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I just I thought I'd open up a seperate thread as there has been some inevitable drift on the Chris Hoy thread.
I'm sure I'm not alone in finding myself thinking about Hoy family a lot in the last 24 hours. Partly such a devastating update for such a lovely chap, partly in awe for his positive outlook completely devoid of self pity. But......I've got confess there is a little bit that has also been thinking about this from a selfish perspective too. The poor guy discovered his situation because he had a sore shoulder.
From what I've read there is no age related screening in the UK unlike some other cancers. And I'm assuming this is for a good reason. A lot of 'survivors' say - "just get yourself tested". But how? I'm guessing this means hassling your GP for a PSA test...which don't sound that accurate - which is I assume why there is no national screening programme. Lots I've read in the last 24hrs suggest you might want to discuss "the pros and cons" of doing this prior to the blood test. I can only assume for there to be any cons there must be a lot of false positives that leads to unnecessary angst. Can't think of a 'con' otherwise.
So what are the obvious signs....other than being in your 50s and a bloke? Who needs to get up 2 or 3 times a night for a piss....and has a sore shoulder.....Should the worried well be descending in their millions on their GPs asking for tests for no specific reason or is that just selfish?
It sounds like we have a few on here who have been through or are going through prostate related issues. You have my sympathies. But do you have any pearls of wisdom for the rest of us too?
What the OP said. Been reading all the Chris Hoy stuff with sympathy, and re-reading some of Stanley’s content also. For weeks now I have had a “feeling” down there. No idea what it is, not a pain or an itch but like there something there that shouldn’t be that hasn’t gone away, perhaps a little like the very early feeling of “needing to go”. All other bodily symptoms are fine, but this makes me think I should get a check up despite being quite reluctant to do so. The recent news has made me nervous.
My experience.
Went to the docs because I get times when I either need to pee 'a lot' or can't go despite feeling like I need to, so took the IPSS test and GP suggested that we get it checked. She did a finger up the bum - By the way; every doc I spoke with from the GP to the Urologist wanted to stick their finger up my arse, joyous. Anyway bloods came back with PSA of 6, so MRI scan to look to see if prostate was enlarged- which mine was not, so I've another blood test and PSA measurement for next March to see if it moves at all. - which I'm not expecting it to.
Single PSA measurement in of it self isn't really much of a thing, and finger up the bum is inconclusive. The bit that was at all useful was the all clear from the consultant urologist.
So yeah, take this test. get yourself booked in with GP,talk frankly about your symptoms if you have any.
Around here, you get asked in for a 'finger' test after you turn 50. It used to be 40, but, you know, cutbacks.
After a thread on STW started by someone who sadly was diagnosed with prostate cancer recommending people request a PSA test, I did just that. They booked it in pretty quickly and did both types of test.
Nationwide screening would throw up lots of false positives because the PSA test alone is not a foolproof test. All those false positives would create anxiety and possibly overload the NHS. However, if you have a concern because of your age, family history or symptoms* get a test. A high PSA alone doesn't necessarily indicate cancer, but will prompt follow-up tests which might (or will rule it out).
I have a prostate cancer diagnosis. Mine is a small volume, low grade (1) and I have opted for active surveillance than treatment. I have 3 monthly PSA tests and an MRI every 18 months or so to see if it remains stable.
*Prostrate cancer mostly has no symptoms. Mine was found "accidentally" when I had an unrelated urine infection which was quickly treated with antibiotics but I did some tests including a PSA which led to biopsies and a diagnosis. Most of the urinary symptoms people think of are caused by an enlarged prostate which happens to most men as they age and does not necessarily mean cancer.
most of my points were in the other thread :
I was diagnosed at same age as Sir Chris is now, 48. Thankfully mine was caught at Stage 2 and was still contained in the prostate, which was removed 10 years ago next month and so far I remain cancer free.
There are a few GPs on here who will be along shortly, they usually are, to say that the PSA blood screening test is not much good and will only be applied by your GP if you have other risk factors, which is about right unfortunately.
In mu case, I was at the doctor anyway, on the back of a bad bike tumble, and mentioned that I was up at the loo a few times most nights, so he suggested checking my PSA as a precaution. It was elevated and they retested it a month later and it was the same, so that led to more tests and I had surgery a few weeks later.
If you have any concerns it is best to have a proper chat with your GP, and be aware that they may reluctant to do a PSA blood test if you have no other indicators of risk.
and some of the story here :
https://singletrackmag.com/2016/04/prost-8-riders-aim-high-for-prostate-cancer-uk/
Better to be told that you have been worrying needlessly than to die of embarrassment. Treatment if caught early is pretty successful. I seem to recall most men die with it, not because of it.
