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Mr Optimistic
25th Jan 2018, 19:42
Well my true nature has been revealed. After years of sqeamishly overlooking the lollipop stick smear-it-yourself bowel cancer test kit the NHS send out to over 60 year olds, wife's derision overcame my hygiene management worries and I did the necessary and posted it back last week.

To my horror they sent another kit and said the first had been incorrectly dated!

Not only do I have to repeat the gruesome exercise, now I am wondering whether this isn't a clever ploy to get a second sample based on suspicions raised by testing the first.

Is my paranoia ill-founded? I could just be talking sh*t.

bafanguy
25th Jan 2018, 20:28
Mr. O,

I doubt the medicos would be that sneakily sophisticated. They'd probably just say the first test was "inconclusive" or words to that effect.

Can't you just get a colonoscopy and have the question definitively answered ?

charliegolf
25th Jan 2018, 20:31
Mr. O,


Can't you just get a colonoscopy and have the question definitively answered ?

So, let me get this straight... You're suggesting that the bloke who didn't want to scoop some poop onto a stick and post it off, turn his bum into a movie theatre?

CG

bafanguy
25th Jan 2018, 20:37
So, let me get this straight... You're suggesting that the bloke who didn't want to scoop some poop onto a stick and post it off, turn his bum into a movie theatre?

CG

Precisely !! He doesn't have to do the camera work himself. :}

Once he gets by the prep, it's a walk in the park...with a nap in the middle.

The peace of mind is worth the inconvenience. And now for the famous Dave Barry essay on the colonoscopy:

http://www.empowher.com/community/share/hilarious-dave-barry-column-about-colonoscopies

yellowtriumph
25th Jan 2018, 21:41
Mr. O,

I doubt the medicos would be that sneakily sophisticated. They'd probably just say the first test was "inconclusive" or words to that effect.

Can't you just get a colonoscopy and have the question definitively answered ?

Things are a bit different in the UK. You can’t just walk in and have this carried out unless you are prepared to pay for it or have suitable medical insurance.

yellowtriumph
25th Jan 2018, 21:47
Well my true nature has been revealed. After years of sqeamishly overlooking the lollipop stick smear-it-yourself bowel cancer test kit the NHS send out to over 60 year olds, wife's derision overcame my hygiene management worries and I did the necessary and posted it back last week.

To my horror they sent another kit and said the first had been incorrectly dated!

Not only do I have to repeat the gruesome exercise, now I am wondering whether this isn't a clever ploy to get a second sample based on suspicions raised by testing the first.

Is my paranoia ill-founded? I could just be talking sh*t.

I’ve returned two lollipop sticks since turning 60. I am pretty sure the paperwork accompanying the test kit said that sometimes the results are not clear cut and they may send you another kit - It does not mean they have found anything suspicious. If you still have it try and read the paperwork.

Wishing you good luck, and for it’s worth I have had two cameras up the bottom, on two separate occasions I should quickly add, and it was not unpleasant. The second one was very interesting as they gave me a drug that prevents you from making any memories whilst the drug’s effect lasts. In effect, I was fully co-operative with the surgeon during the inspection but I was unable to remember any of it.

G-CPTN
25th Jan 2018, 21:58
In effect, I was fully co-operative with the surgeon during the inspection but I was unable to remember any of it.

Indeed.
When I was 'offered' a top-down endoscopy, I refused to listen to the technician, as I 'didn't want to be there when it was done'.
When I emerged from the theatre, I regaled the details to my wife, fell asleep - then denied it all when I woke up.

yellowtriumph
25th Jan 2018, 22:10
Indeed.
When I was 'offered' a top-down endoscopy, I refused to listen to the technician, as I 'didn't want to be there when it was done'.
When I emerged from the theatre, I regaled the details to my wife, fell asleep - then denied it all when I woke up.

I’ve had a couple of those too, just had the throat numbing spray. First one wasn’t too bad so did the same on the second one. All was going well then after a few minutes I sort of got fed up with it and had a mild sort of self induced panic attack. Luckily the surgeon detected my distress and quickly brought it out again. As luck would have it he was just about finished anyway. Not so bad that I wouldn’t have another one if needed. Wouldn’t want anyone to think I was a hypochondriac or anything with all these internal inspections!

bafanguy
25th Jan 2018, 22:13
Things are a bit different in the UK. You can’t just walk in and have this carried out unless you are prepared to pay for it or have suitable medical insurance.

Good grief. So a colonoscopy isn't considered routine preventative screening above a certain age ? And therefore paid for by your NHS ?

Here, if you have no polyps, you get to go 10 years between...polyps get you a return in five years. Here you pay the deductible. Not sure what Medicare pays. I've not yet had to surrender to its crapulence even though I'm old enough to be its victim.

Since catching colo-rectal cancer early is the key to high survival rates, a colonoscopy is much cheaper than treatment/surgery/chemo/radiation.

yellowtriumph
25th Jan 2018, 23:11
Good grief. So a colonoscopy isn't considered routine preventative screening above a certain age ? And therefore paid for by your NHS ?

Here, if you have no polyps, you get to go 10 years between...polyps get you a return in five years. Here you pay the deductible. Not sure what Medicare pays. I've not yet had to surrender to its crapulence even though I'm old enough to be its victim.

Since catching colo-rectal cancer early is the key to high survival rates, a colonoscopy is much cheaper than treatment/surgery/chemo/radiation.

I'm sure that routine preventative screening is considered best practice here in the UK too, but it comes at a cost and it is not one the NHS is prepared to pay given the way it is funded (through taxation).

Here, after you reach the age of 60 the NHS sends you a kit (lollipop sticks) every two years whereby you wipe a small sample of the contents of your bowel over the course of 3(?) days onto these sticks and return them to the NHS who will give you the all clear or not, or request a second set of samples if the initial results are unclear. Not foolproof, and clearly not as good as an inspection but there you go we have to live within our nations budget.

In order to get a colonoscopy (free at the point of usage by the individual) you would have to be referred to a consultant bottomoligist (free at the etc etc) by your GP (free etc etc). I'm sure you would get one if your GP and consultant believed you would benefit - but 'no' it is not a routine procedure here in the UK.

If you have the financial means or medical insurance then of course that is a different matter.

cavortingcheetah
25th Jan 2018, 23:24
Just mix up a little raw steak blood with the smear test sample and you'll be in for a colonoscopy so quickly you won't even have time to say By Jingo!
By the way, the colonoscopy will reveal whether you have diverticulosis or piles but it will not shed light on whether you have gnomes at the bottom of your garden.

chevvron
26th Jan 2018, 01:25
I had a colonoscopy even though was sXXt scared; decided I would keep my eyes closed and try to sleep through it. Just after they started I opened my eyes and right in front of my face was a video screen displaying my insides! I couldn't resist opening my eyes again every minute or so especially when it came to seeing my appendix from the inside.
They offered me a DVD of it afterwards but I declined.

ChrisVJ
26th Jan 2018, 03:27
Grandfather died of stomach and intestinal cancer. Sufficient reason for a colonoscopy at around 55yrs old.

"Just take this, it will clean you out before the procedure."

Don't, It's like sh*tting lava from an erupting volcano.

"We're just going to inflate your bowel and then we'll have a look." Didn't mention that I'd be farting like a carthorse for the next twenty four hours. Did watch the progress up my insides, actually quite interesting. Couple of small polyps removed. Not dangerous.

Did the poo test last week, results came yesterday in the post. "Normal."

Pooh tests not reccommended after age 75 (not worth saving?) so that was probably the last one.

