Looking to get a PSA test done as recently hit 50 and sometimes need to pee really urgently.
Not sure the GP is the best answer with Covid and the likes.
I did a quick Google and have seen home tests from £19.99 to £450!
Any recommendations?
Cheers,
Adam.
Cheers,
Adam.
I have a 'flow' problem and was diagnosed with an enlarged prostate by the doctor. He then sent me for a PSA test which was above where it should have been for my age. I ended up having a biopsy which thankfully came back negative.
I now make sure I have a PSA blood test every 6 to 12 months.
Doctor is your best route - if you can get an appointment that is!
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Talk to your GP Adam. It's not as simple as just getting a PSA done- other things to consider as well.
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As has been said....speak to your G.P.
I had prostate cancer, saw the doctor, he did the "finger"! thing...the first test will be a simple blood test.
(at least it was when I was being seen to!).
Of course , it may well be nothing, it may be something else altogether, but your doc. will know what to do.
Originally Posted by stoneyloon
Really don’t understand this. Why worry about worrying the GP, they are not troubled with treating covid patients and he/she will simply order bloods via the nurse/phlebotomist. Ask and you shall receive.
Ok, will give the doc a call.
Thanks folks....
Cheers,
Adam.
Very wise. I had PSA test and, as it was high, had a biopsy. It was found to be cancer and caught just in time. I opted for radiotherapy which I completed just before original covid lockdown so count myself as very, very lucky.
I would advise anyone over 50 to get PSA test yearly.
I had the ‘finger test’ a few years ago. A locum was in. She asked if I wanted her to do it there and then or I could have my regular GP do it later. She was a tiny Chinese lady. I did the maths and said she could do it. Boy did I miscalculate. She may have been sub five foot but she appeared to have the hands of Pat Jenning.
Cheers,
Adam.
Don’t let it put you off though. She can’t work everywhere…
Cheers,
Adam.
When you look long into an abyss, the abyss looks long into you.........
We are actually
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Are you troubled to the extent that people in the OP’s situation shouldn’t bother coming forward/should go elsewhere for PSA test?
Absolutely not- I would strongly encourage him to speak to his GP
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Don't think he said that. Don't turn into Oaky.
"You stick your right oar in,
And your left oar too,
Jump in with your size 9s,
And stamp 'em all about.
You do the old oakey cokey then you turn around,
That's what it's all about … hey.
Waaaaay, the old oakey cokey
Waaaaay, the old oakey cokey"
That’s just the kind of thing that Ali would have said if he was still here, trust me you wouldn’t want his reputation.
Definitely speak to your GP.
We are seeing unprecedented demand and the whole system is tearing at the seams because of COVID itself and the fallout.
That is the fault of chronic underfunding of health and social care from our government.
It is not the patients fault. It is not your job to worry about the demand, it’s our job and the job of the government (not that they give a shit).
Don’t let COVID stop you getting an appointment. But do write to your MP about the ridiculous strain the whole NHS is under and ask that it be funded properly!
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Done my online consult so waiting for a doc to call over the next couple of days...
Cheers,
Adam.
I didn’t know what a PSA test was so I looked it up and was surprised the NHS website seems to read against testing - especially as the message I’ve been seeing on the TV about Mens prostate cancer is to get checked regularly.
As a regular cyclist and therefore fit man in my 50’s without any family history of such things I’m now confused. Like I guess a lot of other men, I don’t particularly want sausage fingers going the wrong way up my back passage so is this test something I should really be considering?
This is the page I read https://www.nhs.uk/conditions/prosta...r/psa-testing/
Isn't it because prostate cancer can be a relatively benign and slow growing cancer, where the treatment can be more life affecting than the disease? IANAE, so I'm sure someone will be along to correct me if I've got it wrong.
It can be, and it can also be a fast acting and deadly cancer.
Testing and treatment can be a contentious discussion. But I wish my lifelong friend had known he had the fast moving kind before it was too late for him at 60 years old. Equally, I’m glad my other lifelong friend who has a slower developing kind, knows about it and has a very sensible consultant who is just monitoring it. He hasn’t had any of the invasive treatment, but knows he could if/when it develops further. In the meantime, treatments are improving and don’t have to be more life affecting than the disease.
Get yourself armed with the facts and then you can make your own decisions. Just not knowing can’t be the answer.
https://prostatecanceruk.org/prostate-information
The issue of PSA testing is pretty controversial. The evidence and guidelines are all pretty confused. Mainly because of stats like these:
Roughly 1 in 7 asymptomatic men who undergo PSA screening will have an elevated PSA result.
In trials, 85% of men with a raised PSA proceeded to have a biopsy.
66% of men offered a biopsy because of a raised PSA result will NOT have prostate cancer.
15% of men with a normal PSA result will have prostate cancer.
2% of men with a normal PSA result will have advanced cancer.
Having a biopsy is not a trivial thing. There are potential complications. Your doctor should discuss the pros and cons of a biopsy with you.
The approach I take is to educate my patient as much as possible and we make a joint decision over whether or not to get the test.