I got tested a few years ago after a few issues with flow rate and a bit of dribbling. Luckily the poor lady doctor had small thin fingers and after a inserting one up my bum determined that my prostate was enlarged but had no signs (or my symptoms) to indicate something more sinister, and prescribed Tamosulin(?) to help with the symptoms.
I can only assume for there to be any cons there must be a lot of false positives that leads to unnecessary angst.
Even a 'true' positive isn't really as informative as you'd imagine
I think the biggest factor in terms of broad measures to test and screen is that as a condition prostate cancer is a very inexact condition. Lots of people die from prostate cancer but also lots of people live with it. Identifying its presence doesnt really do much to inform what steps to take next - its difficult to determine whether its better to treat it or leave it alone in that the outcome of 'successful' treatment isn't without consequence and can leave you in a worse condition in general health terms than no intervention at all. It seems to be something that at present you just can't really formulate a winning strategy for in public heath terms.
I can only assume for there to be any cons there must be a lot of false positives that leads to unnecessary angst.
But.. a screening where you got a PSA at 40, 50, and then every 5 years would be useful to track what's happening.
As it is, your first test is when you think something might be up... and the medical pros have no past personal baseline to compare to.
If you have any concerns or suspicions then don't hesitate to contact your doctor, even if only for a chat to see if it is worth following up. Don't wait, especially if it is causing any anxiety.
I had real concerns earlier this year with a weeks long episode of hematospermia (google it). I have also always needed to pee in the night which has got much more frequent (up to 5 times), and had a grandfather with prostate cancer on his death certificate, even though he was 82. Cue lots of tests, which were all inconclusive. Then a few months later another episode, this time with blood in the urine. This prompted more tests including MRI and Cystography (that will make your eyes water) and another PSA. Still nothing found of any concern.
And so I carry on with less anxiety and will probably get annual checks now if nothing changes in between. Currently there is nothing happening with my body other than some nights needing to pee multiple times. The conclusion to my episodes in the absence of any other medical explanation has been some sort of traumatic cycling induced episode.
And so I carry on with less anxiety and will probably get annual checks now if nothing changes in between. Currently there is nothing happening with my body other than some nights needing to pee multiple times. The conclusion to my episodes in the absence of any other medical explanation has been some sort of traumatic cycling induced episode.
Had similar. Peed blood a few years ago and GP sent me to the urologist for camera insertion. He was a cyclist and said if I'd have come to him directly he'd have told me off for not drinking enough water on rides and sent me home. But if you see the GP you're getting the camera. All was clear thankfully. That was ten years ago and it happened again a few weeks ago. It's bloody alarming but yes I'd done my usual of a long ride barely drinking plus was probably dehydrated anyway after a "hectic" weekend.
But.. a screening where you got a PSA at 40, 50, and then every 5 years would be useful to track what’s happening.
As it is, your first test is when you think something might be up… and the medical pros have no past personal baseline to compare to.
You know there are healthcare economists who spend months pouring over data and understanding the true accuracy of these tests and variability of the population to work out if screening, and at what age / interval would be useful. Or if all the follow up appointments actually delay patients with the condition being able to access expert advice. There's plenty of people willing to fund those studies too - because if they do recommend a screening programme there are people who supply the test technology and the early interventions who will benefit!
Screening tests....
Screening every man for prostate cancer is a waste of everyone's time and cash. As the saying goes, nearly every man dies with either prostate cancer or an enlarged prostate, very few men (relatively) die because of it. Take the IPSS test, if it comes back with a high score, then go make an appointment, and do the thing. Take some responsibility for your own health. Don't just sit there and do nothing and expect some-one else to take the time to contact you about something that you can act positively about if only you could be arsed*
*insert your own pun (or finger, whichever) here.
Go check it out the moment you are dripping or having flow issues or you find lumps on your body.
Some have no symptoms until the very late stage.
I had the blood test a while back after some symptoms (turned out to be nothing). The GP was clear that the blood test wasn't hugely accurate & could easily throw up false positives & false negatives; his approach was to do a digital exam regardless of blood test results (although I gather that this only checks for enlargement).
Screening every man for prostate cancer is a waste of everyone’s time and cash.
Except for the ones whose lives are saved and their family & friends. I don't know the numbers (or how prostrate cancer testing/outcomes compares with say, cervical cancer screening) but currently I'm seeing a lot of posters up in male loos about prostrate cancer & encouraging men to be aware of symptoms & to go for tests.
It seems odd to be encouraging men to go for tests if they're not cost effective and if they are, then surely screening is the way to go (I think I got offered a "poo in a box' bowel cancer screening test out of the blue - presumably because of my age).
