Monday 24 October 2016

Rog T's Cancer Blog - PSA test is a life saver

For those of you who are regular readers and have read the previous posts on Cancer, you can skip this first paragraph. I write this blog because knowledge is power and if you know what you are dealing with, you have more weapons in the locker to fight it. It is a personal view, I'm not medically qualified. This is for the sole purpose of information for those who are interested. This is the latest installment in my occasional series about how I'm adjusting to living with a big C in my life.  For those of you who aren't, here's a quick summary. I'm 53 years old and in October 2011 I  had a prostate biopsy following two "slightly high" PSA tests - 2.8 & 4.1. The biopsy took ten tissue samples and one of these showed a "low grade cancer" which gave me a 3+3 on the Gleason scale. I'm now on a program of active monitoring.  In early February, I got the results of the a PSA test - down to 3.5 and an MRI scan which found absolutely nothing, two more tests in 2012 were at 3.5 and 3.9, in 2013 my test was 4.0, Jan 2014 was 3.8, August 2014 was 4.0,  February 2015 it was  up to 5.5  and my latest in August 2015 was down again at 4.6. In October 2015 I had a transperinial Prostate biopsy, that revealed higher grade cancer and my Gleason score was raised to 3+4 (Small mass + more aggressive cancer), albiet with small mass. On 22nd Jan 2016 I had HIFU (Hi Intensity Focused Ultrasound) treatment at UCHL). My post procedure PSA in May was 4.0 which was down, followed by 3.7 in August, which means that the direction is positive . I've no symptoms and sadly for a few people, if I'm gonna die soon, it won't be from Prostate cancer. Got the picture?

It is now eight months since I had HIFU therapy to kill the aggressive cancer cells in my Prostate. There has been no news on the subject since my last blog in August, I wasn't planning another installment when I got up this morning. But to quote MacMillan "Events" occurred. In short, I woke up and on the radio, BBC London was reporting that 40 medical procedures have been deemed unnecessary. To my amazement, the PSA test was deemed one of the unnecessary procedures. The BBC website reports "Routine screening for prostate conditions using a test known as a Prostate Specific Antigen, or PSA test, does not lead to longer life and can bring unnecessary anxiety".

I was astounded. Prostate cancer is a progressive disease. The earlier it is detected, the wider the range of treatment options and the less impact it will have on your life. Of course most men given a PSA test will test negative and of those that have high readings, some will have unnecessary MRI scans or prostate biopsies. For those men, it is clearly unnecessary and unpleasant. But for people like me, had I not had a Prostate biopsy in 2011, I would not have been on a program of active surveillance. If I had not been on that, then last year, no one would have picked up that the cancer had become more aggressive. I would be completely unaware of this. The first I would have known would have been when it started to spread. At that point, low impact procedures, such as HIFU would not be an option. I would simply be in a situation where I would be taking medication to slow the progression. Who knows whether it would have killed me, but I most certainly would want the choice in dealing with it. I have many friends who have also been diagnosed. Three as a direct result of PSA tests following reading my blog. In one case, the disease was more progressive and was caught just in time. There were no symptoms.

I immediately rang BBC London and spoke to Vanessa Feltz (you can listen on todays iPlayer). I explained my circumstances. Immediately after my call, another chap called up who's husbands life had been saved by a PSA test, which flagged up an aggressive cancer shortly before it spread.

It is probably true to say that statistically the majority of PSA tests do not result in lengthening of the life of the person. But in a significant minority, such as me, it is highly likely to be hugely beneficial. the ideal time to detect prostate cancer is when it is in early stages and non aggressive. At present, this can only be done via  a PSA test. For most, they will simply go onto a program of active survelliance. This allows the cancer to be monitored and dealt with, when it becomes appropriate.

One other thing I have done as a result of the PSA test. I have significantly changed my diet and exercise regime. I am healthier and fitter than I was in 2011. The test gave me the opportunity to review my lifestyle and adapt it. This is a personal choice that I wouldn't have made, had I not had the PSA test. To deem a PSA test a waste of money, could condemn people in my situation in 2011 to an early death, unnecessary treatments and  misery. Of course biopsies and blood tests are unpleasant. I have friends with late stage prostate cancer. That is far worse. That is a bullet I hopefully will dodge. Preventative medicine is the best form. That is what the PSA test is. The longer cancer is undetected, the more dangerous it is. If you have a PSA test and it is low, then you are now worse off than you would have been otherwise, save for a small blood test. If you are in my situation, you'd feel completely different.

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