No ifs, no buts, gentlemen: get your PSA tested

By - Thursday 16th March, 2017

Prostate cancer kills, but can be caught early and treated effectively in Croydon

Photo public domain.

My brother is a hypochondriac. Every headache or shortness of breath is in his mind a forerunner of some ghastly disease. I once asked him how often he thought about the possibility of his imminent demise, his answer was many times a day. His one comfort is that I am four years older so he reckons that he will get four years’ notice of whatever might get him because it will get me first.

I, on the other hand, whilst being very keen not to die, have always been most concerned about not dying from something preventable. Maybe once a year, usually around new year, I ponder whether there is anything I should be doing differently to make sure I get to the next one. You might call it reviewing my ‘Staying Alive’ plan.

Nothing fancy, you understand, just things like never being in a car without putting on the seatbelt or on a bicycle without a helmet. Cheap and easy things like checking that the smoke alarms are all working. Quick and painless medical things like a blood test to check my cholesterol and PSA.

PSA, or Prostate Specific Antigen, is an indicator of the possibility of prostate cancer. It is not a simple yes/no, rather more of a definitely maybe. PSA readings can be affected by other factors such as urinary infections, but it is quick and simple to measure. A high reading, sudden changes or a build up over time indicate the need for further testing.

Bottom line, I had prostate cancer

So it was that about two years ago my PSA went up and, via my GP, I was off to the Croydon University Hospital (née Mayday). A rather uncomfortable (but no more than that) half hour later they had taken a dozen samples. A week later I was back, supported by my wife.

Never a fan of the lengthy “do you want the good news or the bad news” conversation I asked for the straight, unvarnished truth. Bottom line, I had prostate cancer. The good news is that they had caught it early, so I had plenty of options.

The best option varies with your age, how soon it has been caught, and how aggressive it might be. There is also a fair element of personal choice. Some people can’t bear the idea of having something potentially dangerous inside them, while others have a fear of the surgeon’s knife.

The consultants and nurses at Croydon University Hospital and St George’s were excellent

Always hungry for data (as you may have noticed from my articles), I went for more investigation, which involved taking a lot of samples under anaesthetic. It turned out that my golf ball-sized prostate (not untypical) had a lesion the size of a pea. On a scale of one to ten, with one to five not being cancer at all, my cancer was an eight.

This is where I joined the excellent South East Cancer Help Centre in Purley. Their monthly support group meetings helped me to understand my options and talk to people who had been through the same experience and come out the other side. There is much other excellent information from the NHS, Prostate Cancer UK and Tackle. Of course my main sources of advice were the consultants and nurses at Croydon University Hospital and St George’s, who were excellent.

There are many treatment options: radiotherapy, hormone treatment and fancy new techniques coming in all the time. But these options are greater the earlier you detect the cancer. At the end of the day, it was my choice and I chose a prostatectomy. Six small incisions, five of which I can no longer find even though I know roughly where they were, and one just large enough to get a golf ball through are all that’s visible. I’m fine, thank you.

If you have any concerns at all, and even if you don’t, get your PSA tested

So here’s the punchline in Prostate Cancer Awareness Month. If you are a man over fifty, then get your PSA tested (in its early stages prostate cancer does not normally have any symptoms). If you have any symptoms, like frequently getting up in the night, it doesn’t mean that you have prostate cancer. But get your PSA tested to be sure.

If you have a family history of prostate cancer, or are of African-Caribbean origin, get your PSA tested. If you have any concerns at all, and even if you don’t, get your PSA tested. No excuses: get your PSA tested.

My brother has had his PSA tested and it’s pretty much where mine was at the same age. Funnily enough, prostate cancer is something he no longer seems to worry so much about.

Robert Ward

Robert Ward

Engineer and project manager specialised in helping businesses make better strategic decisions and improve safety, quality and effectiveness. Conservative Party Councillor representing Selsdon and Addington Village on Croydon Council. He tweets as @moguloilman.

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  • Peter Staveley

    I also have prostate cancer and, as it happens, today I had a Template Biopsy (which is where samples are collected under anaesthetic which you describe). I am probably under the same Consultant which you were!

    I too must congratulate the consultants and nurses at CUH (and St George’s). Today was the fastest day-case operation that I have ever seen.

    As you say, the earlier the cancer is found the more options you have. At the moment I am on Active Surveillance which means that I have no treatment, but I see my Consultant every 3 months where we look for any changes in my condition.

    I too repeat your advice that all men over 50 should go to their GP and insist on a blood test. I was diagnosed only because my GP included the PSA test in a range of other blood tests in connection with other medical issues. I can confirm that even now I do not have any symptoms related to the cancer.

    • Robert Ward

      Hello Peter, hope you feeling ok this evening and thanks for sharing. Best wishes for your results, sounds like your situation is similar to what mine was. You are in good hands.

  • Anne Giles

    My husband used to have the test done every year when he was having a full medical with our private GP in London. When we could no longer afford the medicals, he went just for a PSA test, but the GP misunderstood and did a full blood count plus one or two extras, which cost a lot. He tried asking our NHS GP surgery, but they wanted him to have an appointment with a young doctor to discuss why he wanted the test. We got the feeling that they wanted him to prove that his was a special case.

    • Robert Ward

      Anne, above a certain relatively young age the GP cannot refuse a PSA test. However it is not something you just phone up and order. The GP will want to talk to your husband and explain the process. Mainly I think this is to prevent people panicking if they get a high reading because this is not necessarily indicative of cancer.

      • Anne Giles

        Thanks. I’ll tell him.