Interestingly I've just this minute come off of the phone after booking my annual review with the surgery. It seems to be offered to all over 50s and involves a face-to-face appointment & a reasonably thorough exam & blood/urine tests. I would imagine that it wouldn't be impossible to train the clinicians here (although they may be low band HCAs) to do a digital exam if requested; it would probably only add a few minutes to the appointment time.
Anyway, it seems well worth doing if you have the slightest concerns and at no point was I made to feel that I was wasting any ones' time.
For me, I had a regular blood test because of some medication that I take.
The nurse said that I might as well do a PSA test whilst I'm at it.
Results said I had a high reading so come back in a few weeks for another test.
PSA down and doctors are happy with the reading. Great news for me, or so I thought!.
Also under a constant and he wanted to change some medication but wanted me to see the uroligy dept just to confirm all was ok.
After an MRI scan and then a biopsy session where everyone said all looks good and nothing obvious. It turns out that I have level 2 prostate cancer.
So what I am saying is getting checked out is not as black and white as you would hope for.
But for the sake of a blood test, it's worth giving it a go.
Peed blood a few years ago and GP sent me to the urologist for camera insertion. He was a cyclist and said if I’d have come to him directly he’d have told me off for not drinking enough water on rides and sent me home. But if you see the GP you’re getting the camera
Lucky you, maybe. I had a bloody pee incident just now and all I got was a phone consultation with a Nurse Practitioner who diagnosed UTI and prescribed antibiotics. Separately from that I have 6 monthly PSA tests following a very elevated level which resulted in multiple MRIs and 2 biopsies that were negative. PSA has now subsided to a lower stable level.
My dad, exactly like Chris Hoy, has had his prostrate cancer spread to his bones (spine, pelvis and jaw). However, he’s a lot older and not as fit as Chris Hoy, so has just been given 2-3 months to live. We’re all very much still processing this bombshell
I’m booked in for a prostrate exam and blood test later this afternoon as I’m now in the ‘at risk’ group
If you think you’re at risk, go and get checked and don’t be a bloke and just cross your fingers and hope everything will be fine
John Holmes Says the C-Word on the iPlayer. Very good. Mate had a biopsy after high PSA results and likened it to having his perineum repeatedly attacked with an industrial nail gun...
But do you have any pearls of wisdom for the rest of us too?
I'm not sure that I do!
The usual symptoms of prostate problems are: reduced urine flow, increased frequency, not finishing properly (rogue drops) and not emptying fully. Any of these could indicate an enlarged prostate or prostate cancer. An enlarged prostate does NOT mean it will become cancerous.
Increased risk factors include: age, family history, weight, diet and ethnicity (increased risk in black men),
Most prostate cancers occur in men of around 70 years of age and are slow growing. Hence, men dying with it, not because of it. Obviously that changes if you are a younger man with a faster growing cancer!
Caught early it is fixable although that isn't without its own challenge (as I'm sure @iainc will attest to). Once the cancer has spread beyond the prostate then curative treatment is less likely. It usually becomes incurable when it has spread to tissue further away from the prostate (usually bones or lymph nodes).
Treatment depends on stage: cutting, burning or poisoning... I mean: surgery, radiotherapy and chemotherapy. Lots of other drugs can be used too; these usually inhibit testosterone production which then slows cancer growth.
Me? Aged 53 at diagnosis (probably had it for years though). No family history, I'm white, fit and not overweight. No symptoms other than fatigue (and maybe the odd rogue drop), GP took a while before considering DRE and PSA (no blame whatsoever). PSA came back at 374 (not a misprint). Initial prognosis was that I was unlikely to live 5 years. Treatment took me to hell and back but I'm quite well at the moment. I try and exercise every day (100 days of exercise until Christmas), eat healthily and consume a cocktail of supplements. I have no testosterone owing to hormone therapy, so loads of menopausal symptoms :-/
My advice would be: Consider your risk factors, monitor your urine flow/frequency and chat with your GP if concerned. There is loads of information out there: Prostate Cancer UK, Prostate Cancer Research, Macmillan, etc.
Some of my history here https://adventureswithprostatecancer.com/ see "cancer life" tab, although I've not updated for some time.
Contact me for a chat if you like and... try to live a little more each day 🙂
Who needs to get up 2 or 3 times a night for a piss….and has a sore shoulder…..
Me. But only after a few beers on a Frid/Sat night and I fell of my bike a few months ago, shoulder hasn't been quite right since.
Think I'll get a check up.
Thanks for the IPSS test link…I’ve just score high enough (though have sneaky feeling the majority of men above 50 might too) to justify an appointment.
