If you're fifty, get your prostate checked...

RE: If you're fifty, get your prostate checked...

ruths — Tue, 08 Nov 2016 11:40:46 GMT

Lol- yes hello.

I've been quite busy and realised social media wasnt helping.

My point was that wynne seems to think the doctors want to sign the sick notes - and my reasearch refutes that (ps- they aren't called sick notes may more)

I believe your comment was about doctors finding it stressful that people waste their time with such things as sick notes and worried well and the 'malingerers' and so they are 'pleased' to see somebody who has a genuine problem and can discuss it

i thought these comments contradicted one another.

and I couldn't work out why the demise of the NHS would change anything.

if schools and workplaces and DWP will still ask for doctors' notes how will privitising the NHS fix that?

how does wynne actually know that Many doctors think their job is to sign sick notes?

arlo- yes, looking at mortality isn't always about one's own life-- keep well!

RE: If you're fifty, get your prostate checked...

Martin Atkinson — Tue, 08 Nov 2016 10:55:21 GMT

[quote user="ruths"]So, wynne thinks manynof the GPs think their job is to sign sick notes that aren't required.[/quote] Back with a vengeance then Ruths!? I've missed your forthright arguments however you still seem unable to read between the lines and only see black or white. While I rarely agree with Wynne's politics any more than I see eye to eye with you I don't believe that she, and I certainly don't, really think that this is true, more a reflection of the state of the system.

[quote user="ruths"]Martin suggests that his doctor's surgery are happy to see somebody who is not 'worried well' or malingering..... so I suppose thisnsuggests that they are less than happy to see the false sick notw claimants .....[/quote]In answer to this I would ask you if you would rather spend so much time with clients presenting with unnecessary cases that you don't have time to properly deal with genuine ones? Then pose the question again - you might come with a different view.

RE: If you're fifty, get your prostate checked...

Arlo Guthrie — Tue, 08 Nov 2016 08:33:43 GMT

[quote user="ruths"]And back to the point of the thread- Arlo, I'm glad your prostate is ok- must have been very worrying. [/quote]

Thanks Ruths; yes it was quite worrying. I mean, I was trying not to get too windy about it because I read that something like 98% of people with PC survive beyond 8/9 years, and the consultant had said 'I can cure it'.

Still, a 'cure' can come at quite a heavy price. And however treatable this particular version, there's nothing like the word 'cancer' to make one reflect on one's own mortality. Something I dread, not especially because I fear it myself (I take Mark Twain's view: "I do not fear death. I had been dead for billions and billions of years before I was born, and had not suffered the slightest inconvenience from it."), but mainly because of the need to be here for my wife and children, because of daughter's illness.

RE: If you're fifty, get your prostate checked...

ruths — Tue, 08 Nov 2016 07:00:55 GMT

So, wynne thinks manynof the GPs think their job is to sign sick notes that aren't required.

'Sick notes' are usually required from schools and places of work and doctors find them a drain to pricide according to my google search. There are surgeries that have refused to supply them for schools according to one source I read. In this, it seems the doctors really aren't happy to do the forms.

people who are on long term sick/incapable of are assessed by a private company now.

The doctor's note is a part of the asssssment but not the whole of it.

Martin suggests that his doctor's surgery are happy to see somebody who is not 'worried well' or malingering..... so I suppose thisnsuggests that they are less than happy to see the false sick notw claimants ......

And back to the point of the thread- Arlo, I'm glad your prostate is ok- must have been very worrying.

RE: If you're fifty, get your prostate checked...

Hannah Wynne Richards — Mon, 07 Nov 2016 11:12:17 GMT

Thanks Martin

Wynne

RE: If you're fifty, get your prostate checked...

Martin Atkinson — Mon, 07 Nov 2016 10:18:54 GMT

[quote user="ruths"]

[quote user="Hannah Wynne Richards"]

Many seem to think their job is signing "sick " notes for people who aren't ill, as opposed to curing those that are. One of the reasons I think the NHS is well past its sell-by-date.

