When < means > you can possibly imagine!

[Gibbon]

Had 6 monthly PSA test this week. Phoned up for results yesterday and receptionist (yes I actually got through!) told me it was 0.1 normal. I said that was not normal for me and does it actually say less than 0.1 i.e. undetectable. She send she couldn't see that and would send me a email in 10-15 mins time.

And then time stopped advancing...... (for those who don't know, when they've removed a prostate then PSA should be undetectable otherwise its cancer)
My Inbox wouldn't refresh, I went for a long walk round the garden got back and 1 min had passed, WTF was I going to do if its come back, usually radiotherapy can work but I've got a new super duper kidney right in the firing line, what a fecking waste. And ten thousand aeons eventually passed and I had aged appropriately when the email dropped! with a big fat super delicious jumping for joy






























<0.1

Now that is success!!

[ladymuck]

Phew!

What a numpty receptionist though.

[ravenshaw]

What a numpty receptionist though.

But she did so well in her test.



p.s. Excellent news Gibbon!!

[vetran]

oooh the funky gibbon!

congrats.



Most doctors receptionists in my experience are jobsworth idiots.

[Paddy]

Had 6 monthly PSA test this week. Phoned up for results yesterday and receptionist (yes I actually got through!) told me it was 0.1 normal. I said that was not normal for me and does it actually say less than 0.1 i.e. undetectable. She send she couldn't see that and would send me a email in 10-15 mins time.

And then time stopped advancing...... (for those who don't know, when they've removed a prostate then PSA should be undetectable otherwise its cancer)
My Inbox wouldn't refresh, I went for a long walk round the garden got back and 1 min had passed, WTF was I going to do if its come back, usually radiotherapy can work but I've got a new super duper kidney right in the firing line, what a fecking waste. And ten thousand aeons eventually passed and I had aged appropriately when the email dropped! with a big fat super delicious jumping for joy






























<0.1

Now that is success!!

I can sympathise with that. Just a couple of related facts.

There is a relatively new treatment for prostrate issues being green laser. The procedure takes an average of 60 to 90 minutes under general anaesthetic. A thin laser fibre is positioned within the laserscope and is passed up through the urethra to deliver the treatment. You still get to keep your prostrate but you need to stop wanking for a few hours afterwards.

PSA is not a reliable way to detect cancer, it is only one factor. Too many PSA checks can lead to crying wolf. For some reason in the UK they don't do PSA in conjunction with hi res CTC scans.

[vetran]

I can sympathise with that. Just a couple of related facts.

There is a relatively new treatment for prostrate issues being green laser. The procedure takes an average of 60 to 90 minutes under general anaesthetic. A thin laser fibre is positioned within the laserscope and is passed up through the urethra to deliver the treatment. You still get to keep your prostrate but you need to stop wanking for a few hours afterwards.

PSA is not a reliable way to detect cancer, it is only one factor. Too many PSA checks can lead to crying wolf. For some reason in the UK they don't do PSA in conjunction with hi res CTC scans.

oh great you can wank during?

IANAD but this makes sense

If the PSA test only gives false positives its near perfect for screening, if only 1 in 1000 gets a positive then you only need to do 1 CT scan. 999 fewer CTs saving resources and costs.

It does however give a 15% false negative so for those at high risk could be offered a scan or a more precise test which probably is much more expensive.

https://www.nhs.uk/conditions/prosta...r/psa-testing/

Thing with testing it doesn't have to be 100% accurate to make a massive change. If currently we only test 10% of at risk males for PSA and we can move to testing 80% at risk even if we are only 85% efficient we will massively increase the number of cancers detected. Yes some will be missed because the technology is not perfect but we are in a much better place than we were with more non invasive tests. Or we could just wait until symptoms show and many are inoperable.

[Paddy]

oh great you can wank during?

IANAD but this makes sense

If the PSA test only gives false positives its near perfect for screening, if only 1 in 1000 gets a positive then you only need to do 1 CT scan. 999 fewer CTs saving resources and costs.

It does however give a 15% false negative so for those at high risk could be offered a scan or a more precise test which probably is much more expensive.

https://www.nhs.uk/conditions/prosta...r/psa-testing/

Thing with testing it doesn't have to be 100% accurate to make a massive change. If currently we only test 10% of at risk males for PSA and we can move to testing 80% at risk even if we are only 85% efficient we will massively increase the number of cancers detected. Yes some will be missed because the technology is not perfect but we are in a much better place than we were with more non invasive tests. Or we could just wait until symptoms show and many are inoperable.

It does not work that way. PSA is not an indicator of positive or negative. Any PSA reading over 10 will be followed by a biopsy. For many people a biopsy is a little unconfutable but for me it is agony (I am obviously not gay) therefore, I need to be under sedation (unconscious). Hi res CTC is a better indicator but due to cross-charging and privatisation, there is a higher cost for CTC in the NHS, Other countries go strait for Hi res CTC. The problem with biopsy it just takes random samples and cancer can be missed

[vetran]

It does not work that way. PSA is not an indicator of positive or negative. Any PSA reading over 10 will be followed by a biopsy. For many people a biopsy is a little unconfutable but for me it is agony (I am obviously not gay) therefore, I need to be under sedation (unconscious). Hi res CTC is a better indicator but due to cross-charging and privatisation, there is a higher cost for CTC in the NHS, Other countries go strait for Hi res CTC. The problem with biopsy it just takes random samples and cancer can be missed

Point I was making was that financially PSA screening makes sense even if we miss a few. You can ask about the symptoms at the sae time and catch a few the PSA test misses.

According to the NHS generally a PSA test is a good way to screen. Say we screen 100,000 people with each test costing £5 and 100 tests come back positive the cost to screen 100,000 people was £500,000. I assume treating the cancer in late stages would cost £100k per patient and £10k in early stages if we find a few patients early via the screening we are in profit.

We then have a choice between a biopsy and a CTC scan to sort the false positives, Assuming a CTC costs £500 and an invasive procedure costs £2000 then economically its a better choice for CTC over invasive procedure. If a CTC is more effective its a no brainer.

Now the cross charging is something that the NHS needs to sort out.

just gad your test came back negative!

[Gibbon]

PSA is not a reliable way to detect cancer, it is only one factor. Too many PSA checks can lead to crying wolf. For some reason in the UK they don't do PSA in conjunction with hi res CTC scans.

Just to clarify. If you've had your prostate removed it is a reliable indicator, that is what initially the test was developed for.