Prostate Cancer

[Hope]

I have seen a couple of TV adverts recently encouraging men to get their prostates checked for cancer, especially as it is one of the top causes of death in me.  My question is, if this is the case, why isn't there a national screening programme, in the same wy that there is for women's breast cancer or bowel cancer?  The adverts and all I've read suggest that if it is dignosed early on enough, it is fairly straight-forward to deal with.

[BeRational]

I have mine checked yearly.

Ouch

[Harrowby Hall]

The standard test for prostate cancer appears to be digital rectal examination - doctor sticking finger up patient's rectum. On the couple of occasions I have submitted to this procedure I felt violated and would hope that a more ... err ... comfortable method of examination could be devised. A better blood test perhaps? There is the PSA test but this is notoriously unreliable.

One problem with prostate cancer is that many cases appear to be benign - it is said that almost all men over 80 have prostate cancer but most will not die from it. Having said that I do know of friends who have died from prostate cancer - or rather the metastatic developments in other places such as their skeletons. Their final illnesses were not pleasant.

I think that one problem is the NHS system itself does not seem to be very devoted to preventative medical practices. I suspect that HM Treasury shudders at the thought of the costs of doing lots and lots of investigative tests which will result in finding no conditions needing treatment.

[Hope]

Why is a blood test not possible?

[Nearly Sane]

Why is a blood test not possible?

It is possible, but as has already been mentioned, it isn't that reliable and will give a very large number of false positives which would  defeat any benefit of screening

Can I suggest that you talk to your doctor, if you are worried, rather than get advice on this forum?

[Hope]

Can I suggest that you talk to your doctor, if you are worried, rather than get advice on this forum?

I started the thread partly to get some idea about folks' understanding of the issue, partly to try to get some discussion going, and partly out of interest.

[Jack Knave]

Isn't prostrate cancer easy to know about - I becomes more and more difficult to wee.....?

[Shaker]

Isn't prostrate cancer easy to know about - I becomes more and more difficult to wee.....?

That's not necessarily cancer, Jack. Prostatic hyperplasia (i.e. enlargement) is something that comes to all us boys as we get older. It's just a feature of male plumbing - Anno Domini and all that - and doesn't in itself, by itself indicate anything sinister.

The point however is that better safe than sorry is the watchword and that it's always, always, always worth the gentleman of maturer years nipping along to see the sawbones for a quick chat and in most cases reassurance that the plumbing system is banging and knocking along safely in the way that evolution has decreed.

[Brownie]

GP surgeries run Well Man clinics and encourage men to go along and have various things checked:  blood pressure, weight, routine blood tests which will include PSA.  Then they take it from there but men really shy away from the rectal examination, understandably.  I would think if the PSA is raised, further examination is indicated.  It may be nothing to worry about but better safe than sorry.

Wee problems can be caused by all sorts of things, as has been said.  Sometimes they go away by themselves too.   Too much abdominal fat can put pressure on the bladder and lower down.

It is a scary business though.   I'm sure we've all known people who've had prostate cancer, sometimes it is kept well under control.  No man wants to have it and it is a pity that there isn't an easier test for it, as Hope said like the bowel cancer test for both sexes, routine mammography and cervical screening for women, none of which are invasive.

[L.A.]

I had Prostate cancer detected in a blood test a few years ago. Biopsy tests confirmed it was cancer 'Stage T1c' . . . which basically means that it might eventually become dangerous if nothing else kills me first . . . but they recommend surgery.

After some deliberations, I finally opted for treatment, but I still don't know whether I made the right decision.

We are all going to die of something sometime. I've had a friend go through a hideous death with Motor Neuron disease and others with Alzheimer's. Maybe having a terminal condition 'up your sleeve'  is not an entirely bad thing?

[Shaker]

There used to be a slogan doing the rounds a good few decades ago that usually elderly men died with prostate cancer rather than of prostate cancer. I suspect one too many cases of prostatic cancer metastasis (often to bones) put that one to bed, but I doubt if it has entirely gone away.

Unfortunately.

[L.A.]

There used to be a slogan doing the rounds a good few decades ago that usually elderly men died with prostate cancer rather than of prostate cancer. I suspect one too many cases of prostatic cancer mestasis put that one to bed, but I doubt if it has entirely gone away.

Unfortunately.

If I had to make the choice, I would die of prostate cancer tomorrow rather than motor neuron disease in five years!

. . .  but of course, we never have that knowledge.