ExSp33db1rd
26th Jan 2018, 07:52
Good grief. So a colonoscopy isn't considered routine preventative screening above a certain age ? And therefore paid for by your NHS ?


My wife - American - has just suggested to her doctor - also American - that perhaps she should have a screening colonoscopy, not for any real reason other than it seems like a good idea, considering her advanced age, and why not ?

The Dr. explained that my wife's very expensive New Zealand Health Insurance will not pay for routine screening colonoscopies, and quoted a figure that is ridiculous to contemplate, should my wife choose to go ahead and pay anyway.

The Dr. remarked that NZ isn't like the USA, is it ? Not only will the NZ public service not pay for a screening test, neither will NZ Private Insurance.

By comparison, my own Health Insurance, a UK one, not only paid for the colonoscopy but the whole procedure for the ultimate bowel cancer removal that proved that my "screening" was justified. Horses for Courses I guess.

crewmeal
26th Jan 2018, 07:57
Not only do I have to repeat the gruesome exercise, now I am wondering whether this isn't a clever ploy to get a second sample based on suspicions raised by testing the first.

No is the answer. I had exactly the same with a blood test and the first one was messed up along the line somewhere.

Can't you just get a colonoscopy and have the question definitively answered ?

No The NHS is too busy>

VP959
26th Jan 2018, 08:11
Well my true nature has been revealed. After years of sqeamishly overlooking the lollipop stick smear-it-yourself bowel cancer test kit the NHS send out to over 60 year olds, wife's derision overcame my hygiene management worries and I did the necessary and posted it back last week.

To my horror they sent another kit and said the first had been incorrectly dated!

Not only do I have to repeat the gruesome exercise, now I am wondering whether this isn't a clever ploy to get a second sample based on suspicions raised by testing the first.

Is my paranoia ill-founded? I could just be talking sh*t.


I've had two of these tests since I turned 60. The first one they asked for a repeat test, I can't remember why, but I did the second kit, sent it off and got a letter back a couple of weeks later saying all was OK.

The test itself (if it's the same screening test I've had) just looks for occult blood in the faeces, which is an indicator of a small bleed somewhere. There a several possible causes of a small bleed, ranging from a scratch on your bum, through haemorrhoids to growths in the bowel, that may or may not be cancerous.

I'd not worry about it, as the test is just a cheap and pretty crude way of screening a group of people who are at slightly greater risk of bowel cancer, and if caught early, bowel cancer seems to be one of those that can be treated pretty successfully. IIRC, a very high percentage of occult blood in faeces tests turn out to be due to a benign cause, anyway.

Pontius Navigator
26th Jan 2018, 08:16
Well I had a regular test, satisfactorily all clear. I had symptoms before the next test. As recounted above, GP 9 Jan, Colonoscopy, 19 Jan, CT scan, second colonoscopy 21st, operation 28 Feb.

Next exploration next month.

As an aside for Benenden Best Health subscribers, they will not shell out the £40 for the hospital benefit unless you are sedated.

yellowtriumph
26th Jan 2018, 10:15
... By comparison, my own Health Insurance, a UK one, not only paid for the colonoscopy but the whole procedure for the ultimate bowel cancer removal that proved that my "screening" was justified. Horses for Courses I guess. ...

May I ask who your insurer is?

My own insurer (Bupa) would certainly pay for all of that too, but, I couldn't just have a colonoscopy just because I fancied it in the first instance.

If I had symptoms, went to my GP and they agreed I needed it then it would all be arranged from start to finish. But, if my GP didn't agree then it wouldn't go any further.

You seem to imply you just fancied a screening colonoscopy, that they found a problem as a result and you had it treated. Or am I reading it wrong?

Very pleased to read that everything worked out for you.

tow1709
26th Jan 2018, 10:18
I don't know if this is still the case, but a couple of years ago the Telegraph reported that GP's are given financial incentives not to refer patients to hospital for scans etc.

How your GP is paid to stop you going to hospital - Telegraph (http://www.telegraph.co.uk/news/health/news/11904082/How-your-GP-is-paid-to-stop-you-going-to-hospital.html)

When you see your GP, do a bit of research first, and if you are not happy with the typical Occam's Razor response you are in a better position to question why he thinks you don't have such and such a disease.

Airclues
26th Jan 2018, 10:42
I had a positive test and was called for a colonoscopy. They removed six polyps and also discovered a 5cm tumor of which I was unaware. I spent 16 days in hospital having it removed. Fortunately it was benign but could have turned nasty at any time.

ExXB
26th Jan 2018, 13:06
Swiss health insurance companies are required to cover the cost of a colonoscopy, subject to deductible and 10% copayment, of course.

I’ve had two now. After the second Dr. said, “see you in another 10 years” to which I replied “I don’t think so”. He looked at me worriedly so I replied “I expect you will be retired by then”. To which he just nodded.

cavortingcheetah
26th Jan 2018, 13:13
British health insurance companies will cover the cost of an initial colonoscopy on referral but will not cover the cost of any routine follow ups. It's not an attitude fit for purpose in 21st century preventive medicine but then it follows by example fro the UK NHS.

Blacksheep
26th Jan 2018, 13:44
I've been very pleased with the treatment I've had on the NHS. Not as good as I received in Singapore, but then it's free at the point of delivery. The only time I've had to wait more than half an hour to be seen was one Sunday when I went suddenly deaf in one ear. I went off to A&E and a waited four hours in a queue. Most of the others in the waiting room were not speaking English to each other. :hmm:

HZ123
26th Jan 2018, 15:05
I discovered after a colonoscopy that I have rectal cancer or a doughnut ring within. I have had 25 sessions of radiotherapy, IV and take 3000 mg of chemo tablets twice daily treatment should finish in a couple of weeks. Then I await what further action operation / nfa will occur. What I find odd is the comments of those that seemed scared to do a test! Some of you need to man up it might save or extend your life!

As for the NHS comments it is little wonder it costs so much as it is overrun with EU and tourists getting treatment for nothing. That was/is my experience attending a local cancer hospital. You could not make it up !

ricardian
26th Jan 2018, 15:22
I had a scare 8 or 9 years ago (very obvious occult blood in faeces) which lead to an initial gastroscopy & colonoscopy in an effort to track down the source of the blood - they found a few polyps & diverticula but nothing worse. I now have a colonoscopy every 5 years but, after acid reflux & stomach problems, my GP has me booked in for another gastroscopy next month. No difficulties about the procedures, the anaesthetist sends me off to la-la land and I wake up in the day surgery ward feeling very hungry. Good old NHS Orkney

bafanguy
26th Jan 2018, 15:25
What I find odd is the comments of those that seemed scared to do a test!


HZ123,

Agreed. Once you drink the "coloblast" stuff and get that over with, it's much ado about nothing. Propofol...effective stuff...works great.

And the peace of mind is priceless.

The protocol here is 10 years between if they find nothing...5 years if they remove some polyps. I'm on the 5 year plan.

The removal of polyps has NO post-op effect. I've had more pain getting a haircut.

When one reaches a certain age, it's reassuring to reduce the number of things that are gonna gitcha...or at least head them off.

VP959
26th Jan 2018, 15:29
I've once had a colonoscopy, and, TBH, it wasn't at all unpleasant, just a bit embarrassing. In terms of discomfort it's less unpleasant then a prostate exam by a fair bit (I don't like those at all!).

I'd have no qualms at all about having to have one again, TBH, especially given the fact that it's a proven way to detect early, or pre-cancerous, conditions, that can often be treated very effectively.