Just to provide a second data point, I only scored 3 on that test and am mid 50s. So if you score higher, then it may well be a wake up call to get some more tests done.
It seems odd to be encouraging men to go for tests if they’re not cost effective and if they are, then surely screening is the way to go (I think I got offered a “poo in a box’ bowel cancer screening test out of the blue – presumably because of my age).
there’s a difference between encouraging men with symptoms to go for a test and encouraging all men to go for a test. The predictive power of a PSA test in men with symptoms is better than in the whole population. But it’s not even as simple as saying - one symptom some of the time - hence the little IPSS questionnaire. You see we all start to think it’s just part of “natural aging process” but it’s more variable than that.
I'm not sure if this has been posted up in the Chris Hoy thread, but the BBC have a page up on prostrate cancer following Chris Hoy's announcement.
https://www.bbc.co.uk/news/health-62755001
I seem to remember reading somewhere that cycling can cause problems down there as well? Probably from the constant impacts. I know that after riding my hardtail it seems like I can have a bit of trouble peeing. Or am I just not remembering correctly?
Taken me a long time time to see the clever name of the I-PSS test.
I seem to remember reading somewhere that cycling can cause problems down there as well? Probably from the constant impacts. I know that after riding my hardtail it seems like I can have a bit of trouble peeing. Or am I just not remembering correctly?
Cycling can put pressure on the perineal area (in-front of bum hole to behind ball bag). This contains lots of nerves and delicate tissues. Pressure in this area may cause numbness and other symptoms. Best avoided! So get a saddle that relieves pressure in that area! Cycling can also slightly raise PSA for 24 hours, but it doesn't cause cancer or make it worse (according to the research I have read).
Just to provide a second data point, I only scored 3 on that test and am mid 50s. So if you score higher, then it may well be a wake up call to get some more tests done.
Thanks.
Convert - score 27.
On BBC News now.
We can opt in (salary sacrifice) for skin, bowel and prostrate cancer checks via a workplace benefit with these people: https://www.check4cancer.com/
I must admit last year and up until today, although I'd signed up (and effectively paid for it) I hadn't actually gotten around to requesting the kits (I did a couple of years back when I first signed up). I'm over 50 now so probably qualify on the NHS but given it's cheap and easy enough to sort privately I'm happy to.
I got diagnosed with a benign enlarged prostate at 48 - I was informed by the consultant that as I was under 50, treatment options were limited, so he put me on Tamusolin for a few months to see if it made any difference. It didn’t. Roll on 11 years, I had another PSA earlier this year and it was above the threshold so off for an MRI - it’s the size of a lemon (not walnut) but not cancerous.
I’m nowon a 6 month cycle of PSA tests and daily Solefenacin - the biggest difference however has been a daily supplement of cranberry powder in terms of reducing the urge and frequency of needing to go.
Screening every man for prostate cancer is a waste of everyone’s time and cash....
Except for the ones whose lives are saved and their family & friends....
Well this is the issue with thinking on an individual "one by one" basis, as opposed to national medical screening criteria basis.
Firstly - I'm a GP
Secondly - cancer and other illnesses are a terrible disease, and of course if you can catch them earlier, generally the outcome is better. I'm extremely sympathetic to those who ahve been troubled by prostate cancer, and grateful treatments are available for those of us who get it.
That being said, I have to put my medical hat on and agree with the scientific basis of NOT having a screening programme for prostate cancer.
Note - screening is when you apply a test to PEOPLE WITHOUT SYMPTOMS. As soon as you have symptoms it's not screening, but "investigating symptoms". This is key, because if Mr X has no symptoms and a random PSA of 7 (technically elevated), his chance of having prostate cancer is (on a population basis) significantly less than Mr Y who has poor urine flow, peeing 5 times a night, and a bit of dribbling, AND a PSA of 7.
Thus, Mr Y is justified going through further invasive testing (and the complications that arise from it) to see if he has cancer. Mr X less so.
many people get emotive about this subject because, of course, cancer is terrible. And of course, there's always going to be someone who incedentally has a cancer picked up via random testing, and of course they'll be grateful that THEY had the test. But on a population level, more men will be harmed/alarmed by random testing. But you never hear from them on social media etc etc.
