The system needs an overhaul!

I think everyone who has replied is making valid points which, if you put them together, would constitute a system (because it ain't systematic at the moment) that would provide men with more choice if proactively pursued by the NHS or your private health company. I never received a letter asking me to come for a PSA test. I did not even know that I could have asked for a test at age 50 (and I work in the NHS). Again, I go back to my previous posts - disease prevention is best (and cheapest), the earlier you catch cancer the better your prognosis, new treatments are all well and good but they are much more expensive than education programs or letters from your GP. Also, some cancers are now seen as what the NHS likes to call Long Term Conditions (LTC's) - that is you have them a long time and you live with the effects (like most prostate cancers). Good examples of these would be diabetes, ischaemic heart disease, Chronic Obstructive Pulmonary Disease, asthma and so on. A lot of these are seen as lifestyle related illnesses i.e. your diet, your job, smoking etc. Walk into any GP surgery and there will be loads of information dotted about giving you information about prevention, self care, treatment and check ups for all these illnesses. There is massive investment in LTC's in the UK. I wonder if there any health economists perusing this forum and I wonder if they could tell us if its cheaper to actively pursue prostate cancer routinely or to wait for it to become a LTC. Sadly, when i had my well man check a few years ago, I remember asking the nurse about a psa test and she replied along the lines of 'only if you have symptoms'. So I didn't get one. I am not angry with her because I suppose I could have insisted - but i could have also been referred at that point to my GP or other health care professional who would have had more knowledge and enabled me to MAKE A CHOICE. Health care systems that miss these opportunities or trivialise mens legitimate concerns are, in my opinion, broken. All men know that broken things need to be fixed.

The stats:

46,690 new cases of prostate cancer in the uk in 2014

11, 287 deaths in 2014

'Preventable cases of prostate cancer are not known as it is not clearly linked to any preventable risk factors'

These are, as far as i know, the current national screening programs available in the NHS:

Bowel

Breast

Cervical

New born (there are at least six of these)

Abdominal Aortic Aneurysm (celebrated its one millionth screened over 65 year old in 2016 with 10,000 aneurysms detected since 2009)

Diabetic eye screening

Edited by member 05 Jan 2018 at 18:16  | Reason: Not specified

We know that with every year a man goes past middle age his risk of PCa increases significantly so in due course if he lives to average age he stands a greater than lesser chance of having it. Yet most men go on to die from something else because their cancers do not develop sufficiently. What is just as vital as a better PSA test and even more so in some respects, is a test or way of determining accurately those men who really need treatment and those who could just be monitored long term in case they confound predictions. Such a way of accurately predicting the advance of PCa in men would result in a major reduction in radical treatment for men who presently have it and suffer the adverse effects over treatment causes in many cases. It would also mean more effort could be concentrated on men who are more at risk and would benefit from earlier and better treatment, (a lesser need for so much RT for example but of more quality cutting edge).

But consultants have to use the tools they have now and they are overloaded and likely to be so for quite a time without drawing in and treating other patients. So logistically, there is a problem with the NHS despite what many may consider is desirable or even a 'right'. The NHS is under constant pressure as we know with many operations being cancelled this month and people waiting to be seen in corridors and ambulances and failed targets. More money would help but it takes time to recruit, train and retain high calibre medical staff.

Obviously we on this forum have a particular interest in Prostate Cancer, although some may also have other kinds of cancer or other heath problems outside cancer. So virtually everybody who has a form of cancer or other condition is in effect competing for more and better resources.  Then amongst many other demands on the NHS is the burgeoning cost of drugs.  Hospitals feel so underfunded that despite recommendations to the contrary they charge patients and in some cases even staff high car parking charges  to augment funds to provide health services.   It is not possible therefore for the NHS to be protractive to a degree that would be ideal.  People can be more proactive if they are able and prepared to pay privately for health checks and treatment beyond which the NHS can provide, either directly or through insurance cover.  This could in some circumstances mean going abroad.  Unfortunately, this means many will not do as well as they might if they had the ability to pay and will to do so.  This applies to other things of course, such as with private education and housing as examples.     

Edited by member 06 Jan 2018 at 12:04  | Reason: Not specified

I thought that was all already happening - there can't be many men who don't know that premier league footballers regularly wear the Men Utd man on their shirts, that sports pundits on the TV wear their Men Utd badge, that Jeff Stelling and friends complete numerous back to back marathons to raise awareness, Movember and all the events / activities that PCUK arranges. Women in motorway services would struggle to miss the posters on the back of the toilet doors - "does your husband / father have problems weeing - get him PSA tested" or similar. And then there is the education of younger men and boys - with major sports teams wearing Oddballs pants / hats.

I think there is quite a lot going on - although we can always do more!

It would then be up to men whether they want to put it in the bin or perhaps keep it in mind to get checked out.

I don't think it would cost a fortune to send a leaflet. You could argue that the cost of treatment must surely be less in the long run when the disease is caught earlier as 2nd and 3rd line treatments would not be necessary not to mention saving thousands of men the morbidity or failure of later treatments.

There must be lots of men out there who are not aware of symptomless prostate cancer or having low PSA but significant cancer. Not everyone is knowledgeable about this disease. Many still believe it is an old man's disease and you possibly couldn't have it your forties.

I don't think it helps that the media is always giving the impression that it's a disease you die with not of. We all know on here that isn't always the case at all.

Regards

Ann

Ker-ching! Is this thread dead? 

I don't think so Fabio - where have you seen that?

Thanks Chris - no mention of a national screening programme though; research into better diagnostic tools and better targeting of high risk groups which personally, I think is a much better way of spending £75 million. Hopefully, there will be some left over to speed up the NICE approval system for new treatments as well - and maybe even a bit to help men in the South West?????

https://www.newscientist.com/article/2165916-theresa-may-pledges-75-million-for-prostate-cancer-research/

https://www.healthbreakingnews.net/2018/04/theresa-may-set-to-pledge-75million-for-prostate-cancer-research-to-tackle-killer-disease/

I also saw this while browsing the £75 million announcement - great results on ADT + Abbytabby for T3 / T4 men :-)

https://www.independent.co.uk/news/health/hope-for-20000-prostate-cancer-patients-after-worlds-biggest-treatment-trial-a7770871.html