Pontius Navigator
26th Jan 2018, 16:09
Not mentioned, but between my two colonscopies I had a CT scan. After the op and before the chemo I had an MRI to check there was no spread to the spine. Post chemo I had a further CT scan.

Dan Gerous
26th Jan 2018, 20:56
Don't know about the over 60 thing as I've been doing them for a few years now and I'm 59. Don't see what you have to be so squeamish about, it is fairly straightforward, and this year, in Scotland at least, it was a new type of test that only required one sample to be taken. Not a lot of inconvenience for peace of mind.

Pontius Navigator
26th Jan 2018, 21:30
DG, one sample is a single point sample. Surely 3/samples over a period increases the chances? Certainly in my case it developed between tests. It was bleeding obvious so didn't need any tests :)

dsc810
26th Jan 2018, 21:38
I recall I was offered a colonoscopy on the NHS in my mid 50's
They said the usual test as mentioned above for the over 60 was not being offered.
This was a new thing they were trying out - which universally means stay well clear and let others be experimented on.

Having read the risks and I declined.
The leaflet said something like 1 in 2000 require immediate surgery as a result of the procedure - ie in plain language it goes wrong and damages you and suddenly you are an emergency case...to be put in a 2 day queue in A&E probably.
Then it went on to say most of those needing the immediate surgery fully recover from the said surgery....which of course did not mention anything about those who did not recover "fully" or those who did not "recover" at all. I assumed that "Most" here means 50.0001% and presumably the other 49.99999% probably die.

ChrisVJ
26th Jan 2018, 21:55
As I understand the poo stick test there is a difference in blood from internal bleeding and haemorrhoids and that is why the envelope has to have the date of collection accurately.

yellowtriumph
26th Jan 2018, 22:35
I recall I was offered a colonoscopy on the NHS in my mid 50's
They said the usual test as mentioned above for the over 60 was not being offered.
This was a new thing they were trying out - which universally means stay well clear and let others be experimented on.

Having read the risks and I declined.
The leaflet said something like 1 in 2000 require immediate surgery as a result of the procedure - ie in plain language it goes wrong and damages you and suddenly you are an emergency case...to be put in a 2 day queue in A&E probably.
Then it went on to say most of those needing the immediate surgery fully recover from the said surgery....which of course did not mention anything about those who did not recover "fully" or those who did not "recover" at all. I assumed that "Most" here means 50.0001% and presumably the other 49.99999% probably die.

Yes, that was explained to me by the consultant just before undertaking the procedure (I was signing the consent paperwork just before going down to the theatre).

He said that there was a very small possibility that he might puncture the side of the colon with the kit and whatever is upstream of it. He explained that it was a very, very remote possibility, but if it happened he would stop there and then, I would be taken to the operating theatre next door, opened up, and he would carry out the necessary remedial work there and then. I wasn't worried about it and I pleased to say it never happened (I've had two colonoscopies).

Tankertrashnav
26th Jan 2018, 23:36
Colonoscopy? Pah! What a bunch of wimps.

I'm going in for my 11th annual cystoscopy next week, post bladder cancer. If you think a colonoscopy makes your eyes water try having a camera poked up your old chap. After 10 previous ones they no longer hold any fears for me, although I wont go so far as to say I am enjoying them yet!

I've also been playing poo sticks every 3 years since my 60th birthday. All clear so far. On one test I had a "repeat" request because of an inconclusive reading, but that was ok on the second try.

wiggy
27th Jan 2018, 00:46
I’ve had two colonoscopies.....fortunately where I live the procedure is done under a GA and as was mentioned earlier the prep is the really unpleasant hit....however given what was discovered after the first one I’d second the advice to just get on with it if offered, most most especially if you have family history.

wiggy
27th Jan 2018, 00:48
I’ve had two colonoscopies.....fortunately where I live the procedure is done under a GA and as was mentioned earlier the prep is the really unpleasant hit....however given what was discovered after the first one I’d second the advice to just get on with it if offered, most most especially if you have family history.

Catch it early and colon/bowel cancer is nowadays often v treatable....sadly back in the day when my dear old Dad was diagnosed with it that wasn’t the case.

Mr Optimistic
27th Jan 2018, 07:48
Well by coincidence I had my first 'medical' as a grown up yesterday, courtesy of the arsenal of democracy. Nice young lady doctor and technicians. Very nice doctor. Really.......anyway. This included a physical assault on places I rarely wash, let alone fondle. I have mixed feelings about the experience.

ExSp33db1rd
27th Jan 2018, 08:53
You seem to imply you just fancied a screening colonoscopy, that they found a problem as a result and you had it treated. Or am I reading it wrong?

No, exactly that. Visible blood in the stool, sent for a colonoscopy, tumour removed, proved cancerous, subsequently Radiation and Chemotherapy treatment, then lower bowel removed, too low to re-connect so now have permanent "bag", but still living a normal life ( wot's normal ? ) flying, motor-biking, occasionally swimming, drinking, swearing at other drivers etc.

Yellowtriumph .. May I ask who your insurer is?

Insurance Co. was AXA-PPP in UK, eventually it was all covered under the same case no., so the initial colonoscopy was part of the whole plot, including a couple of years observation, including MRI / CAT scans.

Pontius Navigator
27th Jan 2018, 10:42
Prior to my surgery the consultant ran through the risks concluding with something like 0.01% chance of dying, or some very small number, say 1:1,000 or less.

I asked him outright how many of his patients had died. Stunned pause, grin, and none was the answer. As it happens none of the risks materialized. Similarly with Chemo side effects. The bad effects such as 1:10 are highlighted. I think they should say 90% don't etc. In fact chemo fixed a couple of long standing issues one going back 60 years and the other cured fungal nail infection.

goudie
27th Jan 2018, 11:32
It's been 20 years now since I had rectum cancer. Lower bowel removed and fitted with bag and no need for chemotherapy because it had been caught early.
The op is rather severe but made good recovery and walking in the Austrian Alps six months later. Have travelled the world since, no problems.
Mental attitude is as important as physical recovery. I just accepted it and got on with my life.
I was a volunteer counselor for some years afterwards for people who were about to have the operation Some were absolutely terrified at the thought of having to wear a bag but hopefully I persuaded most of them it wasn't the end of the world. '' Better a bag, than a box'' my stoma nurse used to say.
In some ways the mk. 2 version is better than the original mk 1!

Dan Gerous
27th Jan 2018, 14:17
I had a triple bypass recently and had all the speel about %'s of dying or stuff going wrong. I was told this was because years ago when some folk did unfortunately die from an op, relatives were complaining that they weren't told about the chances of dying. Being of the pessimistic faith, I said watch this, I'll be the one in a hundred, but at the end of the day having it fixed and getting on with life, outweighed any disadvantages, and having a rubbish rest of my life.

goudie
27th Jan 2018, 15:57
When I asked the surgeon ' what if I don't have the op?' He replied ' this Christmas will probably be your last one!' I was convinced the op was the right move!

Pontius Navigator
27th Jan 2018, 22:27
Goudie, OTOH I was offered chemo for a 5% improvement on prognosis. Had I not been married I would not have bothered. Yes, positive attitude is the answer.

I knew I probably had cancer before the Bi op, I mean, why else did I go the the doc. The big decision was keeping it secret till after Christmas. Everyone enjoyed Christmas and I wouldn't have been treated any earlier.

BigEndBob
28th Jan 2018, 22:42
My local NHS offers all men over 55 the camera test.
I didn't hesitate to accept and all is fine.
The next test at 60 i won't mind doing, as i have seen one guy with head in sand anal bleeding die from bowel cancer and another friend missed diagnosed by a doctor who said it was piles, finally had some colon removed. And another guy who's poo test came back positive and was treated.

