Prostate checking

[spikey]

On 30/01/2020 at 16:39, Legend said:

We suffer embarrassment talking about these things ... be prepared to suffer the indignity .

 

I'm sorry Legend but I have to take issue with you there. 

 

Some folk suffer embarrassment talking about these things.  Some folk consider a doctor inserting his finger up their bum to be an indignity.  Thankfully, many are not embarrassed by such talk, and they couldn't care less what a doctor does to them if it may save their life.

 

 

[boxbrownie]

52 minutes ago, spikey said:

 

Some folk consider a doctor inserting his finger up their bum to be an indignity. 

 

 

My first prostate exam was several years ago now, on the table on my side knees up and .......whooaaa.......that’s cold!........no problem though, what was a problem was the doctor asking me during the exam what I was doing Saturday night.......

 

 

Dont worry though, he was a very good old friend of the family......I laughed so much his finger popped out 

 

 

 

Edited January 31, 2020 by boxbrownie

[spikey]

One of several reasons I have for being a bit touchy about implications that there's no reason why people shouldn't be embarrassed about bodily functions, examinations and whatnot is to do with the slow and painful death of a friend, who finally admitted to his wife that the reason he wouldn't go to the GP about his problems when he should have done was his steadfast refusal to entertain the idea of a finger up the bum.  All that she could make of it was that he considered that to be a gross indignity associated with homosexuality.

 

It was all very sad, and completely unnecessary.

[Chris M]

3 hours ago, The Johnster said:

PSA testing has alerted my GP to a raise level, and consequent scans and biopsy shows an aggressive and malignant prostate cancer, which I’m currently half way through a course of radiotherapy for.  I had no idea, and the only symptom is increased urination.  PSA may have saved me; get yourself checked, chaps!

Sorry to hear that, I hope things go well.  I recently finished my radiotherapy and am awaiting the recent PSA test score to see if it has worked. 

I had no symptoms to speak of either  when I had my PSA test.

[Chris M]

2 hours ago, spikey said:

 

I'm sorry Legend but I have to take issue with you there. 

 

Some folk suffer embarrassment talking about these things.  Some folk consider a doctor inserting his finger up their bum to be an indignity.  Thankfully, many are not embarrassed by such talk, and they couldn't care less what a doctor does to them if it may save their life.

 

 

If you thinks that's undignified try having a colonoscopy with nitrous oxide to ease the pain. Now that really is a loss of all dignity.

[chris p bacon]

13 minutes ago, Chris M said:

If you thinks that's undignified try having a colonoscopy with nitrous oxide to ease the pain. Now that really is a loss of all dignity.

 

I've had 2 and opted for it without Nitrous Oxide as I didn't want to feel sick after,  I didn't find it painful but more like cramps.  As the procedure went on I asked if the consultant had got it up to 100psi.....he said if I wanted it, he could try 

[melmerby]

24 minutes ago, Chris M said:

If you thinks that's undignified try having a colonoscopy with nitrous oxide to ease the pain. Now that really is a loss of all dignity.

Had It done twice, wasn't offered any anaesthetic and didn't need it. Bit uncomfortable but that's all.

Try the "Filling the bowel with X-ray opaque fluid" investigation. That is more uncomfortable and they normally adminster relaxant. (had that done as well.)

You can actually watch the pretty pictures whilst it's being done! *rse was a bit sore afterwards.

[The Johnster]

Several of them have inserted fingers or even entire hands in locations I would not normally consider appropriate, and none of the swine so much as bought me a beer and a bag of chips first, no phone calls, no flowers afterwards, I feel cheap and used.  And very grateful and relieved that they did it!

[chris p bacon]

15 minutes ago, melmerby said:

You can actually watch the pretty pictures whilst it's being done

 

Best thing I've seen on telly for years 

[KeithMacdonald]

On 15/08/2018 at 18:06, spikey said:

To anyone out there worried about the Digital Rectal Examination, I can only say get over it. It's no big deal whatsoever, there's no discomfort to speak of, and it might just save you and yours major grief in the future.

