Latest news with #ProstateCancer
Telegraph
2 days ago
- Health
- Telegraph
The PSA test for prostate cancer – everything you need to know
Prostate cancer is the most common form of cancer among men in England, with cases surging among both men and women by 25 per cent between 2019 and 2023 according to NHS data. It's also the second deadliest form of the disease for men after lung cancer, killing one man every 45 minutes despite being highly curable if caught in time. Yet there is still no formal screening programme for prostate cancer in the UK. In the US, Czech Republic and Lithuania by contrast, screening is offered to men within a certain age bracket via a simple blood test, the PSA test. 'We know that in countries with formal PSA screening programs, the rates of advanced prostate cancer are a lot less,' says Prasanna Sooriakumaran, a professor of urology at the University of Oxford, and a consultant urologist at University College London Hospitals. 'In this country, one in five men with prostate cancer present at an advanced, incurable state whereas in the US, that number is significantly under 10 per cent and that's because of PSA screening.' So what is this test and what does it tell you? What is a PSA test? As David James, the director of Prostate Cancer Research, explains, the PSA test measures the levels of a prostate-specific antigen, a protein made by cells within the prostate. Because cancerous cells can enable PSA to slip more easily out of the prostate and ultimately reach the bloodstream, it can serve as a biological signal for the presence of a tumour. 'High levels don't always mean cancer, but they can be an early warning sign and usually lead to further tests to find out if cancer is present,' says James. 'It's one of the best tools we have right now to help catch prostate cancer early, often before any symptoms appear.' Who can have a PSA blood test? While PSA testing is not routinely available on the NHS, all men aged 50 or over can, in theory, request an appointment with their GP to discuss the possibility of getting a test. Black men over 45 who are at higher risk of prostate cancer because of their ethnicity are strongly recommended to discuss having a PSA test with a doctor, as well as all over-45s with a known family history of the disease. Clément Orczyk, a consultant urological surgeon at University College London Hospitals says that PSA testing is also highly recommended for men who have blood in their urine, problems getting an erection or have begun peeing more than usual, although he urges men not to panic if they are having any of these symptoms. 'Most of the time it's linked to benign prostatic hyperplasia, the normal age-related enlargement of the prostate, not cancer,' he says. What happens during the test? Emma Craske, a specialist nurse for Prostate Cancer UK, explains that the PSA test is taken like any other blood test. While some men are reluctant to come forward for testing because they are worried that it will lead to a digital rectal examination (DRE), she says this is unlikely to happen. Instead, an abnormal reading would lead to an MRI scan being booked at the hospital. 'The MRI scan is far more accurate at identifying abnormalities within the prostate than a DRE,' she says. How do I request a PSA test? Orczyk says that you simply have to book a GP appointment and request one. 'But before asking for a test, it's important to be prepared for the potential consequences of having the test,' he says. 'For example, the fact that you might then need to be referred for further screening, and because the test isn't necessarily specific to cancer, people can be sometimes falsely reassured or falsely alarmed by their results.' Why would I be refused a test? The most obvious reason is because you are not considered eligible, for example under 50 and with no standard risk factors. When such instances happen with men who should be eligible for a test, Sooriakumaran suggests that it may be because the GP is worried about their capability of interpreting a borderline result. 'If the result is grossly abnormal, it's easy for the GP, they send them on to a specialist, and if the result is normal, it's also easy for the GP,' he says. 'But it's that grey area which causes concern.' What can I do if my GP refuses a PSA test? There are an increasing number of high-street providers which offer low cost PSA tests, but Orczyk advises people to steer clear of them, as getting an accurate result requires the use of medically certified laboratories, such as those used by the NHS. Instead, Sooriakumaran recommends pushing back, emphasising your concerns and explaining why you wish to have a test. 'I don't know many GPs these days that would point blank refuse if they were getting pushback,' he says. 'Tell them that specialists would much rather see men who got early curable prostate cancer, then men presenting much later with advanced cancer.' Is there anything I can't do before the test? According to Craske, anal sex and any form of prostate stimulation are out of bounds for a week before the test, while in the 48 hours prior to testing, men should also abstain from vigorous exercise and ejaculation. If you have recently had a urine infection, bladder or prostate surgery, she says it is advised to wait six weeks before having the test. 'You can eat and drink as normal before a PSA test, including alcohol,' says Craske. 'There are a group of medicines used to treat benign enlargement of the prostate that may artificially reduce the PSA level, known as 5-alpha-reductase inhibitors such as finasteride or dutasteride. Patients on these drugs need to have this taken into account when doctors interpret the results.' How long will the results take? Craske says that results usually come back within a week, and can be obtained either via the NHS App or by calling the surgery. She advises asking for the exact figure, even if the result is normal. 