Alsacienne
28th Jan 2018, 22:56
If you can cope with the prep, the procedure is a walk in the park!

cavortingcheetah
29th Jan 2018, 00:21
Think of the prep as a spring clean.

5000 metres
29th Jan 2018, 03:02
The prep is a beast, but once they wheel you in it’s just 60 minutes of non-existence.
btw, for DIY monitoring (useful if you have a family history), you can buy, online, the same at-home kit that your MD uses. Last time I checked, was about $80 for 100 or so. Put your poop on the popsicle stick, smear it onto the assay strip, and it changes color if you have occult blood.

ExXB
29th Jan 2018, 10:09
My Dr. gave me the opportunity twice to be sedated for the procedure, but he said the effects of the sedative would be worse than any discomfort I experienced during the procedure.

While I can’t say he was right, as I chose not to have the sedative, the procedure was not painful and I could watch it all on TV. There was some discomfort as he went around corners, but nothing like sitting in a Dentist’s chair.

Yes, I farted continually, and for a couple hours afterwards. But I was able to take the bus / train / bus home unescorted.

VP959
29th Jan 2018, 10:19
Likewise I had no sedative, and the worst bit was really the embarrassment of farting all the time. The only slight discomfort was the initial insertion of the thing, but frankly that was no where near as uncomfortable as a prostate exam.

If anyone is concerned about having a colonoscopy, then I'd say there's absolutely no need to be, especially given the proven benefit of detecting something early.

Pontius Navigator
29th Jan 2018, 10:29
As I said above, my Benenden claim will not be met if I don't have a sedative.

ExXB, you were lucky. Everything was fine for about an hour then as we arrived home, a shart.

goudie
29th Jan 2018, 10:51
Compared to having a camera stuck in your willy, a colonoscopy is a non event. I certainly chose to have a sedative for that one. Poor little chap must have wondered where all the fun times had gone!

HZ123
29th Jan 2018, 11:47
Radio 4 BBC am there was a scientist on from Sheffield Uni and he has developed a virtual colonoscopy, no pain no intrusions. Interestingly he stated the majority of patient cannot tolerate this minor procedure!

VP959
29th Jan 2018, 11:56
Radio 4 BBC am there was a scientist on from Sheffield Uni and he has developed a virtual colonoscopy, no pain no intrusions. Interestingly he stated the majority of patient cannot tolerate this minor procedure!

I think the "patient intolerance" is mainly embarrassment at having something shoved up your behind, combined with being internally inflated so you fart all the time.

It's probably the idea of having a colonoscopy, rather than the non-ordeal of actually having one, that may put people off, I think. If yy doc said I should have one, I'd have one with no qualms at all now, but that's with the benefit of hindsight.

k3k3
29th Jan 2018, 13:24
I had a trace result on the "sh*t on stick" test, after drinking the stuff that makes your arse do a passable imitation of a fire hose went off for the colonoscopy, needle in the back of the hand, sweet dreams, wake up an hour later and have the wife drive me home.

In my case they found two polyps which were removed and found to be benign, five years later I had another colonoscopy which found nothing untoward.

It really is a non-event, the colonoscopy just means one day out of your life where you spend the rest of the day lazing around, and could mean you avoid an unnecessary early demise.

MurphyWasRight
29th Jan 2018, 15:38
Quote:
Originally Posted by HZ123 View Post
Radio 4 BBC am there was a scientist on from Sheffield Uni and he has developed a virtual colonoscopy, no pain no intrusions. Interestingly he stated the majority of patient cannot tolerate this minor procedure!
I think the "patient intolerance" is mainly embarrassment at having something shoved up your behind, combined with being internally inflated so you fart all the time.

It's probably the idea of having a colonoscopy, rather than the non-ordeal of actually having one, that may put people off, I think. If yy doc said I should have one, I'd have one with no qualms at all now, but that's with the benefit of hindsight.

What they leave out on 'virtual colonoscopies' is that the exact same prep is required, which as others have pointed out is the hard (well very soft) part.

That and the fact that you end up with a 'real' one if they see anything at all limits the benefits in my mind, especially if there is no guarantee of the 'real' one being available in time to avoid a second round of prep.

dsc810
29th Jan 2018, 19:01
I was a volunteer counselor for some years afterwards for people who were about to have the operation Some were absolutely terrified at the thought of having to wear a bag but hopefully I persuaded most of them it wasn't the end of the world. '' Better a bag, than a box'' my stoma nurse used to say.
In some ways the mk. 2 version is better than the original mk 1!

Given that my mother died of it you might have thought I'd have taken up their offer to me of the procedure I mentioned earlier.
Rather the case that my late mother endured 5 years of hell prior to dying anyway so thank you very much in the case I get the same I'll take the box.
Secondly that no member of my family in living memory has ever come out of hospital better than they went in hardly encourages me to go anywhere near the places.
I do have some medically qualified friends now long retired and I regularly hear the refrain of them re-telling what happened to x - "you know went into the (local hospital) and they managed to kill him as usual".
In fact its so bad that I've know of car crash victims pleading not to be taken there and others walking wounded saying take me home and I'll see my GP - anything except go near to the place.

Mr Optimistic
29th Jan 2018, 20:37
You're not selling this to me fellas.

Pontius Navigator
29th Jan 2018, 20:58
You're not selling this to me fellas.

As for shit on a stick, I am with you. Nasty, messy, smelly and it travels with everyone's letters, and your letter with theirs. Did it dutifully and didn't work. Now blood in your poop - it might be piles - but that IS worth checking.

My first spot was September, a bit more in November and an explosive event in December. Could I have avoided a bowel op? I doubt it.

Mr Optimistic
29th Jan 2018, 21:29
Did it again today. I am getting quite good at it, thinking that the more if the square I cover the better the test. Sitting there wondering about the optimum thickness and the net transparency through the window. Quite calming really. Just glad you don't have to kick the envelope.

bafanguy
29th Jan 2018, 21:54
Compared to having a camera stuck in your willy, a colonoscopy is a non event.

So true. If you see the inside of your bladder on a TV screen, you're not having a fun morning. :eek:

ExSp33db1rd
30th Jan 2018, 09:04
Now blood in your poop - it might be piles - but that IS worth checking.

Agreed, that was my signal, colonoscopy followed by Radio/Chemo, followed by bowel surgery, followed by a lifetime "bag".

No contest.

wiggy
30th Jan 2018, 09:31
Those going “**** me, I’m not having one of those” perhaps need to be aware the outcome (e.g. permanent bag or not) depends to some extent on exactly where a tumour is, and the fact that treatments are advancing rapidly.

FWIW in my case (very recent) it was colonoscopy that rang the big first alarm bell, then MRI and CAT scan that led to diagnosis of Stage 3 colorectal cancer.

Treatment was targeted radio, surgery (Lower Anterior Resection), temporary bag for 3 months whilst the joints healed, then surgery to restore slightly shorted pipe run to original configuration, and along with all this low level (tablet) chemo, done at home - no hair falling out or sickness......18 months off work then Class One restored and back to flying....by way of comparison twenty years ago the same condition in much the same place killed my father.....

If the idea of a bag bothers you modern kit is very good, ( in fact getting the system back to err...normal after restoration was much more awkward than handling the bag)...

Certainly if there is any history in the family, just do the test(s).

Pontius Navigator
30th Jan 2018, 09:48
To reinforce Wiggy as my case was very similar. Mine was colonoscopy, CT, colonoscopy too stage 1 but right at the bottom of the bowel, an awkward position.