Wynne

[/quote]

whaat?

Where's your evidence for that sweeping statement?

[/quote]While this is an over-generalisation there is a large element of truth in it. Add in the worried well, those whose problems are entirely self-inflicted by their lifestyle and those who go to the doctor for every sniff and snuffle and have absolutely no idea how their body functions, it is no wonder GP's go into auto-pilot and become dismissive and miss the odd genuinely serious problem. I honestly feel like a breath of fresh air has blown into the consult room on the rare occasions I go to the doctor as I only go when I have a serious problem and I can discuss medical matters with them.

RE: If you're fifty, get your prostate checked...

Aine Seavers — Sun, 06 Nov 2016 00:05:16 GMT

Agree on all 4 points. My own spine looked fine on xray so the 3 HVE disc ;lesions missed until the MRI. Which is why the Dachs screening test in the Vetsurgeon news is an unusual take on using xrays for spinal disease screening for IVDD breed selection and will make interesting following.

RE: If you're fifty, get your prostate checked...

ruths — Sat, 05 Nov 2016 23:41:34 GMT

[quote user="Hannah Wynne Richards"]

Many seem to think their job is signing "sick " notes for people who aren't ill, as opposed to curing those that are. One of the reasons I think the NHS is well past its sell-by-date.

Wynne

[/quote]

whaat?

Where's your evidence for that sweeping statement?

RE: If you're fifty, get your prostate checked...

Hannah Wynne Richards — Sat, 05 Nov 2016 16:24:51 GMT

Many seem to think their job is signing "sick " notes for people who aren't ill, as opposed to curing those that are. One of the reasons I think the NHS is well past its sell-by-date.

Wynne

RE: If you're fifty, get your prostate checked...

Robin Grimmer — Sat, 05 Nov 2016 14:38:56 GMT

I'm saddened but not surprised to hear of these missed diagnoses by gps given my recent experience. A clinical examination doesn't seem to be part of their remit.

RE: If you're fifty, get your prostate checked...

David Mills — Sat, 05 Nov 2016 14:31:55 GMT

In a recent review, PSA, along with x-rays for back pain, was condemned as a pointless but commonly used test. The problem with it, I believe (from memory not experience), is that is only about 60% sens/spec. This rises in the face of clinical disease, but it begs the question whether it gives you any more info.

The alternative is to shack up with a Doctor and then you'll be subject to all sorts of unethical invasive "teaching experiences".

RE: If you're fifty, get your prostate checked...

Gillian Mostyn — Sat, 05 Nov 2016 10:25:01 GMT

[quote user="Hannah Wynne Richards"] That sounds absolutely horrendous[/quote]

It was. Dad was diagnosed the year after I graduated, and died 8 years ago. It certainly changed my approach to life.

RE: If you're fifty, get your prostate checked...

Hannah Wynne Richards — Sat, 05 Nov 2016 10:21:32 GMT

That sounds absolutely horrendous.

Wynne

RE: If you're fifty, get your prostate checked...

Gillian Mostyn — Sat, 05 Nov 2016 10:18:07 GMT

[quote user="Braden Collins"]Dad's diagnosis was a shambles. [/quote]

Yep - no test is infallible. My Dad had one episode of haematuria at 52 ....a trip to the GP, a blood test later....he was put on meds for BPH and he just 'lived with' the occasional haematuria and urinary tenesmus. 18 months later, when he could hardly pee at all, the 'original' (missed) transitional cell carcinoma in his renal pelvis had spread to his ureters and bladder. He died 8 years later, at 60, of metastatic TCC after having undergone 8 years of extremely difficult treatment (including bilateral nephrectomy, cystectomy, 18 months of dialysis, a kidney transplant, radiotherapy and chemotherapy.).

Like us, doctors can miss things and tests can be wrong. Like Arlo says, if you have symptoms it is vital that things are found early, and usually that's it. BUT if those symptoms don't improve on treatment, it is equally important that you GO BACK TO THE GP.