[Brownie]

Many would agree with you LA - I can't die of prostate cancer but I would rather have a comparable disease than a degenerative neurological one - and your prostate cancer may not progress.  It often doesn't so we will hope for the best for you.

[Shaker]

If I had to make the choice, I would die of prostate cancer tomorrow rather than motor neuron disease in five years!

. . .  but of course, we never have that knowledge.

I don't know how many other people here saw it but recently on BBC whatever there was a documentary called Simon's Choice* about a chap in his late fifties called Simon Binner who was diagnosed with a very rapid and aggressive form of MND, who chose to go to Switzerland (not to Dignitas, the well-known one; there are apparently three assisted suicide companies in Switzerland, one of which is called LifeCycle which Simon chose - I can't remember the third) to be helped to die, when his incapacity and disability became unendurable to him. Rather than a disgustingly distressing death unable to speak, move or even swallow a mouthful of water let alone food, he died quickly, painlessly and peacefully, at his own hand and under his own control as Swiss law dictates.

Which ought to be everybody's right in their own home country, not thousands of miles and thousands of pounds away.

* ETA: http://goo.gl/6S1Gce

[Leonard James]

I don't know how many other people here saw it but recently on BBC whatever there was a documentary called Simon's Choice* about a chap in his late fifties called Simon Binner who was diagnosed with a very rapid and aggressive form of MND, who chose to go to Switzerland (not to Dignitas, the well-known one; there are apparently three assisted suicide companies in Switzerland, one of which is called LifeCycle which Simon chose - I can't remember the third) to be helped to die, when his incapacity and disability became unendurable to him. Rather than a disgustingly distressing death unable to speak, move or even swallow a mouthful of water let alone food, he died quickly, painlessly and peacefully, at his own hand and under his own control as Swiss law dictates.

Which ought to be everybody's right in their own home country, not thousands of miles and thousands of pounds away.

* ETA: http://goo.gl/6S1Gce

It is tragic that stupid religious beliefs are allowed to cause so much unnecessary suffering.

[Sassy]

I have seen a couple of TV adverts recently encouraging men to get their prostates checked for cancer, especially as it is one of the top causes of death in me.  My question is, if this is the case, why isn't there a national screening programme, in the same wy that there is for women's breast cancer or bowel cancer?  The adverts and all I've read suggest that if it is dignosed early on enough, it is fairly straight-forward to deal with.

Breast cancer screening only starts when a woman turns 50 years of age.

Bowel cancer for people over 60 years of age.

So anyone under that age do not get screened unless a family history.

You have to rely on finding a lump or blood in your stool.

It is a case the rich get good health checks the poor don't even have decent hospitals anymore.

Go figure...

[Harrowby Hall]

Breast cancer screening only starts when a woman turns 50 years of age.

Bowel cancer for people over 60 years of age.

So anyone under that age do not get screened unless a family history.

You have to rely on finding a lump or blood in your stool.

It is a case the rich get good health checks the poor don't even have decent hospitals anymore.

Go figure...

I couldn't agree with you more, Sassy.

The NHS is far too reactive and far too obsessed with cost control.

My lovely, wonderful wife suffered constipation and consulted her GP. The GP diagnosed irritable bowel syndrome and hung onto that diagnosis for about a couple of years. My wife had colon cancer.

Cost constraints - it would seem - prevent GPs from requesting investigation to eliminate the possibility of a serious disorder. But the cost of a cautionary colonoscopy was microscopic compared to the costs of surgery, chemo- and radiotherapy and hospitalisation incurred over the seven years it took my wife to die. The cost of establishing a genuine preventative strategy may be high but its ultimate savings would be higher.

[Shaker]

I couldn't agree with you more, Sassy.

The NHS is far too reactive and far too obsessed with cost control.

My lovely, wonderful wife suffered constipation and consulted her GP. The GP diagnosed irritable bowel syndrome and hung onto that diagnosis for about a couple of years. My wife had colon cancer.

Cost constraints - it would seem - prevent GPs from requesting investigation to eliminate the possibility of a serious disorder. But the cost of a cautionary colonoscopy was microscopic compared to the costs of surgery, chemo- and radiotherapy and hospitalisation incurred over the seven years it took my wife to die. The cost of establishing a genuine preventative strategy may be high but its ultimate savings would be higher.

That's a dreadful story HH - not an isolated case either - and you have my sincerest condolences.

