Advice for well (asymptomatic men) wishing a PSA test to detect prostate cancer.
Have you been thinking about getting a PSA test?
Prostate cancer is the commonest cancer in men; about 1 in 8 men will get it in their lifetime however, only about 1 in 25 will die from prostate cancer which means more men die with prostate cancer than of it.
Recently there has been lots of media attention focussed on prostate cancer. Several celebrities have shared their experiences and data has been published showing deaths from prostate cancer have overtaken the number from breast cancer for the first time in the UK.
Unlike breast, bowel or cervical cancer there is not a national screening programme. This is because there is currently no single, reliable test that could be used.
At the moment clinical history, physical examination, a blood test called prostate specific antigen (PSA) and sometimes a biopsy are used to make the diagnosis in men with symptoms.
In those without symptoms it is important to consider carefully the advantages and disadvantages of testing, especially in those who are otherwise low risk; under 50 or without a family history of prostate cancer.
To be clear this means some of the prostate cancers diagnosed will never cause any harm during the man’s lifetime. This is crucial to understand when talking about prostate cancer and PSA testing. As a result, PSA testing may lead to detection and treatment (with all the associated side effects) of a diagnosis that would otherwise not have caused any bother.
Therefore, despite the increasing amounts of publicity there is still no evidence that the benefits of PSA screening in asymptomatic (well) men, outweighs the risk of harm.
The arguments for and against testing can be complex and difficult to fully explain and deal with in a normal GP consultation so we have put together the following self-help pathway for patients wishing or considering a PSA test.
Step 1. Watch the following 8 minute video
Step 2. Read the 2 page advice sheet published by Public Health England CLICK HERE
Step 3. If you wish to have the test, print the Public Health England advice sheet, initial it and make an appointment to see the phlebotomist with the advice sheet for a PSA test followed by an appointment with the GP to discuss the result, bring a urine sample and have a digital rectal examination.
SOME PROSTATE CANCERS WILL HAVE NORMAL PSA LEVELS SO IF YOU EMBARK ON A DECISION TO SCREEN THEN IT MUST BE COMBINED WITH A DIGITAL RECTAL EXAMINATION.
Things to avoid before having a PSA test
1) Vigorous exercise, especially cycling 48 hours before test.
2) Sexual activity involving ejaculation 48 hours prior to test.
3) Have a test when you have a urinary tract infection.
Finally it must be emphasised this advice relates to well (asymptomatic) men; if you have urinary tract symptoms (frequency,hesitancy,poor flow,getting up lots at night,pain) consult your GP.
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