Spreading myths, lowering the public’s and the male’s guard, and for what reason? It must be for some agenda that you and I, “the unenlightened” don’t understand. I do have some thoughts however and it has to do with all those sparkling and well pressed and provided that day white lab coated M.D.’s standing in front of the White House supporting Obamacare. Who exactly were those doctors? No doctor I know , however I am just a doctor who treats it daily, wants or likes the program. How can that be? Were they ACS and AMA doctors?
Since prostate cancer is slow growing? Are you kidding me? 25,000 deaths to prostate cancer and someone you probably know who has succumbed early from this disease…beg to differ?
American Cancer Society recommendations for prostate cancer early detection
The American Cancer Society (ACS) recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening. Men should not be screened unless they have received this information.
The discussion about screening should take place at age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
This discussion should take place starting at age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
This discussion should take place at age 40 for men at even higher risk (those with several first-degree relatives who had prostate cancer at an early age).
After this discussion, those men who want to be screened should be tested with the prostate specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.
If, after this discussion, a man is unable to decide if testing is right for him, the screening decision can be made by the health care provider, who should take into account the patient’s general health preferences and values.
Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years.
Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher.
Because prostate cancer grows slowly, those men without symptoms of prostate cancer who do not have a 10-year life expectancy should not be offered testing since they are not likely to benefit. Overall health status, and not age alone, is important when making decisions about screening.
Even after a decision about testing has been made, the discussion about the pros and cons of testing should be repeated as new information about the benefits and risks of testing becomes available. Further discussions are also needed to take into account changes in the patient’s health, values, and preferences.
Prostate Diaries 
This form of screening programme would work but requires the full support of ALL healthcare professionals because for men to make an ‘informed descision’ he needs to have access to that information and it is the healthcare professionals that have the information. Currently many of these healthcare professionals do not agree with screening for prostate cancer yet ironically they are willing to treat men such as myself who have advanced cancer and for whom a timely PSA test would have given us the chance of a cure.
Through my lone red sock campaign I try to reach as many men and their families in the UK to alert them to the dangers of ignoring prostate cancer risk.
For the ‘informed man’ to be involved in shared decision making about the health of his prostate he needs to ‘ASK 3 QUESTIONS’.
The first question should be ‘What are my options?’
The second question should be ‘What are the risks and benefits of these options?’
The third question should be ‘What are the possibilty of these risks or benefits happening?’
Just as a footnote, it is the healthcare professionals that not only have the information but also happen to be the custodians of the PSA test!
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Yesterday a dear friend to the red sock campaign lost his fight with prostate cancer he died in a hospice at 5am.
Alex didnt make the ‘informed decision’ because he wasnt looking for the information and why should he he had no symptoms he didnt even know he had a prostate, it wasnt hanging from his chest or his scrotum so he couldnt have seen or felt it.
He never knew what prostate cancer was prior to diagnosis in 2010.
I speak to many men from all walks of life with prostate cancer a vast majority of them had never heard of prostate cancer before their diagnosis. Interestingly most of those that did know about prostate cancer had private medical cover.
Too many men are ready to sit back and wait for a better diagnostic tool which then puts little or no pressure on the Health Service to introduce screening.
It is so simple to identify which of our men would benefit from a prostate test and what the optimum age for each of the risk elements (as you have detailed above).
Yet we do NOTHING but sit back and watch one man every 16 minutes die from a disease that could have been cured by timely intervention.
Alex Munro was a fantastic man but like each of the 11,000 UK men who will die from prostate cancer this year he wished he had been invited to have a PSA test earlier.
Saying SORRY to Alex, these men and their families is just not good enough.
How many more Alex’s? how many more young men?, how many more African Americans?, how many more men with a family history of prostate cancer, breast cancer, ovarian cancer?, how many more men with symptoms?, how many more men who have no access to the information about prostate cancer risks? are we going to allow to die.
I will continue to speak out for ALL men and their families even if no one listens.
Alex deserved better and his family deserved better and I have lost a dear friend.
Thank you for ‘prostate diaries’ red sock follow you on twitter.
Keith S. Cass
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