MISMATCH, CONFLICTING INFORMATION & HEALTH POLITICS
NHS policy, endorsed by Cancer Research UK, is that there are no suitable tests accurate enough for a NATIONAL SCREENING programme, Mancheck challenges that policy.
National screening implies putting 'healthy' men at risk from biopsies and over-treatment, the crux of the argument. Any self-respecting urology department is expected to minimise risks and over-treatment. Mancheck asserts that most men would prefer to be given the choice between screening and treatment risks versus the risk of palliative care and eventual death from advanced prostate cancer, currently 11,000 UK men per year.
MANCHECK SUPPORTS TARGETED SCREENING OF RISK GROUPS because there are very good tests that can diagnose life-threatening grades of prostate cancer in many cases. At the very least MANCHECK IS DETERMINED TO BROADCAST ALL MEN TO BE SYMPTOMS ALERT ! and encourage all men (with or without symptoms) from age 40/50 to consider regular DRE's & PSA tests.
The mismatch of information put out by the NHS, medical professionals and some charities causes many men to think prostate cancer is a health lottery, so men take the natural and easy option of INACTION, THIS IS FAR FROM THE TRUTH. Mancheck believes the figure of 11,000 UK deaths per year can be substantially reduced through men responding to personal symptoms, and by having PSA tests, Digital Rectal Examinations (DRE's), and the new mpMRI scanning techniques.
MISMATCH EXAMPLE 1:
HARD TO SPOT? NO SYMPTOMS?
Prostate cancer can be cured if caught early. But it’s hard to spot. Early prostate cancer usually has no symptoms. And the best tests we have are too unreliable for screening. So, too many men don't find out until it's too late. Prostate cancer already kills 10,000 [England & Wales] men a year and by 2030 it will be the most common of all cancers in the UK.
MANCHECK DISAGREES that there are usually no symptoms and it is hard to spot.
MISMATCH EXAMPLE 2:
NO ENCOURAGEMENT TO LEARN & RESPOND TO SYMPTOMS
“...only about half of the 47,000 men diagnosed with prostate cancer each year in the UK are caught at this early stage. While they have a 99 per cent chance of surviving for 10 years,” he says, “the latest figures show that only 22 per cent of men diagnosed at the latest stage live this long. This discrepancy demonstrates why we must do all we can to find more cancers at an early stage by raising awareness of the disease and funding research that will deliver better diagnosis.”
MANCHECK SAYS 'raising awareness' IS A FUDGE STATEMENT.
NO MENTION OF ENCOURAGING MEN TO BE SYMPTOMS ALERT ! OR CHECK-UPS FROM AGE 40/50.
AT THE VERY LEAST SHOULD WE NOT ENCOURAGE MEN TO BE SYMPTOMS ALERT ! ?
MISMATCH EXAMPLE 3: MANCHECK challenges aspects of this statement
Unless you are at risk of prostate cancer because of race or family history, screening for a specific protein produced by the prostate (Prostate Specific Antigen-PSA) does not lead to a longer life. There is a misperception that early testing of PSA is of benefit in detecting prostate cancer in its early stages. There are important trade-offs between the potential benefits and harms involved with either screening or not screening for prostate cancer and a lack of evidence on screening outcomes. Potential benefits include earlier diagnosis of prostate cancer but potential harms include additional hospital visits, tests, anxiety and over diagnosis (the identification of prostate cancer that would never have caused symptoms in the patient’s lifetime, leading to unnecessary treatment and associated adverse effects). It is particularly important that patients make informed decisions about the value of having the test.
MISMATCH EXAMPLE 4:
and finally this one from BAUS is the biscuit !
Q: What should I do if I have a raised PSA?
A: If you have a raised PSA or you have been told that your prostate feels abnormal [DRE], you should contact your GP or your urologist for further advice
This is a back-to-front statement. A man can only know if he has a raised PSA (blood test) or abnormal prostate by going to his GP in the first instant, and access to a urologist is by GP referral. REPLY from BAUS 18.11.2016. 'Dear Mr Buckle Your email has been referred to our Surgical Web Editor. He has commented that he understands your comments but it is important to explain that a high proportion of patients having a PSA done nowadays come from other clinicians or health screening units, and not from the patient’s GP or urologist; the PSA test is often done without any counselling about what happens if the result is abnormal. There are, therefore, a significant number of men who do not know who to contact when they are told their PSA is raised. However, BAUS is currently reviewing all its patient information and we will refer your comments and concerns to the WG undertaking the review.' No doubt BAUS are now on the case, but how many men have a DRE before or even after going to a GP?...more to follow.
MANCHECK does not wish to negatively criticise the excellent work being done by many of the UK’s GP's and hospital urology departments, but address the urgent need for all GP's to be aware of the latest referral protocols and to get more at-risk men in front of urologists earlier.