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Feb. 2018
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The uncomfortable facts about prostate cancer

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  • The uncomfortable facts about prostate cancer

    There was an item on the BBC Today radio program this morning about prostate cancer. As soon as the audio is available on-line, I will make a link to it. It's an important subject, and the essence of the item echoed the experience of a friend who has been through the 'PSA test' and the following investigation.

    He urged me that, as a routine precaution considering we are about the same age, I should present myself for the PSA test merely as a precaution. Consulting with my doctor I was advised that she would if I insisted, perform the test, but the results may not be that useful an indicator.

    The BBC report covers the very same scenario with statistical information and confirms what my doctor told me directly. I hope that this is of some use to our membership.



    A BBC voice lost to prostate cancer here.
    Alan A. Shaw
    Designer, owner
    Harbeth Audio UK

  • #2
    Advice from my GP

    I asked my GP about this. After describing the limitations of the PSA test covered in your audio clip, he said that unless there were any symptoms of something amiss he would not advise having a PSA test.

    He said most men dying in old age would die with a cancer in their prostate but they would not die OF the cancer, as most of these cancers are not aggressive.

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    • #3
      Baseline testing?

      My GP suggests having a PSA test. It is a non-invasive blood test (except for the drawing of blood) that can be done during your annual or otherwise periodic physical checkup/blood work up. Though the test may have its limitations, isn't monitoring it worthwhile? I personally have had one annually over the past decade+ and established a baseline, much like can be realized with other blood chemistry components. Men, we must decide to be in charge of our own health and wellness......or not!

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      • #4
        PSA testing - bitter experience

        I've been through the consequences of an over-aggressive follow up of a PSA test. The test, done 7 years ago after several years of slowly rising numbers, measured about 5.5. The urologist then put unsuspecting me through a couple of simple tests followed by a prostate biopsy, without sedation. Despite his assurance that I would only feel some "pressure", I near passed out from the pain, I was soaked in sweat by the time he and his assistant had their ten tissue samples, and the results were 100% negative for cancer.

        Since then my annual PSA numbers have slowly risen to about 7. Back to the same urologist - this time he wanted to do a sistoscopy because I get up to urinate once or twice every night. He typed the order into his computer and left the room without asking me how much water I drink every evening. I drink lots of water. I tried a test, for five consecutive days I drank nothing after 5 pm. Only one night did I get up, once. He won't be shoving a 9 mm scope up there, I'm going to see a different urologist.

        As confirmed by my doctor, a rectal exam before a blood test will increase the PSA level. So will ejaculation within a couple of days before the test. So will constipation. So will certain **********s. Riding a bicycle or a horse. Anything that applies pressure to the prostate, I'm told, can increase your blood PSA level. In my case, among other factors, the urologist did a rectal exam a few minutes before the most recent blood test.

        I'm 63 years old and worried. I need an hour or two of Debussy and Ravel piano pieces with my 32 year old Harbeth speakers.

        Comment


        • #5
          Originally posted by kencohen View Post
          I've been through the consequences of an over-aggressive follow up of a PSA test. The test, done 7 years ago after several years of slowly rising numbers, measured about 5.5. The urologist then put unsuspecting me through a couple of simple tests followed by a prostate biopsy, without sedation. Despite his assurance that I would only feel some "pressure", I near passed out from the pain, I was soaked in sweat by the time he and his assistant had their ten tissue samples, and the results were 100% negative for cancer.

          Since then my annual PSA numbers have slowly risen to about 7. Back to the same urologist - this time he wanted to do a sistoscopy because I get up to urinate once or twice every night. He typed the order into his computer and left the room without asking me how much water I drink every evening. I drink lots of water. I tried a test, for five consecutive days I drank nothing after 5 pm. Only one night did I get up, once. He won't be shoving a 9 mm scope up there, I'm going to see a different urologist.

          As confirmed by my doctor, a rectal exam before a blood test will increase the PSA level. So will ejaculation within a couple of days before the test. So will constipation. So will certain **********s. Riding a bicycle or a horse. Anything that applies pressure to the prostate, I'm told, can increase your blood PSA level. In my case, among other factors, the urologist did a rectal exam a few minutes before the most recent blood test.

          I'm 63 years old and worried. I need an hour or two of Debussy and Ravel piano pieces with my 32 year old Harbeth speakers.
          I'm sorry to hear of your experiences. Anything relating to the UG area is both personally invasive, embarrassing and frightening in equal measure. A couple of weeks ago, at the suggestion of our Hong Kong distributor, an old friend, I finally presented myself for a whole-body Wellbeing examination (at BUPA). When it came to discussion about prostate issues, which apparently are latent in all men, one does want to push the subject off the agenda. But as with most cancers, if they are caught early they can be very successfully treated. As you say, with a PSA rating of around 5 which by no means is a positive indicator of a serious problem, the medicos will push for invasive testing. And judging from my own anticipation, let alone the reality of a physical examination of the prostate, its easy to just ignore the matter altogether.