Then a practice bag followed by surgery rather than chemo first. The plumbing repair was immediate and no bag. Chemo was 5 weeks after the Op. Again tablets, 1800mg twice per day for 8 3 week cycles. Again no noticeable side effects apart from dozing off occasionally. I had a couple of part time jobs during chemo and these were at the end of each cycle (least vulnerability period). Caribbean cruise 6 weeks after chemo with no effects.

Glad too know that Wiggy's final point re nornal is normal. I am eating normally but with 6 inches less bowel I have less storage capacity.

ED is a risk but is by no means a given :)

wiggy
30th Jan 2018, 10:25
.....I am eating normally but with 6 inches less bowel I have less storage capacity.


I know exactly what you mean PN...:} my system is still slowly adjusting.....ohhhhh must rush ... :E

ChrisVJ
30th Jan 2018, 20:10
Just a brief word for those of you reading this thread and having difficulty peeing.

I put off getting it seen to for over ten years. Eventually started getting headaches, high blood ressure etc, apparently due to poor kidney function, down to about 16%. Turned out I was 'holding' a litre of pee even after going!

Had a catheter for four weeks (we were moving house!) and then had a cystocopy. Very minor discomfort just for a second. Sedative not required. Interesting view and explanation all caught on CD.

Two weeks later had TURPS. No discomfort after. Didn't even need the Tylenol they gave me. Did however have a terrible bout of constipation after the sedative. TAKE the stool softener they offer before the procedure.

yellowtriumph
30th Jan 2018, 21:37
Just a brief word for those of you reading this thread and having difficulty peeing.

I put off getting it seen to for over ten years. Eventually started getting headaches, high blood ressure etc, apparently due to poor kidney function, down to about 16%. Turned out I was 'holding' a litre of pee even after going!

Had a catheter for four weeks (we were moving house!) and then had a cystocopy. Very minor discomfort just for a second. Sedative not required. Interesting view and explanation all caught on CD.

Two weeks later had TURPS. No discomfort after. Didn't even need the Tylenol they gave me. Did however have a terrible bout of constipation after the sedative. TAKE the stool softener they offer before the procedure.

I find these days that I need to have quite a few wees for the first hour or so after getting up, but they are just little wees sometimes just a couple of minutes apart - but not much wee each time. After the first couple of waking hours I no longer feel the need to go other than what most men would consider to be at a normal number/times during the day. Certainly don’t feel the need to go to the loo if I pass one when out and about. The pattern seems to repeat every 24 hours. Definitely don’t feel as though I am emptying my bladder though. Any thoughts?

Slow Biker
30th Jan 2018, 21:45
I am encouraged by the equanimity displayed by those here with 'bags'. My daughter has severe Crohn's and is likely to lose a good portion of bowel and I have mentioned to her that PPruners don't consider the bag a problem; it certainly helps. I won't be a bore with my medical issues, but I was intrigued to note that PN went on a cruise shortly after chemo. We have given up going to the US, travel insurance is just too difficult and Europe is going the same way; do any of you out there have similar problems?

Pontius Navigator
30th Jan 2018, 21:59
SB, I confess my insurance did not cover the cruise. We took the risk based on the negative effect from the chemo and how I felt. Someone earlier mentioned a positive attitude. At the outset I set the cruise as a target.

We actually cancelled a holiday 4 weeks post op pre chemo. In retrospect wish we had gone. Must say though EasyJet was amazing.

In the ordinary event they will only refund APD. I couldn't get their link to work and contacted the CEO. One of his office rang me and asked why I was cancelling. When I said cancer he immediately refunded the lot.

goudie
31st Jan 2018, 10:57
Being 80 years old certainly puts up travel insurance. . I've just taken insurance out for my three weeks stay with my daughter in Hawaii. Comprehensive, taking my Hypertension tablets and statins into account was going to cost 750 quid! By discounting my two medical conditions and taking the basic it came down to 244, which is valid for a years travel (hope to go there next Christmas). My eldest daughter who is coming with me and is 55 paid 80 quid.

Pontius Navigator
31st Jan 2018, 12:41
Goudie, you will probably be OK but here is a recent case.

He had cover for cancer IIRC but his wife had separate insurance. He had to cancel and it was covered. When she tried to cancel she found she was not covered. The grounds were that a close relative, her spouse, had a pre existing condition which might result in her needing to cancel. She had not declared this.

OTOH, my MiL, 92, is fit. We don't need to declare her as she is not expected to die.

gingernut
31st Jan 2018, 19:46
Screening is always a bit of a "tricky" one.

This is yonks old, the WHO have updated this, but "Wilsons Criteria" is probably as good today, as it's ever been.

the condition should be an important health problem
the natural history of the condition should be understood
there should be a recognisable latent or early symptomatic stage
there should be a test that is easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific
there should be an accepted treatment recognised for the disease
treatment should be more effective if started early
there should be a policy on who should be treated
diagnosis and treatment should be cost-effective
case-finding should be a continuous process

visibility3miles
1st Feb 2018, 02:00
Afraid to look where the sun don't shine?

DON'T BE!

A colonoscopy can save your life!

Colon cancer steals in like the fog, on little cat feet, causing no pain or discomfort until you are seriously afflicted with the disease and it has spread, often to a lethal extent.

Get screened.

A colonoscopy is not a big deal, given that they can nip (pre)cancerous polyps in the bud before they have a chance to spread.

Sticking a swab in a piece of doo-doo is as easy as it gets.

Ask anyone who's changed a diaper if they could hold their nose while doing their duty, and they'll say, "Yes, you too can do this with your doo-doo."

visibility3miles
1st Feb 2018, 02:11
When I was five, my father had some blood in his stool/bowel movement...

Three weeks later, I was an orphan.

Sucks to have colon cancer spread everywhere without having a clue.

I did not take it well. Got kicked out of school for bad behavior and had to repeat kindergarten.

I don't think my mother ever got over it.

ChrisVJ
1st Feb 2018, 07:22
Yellowtriumph

Similar symptoms to start. Also found that if I held it for a while I didn’t go much but could release it shortly afterwards. Later it became seriously uncomfortable when I wanted to go but no opportunity. Eg last couple of miles before home or worse, five miles from airport. Later my range got shorter so I’d have to stop beside the road.

Eventually, maybe a couple of years the major discomfort went away and for three or four years there was nothing more than the occasional need to go every hour or so.
December two years ago I started getting a persistent headache. Not a killer but it was fairly constant. Turns out I had very high blood pressure. While chasing down the cause I mentioned the bladder thing and doc sent me for ultra sound. It showed over a litre retained after peeing and doc ordered an immediate catheter.

VALUABLE TIP. When you first get a catheter stay in the clinic or hospital until the bag stops filling and empty it before you leave. Here is how I know:

“Might pinch a bit as it goes in,” the nice nurse said. She pushed the catheter in until a little urine started coming out of the other end into a kidney bowl. She clamped it and then attached a syringe and inflated the little balloon that keeps it your bladder. Then she attached the bag, put the strap around my thigh, removed the clamp and told me I was “good to go.”

As I left the clinic I could feel the bag was filling but home was only four minutes away by car so . . . . As I pulled up in our drive I could feel the bag squeezed between my thigh and jeans. Going up the steps it was slipping until it was down at my knee. Across the hall and into the half bathroom it was still slipping. Drop pants and reach for bag but it was stuck. Give it a tug and the tube comes out of the top. A small fountain shoots up from the squeezed bag while the tube imitates a loose fire hose. I can’t go anywhere because my pants are around my ankles and getting soggier by the minute.