This is a useful leaflet i give to chaps to spend a bit more time pondering over the decision:
https://www.gov.uk/government/publications/prostate-specific-antigen-testing-description-in-brief
It's a similar thing with cervical screening in women - there's many groups out there saying "it's a crime we don't do cervical screening from 16 years old... NHS saving money blah blah blah", but if they actually understood the science, rather than believe it's a 'money saving cut' they'd realise the cancerous changes that screening is looking for in the 25-64 year olds, can be 'mimicked' by the NATURAL CHANGES that pubescant and adolescant women's cervixes go through. THUS... you'd end up 'detecting changes' in all those women (/girls) and have to send them for biopsies and loop excisions etc, and cause potential fertility and birthing issues. And you wouldn't detect any more cancers in asymptomatic women.
Anyway - it's certainly worth speaking to a GP if you're getting older, peeing more, slow flow, dribbling etc etc, as THEN you have symptoms, and warrant further testing.
DrP
The usual symptoms of prostate problems are: reduced urine flow, increased frequency, not finishing properly (rogue drops) and not emptying fully.
Adding another data point, I went through testing for those sorts of symptoms in my late 30s/early 40s. Started out with the finger and PSA tests and as mentioned above, once one doctor has done the finger you can bet that everyone you see along the diagnosis chain will want a go too.
Anyhow the initial tests found I had a normal prostate and I ended up having a bunch more tests, some of which made the finger look pleasant. The conclusion was that my detrusor muscle is just a bit crap at its job. All good but it means that any warning signs about prostate cancer are going to be much harder to notice.
The GP was clear that the blood test wasn’t hugely accurate
The reason for this is that the briefing for you before the test is missing or given improperly.
One should not: have sex, ride a bike or run for around 72 hours before the test. (I found this out by accident from the MacMillan Nurse Practitioner at the hospital). This gives a better baseline for your numbers.
My consultant was all for doing a test at a follow-up appointment but on being told I had cycled the day before and got lucky that morning he conceded that this would not be accurate.
I am currently low-risk prostate cancer as the two early biopsies took the cells from my prostate and the follow up biopsy and MRI's have been clear. 6 monthly PSA tests aer now order of the day with urology only involved if the number heads towards 20. Fingers crossed I will die with an enlarged benign hyper-plasia prostate and not from stage 4 cancer that has metastised though my body.
I get my PSA checked every couple of years ago. Only had the finger test once, but that was before surgery to fix a knackered bollock from 'the snip'. I'm on Testosterone so have to be checked every couple of years. PSA slightly raised, although last test it had come down. Hasn't changed in years.
As someone under surveillance who has regular PSA tests, I can absolutely confirm cycling within a day or so before can elevate the result. In my case although alarming, it droped to my baseline on the next test when I avoided it on the lead up. No-one in the GP practice or my urology department told me this was a thing, I only found out by researching it myself. Some sources say any heavy exercise can do the same. I am a regular runner and gym goer, but I now give myself at least 48 hours rest from exercise before my blood test.
I fortunately knew the PSA can be raised from cycling, and TBH, I've usually been cycling the day before my test. So long as results don't keep climbing.
I pay privately for psa and other routine blood tests. Nothing found and I cycle to appt, I m aware of false positives but thats a further challenge, i d prefer that to a false negative. I m having a routine NHS health screen next week so will ask if they ll do a psa.
Going private is a bit of a luxury, you get seen when you want, have a nice chat about football or rugby, results discussed next day.
I start 20 radiation treatment for it tomorrow, M-F for 4 weeks, back in July, night before I was due to fly out to ride the Maratona dles Dolomities, I had an issue with Urinary retention, ended up in hospital then spent a fortnight with a catheter, subsequently had a series of scans and a biopsy to then be told I had locally advanced prostrate cancer, in two pelvis lymph nodes as well as prostrate, it was a bit of a shock to say the least, but looking forward to getting through the treatment, the Hot Flushes from the Hormone reducing pills/injections are somewhat interesting.
I'm already in the screening thing, awaiting the results of an MRI with a normalish PSA ATM.
@stanley, good to see you're in the pink.
I visited the doc a few weeks ago on another matter, but as my auld man has had prostrate cancer, I thought I'd ask for a PSA test as I'm in my mid 50's.
Came back clear, however I've now had repeated blood tests for other stuff.....
I'll probably ask for a test annually now or if I notice any symptoms from the IPSS questionnaire.
@Shak47 - best of luck on your treatment journey.
it's great seeing this subject into it's second page, STW at it's absolute best. wish i could add a thumbs up !
My Dad was undiagnosed for some time - kept being told he had UTI and ultimately ended up with catheter. Did some more test and guess what - prostate cancer.
Ultimately was not contained within the prostate so various courses of radiotherapy after the prostate removal including for a hot-spot in his spine. He is currently on hormone treatment and monitored via PSA levels and various scans.