          You mention one of the classic symptoms for prostate enlargement - going to the toilet overnight. In fact, I'd noticed that I was developing this tendency myself, and that was at the back of my mind when the subject of PSA testing came up. But I've discovered purely by chance a possible reason why. In preparation for the Wellbeing test I was told to avoid aspirin/ibuprofen for several days beforehand which I did. Strangely enough, during that period I had undisturbed night's sleep. Hardly proof of anything, but curious nevertheless.

          I called my former NEC colleage who's been through difficult times with a raised PSA and the same sort of examinations as you report (his reading also around 5 I recall), pointed him at your post and he replied to me by email as follows:

          "I read the forum and just have these comments:

          It maybe the the physician want to do a cystoscopy to check the bladder and prostate. As men get older the prostate increases in size and puts pressure on the bladder making you want to urinate more often and this seems much more noticable during the night. The increasing prostate size is called Benign Prostatic Hyperplasia (BPH) and is not cancerous and a relief drug can often be prescribed by a physician. Try not to drink much liquid after 6pm to minimise you having to urinate during the night.

          For the PSA test there can be false positives or negatives and lot of men do die of old age with cancer in their prostate but do not die of it. But until the medical industry can come up with a better way of testing it surely currently the best way to keep a check on your body by monitoring it annually. Prior to having a PSA test for a few days it is recommended not to put any pressure on the prostate eg riding a bike, ejaculate or let your physician touch the prostate as this will elevate the level and give a false reading.

          Hope this helps, that will be a 200 consultation fee ;)"


          Prostate cancer is a serious issue but one which is notoriously difficult to reliably detect. When I park my car in Horsham multi-story car park, it's the poster-face of Bob Monkhouse that reminds me of the importance of early diagnosis.

          Video here.

          I'll cheerfully pay the 200 on your behalf!

          P.S. I was lucky enough to be invited to the opening of a new factory in west London about 25 years ago to be opened by Bob Monkhouse. Although a household name as a comedian, he wasn't really my cup of tea. However, my opinion reversed when I watched him in action. He arrived two hours beforehand (in his Rolls Royce) and spent that time touring the entire factory, talking to the 300 staff who he'd never met before. At the appointed hour he took to the stage and entertained us for an hour with accurate and specific anecdotes about innumerable staff members that he'd garnered in his walk about, without notes. It was fantastic to watch and hugely pleasing for the humblest team member to be given start status for a few moments. I'll never forget it. He was a one-off, old-style, intellectual comedian.
          Alan A. Shaw
          Designer, owner
          Harbeth Audio UK

          Comment


          • #6
            Regular checks?

            Originally posted by kencohen View Post
            I've been through the consequences of an over-aggressive follow up of a PSA test. The test, done 7 years ago after several years of slowly rising numbers, measured about 5.5. The urologist then put unsuspecting me through a couple of simple tests followed by a prostate biopsy, without sedation. Despite his assurance that I would only feel some "pressure", I near passed out from the pain, I was soaked in sweat by the time he and his assistant had their ten tissue samples, and the results were 100% negative for cancer.

            Since then my annual PSA numbers have slowly risen to about 7. Back to the same urologist - this time he wanted to do a sistoscopy because I get up to urinate once or twice every night. He typed the order into his computer and left the room without asking me how much water I drink every evening. I drink lots of water. I tried a test, for five consecutive days I drank nothing after 5 pm. Only one night did I get up, once. He won't be shoving a 9 mm scope up there, I'm going to see a different urologist.

            As confirmed by my doctor, a rectal exam before a blood test will increase the PSA level. So will ejaculation within a couple of days before the test. So will constipation. So will certain **********s. Riding a bicycle or a horse. Anything that applies pressure to the prostate, I'm told, can increase your blood PSA level. In my case, among other factors, the urologist did a rectal exam a few minutes before the most recent blood test.

            I'm 63 years old and worried. I need an hour or two of Debussy and Ravel piano pieces with my 32 year old Harbeth speakers.
            Should I be laughing after reading this? As serious an issue this is and as painful as it was to you (never mind the worry) you presented this with a certain amount of humour, sorry for laughing Ken.

            Regard this issue. I'm of the opinion that a test should be mandatory every X years after the age of 50. After all, woman have a regular smear test and a mammogram. They rarely require an hour or two of Debussy or Ravel afterwards !!

            That said, regular checks may not always show up issues. Didn't Frank Zappa dies of this? I am aware he had regular checks for years prior to his death.

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