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Why are'nt men routinly called in for a prostrate check like women get a breast check?

Discuss Prostate Cancer

Why are'nt men routinly called in for a prostrate check like women get a breast check?

Postby livingston » Wed Jan 09, 2013 2:24 pm

The outcome is just as serious. Why are men neglected by the NHS this way? If they don't turn up then that's their fault but it should be offered to them as routine. women are given tests, do men deserve less?
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Why are'nt men routinly called in for a prostrate check like women get a breast check?

Postby iye95 » Wed Jan 09, 2013 2:35 pm

In the USA they are, however the current screening methods and the later 'screening' tests are far from straight forward and can even prove fatal, so the decision to begin screening in the UK has been looked at and no final decision has been made.

The first problem is that the screen blood test is not specific for prostate cancer and may be positive in BPH, benign prostatic hypertrophy. Rectal examination of the prostate is also inexact, even in the hands of an expert urologist.

The next stage in the 'screening' would be to biopsy all patients who appear to have a positive result. This requires multiple needle biopsies. In the UK at least 12 biopsies are taken, more in the US. This procedure has a morbidity and a mortality due to the risk of septicaemia, even when covered with antibiotics.

Despite multiple biopsies this test is known to have around a 20% false negative rate. It thus requires all those with negative biopsies to be retested in a year, (with the same risks.)

Also as yet we do not know how to distinguish between slow growing prostate cancers and the rapidly progressive spreading type. Although there are many thousands of deaths each year from prostate cancer, perversely the majority of prostate cancer sufferers actually die from other causes.

Finally it has been suggested that if every man lived to be 100 years old, and multiple prostate biopsies were carried out, nearly 100% would have at least a small focus of prostate cancer detected.

I hope that helps to answer your question.
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Why are'nt men routinly called in for a prostrate check like women get a breast check?

Postby lyulf68 » Wed Jan 09, 2013 2:37 pm

Men to some degree get a head start on this one in that urinary flow is often the first indicator that there is a problem and then a simple blood test will give a further indicator of a problem. It can be moved on fast from that point.

Breast Cancer can be insidious and hidden and screening has reduced risk, grading of tumours early has led to successful treatment programmes.

Prostate Cancer once diagnosed can in many cases simply be monitored for many years before intervention is needed.

But it is also a Cancer,that like Bowel Cancer produces the symptoms that causes embarrassment and means patients bury heads in sand and leave it to late.

Could be a scenario like Cervical Screening where uptake is variable?

If it bothers you and you are in the relevant age range your Dr will happily do the relevant tests for you if you ask.
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Why are'nt men routinly called in for a prostrate check like women get a breast check?

Postby menzies » Wed Jan 09, 2013 2:46 pm

You are correct. I don't know much about the British medical system, but I'll wager that the DRE is a recommended part of the physical exam. The DRE - digital rectal exam - should be performed at every physical for men over a certain age, perhaps 40. it's obviously not a pleasant exam, but many doctors don't like performing it, either. That's a shame, and probably unconscionable.

But, the DRE doesn't pick up every case of cancer. Mine was anterior, picked up by a rising PSA.
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Why are'nt men routinly called in for a prostrate check like women get a breast check?

Postby parfait » Wed Jan 09, 2013 2:51 pm

You are correct. I don't know much about the British medical system, but I'll wager that the DRE is a recommended part of the physical exam. The DRE - digital rectal exam - should be performed at every physical for men over a certain age, perhaps 40. it's obviously not a pleasant exam, but many doctors don't like performing it, either. That's a shame, and probably unconscionable.

But, the DRE doesn't pick up every case of cancer. Mine was anterior, picked up by a rising PSA.
Prostate cancer screening is controversial, the evidence suggests that it might not improve outcomes in general. In the NHS we require strong evidence that something actually works before we will spend huge amounts of money, in other healthcare systems where the patient pays, such as the US, the threshold is lower. The NHS does offer the tests, but men aren't called for it routinely, it is up to the patient to ask, or after discussion with the GP.
Breast screening is well established but not without controversy. It would be almost impossible for any government to halt breast screening now it has started, even if the evidence firmly suggested it. I believe that most authorities suggest that women should be well-informed before they decide to take up the offer of screening.

Prostate screening is well explained here:
http://www.prosdex.com/index_content.htm

This website was set up by a friend to assist those in the Uk who get targeted by private companies offering health screening to enable them to make a more informed choice.

http://www.privatehealthscreen.org/
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Why are'nt men routinly called in for a prostrate check like women get a breast check?

Postby brigg » Wed Jan 09, 2013 2:55 pm

Hi no but in most cases men have issues as the test is a doctor sticking a finger up a man's anus.
that is the usual test they can tell how large it is and if it feels rocky or smooth.
the smooth suggests it is normal the rocky texture suggests a cancer could be present a blood test is carried out this is conclusive but does give a more likely indication of what is going on in your body.
having this done every 18 -24 months does sort of put your mind at rest.
so it is down to the individual to seek out this test. after a visit to the doctor's.
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Why are'nt men routinly called in for a prostrate check like women get a breast check?

Postby arlis100 » Wed Jan 09, 2013 3:08 pm

Hi no but in most cases men have issues as the test is a doctor sticking a finger up a man's anus.
that is the usual test they can tell how large it is and if it feels rocky or smooth.
the smooth suggests it is normal the rocky texture suggests a cancer could be present a blood test is carried out this is conclusive but does give a more likely indication of what is going on in your body.
having this done every 18 -24 months does sort of put your mind at rest.
so it is down to the individual to seek out this test. after a visit to the doctor's.
do you like to ponder the idea of men regularly getting a finger up their ***?
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Why are'nt men routinly called in for a prostrate check like women get a breast check?

Postby mansfield » Wed Jan 09, 2013 3:15 pm

They are when they reach a certain age. Same as women.
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