Due to the obvious family history and some other symptoms, I now get PSA and physical check every 6 months and have had MRI previously. My prostate is enlarged but PSA has been stable at ~ 2.4 over the last year after showing increases over time. My Dad is 77, I'm 57.
What a great thread. I’ve been dithering about this for some time, in 58. I’m now in the system.
I went to my gp with a sore testicle. He asked for blood tests, including PSA and an ultrasound . He added psa due my dad having an enlarged prostate
The ultrasound confirmed the problem was the weight of an enlarged vain. It’s not serious, the soreness is the extra weight. Currently the symptoms have gone as i pull my knickers up tighter. The ultra sound technician asked to do bladder and kidneys as a follow up. This showed my bladder not fully emptying and an enlarged prostate. My psa was slightly raised at 4.7. The gp did a finger test and says in should retest psa in 3 to 6 months. Top tip in not cycling.
3 gp appointments, blood tests and 2 ultrasounds in under 5 weeks. The NHS does work sometimes
Except for the ones whose lives are saved and their family & friends. I don’t know the numbers (or how prostrate cancer testing/outcomes compares with say, cervical cancer screening) but currently I’m seeing a lot of posters up in male loos about prostrate cancer & encouraging men to be aware of symptoms & to go for tests.
The message “If you have symptoms get tested” seems to fit the advice. But i do see the message “Get tested” which is less helpful. As other have said testing can do more harm than good. Some people have their health damaged or even die from treatment they don’t need. I heard a brilliant analysis on the radio on the effect of some women not being invited for breast screening. It’s not clear that the missed invitations will result in more deaths. I think cancer charities can feel a pressure to act, whether the action has proven success or not
FYI
Cervical cancer screening is a big life saver. If you have a chance to influence some one to participate then do so.
Good luck to all who are getting things sorted.
I went a few weeks ago for a check up as I'd been having some problems peeing.Finger up the bum and a test. Slightly enlarged prostate but tests were ok. Still got issues peeing so back to the Docs in Nov to see what can be done.
Thanks Ian, been useful reading about your journey through this.
Thanks to all who've shared what must be an horrible experience.
Lots of good advice ^^, as one who pees during the night, sometimes too frequently, my GP has said that he's happy to test as often as necessary
Taken me a long time time to see the clever name of the I-PSS test.
I wish that it was 1-PSS, rather than 3-PSS, but fortunately it's controllable for me by drinking less later 🙂
Don't forget that men can get breast cancer as well as testicular so cop-a-feel in the shower 🙂
@timba The first biopsy was referred to as a dignity bypass here. Involving, as it did, the youngest female doctor in urology and what sounded like an industrial stapler.
Cytoscopy ran it a close second though involving possibly the oldest female consultant in urology and standing naked from the waist down in the consulting room.
Though both are a better experience than dying early of a survivable cancer.
I’ve had PSA test, came back normal fortunately. Was a bit worried cos there’s two GP’s in my practice, one an ex rugby player with fingers like Cumberland sausages, the other is an attractive young woman with huge acrylic nails, nightmare scenario is she goes first, loses a nail, then he has to dig around to fish it out!!
Does anyone knowledgeable have a view on why the NHS does not widely use laser therapy to reduce the blood supply to the prostate, in the way that some countries do? It seems to be an effective treatment option for halting non invasive and relatively early cancerous growth.
On BBC News now.
I've just noticed that yesterday's News at 1 is still on IPlayer (I'm not sure for how long) if anyone missed the prostate report and wants a look (it's the headline piece).
https://www.bbc.co.uk/iplayer/episode/m00246w9/sign/bbc-news-at-one-21102024
Thanks to this thread and its awareness posted by people I’ve booked myself in for an exam / test, perhaps something all us Middle Ages should do.
Yep. I had one a couple of years ago due to something that turned out to be nothing.
In retrospect the old "finger up the butt" is nothing to get worked up about. Over and done with in a matter of seconds.
PSA came back normal too.
The first biopsy was referred to as a dignity bypass here. Involving, as it did, the youngest female doctor in urology and what sounded like an industrial stapler.
Felt like one too. I also had a trans-perineal template biopsy for which I was blissfully asleep. It was much less unpleasant and my understanding is that the results are more definitive than the stapler-up-the-bum technique, to the point where some clinics only do them.
Felt like one too. I also had a trans-perineal template biopsy for which I was blissfully asleep. It was much less unpleasant and my understanding is that the results are more definitive than the stapler-up-the-bum technique, to the point where some clinics only do them.