 

I'm glad to read you are encouraging people to get tested, and I would encourage anyone who is dithering to get it done as well.

 

However, I'm surprised anyone still lives in an area where a doctor (or nurse) is going to stick a finger somewhere personal. Round our way, it's a quick and simple blood test in a social center, and people are far more willing and less embarrassed when they know that's the procedure. So quick that at the last session they processed something like 400 people in one hour.

 

M'Lady heartely approved of me having that test (and others), as she knows I'm good to carry on working for many years yet.

 

If anyone wants to know more about the blood test option, let me know, and I'll willingly find some proper references.

 

[Legend]

Yes just to be clear the test is a blood test not a digit up the rectum .  Again can only encourage people to get tested . It literally could save your life . 

[melmerby]

To be clear, the digit up the rectum is a first check if the PSA test is above the "concern" threshold.

My first PSA blood test nearly twenty years ago was taken as part of a batch of blood tests when I had some non-urinary disorder.

It came back well over the threshold, so the next was the finger, then a camera up the willy & a biopsy, all were clear.

After that I had regular PSA tests and they remained high, eventually the GP decided it was a waste of time as he thought that as I also have Ulcerative Colitis (for 30+years), that may have been affecting the readings, so the tests stopped.

Move on a few years and the first GP has now retired and his replacement started them up again as he could see no reason to discontinue them as even if they were high constant monitoring is good clinical practice.

These days my PSA is actually below the level of concern and has been in a slow but steady decline for a while.

 

 

[spikey]

9 hours ago, KeithMacdonald said:

... However, I'm surprised anyone still lives in an area where a doctor (or nurse) is going to stick a finger somewhere personal. Round our way, it's a quick and simple blood test ...

 

9 hours ago, Legend said:

Yes just to be clear the test is a blood test not a digit up the rectum.

 

Hang on.  Are you two actually saying that the PSA test is an alternative to a finger up the bum?

 

Meanwhile, allow me to direct all interested parties to https://prostatecanceruk.org/

Edited February 1, 2020 by spikey
to add URL

[big jim]

I’ve put the link below in my ‘down by the tracks thread’ but not everyone reads it so I’ll repost here as it’s highly appropriate 

 

https://www.gbrfcharityrailtours.co.uk/news

 

GBRf are running a 4 day charity railtour later in 2020 raising money for their new chosen charity prostrate cancer UK, you can read the reasons behind it in the link

 

Of course, I’ve volunteered and hope to get to do something over the course of the tour 

[big jim]

I’ll also add this for those reluctant to get the test done, whatever your opinion of Ricky gervais is, love or hate him this is 5 minutes of TV that gets straight to the point with the superb Karl Pilkington getting an unannounced prostate examination, yes it’s set up for TV but it gets the message across that 10 seconds of uncomfort can save your life 

 

(and some superb one liners from Karl!) 

https://dai.ly/x2yy0aa

[Joseph_Pestell]

35 minutes ago, big jim said:

I’ve put the link below in my ‘down by the tracks thread’ but not everyone reads it so I’ll repost here as it’s highly appropriate 

 

https://www.gbrfcharityrailtours.co.uk/news

 

GBRf are running a 4 day charity railtour later in 2020 raising money for their new chosen charity prostrate cancer UK, you can read the reasons behind it in the link

 

Of course, I’ve volunteered and hope to get to do something over the course of the tour 

 

I had not heard about these previous tours but what an amazing venture. Must be very difficult to organise and run on today's railway. Well done to all - and keep doing them until I don't have work commitments which mean that I can't take part.

[Chris M]

As it might help others, here is my story so far.

 

I didn't have any of the symptoms, except sometimes needing to have a wee more than I used to. This is kind of what tends to happen to folk in their 60s so it didn't worry me. I did develop just a slight discomfort in my side which lasted a month so, unusually for a bloke, I went to see my GP.

