BBC article about PC screening made me mad.

From another article I read on this news item, the concern seems to be that for each 1000 men in their 50's tested, 20 would be told they had PC of which 12 would never have needed treatment & it would only save 2 lives.  The essence being that 8 guys would get all the stress & worry + be treated when there was no need.

If this is the case then I can maybe see their point of view, however, I didn't see any mention of the numbers of men in their 50's who are being diagnosed with PC that did need treatment or any comparison with numbers in the past.  

Until such time as tests become more accurate (without the need for MRI or biopsy) it seems likely that this topic will not go away given the number of high profile public figures are behind it.  

With my cynics hat on, maybe the long term aim is to get us living past the age of 120 so we can continue to pay our taxes!

It's a complex issue I think. Many decades since I studied statistics, but there seems to be an assumption that diagnosis always leads to treatment, rather than 120 years (!) of active surveillance. And I suspect that there is some truth in this. Consultants don't press AS because not what they're trained to do  -  and makes no money. Patients don't want to be watched  -  they want action. Reducing "unnecessary" treatment is surely a key?

Consultants (especially surgeons?) are only happy when they offer treatment, hold out a cure, after all it's their purpose! They do not feel comfortable offering nothing, whether it be because "no real need" or "no point  -  any treatment will fail and will just make your final months/years not worth living".

This is of course only 1 aspect of the experts' recommendation. One could also question the psychological burden  -  could not this be managed, eased, by better medical advice and information?

I guess the conclusion is statistically correct, but that the underlying environment which the numbers reflect requires further study and alterations.

The bottom line is as always "it's the resources, stupid" to misquote some US President whose name escapes me! If the numbers say £100m saves only 2 lives, then it ain't gonna happen. Some poor random dying ain't in the same game as cutting waiting lists (however much that relies on smoke and mirrors!).

Good luck, Dave 

They have their thinking back to front!  If it saves 1 life then the 8 are worth it.  The fact that it saves TWO lives makes it doubly worth it.  I am stunned by the stupidity of the people in charge around the world.  Obviously one wonders if the driving force is more if we test then 8 more people are removed from the workforce and we don't want to lose that and have to pay for treatment.  Cynical I know, but it feels that way.

I strongly agree that there is enough negative messaging about PC already before you get this stupid statement about the slow moving cancers.  Again is it the wish that more don't get diagnosed and some more precious money can be saved?

^"I strongly agree that there is enough negative messaging about PC already...."

Oh yes. And over-positive "messaging". The oft repeated more men die  with than from mantra, sometimes claiming only 1% of sufferers die from it, is deliberately misleading. It is based on ALL men, not those diagnosed with it, where the mortality rate is 26-40%. 

Good luck, Dave.

Cracking reply Paul65plus1 

I wasn't going to comment, but then why did I get invited to a Lung Cancer screening a few months ago - I've never smoked.

I had my bowel cancer screening the other day - strange timing as the "joined up" NHS had given me a Colonoscopy and all clear about 4 weeks before.

Why is there breast and cervical cancer screening for ladies but not prostate screening for men? Where's the equality here? (just saying! before I get in trouble, sorry ladies).

More food for thought?

Best wishes - Brian.

It’s not the screening I bothered about at all it the phlegmatic way in which the “live to 150” gives guys the counter argument that prostate cancer is anything to worry about.

I have incurable stage four and in loads of trouble at 61 years old. It’s not the case that we should be saying or linking 150 with prostate cancer, it’s just not true!

It is true that some prostate cancers are very slow growing.

It is true that having a cancer diagnosis can be a psychological burden.

I am living proof of both of those.

The decision on screening is the right balance. Anyone who wants a PSA test can still go to a GP and ask for one 

Hello David193 

It is true you can ask for a PSA test from your GP if you are 50 or over. NICE guidelines say the GP should discuss the pros and cons of having the blood test before it's done - just what are the bad points of having the test, you may find you have cancer?

It is true you can have Prostate Cancer without any symptoms - I was admitted to hospital with a kidney issue, caused by an enlarged prostate - my PSA was 182!

It is true regular testing would have found this.

I rest my case!

Best wishes - Brian.

Hello Brian 

Almost 10 years ago I asked my GP for a PSA test because I was motivated by an awareness campaign to do so. 

I remember the GP saying that a prostate biopsy is not a nice experience and I may end up having treatment I don't need. But I insisted.

The GP's first warning did come true. I still suffer prostatitis caused by the biopsy. The second almost came true. I was offered surgery but after reading many posts on this excellent forum about the suffering that men have endured I chose active surveillance. 

In the early years I had a hard time with active surveillance. Always the niggly doubt. Made worse when people say things like "cancer is cancer", "it's not going away", 'just get rid of it while you're young" etc.

I saw several consultants in the NHS and privately and I was offered a variety of treatments. A turning point was when I saw a very eminent urologist in Harley Street and she told me affirmatively that the only treatment I qualify for is active surveillance. I then started to realize that my low Gleason score prostate cancer is actually not my biggest threat. I have high blood pressure and my dad died from that when he was 54.

So that PSA test 10 years ago didn't work out well for me. But at least I made my own decision to ask for it. The screening decision is right.

I hope the above answers your question about what were the cons.

Best wishes 

Hello David (David193 ) 

Thank you for your reply. 

Yes I understand where you are with your diagnosis - I had the older TRUS biopsy, not nice at all! I am sorry the TP biopsy left you with prostatitis, this is one of the unfortunate possible side effects of the biopsy.

AS isn't for everyone, If you suffer from anxiety or you worry about constant testing then it's not for you.

I do advise people with Gleason 6 or low Gleason 7 (3+4) is's a possible solution rather than treatment but personally don't like it as I am aware of 2 Community members who have gone from AS to Stage 4 and sadly one is no longer with us!

IF there was screening at 50 onwards - I doubt I would be where I am now, yes I am Stage 3 on a "curative pathway" but for how much longer? I know my team are doing what they can BUT if mine had been caught earlier I assume I would have needed less treatment and cured!

It's very personal and to me some form of testing is needed.

Best wishes - Brian.