I've had both too. The template biopsy was fine in that I was under GA. Except that what should have been a day procedure saw me catheterised and admitted for 24 hours because I could only piss blood afterwards. A special 'wide' catheter so they could flush me out, which they had to get past my minced prostrate. That was an experience I'll never forget. 24 hours on a saline drip into the old man until all the blood and livery bits had been flushed out. Then the joy of having the mushroom ended hosepipe pulled out by two medics like they were in a tug of war team. So yeah, I'm sure a trans-perineal template biopsy is fine when it goes to plan!
I had been wondering about this even before Chris Hoy's announcement. Mainly because I have recently been changing saddles wholesale to wider saddles with cut-outs, as I noticed by the end of longer rides I was getting distinctly more uncomfortable down there and even felt like a little bit of pee was getting 'squeezed out'.
As per the poster above I also wondered if too high/too thin/too hard a saddle might cause issues.
My dad died from a metastatic renal carcinoma, after surviving testicular cancer a decade earlier. The initial symptoms of the renal cancer were shoulder and hip pain, so easily overlooked as just cycling related muscular issues.
Crumbs, I’ve a 3pm “back passage” appointment with a young sounding female Dr. I’m very embarrassed / anxious although I know I need to get over it.
Crumbs, I’ve a 3pm “back passage” appointment with a young sounding female Dr.
You'll be facing the wall, and once you've got past your embarrassment you'll appreciate small fingers.
I’m very embarrassed / anxious although I know I need to get over it.
Face the wall curled up slightly, relax, and be grateful she isn't a 6'8 prop forward with hands like shovels nicknamed Gnasher.
It's all in a day's work for her, she'll have seen better and worse, and some people pay good money for that kind of experience. None of which are great conversation starters...
Don’t get hung up on the embarrassment. If it is just a finger up the bum it’ll be over in less time than it has taken you to read this sentence.
Mine was by a young locum. Conversation was something like. “Let’s get it checked then. Get on the bed, pull your knees up… done.”
Pull you pants up, say “thank you” and escape back to the car as quickly as you can without breaking into a run.
I was nervous as Hell and had worked myself up into a bit of a state. A couple of minutes later I was sat back in the car. Job done.
I think on the whole it's just one of those things that will catch out a small proportion of people. Obviously good to get tested asap if any symptoms, but probably not worth it if there aren't any risk factors.
I remember hearing that increased screening in the USA had resulted in a large increase in the number of people surviving it, but no real change in the number of people dying from it. The implication being that early diagnosis in symptomless people wasn't actually achieving anything (but resulted in lots of further treatment, sometimes with nontrivial consequences). That was years ago though and may be a somewhat outdated view. FiL had prostate cancer for at least a decade, maybe two (diagnosed and under minimal treatment, an occasional injection IIRC). Died unrelated causes aged 93.
I’m very embarrassed / anxious although I know I need to get over it.
being 5 years into an MS diagnosis I can confidently say that if the worst medical test you ever receive is a finger in your bum you’re winning at life. Who knows, you might even enjoy it 😉
When I had my digital exam, I was actually with MrsF - I was there for 'nut' problems and we were discussing my forthcoming nut surgery, but the Urologist said he'd check - I said to MrsF 'erm you might not want to be in here for this bit' - didn't want her seeing visions of the doctor sticking his fingers up there. Does make you feel like you need to pee though.
Just to provide a second data point, I only scored 3 on that test and am mid 50s. So if you score higher, then it may well be a wake up call to get some more tests done.
I'm early 50's and scored 3 as well. Though i'm sure if you discount that i drink almost continuously, that could probably be 2 or maybe even a 1. (I've already polished off nearly 1.5 litres of water this morning).
I'm already in a high risk group as my dad has it.
You know there are healthcare economists who spend months pouring over data and understanding the true accuracy of these tests and variability of the population to work out if screening, and at what age / interval would be useful.
That's what has lead to almost every man in Sweden receiving a completely optional offer to go for a PSA test on their 50th and then at regular intervals afterwards (maximum of 5 years i think), and based on their results and follow up. So they have population data, baseline data and loads of samples for improving the testing protocols.
healthcare economists who spend months pouring over data
Sounds like they need a checkup themselves if they're that incontinent 🙂
Well on the plus side, no ‘roids. But I have an enlarged prostrate suspected to be benign as it’s “smooth”. I have Bloods/PSA and stool/urine tests and an ultrasound to complete over the next few weeks.
Another plus, she double my setraline dose.
All this is minor compared to what some are suffering but I’m very grateful to this thread and its contributors for convincing me to get examined - if you haven’t already, get it done.
I think more likely by the look on my face either side of it 😉
In honesty I discussed it whilst I was there, NHS time is precious for people suffering worse than me so I didn’t want to make another appointment if I didn’t have to.