Luckily my GP was interested and set off a process of tests.
1. Ultrasound scan to check my kidneys, liver and balls - all OK. This is a very cheap test and eradicates some possibilities which is why it was done first.
2. PSA test even though there wasn't much to point in that direction. I scored a rather impressive 26 which led to hospital appointment.
3. At the hospital I had a DRE by specialist and further PSA test which gave enough cause for the specialist to require further tests
4. MRI scan. This shows up where the prostate may have a problem and in my case they could see quite a problem but I didn't know at the time.
5. Biopsy. This was the first invasive test and is the one required for medics to know exactly what the situation is. I had mine under full anaesthetic because they wanted to take lots of samples. Because there is so much stuff close together down there there is a risk of infection following a biopsy of this kind. I was fine and all of my friends who have been through the same were also fine.
6. The biopsy showed I had a problem but I was not informed at this point. I did however get cordially invited for more tests which kind of told me they had found a serious problem.
7. CT scan - makes you feel hot and that you have wee'd yourself. This is done to look for cancer around the body and see how close it is to any organs.
8. Bone scan - you get an injection of something radioactive and are told to keep away from young children for the rest of the day! This is to check whether cancer has spread to your bones.
9. Meeting with consultant to discuss findings and further treatment.

The reason for not saying anything to me before meeting the consultant was so that they he could give me a full picture of where I was and what he recommended next. I'm having the standard treatment (drugs and radiotherapy) and should be OK. If I had left it much longer it might have been a very different story; the cancer was  found just as it was about to break out of the prostate.

 

The point is that it is a logical sequence of events. The PSA test being just a start point to kick off further investigations and these investigations only continue if the previous one gives cause to continue. So far as I am concerned I am very pleased that my GP decided that a PSA test was worth doing even though my one slight problem (and it was very slight) was not a symptom of prostate cancer. I'm also pleased with myself for going to my GP because the normal bloke reaction would be to just ignore such a small problem.

The PSA test did good for me. Based on what happened to me I would say better to do it sooner than later.

[melmerby]

2 hours ago, spikey said:

 

 

Hang on.  Are you two actually saying that the PSA test is an alternative to a finger up the bum?

 

Meanwhile, allow me to direct all interested parties to https://prostatecanceruk.org/

The PSA blood test is not an alternative to a finger test.

It is an indicator that there may be something amiss, it is not conclusive either way, as in my case where I had a high PSA test (several on the trot) but there were and still are, no other signs of anything wrong.

The finger test can feel if the prostate in abnormal in texture and size, even if it is, this may not be due to a cancerous condition, it may just be enlarged.

 

But to all reading this thread and as others have said. Get yourself checked, early intervention has high success rates if there is a something not quite right.

 

 

[Legend]

3 hours ago, spikey said:

 

 

Hang on.  Are you two actually saying that the PSA test is an alternative to a finger up the bum?

 

Meanwhile, allow me to direct all interested parties to https://prostatecanceruk.org/

the finger up the bum checks for swollen or irregular prostate and may well happen if you go to Doctor with issues .   However there is something called PS test. Which is a simple blood test . So if you have no symptoms a simple blood  can put your mind at rest . In my surgery it’s as simple as phoning reception, the nurse takes the test and the doctor calls you if any irregularities show up . I certainly have had some issues over the last 4 years but fortunately it’s diagnosed as prostatitis which is an infection of prostate . My PS is always low . 
 

But just to underline , I’m not an expert , get it tested

Edited February 1, 2020 by Legend

[88D]

33 minutes ago, melmerby said:

The PSA blood test is not an alternative to a finger test.

It is an indicator that there may be something amiss, it is not conclusive either way, as in my case where I had a high PSA test (several on the trot) but there were and still are, no other signs of anything wrong.

The finger test can feel if the prostate in abnormal in texture and size, even if it is, this may not be due to a cancerous condition, it may just be enlarged.

 

But to all reading this thread and as others have said. Get yourself checked, early intervention has high success rates if there is a something not quite right.

 

 

Quite right. The PSA test is not an alternative to the finger test, and is not always accurate. I went to the docs because I had trouble peeing, and. I had a plain, old , common or garden enlarged prostate. They did a PSA test which was slightly too high, but also did the finger test whilst they were investigating the enlarged prostate. Sent for biopsy, then MRI scan, then ‘modelling’ of the cancer spread, then had the prostate out before the cancer could spread - it was due to erupt. Incredibly good, or lucky, timing on my part!

but Melmerby is right, get yourself checked. If you have a problem with the waterworks, go to the doctor: it may be an infection, enlarged prostate, or cancer. It makes sense to find out which and get it sorted.