RE: If you're fifty, get your prostate checked...

Braden Collins — Sat, 05 Nov 2016 05:28:53 GMT

Thanks for the donation Arlo. It's very kind and generous.

Dad's diagnosis was a shambles. He had a PSA test nearly 12 months earlier which showed marked elevation but for some reason wasn't acted on/noticed by his Gp. Once he had haematuria he had an ultrasound which came back as all clear. He was eventually referred to a urologist who was the first doctor to put a finger up his bum and the diagnosis was finally made but too late.

The PSA may have been a life saver for him if his GP had acted on it at the time.

RE: If you're fifty, get your prostate checked...

Martin Atkinson — Fri, 04 Nov 2016 18:15:04 GMT

[quote user="Luca Poddighe"]Well, it is much preferable to have an extra test to validate or not the need of a biopsy/FNA or not?[/quote]That was not the argument. It is that the layman can be seduced by or simply misunderstand the use of advanced imaging as diagnostic when it is little more than prognostic.

RE: If you're fifty, get your prostate checked...

Luca Poddighe — Fri, 04 Nov 2016 16:05:27 GMT

[quote user="Martin Atkinson"]Exactly right - it tells you about growths you need to know about but it doesn't tell you all that you need to know about the growth.[/quote]

Well, it is much preferable to have an extra test to validate or not the need of a biopsy/FNA or not?

RE: If you're fifty, get your prostate checked...

Martin Atkinson — Fri, 04 Nov 2016 16:00:52 GMT

[quote user="Arlo Guthrie"]The specialist told me that it was 99% effective in picking up growths that we need to know about (ie bigger than 1mm-2mm).[/quote]Exactly right - it tells you about growths you need to know about but it doesn't tell you all that you need to know about the growth. There is a difference.[quote user="Robin Grimmer"]I really wasn't bothered that it was a female doctor. [/quote]Well I wouldn't ask questions about your sexual persuasion but I would far rather a woman doctor give me a rectal (so long as she's cut her finger nails) although it doesn't bother me if its a man.

RE: If you're fifty, get your prostate checked...

Robin Grimmer — Fri, 04 Nov 2016 15:08:51 GMT

I have just recently recovered from prostatitis brought on by a cycle trip across France. My own gp was pretty useless and I ended up going to my local ooh gp service who were great. I saw a woman doctor there who examined me properly including rectal exam (my own doctor hardly looked at me ). I really wasn't bothered that it was a female doctor. Now fully recovered and back on the bike .

RE: If you're fifty, get your prostate checked...

Arlo Guthrie — Fri, 04 Nov 2016 14:45:07 GMT

[quote user="Martin Atkinson"][quote user="Arlo Guthrie"]What really surprised me (especially given my GP had said the first thing would probably be a biopsy), is that MRI is now good enough to be diagnostic. [/quote]I think that is an over-simplification. An MRI may show that there is an increased or decreased likelihood of prostatic disease/cancer but it can never be diagnostic. Biopsy/histology is the only way to make an absolute diagnosis and sometimes even that is equivocal. This is something we deal with on a daily basis.[/quote]

Oh - that's not the way I understood it. The specialist told me that it was 99% effective in picking up growths that we need to know about (ie bigger than 1mm-2mm). I guess if there had been any, I'd have needed a biopsy to confirm whether cancerous or not, but since there weren't any, then it's diagnostic.

RE: If you're fifty, get your prostate checked...

Luca Poddighe — Fri, 04 Nov 2016 14:40:11 GMT

I would extend the advice for all the form of diseases, if you're not feeling well get it checked. I'm "only" 40 for the last four years I've been having regular scopes to monitor a "Barrett's epithelium" problem, that in some case is a pre-stadium of oesophageal carcinoma, obviously only a small part of people that has Barrett's epithelium develops a cancer and a lot of people who has Barrett's epithelium doesn't know.