I went for a PSA after being invited by my GP as part of “well man” screening (not a national thing but something our local surgery were running)
Score came back high (no surprise I later discovered as I’d done a 100 mile road ride the day before - as others have said, I too was unaware this was an issue)
anyway, remember, I had no symptoms…..however, in the days after the finger up the bum I started to feel bladder pain and unable to pee…..a few days after that I had an MRI and had a reaction to the dye…..net effect was really bad UTI…..but all tests clear!!
that was that…..until a few months later after a couple of hard ride days (I was training for LEJOG) and I peed what I can only describe as half a dozen blood clot bullets and collapsed in agony….cue 5 days in a constant round of antibiotic and hydration drips in the local hospital (I did LEJOG 2 weeks after that!)……
I’ve since gone private to have more tests to see what’s going on - it seems I have a “tight” prostate which, as I’m getting older (58) is causing me to not empty my bladder fully due to low flow….and the finger and other treatments started a bit of a chain reaction in terms of stimulating infection….so had I not done the tests in the first place I would have been blissfully unaware of all of this (& if I hadn’t done 100 miles before the PSA!!)
anyhow, I’m glad I did go and I’m glad I now know what’s up - whilst I’m on some drugs the actual best treatment is just drinking a lot more water (a LOT more) than I used to to keep everything flushed through - if the demographic on here is anything g like me and my riding buddies, blokes of our age generally don’t drink enough so as well as all the good advice already passed on above - DRINK MORE WATER!
I went to a men’s health talk at the local hospital last week that focused on proctologt & urology.
The proctologist was renowned for developing a particular procedure so the other medics were in awe of him.
He dismissed the DRE as you can only reach a small part of the prostrate. He explained that the problem with the PSA is that there is no “safe” number- set too low & there are false positives with the related stress- too high and you miss some.
He said that there was a study on mens health that took blood samples over c 20 years. When some subjects developed Prostrate Cancer they went back and tested for PSA and saw it was initially low then rose exponentially. If they had been monitoring these people for PSA then all the time it’s level or low growth then ignore- only as it starts to rise start investigating.
He said there could be mitigating factors for a single high reading- recent exercise, sex etc so if he saw someone with a high first PSA he’d want another test to confirm.
his view was to get a PSA when you’re over 50 and that will be the base so any subsequent tests have an initial reading to compare against and MRI is usually the first port of call if they see a patient with a high PSA. He added that more men will die with prostrate cancer than from it.
when he was asked what can we do to prevent it, he replied apart form the usual eat healthily and drink in moderation, ejaculate a lot!
wish i could add a thumbs up !
Unless you're sufficiantly qualified then I politely decline.
Interesting that folk have heard stuff about cycling/PSA tests. Mine told me he expected mine to be high just because I ride my bike a lot rather than advising not to ride in preparation for the test. Am waiting on an ultrasound appt and scheduled for more follow up PSAs. Not to worried at the moment, but I have had a few UTIs so want to rule out anything more sinister than I need to drink more water.
This thread has made me realise the ultrasound referral seems to be taking longer than expected so I'll chase it up this week.
This thread scares the sh1t out of me.
I'm actually going for an ultrasound scan for a small lump on my neck. Some people have said my face is like an arse.
This thread scares the sh1t out of me.
Don't let it. Everyone on here has been scared I suspect to some extent or other and bottling things up don't make it any better. Get yourself checked. It may be nothing at the end of the day.
I had a small lump on my neck, like bit bigger than pea sized at the back of my neck. Doc cut it out under local, it was just a build up of hard fat. No idea where it came from, or why it appeared there. Anyway, it never came back and I don't even have a scar to show for it.
I start 20 radiation treatment for it tomorrow,
I was roughly in your position about 10 years ago @Shak. Radiotherapy knocks the stuffing out of you somewhat, but it's not too bad in the overall scheme of things. Pm me if you would like to discuss things further.
There’s some helpful info here about treatment options, risks etc
and the PSA test - risks and benefits
https://www.cancerresearchuk.org/about-cancer/tests-and-scans/prostate-specific-antigen-psa-test/
Other tests, mri etc
hope it helps
i was told to lay off mountain biking for at least 5 days before PSA test one doc said avoid for 2 weeks.
ejaculation, anal sex, heavy exercise can all affect (heighten) the result which starts the scary rollercoaster
Kryton57
Another plus, she double my setraline dose
Don’t get get too deep into Sertraline man. one can perhaps become dependent. I benefitted from therapy (NHS) and managed to give it up but I realise that for some it’s very hard to do that. ..
I believe It’s an SSRI. So increases available seratonin. Some research suggests seratonin may increase cancer risk. Maybe try look that up.