It took half an hour to clean that lot up.

VALUABLE TIP. There is an alternative to having a fixed catheter. After my cystoscopy I insisted I use regular catheters. Simple tubes with a small hole in the end. Lube it and feed it until you get a stream. Ease it out and wash it afterwards. Easy peasy.

The bag is the problem, at least for me. It slips down my leg. The tape to hold it and the tube causes pustules in my skin and a few times it was inconvenient when half full and I was working. The plain catheters are easy and I had one ready cleaned in a plastic container in the car and one at home.

The urge to pee is triggered by ‘stretch’ nerves in the elastic walls of the bladder. For me, at least, once the walls have been stretched beyond their regular length they lose some of their trigger action. There is a sphincter in the mouth of the bladder and if your prostate is enlarged it can become occluded, often with a flap of flesh that blocks it. (saw it on video!)

Usual caveats, we are all different, results may vary.

yellowtriumph
1st Feb 2018, 11:25
Yellowtriumph

Similar symptoms to start. Also found that if I held it for a while I didn’t go much but could release it shortly afterwards. Later it became seriously uncomfortable when I wanted to go but no opportunity. Eg last couple of miles before home or worse, five miles from airport. Later my range got shorter so I’d have to stop beside the road.

Eventually, maybe a couple of years the major discomfort went away and for three or four years there was nothing more than the occasional need to go every hour or so.
December two years ago I started getting a persistent headache. Not a killer but it was fairly constant. Turns out I had very high blood pressure. While chasing down the cause I mentioned the bladder thing and doc sent me for ultra sound. It showed over a litre retained after peeing and doc ordered an immediate catheter.

VALUABLE TIP. When you first get a catheter stay in the clinic or hospital until the bag stops filling and empty it before you leave. Here is how I know:

“Might pinch a bit as it goes in,” the nice nurse said. She pushed the catheter in until a little urine started coming out of the other end into a kidney bowl. She clamped it and then attached a syringe and inflated the little balloon that keeps it your bladder. Then she attached the bag, put the strap around my thigh, removed the clamp and told me I was “good to go.”

As I left the clinic I could feel the bag was filling but home was only four minutes away by car so . . . . As I pulled up in our drive I could feel the bag squeezed between my thigh and jeans. Going up the steps it was slipping until it was down at my knee. Across the hall and into the half bathroom it was still slipping. Drop pants and reach for bag but it was stuck. Give it a tug and the tube comes out of the top. A small fountain shoots up from the squeezed bag while the tube imitates a loose fire hose. I can’t go anywhere because my pants are around my ankles and getting soggier by the minute.

It took half an hour to clean that lot up.

VALUABLE TIP. There is an alternative to having a fixed catheter. After my cystoscopy I insisted I use regular catheters. Simple tubes with a small hole in the end. Lube it and feed it until you get a stream. Ease it out and wash it afterwards. Easy peasy.

The bag is the problem, at least for me. It slips down my leg. The tape to hold it and the tube causes pustules in my skin and a few times it was inconvenient when half full and I was working. The plain catheters are easy and I had one ready cleaned in a plastic container in the car and one at home.

The urge to pee is triggered by ‘stretch’ nerves in the elastic walls of the bladder. For me, at least, once the walls have been stretched beyond their regular length they lose some of their trigger action. There is a sphincter in the mouth of the bladder and if your prostate is enlarged it can become occluded, often with a flap of flesh that blocks it. (saw it on video!)

Usual caveats, we are all different, results may vary.

Many thanks for your reply. Am I understanding your post correctly? Are you saying that you use a ‘mechanical device/system’ pretty much all the time now - daily perhaps to empty your bladder?

I was maybe expecting the end result might be some sort of medical procedure to give a permanent solution or some sort of course of tablets to shrink something or other? Sorry for the use of non-medical language!

ChrisVJ
1st Feb 2018, 17:58
Yellowtriumph

Absolutely not.

Used the plain catheter between the cystocopy and the TURPS. After the TURPS I pee normally. The trigger sensation is a little different. The surgeon said that after the cystocopy the symptoms might ease but in my case I couldn't pee at all without the catheter until the TURPS.

yellowtriumph
1st Feb 2018, 19:06
Ah, I understand now that I have looked up TURPS. I’m pleased it worked out ok for you.

I’ll give it some further thought and book a GP appointment for a few weeks time after I have returned from a forthcoming holiday. Thanks again.

Pontius Navigator
1st Feb 2018, 19:20
This thread has two strands, the shitty end of the stick (didn't work in my case) and colonoscopies.

All this talk of to have or not have a colonoscopy, certainly in UK, overlooks the first step. You must see your GP. I saw a female GP; no embarrassment, it was just a discussing and referral.

Mr Optimistic
1st Feb 2018, 21:12
Visibility3miles. Thanks, point taken.

yellowtriumph
1st Feb 2018, 22:39
This thread has two strands, the shitty end of the stick (didn't work in my case) and colonoscopies.

All this talk of to have or not have a colonoscopy, certainly in UK, overlooks the first step. You must see your GP. I saw a female GP; no embarrassment, it was just a discussing and referral.

I don’t want to get too personal here, but can I ask for some more detail?

You say the stick test didn’t work for you, can I assume by that that you did the test and it came back clear but for some reason you felt there was an issue and you did not believe the test result. Hence maybe why you went to see your GP?

Ps. Had two colonoscopies myself and as you say nothing to be embarrassed or concerned about.

Pontius Navigator
2nd Feb 2018, 08:13
YT, I had had more than one stick test. In September I first noticed blood but only once or twice. Hoped it was just one of those things.

In December I had an unmistakable event. I made the conscious decision to keep quiet until after Christmas. Saw the GP first week in Jan, had the CS 2nd week, CT scan later that day and second CS on the Saturday. The Op followed 6 weeks later.

My next stick test arrived about April.

yellowtriumph
2nd Feb 2018, 12:50
YT, I had had more than one stick test. In September I first noticed blood but only once or twice. Hoped it was just one of those things.

In December I had an unmistakable event. I made the conscious decision to keep quiet until after Christmas. Saw the GP first week in Jan, had the CS 2nd week, CT scan later that day and second CS on the Saturday. The Op followed 6 weeks later.

My next stick test arrived about April.

Thanks for the clarification, I’m pleased that it has all worked out ok for you.

Pontius Navigator
2nd Feb 2018, 18:25
I meant to add it was only stage 1, the value of an early investigation.

ImageGear
2nd Feb 2018, 18:40
Apparently false positives occur fairly often with the stick. Had endoscopy's, colonoscopy's, prostrate exam, and all clear. In France they push for you to get them every year or two, or more often if something crops up.
All free if you have the top-up insurance.

Imagegear

yellowtriumph
2nd Feb 2018, 19:04
Apparently false positives occur fairly often with the stick. Had endoscopy's, colonoscopy's, prostrate exam, and all clear. In France they push for you to get them every year or two, or more often if something crops up.
All free if you have the top-up insurance.

Imagegear

Just out of interest. How is the French equivalent of the NHS funded? Is there any element of the French ‘man or woman’ paying for any treatment from the GP onwards?

Pontius Navigator
2nd Feb 2018, 20:00
IG, in my case it was not a false negative but too big a gap between tests.

YT, in my wife's case, years ago, she went the NHS route and eventually went to BUPA(don't know why she went NHS). They said she should not have waited. Essentially they preferred to treat early than operate late. She was then called for a second check 3 years later. She was clear both times, just polyops.

yellowtriumph
2nd Feb 2018, 20:29
IG, in my case it was not a false negative but too big a gap between tests.