More of a fit subject for another thread, but in these so-called times of "austerity" how could the NHS afford to meet the demands of pro-active, preventative medicine with a rapidly growing (and ageing) population?

[Harrowby Hall]

Thank you Shaker and Floo

It is several years in the past now. But I still miss her

What really still concerns me is that the complacent GP (a woman) did not even think - after a year or so of repeated consultations - that it would be worth while to rule out any more serious conditions. A doctor friend (a consultant surgeon) told me that irritable bowel syndrome is should be a diagnosis of last resort. Only to be used when all else has been eliminated.

My surgeon friend died from metastacised prostate cancer.

[Sassy]

I couldn't agree with you more, Sassy.

The NHS is far too reactive and far too obsessed with cost control.

My lovely, wonderful wife suffered constipation and consulted her GP. The GP diagnosed irritable bowel syndrome and hung onto that diagnosis for about a couple of years. My wife had colon cancer.

Cost constraints - it would seem - prevent GPs from requesting investigation to eliminate the possibility of a serious disorder. But the cost of a cautionary colonoscopy was microscopic compared to the costs of surgery, chemo- and radiotherapy and hospitalisation incurred over the seven years it took my wife to die. The cost of establishing a genuine preventative strategy may be high but its ultimate savings would be higher.

It is all too sad a repeating history for many people, HH.
It is horrific to hear how your wife suffered due to negligence by the NHS.
I believe prevention is better than cure and that people would be better having a preventative scan every five years to detect anything that might be at the onstart.

The rich have them and it costs about  £2,000. To be honest it would be worth paying just to ensure safe diagnosis early on.
Cost about £200 for same screening privately in India might be better to take a holiday and have it done there.

Keep pushing your doctor if you think something is wrong. When I had my son in 1996 I knew something was not right.
I visited my gp and asked to be sent for investigation. However her words were... We cannot send you for an invesitgation because of changes in your body and your feelings. When I returned for 6 month check up at hospital after the birth I spoke to my consultant. He said he wanted to check me out as I was having a procedure done at the time.

I had it done privately and when he came to tell me the news he said he had good news and bad news which did I want first.
I said bad  news please. He said the bad news was that I was right something was wrong. I had endometriosis the good news was they had caught it in early stages. I have a high pain threshold and so had no pain which should have been severe at this stage to warn me. But I had other signs and somehow I knew.  My consultant told me not to go to my gp in future to ring his secretary and he would see me immediately.

My consultant treated me both privately and NHS so was really thankful.  Now I do not stand on ceremony my doctors know if I want checking I am going to be checked. But to be fair my GP now is a really good one.

[Harrowby Hall]

The rich have them and it costs about  £2,000. To be honest it would be worth paying just to ensure safe diagnosis early on.
Cost about £200 for same screening privately in India might be better to take a holiday and have it done there.

I think, at the time my wife first contacted the GP the cost of a colonoscopy was about £800 - £1000. By the time she died she had had three surgical operations - the first was the one which discovered the tumour and two others which to deal with metastatic tumours. With chemotherapy and radiotherapy over the seven years it took to kill her, treating the cancer may well have cost £70,000 or more. This money could have been better used doing colonoscopies on nearly a hundred other people had she been properly screened in the first place.

In our case the GP should have ruled out anything more serious before deciding that my wife had IBS.

[Sassy]

I think, at the time my wife first contacted the GP the cost of a colonoscopy was about £800 - £1000. By the time she died she had had three surgical operations - the first was the one which discovered the tumour and two others which to deal with metastatic tumours. With chemotherapy and radiotherapy over the seven years it took to kill her, treating the cancer may well have cost £70,000 or more. This money could have been better used doing colonoscopies on nearly a hundred other people had she been properly screened in the first place.

In our case the GP should have ruled out anything more serious before deciding that my wife had IBS.

I totally agree, with you.
I find it sad they can put a price on life. Prevention would be cheaper than the cure.
I am sorry it cost the life of your wife. Thanks for sharing because you may save the  life of another by sharing this sad truth.
Good you can share your heartache and more so the reality of your nightmare. Take care. xx

[Harrowby Hall]

I totally agree, with you.
I find it sad they can put a price on life. Prevention would be cheaper than the cure.
I am sorry it cost the life of your wife. Thanks for sharing because you may save the  life of another by sharing this sad truth.
Good you can share your heartache and more so the reality of your nightmare. Take care. xx

Thank you, Sassy, for your very kind words. My wife died more than a decade ago but I still miss her.