Sir Chris Hoy reveals cancer diagnosis is terminal and he has two to four years to live: “I’m feeling fit, strong and positive, and overwhelmed by all the love and support shown”

Pub bike wrote:

The fly in the ointment here is that the PSA test is only freely available on the NHS for people over 50 if there is no family history, and even then only on request.  Maybe NICE will revisit this in light of Mr Hoy's case.

In other words, "Sure but we can get you an appointment - how does 15 March 2030 sound?"

Don't wait for your GP or the NHS to catch up with you. For PSA testing for those chaps of a certain age sign up here - https://pcaso.mypsatests.org.uk/

National version of the website here: https://chaps.mypsatests.org.uk/

SimoninSpalding wrote:

National version of the website here: https://chaps.mypsatests.org.uk/

The problem with many of these psa testing companies is that they provide a simple 'elevated/non-elevated' indication which means nothing. None of the test I have done has provided and actual value that I could compare to the previous year or refer to my GP (If I could actually get an appointment).

If youre over 50 you are entitled to get a PSA test from your GP but that wont stop him/her refusing to arrange it.

Prostrate cancer in the UK is not being taken seriously. I walk past cancer charity collections because all they seem to do is provide a shoulder when it's too late. I've been watching annual awareness days for 50 years and nothing has changed.  There are ways to screen for prostrate cancer and we should have a screening programme but the NHS wont pay for it.

There are ways to screen for prostate cancer and we should have a screening programme

The problem is that, in lower prevalence segments of the UK population, these 'ways' are not very good and will likely result in more 'ill-health', not less. That's why we don't have a screening programme- not because the NHS is unwilling to pay a reasonable amount for one.

bikeman01 wrote:

The problem with many of these psa testing companies is that they provide a simple 'elevated/non-elevated' indication which means nothing. None of the test I have done has provided and actual value that I could compare to the previous year or refer to my GP (If I could actually get an appointment).

If youre over 50 you are entitled to get a PSA test from your GP but that wont stop him/her refusing to arrange it.

Prostrate cancer in the UK is not being taken seriously. I walk past cancer charity collections because all they seem to do is provide a shoulder when it's too late. I've been watching annual awareness days for 50 years and nothing has changed.  There are ways to screen for prostrate cancer and we should have a screening programme but the NHS wont pay for it.

There's issues around PSA tests and it's likely not beneficial population-wise to have screening.

High PSA scores can be for a number of reasons, so there would be a LOT of false positives. Patients receiving a false positive may then go on to have other procedures to further investigate and that can cause significant stress and possibly other complications. It's also entirely possible to have cancers that are so slow growing that they're better off being ignored than being treated.

jaymack wrote:

Don't wait for your GP or the NHS to catch up with you. For PSA testing for those chaps of a certain age sign up here - https://pcaso.mypsatests.org.uk/

Thanks for the link, although my understanding was that PSA tests in isolation (without the finger) are of less value due to the possibility of false positives, particularly amongst regular cyclists. I'll happily be corrected if not the case.

True, despite the wonders of modern medical science "the finger" remains a crucial diagnostic tool. However, my understanding is that once you've got a baseline PSA reading the professionals have something to guage changes against. 

The lesson from all of this is if you are male and over 40, have a regular PSA test

Or, alternatively says a Caucasian male over 72 with no family history, don't. There's a reason (several reasons) why there is no national prostate cancer screening programme (and it's not because 'they' don't want to spend the money) when there are very good NHS screening programmes for, say, bowel cancer. This is not to say, of course, that there are no tests under investigation right now which could result in an NHS Prostate Cancer Screening Programme in the future. The intrinsic fault here is the assumption that any test is better than no test.

Yes most organisations recommend against PSA testing over the age of 70.  There's an explanation of the pros and cons of testing here.

I'm afraid I will have to disagree with you in regards to bowel cancer screening. As with most NHS trusts it's a bit of a postcode lottery. NHS Scotland has the best standard by starting the screening at 50 but considering our current lifestyles Bowel cancer uk thinks we should start at 45 or earlier. Most of NHS England the screening starts at 60 but there is talks of it aligning with Scotland. Some trusts in England have started at 55. I got mine the other day as I turned 60 if I had waited for it I would probably be dead now or have Stage 4. As it is I went with the symptoms and even then it took 22 months going backwards and forwards to my gp until I got diagnosed with stage 3 bowel cancer at age 56. 

wtjs wrote:

The intrinsic fault here is the assumption that any test is better than no test.

One test result on its own isn't so useful, but a series of tests over time starts to be useful.  Personally I'd rather have this data than not.

It's very sad news for Chris Hoy and his family, and his public pronouncement was wonderful in its way. But using his case to call for a PSA screening programme is plain wrong. We have a National Screening Committee which looks in very great detail at the case for and against, because screening programmes cause harm as well as good, which few lay people seem to appreciate. The NSC has consistently decided not to recommend PSA based screening at population level. The harms of such a programme would exceed the benefits.
It's also why all these private companies that offer "screening" and testing services should be better regulated. In particular they should have to fund any follow up testing required to confirm or otherwise the results. At the moment many just send the patient to their NHS GP for follow up, adding to demand, most of which is being created unnecessarily. Make them include follow up in the testing fee, by insurance if necessary.