'This can be helpful if you choose to have a PSA test in the future, to recognise a trend,' she says. What is a high PSA and what does it mean? Interpreting the PSA test can be complex, according to Sooriakumaran, as the results come with considerable individual variability. There are age-specific reference ranges for PSA because the prostate naturally enlarges and produces more of this protein as we get older. For example, if you are aged between 40-49, a PSA reading of more than 2.5ng/ml may be considered high, while if you are over 70, it would have to be more than 6.5 ng/ml. But exceeding these thresholds does not automatically imply cancer. Craske explains that there can be other factors such as a recent urinary tract infection which elevate your PSA levels, while some men simply have a larger prostate than average, meaning that their 'normal' level is higher than others. Because of this, statistics show that only one in four men that have a high PSA are at risk of having prostate cancer. What is a normal PSA result? Sooriakumaran says this would be a prostate-specific antigen reading which is within the expected range for your age group. So, for example, for men aged 50-59, this would be below 3.5ng/ml. However again, a 'normal' value can differ from one man to another. 'What really matters is how the PSA changes with time,' says Sooriakumaran. 'Because there's no such thing really as a normal PSA or an abnormal PSA. It's all about how it is for your size of prostate.' I have a normal PSA result. When should I check again? Repeat testing tends to be recommended for men who have an increased risk of prostate cancer due to ethnicity or family history. Some healthcare providers, such as Johns Hopkins Medicine in the US, suggest getting PSA testing done every two to four years to see whether there is any change in the trend, but if your values are low and you have no known risk factors, the NHS may not offer repeat tests. 'If the PSA is completely bang normal, or in the low range, the PSA may not be repeated,' says Sooriakumaran. 'But if you have risk factors, it's up to the GP to decide whether they want to repeat the test one or potentially three years later.' I have a high PSA result. What happens next? If you have a family history of the disease, or you are of black or Ashkenazi Jewish ethnicity meaning that you are of heightened risk, or your PSA levels are particularly high, then your GP will have a discussion about referring you to a specialist for further testing. While some urology specialists may suggest a rectal examination, Sooriakumaran says that more expert urologists will not because it is not a very sensitive or accurate test for prostate cancer. Instead the standard NHS pathway, as recommended by Nice guidelines following a high PSA reading, is a referral for an MRI of the prostate. What further tests can I expect? In some cases, a urine test may be offered to rule out infection as a possible cause of raised PSA levels. But the standard procedure is to then book an MRI of the prostate, followed by a prostate biopsy. Biopsy technology has evolved considerably. Some NHS Trusts still carry out a transrectal prostate biopsy, where an ultrasound probe is inserted through the rectum and used to collect tissue samples from the prostate. However Sooriakumaran says that a newer technology, known as a transperineal biopsy – where a thin biopsy needle is inserted through the layer of perineal skin between the testicles and anus – is becoming more common as it is more accurate and carries a lower risk of infection. 'Over the next year or two, there will be fewer and fewer NHS Trusts that do a transrectal biopsy, and more will move to this newer method,' he says. On the NHS, Sooriakumaran says that the standard timeframe for the results to become available is two to four weeks following the procedure. In the private sector, results will be available between three and seven days. I have a high PSA result, but my GP won't refer me for further tests. What can I do? This could be because while your PSA reading may be outside the expected range for your age, it is still considered only slightly abnormal. In such cases, Sooriakumaran says, it may be standard for a GP to repeat the result a few weeks later, before referring you for further testing. If considered borderline, you may be offered a repeat PSA test six months or a year later, to help assess whether such a result is normal for you or not. How accurate is the test? While the PSA test plays an important role in ensuring that more men are put forward for detailed examinations, the test itself is not especially accurate. According to Cancer Research UK, the major issue is so-called 'false positives' with 75 per cent of men with a high PSA value, not actually having prostate cancer. But there are also 'false negatives' with 15 per cent of men with a normal PSA value actually having the disease. 'This is where the value of the test is greatest when there's repeat measurement over time, so you can see if there's been a change,' says Sooriakumaran. What other factors can raise your PSA levels? As well as age and urinary tract infections, there are a range of factors which can increase your PSA levels in the short term, from inflammation of the prostate, or simply because you have recently been cycling or horse riding. In the latter case, the pressure and movement of the pelvic muscles against the prostate leads to increased blood flow and the release of more PSA into the bloodstream. Even ejaculating or having had sex during the past 48 hours can increase your PSA levels. What are the downsides of the test? One of the major risks is that men with a high PSA test reading have then been referred for an invasive biopsy, which can cause an infection, leading to sepsis. In addition, many men have so-called 'clinically insignificant' prostate cancers, which means that they are very unlikely