YT, in my wife's case, years ago, she went the NHS route and eventually went to BUPA(don't know why she went NHS). They said she should not have waited. Essentially they preferred to treat early than operate late. She was then called for a second check 3 years later. She was clear both times, just polyops.

Very pleased to read that PN.

ImageGear
2nd Feb 2018, 23:40
yellowtriumph

I'm not really familiar with the extent to which ordinary French Citizens fund their basic medical care since I am a UK expat. However, I am aware that people working in France pay quite significant taxes that go to fund the service.

As a permanent resident, under the rules of the EU, the Social Security contributions that I and the wife have made over the years in the UK are transferred annually into the French social security system which funds the basic level of medical care that all French Citizens are entitled to.

In addition, we take a "Top-Up" medical insurance (Currently around €2900.00) which brings us up to -100%, private room, all meds etc.

Imagegear

Pontius Navigator
3rd Feb 2018, 10:10
IG, as a matter of interest, does your private room include food and water?

My wife received excellent medical care in a private clinic in Cyprus but care did not include food or drink.

Mr Optimistic
3rd Feb 2018, 13:47
The doctor, having exercised her index finger, advised against the prostate blood test as it is wrong more often than it is right. Still waiting on the lollipop test results but feeling generally negative as ECG declared worthy of interest so now have to present myself on Monday evening for a consultation. Something about late R wave progression and left axis deviation, about which Google was !isn't illustrate illuminating.

That's the trouble with health checks: walk in a well man, walk out a worried hypochondriac.

VP959
3rd Feb 2018, 14:06
The doctor, having exercised her index finger, advised against the prostate blood test as it is wrong more often than it is right. Still waiting on the lollipop test results but feeling generally negative as ECG declared worthy of interest so now have to present myself on Monday evening for a consultation. Something about late R wave progression and left axis deviation, about which Google was !isn't illustrate illuminating.

That's the trouble with health checks: walk in a well man, walk out a worried hypochondriac.


I had the same advice a couple of weeks ago, when I asked whether it was worth having a PSA test. The result of my question was me having yet another prostate exam, plus being given a leaflet explaining the pros and cons of the PSA test. Having read that, I'm pretty convinced that as a screening test PSA is pretty unreliable; it's main benefit seems to be tracking the effectiveness of treatment post-diagnosis.

Sadly it seems that the "lubricated finger up the bum" is the most reliable screening method we currently have. Frankly I'd rather have a colonoscopy than one of those...............

ImageGear
3rd Feb 2018, 14:28
PN

To be honest, although I am entitled to a private room in France, I never bothered because it's never been more than two people in a room and most of the time it was just me. I also enjoy the chats with passing traffic. OK, I did buy internet access once but it costs peanuts. Food and drink - all free, but the food is rubbish. Still I was never eating much so it didn't bother me. A friend in Vence, France was referred to the hospital in Monte Carlo, he thought they were confused and had sent him to the Intercontinental. Food and drink was amazing, room for two with a view of the ocean, and excellent treatment, all free.

At Royal Berks, Reading, the food was good but I had more than 12 in the ward, with dementia, kidney, liver, heart and almost every other kind of ailment one can imagine.) The night noises got to me and I would stagger out of the ward to find a place to sleep. One older gentleman would sit up naked in bed repeating in a quiet mantra "I just want a word, I just want a word" for hours until eventually, his last comment was "b****r, they've cut me off. Needless to say, he never had a visit from a nurse, doctor, or even family.

Imagegear

ExXB
3rd Feb 2018, 16:31
The PSA number itself is meaningless. But the change in value is important. Every man should benchmark his PSA at 30 and retest every couple of years. When (yes when) it starts to change it is time for further scrutiny.

Deaths from prostate cancer has just overtaken breast cancer for third place. Every male will get a form of it, if he lives long enough.

wiggy
3rd Feb 2018, 17:00
Just to add to what IG and others have said about the French system - the locals get hit with social charges, for expats (currently ) that element is effectively covered by the reciprocal Healthcare agreement. So for minor illnesses and GPs appointments just like the locals you (or your top up insurance) picks up a percentage of the bill...OTOH for some major illnesses (such as cancer) you are declared as having a "affection de longue durée (ALD)" and then the state picks almost the whole tab for the medical stuff (i.e. 100% coverage for procedures, drugs etc,)..they'll even pay you motor mileage if you have a string of visits to a distant facility, say for daily radiotherapy over a lengthy period.

Our local hospital doesn't do big wards, two to a room max.. but TBH on my visits they've stuck me in a single room anyway. There is a charge for accomodation, but it's naff all. Pay internet and TV...some of which is quite non PC late at night....only in France....and TBH where I've been in the food has been excellent.

Oh...and colonoscopies are always done under a General...and the system is darned short of money..............

ImageGear
3rd Feb 2018, 17:55
My wife does not like to drive in Nice so when I have a procedure, the surgeon/anaesthetist/consultant gives me an ordinance(Prescription) for a medical taxi. Home to hospital and back. They have to be specially licensed and its at no cost to me.

Imagegear

yellowtriumph
3rd Feb 2018, 18:10
Many thanks to all who have given info on the French healthcare system in answer to my original query.

Mr Optimistic, I hope all goes well for you - live up to your Pprune board name!

VP959, I've had 4 or 5 finger probes and never felt they were at all unpleasant - did you have a bad experience once?

In one of my past employments I was lucky enough to have a 3 yearly private medical check up including the finger test. At the last one I had, which was about 9 years ago, the doctor did mention that he felt my prostrate was increased in size. He just mentioned it and didn't seem concerned, of course it is 9 years later now so I am energised to pursue this further when I return from a forthcoming holiday in a few weeks time.

bafanguy
3rd Feb 2018, 18:15
The PSA number itself is meaningless. But the change in value is important.

Correct. Here's it's called PSA velocity. The faster it changes the more concerned one should be.

Lots of benign or even normal things can elevate the PSA slightly. I get the impression that some benign prostatic hyperplasia (BPH) is normal with age...and can also elevate the PSA to some degree.

The question I have about not getting a PSA and relying solely on the DRE is that by the time bumps can be felt on the aft side of the PSA, how far along is a cancer that perhaps could've been caught and treated much earlier following a suspicious PSA ?

I don't know the answer to that.

VP959
3rd Feb 2018, 18:40
This link is essentially identical to the leaflet the doctor gave me a couple of weeks ago: https://www.nhs.uk/conditions/prostate-cancer/psa-testing/

VP959
3rd Feb 2018, 18:47
VP959, I've had 4 or 5 finger probes and never felt they were at all unpleasant - did you have a bad experience once?



I've had several bad experiences, unfortunately!

I've had one of these annually as a part of my medical once I reached the age of 50, and it was bloody painful every single time. I think it's now reached the point where I hate the damned thing so much that I tense up and make the pain worse.

Until the one a couple of weeks ago I'd not had one since retiring over 6 years ago, but unfortunately it was no less unpleasant after such a gap. I was declared normal, though, and as I have no symptoms at all, my GP was of the view that I was in the lowest risk group for my age and that rather than a PSA test I'd be better off just having regular manual examinations.............

5000 metres
3rd Feb 2018, 20:18
The question I have about not getting a PSA and relying solely on the DRE is that by the time bumps can be felt on the aft side of the PSA, how far along is a cancer that perhaps could've been caught and treated much earlier following a suspicious PSA ?

I don't know the answer to that.

