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BBC news today

2 Feb 2018 07:18

As I'm sure some of you have already seen this is the main headline on the BBC news website today - www.bbc.co.uk/news/health-42890405

Re: BBC news today

2 Feb 2018 09:55 in response to winglets

I'm convinced my prostate cancer was caught early because of an article on Woman's Hour!  I had a late start at work one day and I was listening to Woman's Hour on my way in.  There was a discussion about prostate cancer and the availability of the PSA blood test. For some reason, this registered in my head and I asked for the test. And the rest is history.

PSA is known to be a blunt instrument, since it registers ANY prostate problem, not just prostate cancer. The current thinking is that this limitation means it can't be used as a screening tool, because there will be too many false positives - too many men who get referred for further investigations (possibly including biopsy) that turn out not to have cancer.  Whilst I understand this, in my own case I was monitored for 2 years with my PSA wavering between 4 and 5 before I was given a biopsy. It was only when it spiked to 5.4 that the consultant decided it was time to get out the needles! (Ouch!)

I'm not a doctor but I personally think that it would be possible to create a protocol using PSA for screening.  Start at (say) age 45 with tests every 3-5 years.  Those men who are slightly outside the range get a course of antibiotics for suspected prostatitis and a retest after 2-3 months.  If the PSA is below 4 for men in their 40s, or below 5 for men in their 50s or older, then retest every 4-6 months. If the PSA goes above the age threshold then refer to the hospital urology department for further evaluation and possible investigations. 

What no one seems to mention is that any man with a PSA over 5 is probably showing some symptoms of benign prostatic hyperplasia anyway even when there's no cancer, and that man may well benefit from a prostate shrinking medication.

Re: BBC news today

2 Feb 2018 10:06 in response to telemando

telemando, I am in your debt for the amount of information you provide which helps me understand things of which I knew zilch.  I have now read the article posted here. ( I like to think you might register to say you are willing to be interviewed by a BBC journalist about this as suggested in the article.)

Re: BBC news today

2 Feb 2018 10:11 in response to winglets

Nice to see that although the number of men dying from prostate cancer is increasing due to our ageing population, the percentage of men surviving has improved. 

Great news about breast cancer stats. We need a similar turn around for the 52 rare and less common cancers, which account for 54% of UK cancer deaths Sad deaths. http://www.ncin.org.uk/publications/rare_and_less_common_cancers

Re: BBC news today

2 Feb 2018 10:25 in response to winglets

And thanks to you too winglets for posting the article in the first place!

Re: BBC news today

2 Feb 2018 20:02 in response to telemando

Hi Telemando,

This is going to be a bit controversial but I have thought for years that the PSA test should be used for screening. The false positive argument also applies to cervical, bowel and breast screening. From memory, PSA tests result in 60% false positives but cervical, breast and bowel cancer screening figures are far higher. The BMJ said this about breast cancer screening ... "It may be reasonable to attend for breast cancer screening with mammography, but it may also be reasonable not to attend because screening has both benefits and harms. If 2000 women are screened regularly for 10 years, one will benefit from the screening, as she will avoid dying from breast cancerAt the same time, 10 healthy women will, as a consequence, become cancer patients and will be treated unnecessarily. These women will have either a part of their breast or the whole breast removed, and they will often receive radiotherapy and sometimes chemotherapyFurthermore, about 200 healthy women will experience a false alarm. The psychological strain until one knows whether it was cancer, and even afterwards, can be severe." http://www.bmj.com/bmj/section-pdf/186143?path=/bmj/338/7692/Analysis.fu...

Way above my pay grade but something feels out of kilter here.

Best wishes

Dave

Re: BBC news today

2 Feb 2018 22:20 in response to davek

Hi davek. I agree with you. Let's roll out PSA screening for men age 45 asap!