[spikey]

2 hours ago, Legend said:

the finger up the bum checks for swollen or irregular prostate and may well happen if you go to Doctor with issues .   However there is something called PS test. Which is a simple blood test . So if you have no symptoms a simple blood  can put your mind at rest . In my surgery it’s as simple as phoning reception, the nurse takes the test and the doctor calls you if any irregularities show up . I certainly have had some issues over the last 4 years but fortunately it’s diagnosed as prostatitis which is an infection of prostate . My PS is always low . 
 

But just to underline , I’m not an expert ...

 

1.  The finger up the bum does indeed check for swollen or irregular prostate but what you wrote reads as if someone going to the doctor with "issues" might find themselves having a DRE.  Yes indeed, they might - but not until they've previously had a blood test for PSA and the results are known.

 

2.  It's not a "PS test", it's a PSA test - for Prostate Specific Antigen, and it's not 100% reliable, which is why the next step for a patient with a raised PSA is usually a DRE.  The findings of both tests are taken in conjunction to decide on the next move, if any.

 

3.  Prostatitis is not "an infection of prostate".  It's simply inflammation/swelling of the prostate gland.

 

Sorry if you think I've got it in for you Legend but I haven't.  There's an abundance of extremely useful information in this thread, which I started in the hope that it might encourage more blokes to get checked out, and I'd hate anyone to get the wrong idea about testing because of something they read here.

Edited February 1, 2020 by spikey

[Legend]

If it helps spread the message Spikey I’ve got no problems being corrected . 

[Metr0Land]

One thing I've learned over the last 22 years, and particularly the last 4, is that both the finger test, and PSA are very blunt instruments as others have said, and the only reliable thing about PSA is how it's changing RELATIVE TO YOURSELF.  That aside if you have any doubt get yourself to a doctor.

 

Back in 1998 when I was 50 I started showing symptoms of men's health issues.  My PSA was (I think) 8 initially when it should have been 6 or less for my age group.  As well as the finger and blood tests at the GP, I had a cystoscopy which showed I had an enlarged and vascular prostate.  I then had a biopsy, which in those days was 6 samples without anaesthetic(!)  These showed I had prostatitis but no cancer.

 

For the next five years I shuttled backwards and forwards to consultants in the High Wycombe area with my PSA varying between 7.5 and and a max of 15.  Early 2003 I had another biopsy - this time 8 samples without anaesthetic.  My PSA was below 10 and the consultant said they'd tried very hard to find cancer and pre-cancer but mercifully couldn't (just chronic prostatits) and the consultant signed me off, with a note to my GP saying I wouldn't need re-referral unless my PSA went above 10 (or there were any factors of concern).  Anyone presenting themselves at a GP first time, with a PSA of 10, would be a cause for concern, but as I've discovered PSA is highly personal.

 

Fast forwards to 2016 and I'm now in west Wales.  In June 2016 I went into retention and needed to be catheterised.  The GP referred me to urology down here.  3 months or so later I saw the consultant (well his registrar actually, the catheter was long out by then).  I had a PSA test after the consultation and  before I knew the result, the registrar was on the phone inviting me in for a biopsy in the next few days as my PSA was 28.

 

This time the consultant took 22 (yes twenty two) samples but at least these days it's with a local anaesthetic (have you seen the size of the needled they use to get into your prostate?)  The medical staff couldn't believe that just over a decade earlier standard NHS procedure was NOT to give an anaesthetic.  Whilst they had a very large rod up my bum taking samples, they also measured the size of my prostate which was 128cc (several times larger than normal - not sure what normal is for my age).  On the day, the consultant said that provided there were no signs of problems like cancer, then with a prostate of my size, a PSA of 20 wouldn't be a cause of concern to him.