I don’t usually advise it in men just because of age. But if over 50 and have symptoms then usually recommend it but still with counselling on pros and cons.
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I would encourage anyone over 50 to ask their GP for a physical and blood test. Especially if there is any family history. My late father, who passed away at 90, had mild prostrate cancer in his mid eighties. Due to his age it was controled with medication. My 65 yr old brother had problems and was found to have the cancer. His prostrate was quickly removed and problem solved. Interesting thing is that I always thought that if someone has had the prostrate removed then they would have to wear a catheter for the rest of their life. This is not so, at least in my brothers case. Once the urethra had repared itself the catheter was removed after a few weeks. A short time with nappies after that, but then life back to normal. Job done. No worries. I had myself tested recently and intend to do so every couple of years unless a problem occurs. It's quick and easy and the worst thing about it is having to wait a week or so for the result. A word of caution though. When going for the physical examination, do not wear an expensive watch. My doctor was more interested in my Seamaster than what his finger was doing! :D
GET IT DONE!
I was diagnoeed with BPH approximately 8 years ago, as part of a routine mot from our GP surgery at age 50.
This presents the same symptoms as prostate cancer, and the GP acted without hesitation
My PSA fgure oscillates between 5.5 and 8.5 and is tested every 3 month.
At first diagnosis, I had an mri scan of the area, which highlighted a large dark area on the prostate.
I had two biopsies, the second was a core biopsy which took 40+ samples from across the dark mass.
Both results were negative, which was a huge relief.
Get a psa, followed by an mri if the condition continues.
To do nothing is foolish.
Last edited by W124; 7th July 2021 at 21:26.
MY father has just been diagnosed with Prostrate Cancer, he's 77.
Don't know how long he's had it as it was picked up at the Annual blood test, and last years one was cancelled due to COVID.
His PSA was 485 which is unbelievable. He needs to pee every hour during the night, so obviously not getting enough sleep.
Personally I'm very worried about him, hope things will be alright as I can't imagine my life without him.
PS, all GPs have been told to resume F2F appointments, so make sure you get one ASAP.
How come some GP practices offer valuable services like and others (like mine) don’t? The variability of service levels is crazy and, as you found, the benefits can be huge. Glad yours had a positive outcome.
Last edited by David_D; 8th July 2021 at 01:55.
I take it you are a GP so I hope you don’t mind me asking a question. Why recommend against testing to know your PSA level?
I think it’s great that you would discuss the pros and cons of testing and biopsies on an individual basis. I don’t understand though why GPs ever recommend not having the PSA test. Surely your PSA level, particularly if it changes over time, is very helpful in informing the discussion of what steps to take next?
I've been getting regular blood tests for PSA levels for 20 years or so, plus the finger test from my GP. It was a rise in PSA that raised the concern of my GP. Agreed to a biopsy (six on each side). One side came back positive. I had another PSA blood test and in just two months my PSA jumped higher. I had my prostate removed soon thereafter. The pathology on my removed prostate was bad. Six more months could have killed me!
Get regular PSA tests...to avoid it is like burying your head in the sand.
This is such a frequent discussion we have as a GP-it really needs to be on an individual level as many factors can come in to play (including family history).
The main caution about not randomly recommending it for everyone (ie as in a national screening programme) is the problem with "false positive" results. People can come to harm-both physical and psychological coming to terms with an elevated PSA which is subsequently not found to be caused by cancer. There are many facets to the debate-and no right or wrong answer. Anecdotally we will all know people who have potentially benefitted from having the test, and this can skew our view sometimes.
As wigdog said above. It is an individual thing. Biopsies can (although rarely) have very bad and lasting side effects. It isn't about burying head in the sand it is about doing what is best for the individual. As said above, it can all get skewed and emotive due to individuals all having stories of someone they know.
Also, a PSA will change over time that’s normal. In fact the range of a “normal” PSA level gets higher the older you get. Many prostate cancers grow slowly and would never endanger your life. If you live long enough, it is very likely you will have at least some prostate cancer that will not shorten your life.
I think the bottom line is that no test is perfect. And no answer to this question is right or wrong.
Us doctors can do real harm by over testing as well as under testing. Although fear of litigation is leading us more to an over testing stance like in the US.
With that being said, if a well 50 year old with no symptoms listens to the pros and cons and still wants it, I will do it. I’m there, only to advocate for the patient in front of me. I guess it isn't so much that I wouldn't recommend it, but more that I wouldn't offer it if a person didn't request it and they also didn't have any symptoms. That is the stance advised by NICE (National Institute for Clinical Excellence).
Overall, it probably wasn't a good idea for me to wade into this thread so here is some reliable information for you guys that explains things better than I can:
https://assets.publishing.service.go...r_well_men.pdf
Last edited by watchstudent; 8th July 2021 at 15:59.
Thanks for such a comprehensive answer and for the link, which is really helpful.
I understand why tests without symptoms are restricted to over 50s.
Beyond that the main risk seems to be being panicked into unnecessary treatment because eg you just don’t like the thought of having a slow growing cancer inside you even if it will never spread. I have a friend in exactly this position who lives with it and is checked out once a year.