As well my mum, who was under medical screening for ongoing hypo-sideremia and anaemia, was diagnosed in August a colon cancer, she has been operated for it and she's doing well. Before the diagnose she refused stubbornly for a while a colonoscopy, that would have brought the disease to a diagnose a lot before, thankfully we still have her with us, but she's been very lucky. I was prompted by the surgeon that since there was some familiar predisposition I should have planned some screening for myself and I very practically said "Well I get a camera into my mouth every two years, I can surely endure one up my b** too!"

Early diagnose improves sensibly your chances to survive cancer, everyone has only one life don't waste it on a bet with difficult odds.

RE: If you're fifty, get your prostate checked...

Martin Atkinson — Fri, 04 Nov 2016 14:37:33 GMT

[quote user="Arlo Guthrie"]What really surprised me (especially given my GP had said the first thing would probably be a biopsy), is that MRI is now good enough to be diagnostic. [/quote]I think that is an over-simplification. An MRI may show that there is an increased or decreased likelihood of prostatic disease/cancer but it can never be diagnostic. Biopsy/histology is the only way to make an absolute diagnosis and sometimes even that is equivocal. This is something we deal with on a daily basis.

RE: If you're fifty, get your prostate checked...

Arlo Guthrie — Fri, 04 Nov 2016 13:44:24 GMT

[quote user="Martin Atkinson"]My GP is sceptical about the PSA test as it is only 60% specific and may not only miss prostatic cancer but also lead to false positives[/quote]

[quote user="Aine Seavers"]yes, the 'screening'test esp from 50 is hugely controversial and now in the USA the specialists are trying to stop General practitioners routinely using it as a screening test as more side effects of the investigation than from the cancer death risk[/quote]

Yes, I knew PSA did not give a diagnosis, just an indication which might lead to invasive stuff that could cause more problems than it solves, starting with the biopsy.

What really surprised me (especially given my GP had said the first thing would probably be a biopsy), is that MRI is now good enough to be diagnostic. Infinitely preferable.

[quote user="Braden Collins"]Shameless plug coming up[/quote] Well, I don't normally sponsor stuff unless it has something to do with epilepsy, but made a small exception today because a) it's a subject that's, I was going to say, 'close to my heart', but of course it isn't! and b) it's you, and you contribute so much useful and interesting stuff to the forum.

RE: If you're fifty, get your prostate checked...

Aine Seavers — Fri, 04 Nov 2016 06:13:52 GMT

yes, the 'screening'test esp from 50 is hugely controversial and now in the USA the specialists are trying to stop General practitioners routinely using it as a screening test as more side effects of the investigation than from the cancer death risk(with great respect to Braeden's dad which obviously very severe and yes I will sponsor your fundraiser). And you had symptoms Arlo so at least again a reason to do it. Equally,the reference range here has changed and drs wait until a much higher level than 10 years ago before referring on for investigation. One of the concerns is that so many men have large prostates which are normal (and proven to be after multiple tests and biopsies etc) that maybe the definition of normal size needs to be upgraded. The test also affected by recent intercourse and high protein.meat diet (or perhaps strenuous exercise and protein supplement pre bike rides as noted above). The significance is whether the level rises over time in a patient with symptoms.

RE: If you're fifty, get your prostate checked...

Braden Collins — Fri, 04 Nov 2016 04:18:06 GMT

In 2009 my dad was diagnosed with metastatic prostate cancer, aged 55. He was given a 3-5 year survival time. Fortunately with new and improved treatments he's still with us, but having regular chemo treatments to keep it at bay.

After he was diagnosed, I did an Ironman triathlon to raise funds for prostate cancer research. This year, I've decided to give Movember a go. I think Movember has made it to the UK, but in case it hasn't it's about growing a Mo to raise funds for mens health, including prostate cancer and depression.

I've never been a hairy bloke, so my Mo is looking pretty sad as you can see. Still, it's for a good cause.

Shameless plug coming up: My fund raising page is http://mobro.co/bunburyvets and we'll gladly accept any donations.