After a blood test found a possible marker of prostate cancer, Steve Cardownie is to have a sample taken from his prostate to determine whether he has the disease. Here he writes about the potentially life-saving test that can catch the cancer early.
Prostate cancer is the most common cancer among men in Scotland affecting one in 10 of us and while it is on the increase so are the survival rates, particularly if it is caught early.
As men age, the risk of developing it rises – it is rare in the under-40s, but by the age of 80 most men will have cancerous cells in their prostate, although the majority will never need treatment and some will be totally unaware that they have it.
All men have a prostate and at around the age of 40, it begins to enlarge and this may result in problems when passing urine or not being able to pass urine.
Although there is no actual screening programme in place, men can take steps to find out whether or not their prostate is healthy.
A blood test to determine Prostate-Specific Antigen (PSA) levels can indicate if something is amiss and a simple examination by a GP can also give an indication of potential problems.
The blood test will show if there is an elevated level of PSA and this may lead to further treatment although this does not, in itself, mean that cancerous cells are present as there can be several reasons why the test has flagged up a raised level of PSA.
A prostate biopsy may be recommended where multiple samples of prostate tissue are collected by inserting hollow needles into the prostate and then withdrawing them, a simple and sometimes uncomfortable procedure but by no means painful (I am reliably informed by those who have undergone this procedure).
Once the samples have been analysed, treatment can begin if it is proven to be necessary although this is not always required.
The majority of men with a raised PSA level are found not to have cancer after the results of the biopsy are known, with only 25 per cent of men who have had a biopsy due to an elevated PSA level found to have prostate cancer.
The Prostate Cancer Risk Management pack which is distributed to GPs for guidance states that “any man over 50 who asks for a PSA test after careful consideration of the implications should be given one”.
The test may help detect prostate cancer before any symptoms become apparent, which could allow treatment to start earlier if there is cancer in the prostate as there are several curative treatments available. It can also provide a useful check on men who have an increased risk of prostate cancer due to a brother or father having or having had prostate cancer.
There are some drawbacks to having the test and they can be explored with a GP before making a decision.
They include the possibility of an “all-clear” by giving a normal reading which misses cancer, thereby giving false reassurance (a false negative result); equally a raised level when there is no cancer present can cause anxiety and lead to unnecessary hospital tests (a false positive result).
While there a number of diseases that can affect the prostate, one in two men over the age of 50 may be affected by prostate cancer and early detection, diagnosis and treatment is key to improving the rates of cure.
This has all been brought home to me by recent events.
I was attending my local clinic a fortnight ago to undertake my annual blood test (to check my cholesterol, kidneys, liver etc) when I casually asked the nurse if my PSA level could also be checked.
Surprised, she asked if my GP had recommended this and I replied that he hadn’t but that as I had never had my prostate checked before I felt that it was about time that I had. I also informed her that a friend of mine, who had had a PSA test some years ago which indicated an elevated level leading to a biopsy and the diagnosis of prostate cancer (successfully treated) had suggested that I ask for one. So this was added to the list of checks to be carried out on my blood sample.
On receiving the results, my GP then made an appointment for me to discuss the matter and when I attended he informed me that it had shown an elevated level of PSA and recommended that I visit The Western General for a biopsy and a further appointment was made. I should know the result in a matter of a few weeks but win, lose or draw, I shall always be grateful to my friend who encouraged me to take the test.
Prostate cancer kills too many men and too many men cannot be bothered to go for a check up! I would implore all men over the age of 50 to discuss the issue with their GP as in this case the saying “it’s never too late” does not apply!