ever to spread, and so do not require treatment. According to Prostate Cancer UK, new technologies such as next generation multiparametric MRI scans, which are becoming more common, can help to prevent unnecessary biopsies. In addition, newer transperineal prostate biopsies are more accurate at separating the problematic from insignificant cancers, and reducing risk of sepsis. What happens if I'm diagnosed with prostate cancer? You will be referred to a specialist oncologist to discuss the next steps. There are many different paths which can be followed, depending on your circumstances and wishes. If the cancer has not spread beyond the prostate, there are various curative options available ranging from surgery and radiotherapy, to minimally invasive treatments such as so-called focal therapy which involves zapping the tumour with high intensity ultrasound or freezing it. Sooriakumaran says that the biopsy will also reveal whether the cancer is aggressive or low risk. For patients in the latter category, your oncologist may recommend surveillance, especially if they have other conditions like heart disease which pose a greater threat to their life, because the risk of the tumour spreading is low. 'If it has gone outside the prostate, they typically will be offered hormone therapy,' he says. 'If it's just outside the prostate, then they will have radiotherapy as well, and occasionally they might have surgery as well, depending upon how much disease there is outside the prostate.' What are the different treatment options if I have prostate cancer? The good news for men who are diagnosed with prostate cancer is that the range of available treatment options is increasingly broad. Sooriakumaran says that patients have a huge amount of say in what treatment they end up getting, with various advantages and disadvantages to each therapy. Here are some of the options: Focal therapy Therapies such as ultrasound and cryotherapy tend to hold the cancer at bay for a few years rather than curing it, but they have far fewer side effects than other treatment options. Surgery This has the advantage of being a one-off procedure, but cutting a tumour out of the prostate does carry the risk of driving erectile dysfunction or urinary incontinence. Radiotherapy This is a better option for preserving erections, but has more side effects on bowel function, while it tends to involve regular hospital visits across the duration of the treatment course. Hormone therapy Newer hormonal therapies such as abiraterone are only offered for people with metastatic disease which has spread beyond the prostate. They have made a major difference when it comes to slowing down cancer progression and enabling people to live with incurable prostate cancer for much longer, but carry side effects such as hot flushes, reduced libido, weight gain and fatigue. 'It's often up to the patient to decide because some men would rather preserve their erections at all costs, and therefore may not want surgery, while some men don't want to have to come to hospital every day for six weeks,' says Sooriakumaran. 'So it's very much a personal choice, once the specialist has gone through the treatment options.
Yahoo
3 days ago
- Health
- Yahoo
‘Too many men are dying from prostate cancer needlessly – earlier detection can save lives'
David James is director of patient projects and influencing at Prostate Cancer Research, a leading British charity advancing prostate cancer treatment Prostate cancer is the most common cancer currently affecting men in the UK. Last year, more than 55,000 men were diagnosed in England (where we have the most recent data). It's also the second most common cause of death by cancer, with more than 12,000 men in the UK dying from the disease every year. Sadly, projections suggest this figure will only increase during the next 15 years. My motivation for getting involved in this area is actually three-fold. At a very young age, my mother died of brain cancer. I saw the impact of that being caught late and the implications for my life and our family's life. I have an uncle who developed prostate cancer (he's fine now) and also my father was recently diagnosed, quite early, so it's being monitored. Currently, we have the Informed Choice system, which, technically, is the Prostate Cancer Risk Management Programme. What that means is, if you have no symptoms, but are over the age of 50, you can request a PSA blood test from your GP (this measures a substance that occurs naturally in the prostate – a high score can be an indicator of cancer but can also be unrelated). Younger men should be able request a test if they are in a high-risk category, too. You are supposed to be given the test once you have been counselled about the pros and cons. The problem with this approach is really the guidance, which is pretty poorly understood both by members of the public and clinicians. The guidance leads to huge inequalities in the system. There are examples of men being turned away time and time again, sometimes men with cancer that could have been caught early. Why are men not getting tested? I was speaking to a man in his late 40s the other day. His name is Mark, he has three kids and has been diagnosed at an advanced stage. He'd been trying to get a test and was turned away. This is because of the confusion around these guidelines. Although he was under 50, he was in a high-risk group because he has a family history of the disease. If members of your family have had prostate cancer, you are high risk. If you are black you are about twice as likely to have the illness. There are also certain gene mutations that increase risk. We have polled GPs, and many don't know about the higher-risk categories, so there is an inconsistency in the way the guidelines are being implemented. Doctors are supposed to counsel patients about potential harms and benefits of different treatments and the limitations of