to be balanced with the outcomes for those individuals for whom screening either yields a false positive, or detects a slow growing cancer which will never cause significant health issues.
Plenty of 70-year-olds with false positives or non-threatening cancers might have their activities and quality of life curtailed severely with unnecessary surgery (which can cause some horrible loss of function), or long-term hormone therapy.
I was getting ultrasound for something else higher up last year and as they were finishing off they said they would have a peek at the prostate too, since I was a man in my early 50s and presently on the table, then again a couple of months ago when my consultant was doing pre-clinic before a colonoscopy, I got the "while I'm here with a finger up your arse anyway" talk. Never had symptoms or specifically had a blood test as far as I know.
or long-term hormone therapy.
A friend is on this (he has terminal prostrate cancer) and it sounds horrendous, total loss of energy and drive.
He's been battling prostrate cancer for several years now and no one can tell him how long he has (1 to 10 years is the best they can say). Currently they're cycling him on/off testosterone suppressant drugs every few years, trying to slow the cancer growth.
The statistics make perfect sense to me on a population level. For certain individuals, prostate screening has a clear benefit. But the decision to offer it has to be balanced with the outcomes for those individuals for whom screening either yields a false positive, or detects a slow growing cancer which will never cause significant health issues.
I've no doubt it makes sense on a population level. But I'm an individual, and everyone I know is an individual. My take is if I have a large PSA at 50 I'd want it explained, although I might draw the line an surgery unless there was a very clear need for it. If they were sure it was cancer, even a slowly progressing one, I'd want treatment. In contrast if I had a large PSA at 95 I don't think I'd even want it investigated. My experience is GPs have a pretty good understanding of all this, s I don't think there's especially a problem with the status quo.
Plenty of 70-year-olds with false positives or non-threatening cancers might have their activities and quality of life curtailed severely with unnecessary surgery (which can cause some horrible loss of function), or long-term hormone therapy.
Yup, that's the gamble. ...and it's a gamble you have to take if you have symptoms, not just if you have a high PSA.
I'll be 58 in January and first had it done when I was 55, I got the thumbs up!
first had it done when I was 55, I got the thumbs up!
Unconventional technique. Both at the same time?
What, both of them?
I’ll be 58 in January and first had it done when I was 55, I got the thumbs up!
Here's the cut....
A normal PSA doesn't immediately or necessarily mean you DON'T have cancer....
It's not a perfect test..
DrP
https://www.gov.uk/government/publications/prostate-specific-antigen-testing-description-in-brief
Bloods done – results on Wednesday, and whilst the prospect of the slippery finger doesn’t fill me with too much dread, as long as he doesn’t put both hands on my shoulders, having staples fired into your walnut sounds nasty.
Hopefully it won’t come to that.
My experience: I am now 56 and went to Dr about something else and had a blood test which flagged up high PSA. Got sent for biopsy. This was horrible. Humiliating and painful. Confirmed that I'd got Prostate Cancer but low grade, low risk. So got put on 'watchful waiting' i.e. regular testing. Next biopsy showed that it had got worse and that I needed treatment whilst it was still, hopefully, contained in prostate. I had a Labroscopic Radical Prostatectomy just over 9 weeks ago. I go back to the Consultant in a few weeks to see the results of the tests they will have done to see how aggressive the cancer was and whether they think it is likely to have spread. It's been pretty grim at times, most of the time if I'm honest. I was off work for a month. I have started running again but no cycling as yet. Being pragmatic, I am still here and lucky to have been diagnosed early.
having staples fired into your walnut sounds nasty.
On a par with a dentist visit but at the other end. A bit alarming looking into the toilet bowl for the first day after ...
The Grid Of Needles. Effing painful.
I'm guessing you didn't cycle home ...
A finger? Luxury 😉
I’m going in on Monday to get 50 litres of Co2 and a BBC Film crew up there.
A swift couple of pints of Moviprep will soften me up first.
So what, unless its in the family or you are showing some signature symptoms, dont push to get tested? Its very confusing to my mind, certainly now I'm over 40 and hyper-aware, taking any slight discomfort as something terminal, after losing my mum to cervical cancer in the recent past.
Following the publicity a few years ago I went and asked for a PSA test.
Doctor refused as I didn't appear to have any symptoms. 70 now and still not had it done and still riding my bike although I just ordered a new guitar instead of a new bike.