My prostate surgeon (highly rergarded at major LA hospital) doesn’t even bother with DRE anymore—not a sensitive test. Track PSA velocity; next step is 3T MRI + biopsy; then Tx if necessary.

bafanguy
3rd Feb 2018, 20:35
My prostate surgeon (highly rergarded at major LA hospital) doesn’t even bother with DRE anymore—not a sensitive test.

5K,

I was puzzled about the push for the DRE. I saw a video by some renowned urologist where he said most cancers form on the aft side of the prostate where they can be felt. That still doesn't explain why you wouldn't want a PSA to see something (benign or otherwise) getting spooled up.

How far along are you by the time they can feel bumps ? How much harder is it to treat ? There's prostate cancer...and PROSTATE CANCER !!! Once it's progressed to the point it's escaped the prostate and set up housekeeping in additional spots, you've really got a problem.

The DRE will spot an enlarged prostate but there are symptoms of that before you get to bend over the edge of the exam table.

My GP and I are in agreement that PSAs will be done. If it looks iffy, we'll go from there.

I've known too many guys who got prostate cancer...and one neighbor died of it.

VP959
3rd Feb 2018, 20:46
5K,

I was puzzled about the push for the DRE. I saw a video by some renowned urologist where he said most cancers form on the aft side of the prostate where they can be felt. That still doesn't explain why you wouldn't want a PSA to see something (benign or otherwise) getting spooled up.

How far along are you by the time they can feel bumps ? How much harder is it to treat ?

The DRE will spot an enlarged prostate but there are symptoms of that before you get to bend over the edge of the exam table.

My GP and I are in agreement that PSAs will be done. If it looks iffy, we'll go from there.

I've known too many guys who got prostate cancer...and one neighbor died of it.

The link I gave earlier explains why the PSA is not regarded as a useful means of routine screening, although anyone can request regular testing if they wish, but only after they've read the evidence for and against it. Here's the text from from our NHS that explains the logic behind this policy:

PSA testing

There is currently no screening programme for prostate cancer in the UK. This is because it has not been proved that the benefits would outweigh the risks.

PSA screening

Routinely screening all men to check their prostate-specific antigen (PSA) levels is a controversial subject in the international medical community.

There are several reasons for this:

PSA tests are unreliable and can suggest prostate cancer when no cancer exists (a false-positive result). This means that many men often have invasive and sometimes painful biopsies for no reason. Also, up to 15% of men with prostate cancer have normal PSA levels (a false-negative result), so many cases may be missed.

The PSA test can find aggressive prostate cancer that needs treatment, but it can also find slow-growing cancer that may never cause symptoms or shorten life. Some men may therefore face difficult decisions about treatment.

Treating prostate cancer in its early stages can be beneficial in some cases. But the side effects of the various treatments are potentially so serious that men may choose to delay treatment until it is absolutely necessary.

Although screening has been shown to reduce a man's chance of dying from prostate cancer, it would mean many men receive treatment unnecessarily.

More research is needed to determine whether a screening programme would provide men with more benefit than harm.

One European study showed deaths from prostate cancer could be reduced by 20% if there was a screening programme, but this needs to be balanced against the harms of:

overdiagnosis – people being diagnosed with a cancer that will never cause symptoms or death during their lifetime

overtreatment – people being treated unnecessarily for tumours that would be unlikely to be harmful

To save one life from prostate cancer, 27 men would have to be diagnosed with it. A recent large study in America found no reduction in the number of deaths.

Improving the test

As there are many reasons why PSA levels may be high at any one time, researchers are trying to make the PSA test, or a variation of it, more accurate. This includes looking at how PSA levels change over time and comparing the PSA level to prostate size.

Researchers are also looking at whether new imaging tests, such as MRI scans, or other blood and urine tests, can be used to decide which men with an elevated PSA should have a biopsy.

Instead of a national screening programme, there is an informed choice programme called prostate cancer risk management for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.

If you're a man aged 50 or over and decide to have your PSA levels tested after talking to your GP, they will be able to arrange for it to be carried out for free on the NHS.

If results show you have a raised level of PSA, your GP may suggest further tests.

Should I have a PSA test?

Because the results of the PSA test are not as reliable as doctors would like, other tests and investigations are needed to diagnose prostate cancer.

A PSA test cannot identify prostate cancer on its own, and changes in PSA levels alone are not a good reason to start treatment.

If you are thinking about asking for a PSA test, it is important that you first discuss whether it is right for you with your GP so you understand what the results might mean.

The Prostate Cancer Risk Management Programme has information on the risks and benefits of the PSA test to help you decide whether or not to have it.

yellowtriumph
3rd Feb 2018, 21:49
Very useful post, thank you.

Mr Optimistic
4th Feb 2018, 07:18
Although I haven't seen much evidence that the NHS has due regard for its own costs, if the test is unreliable- the doctor said 60% false positives- then the cost of the abortive follow up investigations plus the costs of the tests themselves may be a factor in the advice. Awful lot of people bring worried unnecessarily also. Where to draw the line.....

RAT 5
4th Feb 2018, 07:52
Seems we shifted from colons to prostates: I read a few months ago there are trials underway for 'smart' blood tests. The thinking being that identifying some markers can be more reliable than PSA. It seems that trial is not yet finalised, but offers hope.

VP959
4th Feb 2018, 09:12
I think it comes back to something we've already discussed in the statins thread, that the quality of evidence that the medical profession rely upon to make decisions is often pretty poor. There seem to be a few reasons for this, not just vested interests by the companies doing the various trials, either. The biggest seems to be that there isn't a lot of time or money spent in verifying the data produced from any trial or procedure.

It seems that this may well be just a consequence of the way that medicine has developed. Instead of there being a rigorous scientific method applied to judge whether or not any treatment/screening/advice etc is fit for purpose before it is hailed as being a lifesaver, the medical profession seem to be quick to seize anything that might look like it's beneficial. It's only later, when lots of evidence is gathered that we realise that it may not be that effective at all.

In some cases this doesn't matter at all, like faecal occult blood testing, as the check on all the many false positives is fairly low risk - a colonoscopy. However, it seems that the evidence that regularly testing and monitoring PSA may be beneficial is not so clear cut, and the only methods currently available to confirm whether a rise in PSA is linked to prostate cancer are pretty invasive and carry a fair degree of risk.

The argument over whether PSA is useful or not as a screening test has been raging for years, yet we still have no clear evidence that there is a net benefit from it. The country that has the highest incidence of PSA monitoring is the USA, where it seems routine for men over 50 to have regular tests, yet even a large study in the USA failed to prove whether this PSA testing regime had saved any lives, compared to those who hadn't undergone regular testing.

The sooner a more specific test is developed, one that will have a far higher degree of reliability when it comes to detecting malignant prostate tumours, the better. I believe there are already indications that this may not be far away, as there are already quite a few cancer marker blood tests for other types of cancer.

RAT 5
4th Feb 2018, 13:44
There was a mayor of NY, a few years ago, that resigned due to prostrate cancer, or withdrew from re-election for that office or a higher one. He spoke about the 'miracle' of PSA testing that was the new test which all men had been waiting for and urging them all over 50 to have it. It seems he was a little mis-informed or just over enthusiastic because he had caught it early. It was a saddening moment to discuss PSA with doctor friends in various countries and hear they all were sceptical. Ouch.

k3k3
4th Feb 2018, 16:00
My annual medical in Germany included a urologist using an ultrasonic probe, you can guess where it goes, to scan the prostate, curl up on your side in a foetal position and he sees the inside of your nether regions on the screen.