I guess the better educated we all are as men about this stuff, the more rational decisions we can all make with our GPs and medical professionals.
Yes, there's no one accepted answer to this question. Here is what I found at Harvard Health:Is PSA reliable?
March 27, 2011
By: Harvard Prostate Knowledge
How reliable is the prostate-specific antigen (PSA) test when it comes to detecting prostate cancer?
Although PSA testing can help catch prostate cancer at an early stage, having an elevated PSA (generally considered more than 4 ng/ml) doesn’t necessarily mean that a man has cancer. Noncancerous conditions, including benign prostatic hyperplasia (BPH), or an enlarged prostate, and prostatitis, can raise PSA levels. In fact, studies have shown that about 70% to 80% of men with an elevated PSA who have a biopsy do not have cancer. However, many men undergo an ultrasound and prostate biopsy, to be certain.
Conversely, the PSA test doesn’t detect all cancers. About 20% of men who have cancer also have a normal PSA (less than 4 ng/ml), so the test may give some men a false sense of security. For this reason, some experts take a man’s age into account when considering a PSA level. And most doctors observe how a man’s PSA level changes over time, a measure called PSA velocity, rather than using it as a one-time indicator. PSA scores tend to rise more rapidly in men with cancer than in those with BPH, for example.
Some doctors also measure the level of free PSA. The PSA protein circulates in the blood in two forms: bound to other proteins or unbound (free). Several studies suggest that men with elevated PSA levels and a very low percentage of free PSA are more likely to have prostate cancer than a benign condition. Knowing your free PSA level won’t give you a definitive answer about cancer, but it may be useful when considering whether a biopsy is an appropriate next step.
Researchers are developing new screening tests for prostate cancer. Like the PSA test, they rely on biomarkers, such as antigens or proteins, which are elevated or may only be present in men who have prostate cancer. The hope is that these tests will better detect existing cancers without raising the alarm for cancer when it isn’t there.
My psa level is high,been high for years.Cleared for cancer but I have benign prostate enlargement,on the list for surgery ,not holding my breath for any time soon.
Piddle sample dropped off today and bloods and poke appointment booked for 27th.
Cheers,
Adam.
When I went to see the Doctors, he said it could be a number of things (this was after the "finger"!) one being prostate cancer.
I had lots of tests the blood test one said 28. something..after more tests etc. I had a biopsy, they said 8 out of 10 of the samples? were cancerous. and that it had spread to the edge of the prostate, They said it was high risk cancer, they were worried it may have spread to my lymph nodes...They said I needed my prostate gland taken out, and almost certainly radiation afterwards.
A few months later (2013) I had the op. had the prostate gland out...Luckily. I didn't need the radiation, as it hadn't spread.
I have to have a P.S.A. test every year, (just a blood test)...luckily.! its always been 0.01 ever since.
It is quite a big op. (apparently though, its done by some sort of "robotic"! type surgery nowadays?
I was off work for 5 months.
As I say, luckily the cancer hasn't come back. I have had to go back 2 or 3 times, for minor ops. to "dilate my utherus",
It can be quite traumatic, as your life does change a bit (or can) after the op. . Im pretty laid back though, so dont let it bother me.
Yes, my prostatectomy last year was laparoscopic robotic-assisted...the surgeon was manipulating the robotics using joysticks and a viewer within a console about ten feet away from me (I was asleep), facing the other way! That week or so connected to a catheter was a real bitch! If I hadn't been retired, I probably could have returned to (office) work after a month.
Glad you're over it, always good to be 'pretty laid back'.
Sods law!
If Id have had the op. a year later at the same hospital, it would have been done robotically too!
Saying that? I'm glad I was working then! As I was of course getting paid lol!
I've since had 3 minor ops. which needed 8-10 days of catheter wearing each time too! Not very "comfortable"are they!lol!
Thanks for that.
I think "laid back" was maybe the wrong term! I mean I just "accepted" the differences the op.would make!
Ok, disclaimer alert - don’t watch this video if you are squeamish!
My brother was recently diagnosed with prostate cancer, with a Gleason score of 8 (the higher the score, the more aggressive, or so I understand).
He had the robotic surgery a couple of months back, and sent me this video which is of the same procedure - not his surgery.
Amazing what they can do really - not what I would call nice to watch, but very interesting:
Last edited by mtagrant; 9th July 2021 at 21:25.
Hope he's doing OK?
I trust you have thought about discussing with your GP about having a PSA done as well with a family history?
All the best,
Richard
Thanks Richard - yes he is recovering albeit slowly.
I got a test a few months back when he was first diagnosed, and then a follow up last week to check the trajectory (which turned out a little higher). Will be keeping an eye on it and testing every 3-6 months until it becomes a bit clearer
Wrong! A year later and you probably would have been here:
This thread has prompted me to book a PSA test later this week. Had one 4 years ago with a reading of below 2, but a history of prostate cancer in the family and reduced flow rate suggests I should be monitoring it.
So thanks OP
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No I wouldnt??Wrong! A year later and you probably would have been here:
(Im getting cremated! lol!)
It's the ashes that are in the coffin!
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