 

At the next consultation I was told they'd found no cancer but wanted to do an MRI just to be sure.   The subsequent MRI showd a 6mm blur on the prostate.  At one time they were going to do something called a fusion biopsy but decided against it as it was likely to be quite hit and miss given the relatively small size of the blur.  I had asked the consultant for somthing like finasteride to shrink the prostate but he declined on the basis that whilst investigations were ongoing, shrinking the prostate would likely lower PSA and cloud the issue.

 

In the end he decided to wait andother 6 months and repeat the MRI which showed no change.  After some more to-ing and fro-ing in June 2018 he prescribed finasteride which I've been on ever since. Before finasteride my PSA was 25.0, after 6 months it was 12.9 and after 12 months 8.8 - anyone presenting with 8.8 as a new patient would be a concern,  For me having 8.8 which is a third of what it was, is good.

 

From discussing such matter with 3 other friends from the model railway club (though they have all had brushes with cancer) it's absolutely clear that comparing our own PSA with each other means nothing, it's only comparing your own PSA with your own history that has any relevance.

 

As it happens this Jan my PSA has risen to 13.3 - not good news.  I'm HOPING it's related to bladder spasms I'm having, causing some irritation to the prostate.  I saw my GP last week - another finger up the bum job.  He wasn't greatly concerned and didn't prescribe any new medication but is getting me to have another PSA test in 6 weeks (ie 8 weeks from last blood test).  If the PSA is still rising then it's another referral.  Anyone presenting with 13.3 as an initial patient would be a lot more worrying.     

 

 

 

[30368]

Hi chaps,

 

Didn't think I would see this subject on the site, I'm not complaining just observing. I have been through the Prostate Cancer mangle with, thanks goodness, a very good outcome. Metr0lands advice and experiences are very useful, hope all is fine lad? There are many more treatment options available now so the prognosis is good.

 

I would just reinforce the message, although PSA testing is flawed, it is still very useful. It is a good indicator that something is changing. It is a relative test and whilst some clinicians talk of limits, these are indicative. It is a good idea to have a PSA test (simple blood sample) in your 40's, i.e. when you are very unlikley to have Prostate Cancer as an indicator of what is normal for you. This can then be used as a benchmark in later life and help to indicate an elevated PSA level that requires subsequent investigation.

I suspect that a better test is on its way but in the meantime PSA test is better then nowt.

 

The very best to you all and don't worry!

 

Kind regards,

 

Richard B

 

[ChrisN]

Just to add some more.  If anyone else is like me you have all had symptoms of an enlarged prostate.  Every time I have an , my prostate enlarges a little and my urine flow decreases, sometimes it hurts a little as well.  Therefore for me, when about 15 years ago I began to have the same symptoms every time I went to the toilet I knew what was going on.

 

Other symptoms are, increased frequency, particularly going to the toilet and feeling you are finished then having to go back within about ten or twenty minutes.  Lack of flow.  In the fifties the flow test was to stand you at the end of a sort of extended urinal and see how far you could wee.  Any sort of pain in passing urine.  If you have any of these symptoms go and see your doctor.  If not then get a PSA anyway.

 

Generally, the doctors will act if it is over 5.0, and do further tests, but yes there are differences between people, and other factors can affect it but over the years I have seen doctors do the extra tests at values over 5.0.

 

I have had prostatitis twice.  The first was about ten years ago as my PSA was rising.  I had the biopsy.  I do not remember a local anaesthetic, but I do remember each time of the 15 or so samples I had a feeling like a small electric shook, nothing really.  When it was diagnosed I was given 28 days of antibiotics.  Job done.

 

The second started in the beginning of December.  It began to hurt to pass urine and over the next weeks my flow began to decrease, too slowly to notice at first, but after about three weeks it was obvious to the point where I had a urine infection.  This was despite taking my normal prostate medication.

 

I was then treated firstly for the urine infection and then when that cleared but my symptoms had not and after further examination I was given another 28 days of antibiotics.  All is back to normal now.

 

I say all this because we need to get the PSA test done,be aware of the symptoms and that it does not always mean that we have cancer.