the PSA blood test. Like any other health problem, it should be up to the individual to make an informed choice – that's what the system is designed for. But a GP may not be up to date with the latest diagnostic and treatment techniques or have some historical objection to screening. If a man has plucked up the courage to ask his GP for a test and is told to go away, that undermines their attempts to be proactive about their health. Prostate cancer in its early stages is usually symptomless. If we don't want to see people dying from late-stage disease, the key is to catch it before symptoms appear. People who are more affluent and health-educated will actively seek out the test and be persistent until they get it because they know their rights (or they have already tested positive privately). Men from areas of socio-economic deprivation are 29 per cent more likely to be diagnosed with late-stage, incurable prostate cancer. Being invited for a test as part of a screening programme is quite different to going along and asking for one yourself. We've spoken to a lot of people. I think receiving an official letter from the NHS, or your doctor saying this is a risk we want to keep an eye on will make you feel emboldened to go. Having something official drop through your letterbox takes away the fear of needlessly troubling a busy GP, for example. Since 2019, UK guidance has been that if a patient has a raised PSA level, then he should go for an MRI scan. And that MRI scan has been a massive game changer, because the MRI is really good at filtering out people who don't have the illness. This avoids sending patients for unnecessary biopsies. No test is perfect, though. No test is accurate at picking up everyone who has the disease, but it is certainly better than not doing anything and we think the evidence shows significant reduction in harm and the benefits of screening. Next-generation testing There has been a fear of over-treatment as screening exposes people with low-risk cancers. We now see that more than 90 per cent of those people are going onto active surveillance, where they are being given a follow-up PSA and MRI every six to 12 months. If you have a slow-growing cancer, you could well live out your life healthily with no problematic symptoms and die in your sleep of old age. But if it does start to grow and become problematic, then you're in the system. We can catch it early and treat it before it spreads and becomes incurable. Our research showed that screening people in high-risk groups is cost-effective. Treating advanced cancer is 10 times more costly than treating it at stage one. We're calling for a targeted prostate cancer screening programme for high-risk groups. The NHS cost of a PSA test is around £33, so we could implement this fairly quickly and start catching prostate cancer earlier in these groups – then, for the general population of men over 50, let's invest in some real-world evidence gathering. We should carry out pilots on the next generation of tests. When we're confident the new tests are effective, we can roll out universal testing to all men over 50. Too many men are dying from a disease needlessly when we know that testing and earlier detection can save lives. The NHS is working with the target of catching 75 per cent of all cancers early. At the moment, only about half of prostate cancers are diagnosed at stages one and two. So, if the NHS is to meet its target, given how significant prostate cancer is, that target is going to be impossible to reach unless we break the back of late diagnosis. The decision is being reviewed by the Government's screening committee right now and they are due to report back this year. This is something that's also being looked at in Europe and the US. The world is watching us right now. I'm really hopeful the UK can be a leader. As told to Phil Hilton Broaden your horizons with award-winning British journalism. 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CTV News
21-07-2025
- Automotive
- CTV News
Sask. motorcyclists raise $31,000 in support of Regina's Prostate Assessment Centre
Trevor Davis, (Left) and Darryl Haas (Right), the treasurer and director of the Regina Hog Chapter #9252. A recent fundraiser by the group has contributed $31,000 to Regina's Prostate Assessment Centre. (Sierra D'Souza Butts/CTV News) Despite the rainy weather impeding a planned rally, local motorcyclists have raised over $31,000 for the Hospitals of Regina Foundation – going towards the city's Prostate Assessment Centre. 'This started a number of years ago by a group of guys that have had prostate cancer. It's been in their family,' explained Darryl Haas, director of Regina Hog Chapter #9252. 'The assessment centre used to be in a storage room in one of the hospitals, and it was downstairs in the basement, kind of dungy and they said, 'You know what? This has to change.' That's where this ride came from.' On Sunday, riders came out to Prairie Harley-Davidson in support of raising money and spreading awareness of prostate cancer. Although the day was supposed to begin with a motorcycle ride, along with a live band and barbecue in Indian Head, Haas said the group had to cancel due to the rainy weather. 'We still came out to Prairie Harley-Davidson. We had our pancake breakfast, we had about 70 people show up this year which is fantastic without a ride,' he shared. 'All of the money that's raised today through a raffle draws or 50/50 is our donations or registrations goes towards the Prostate Assessment Center here in Regina.' Trevor Davis, the treasurer of Regina Hog Chapter #9252, said having the support of the community is the reason it's been going strong for years. 'The community has been great. We've raised in excess of $25,000 already, not including what's going on here today,' Davis said. 'The community has really gotten out and been part of that. That's made us extremely happy and will give us food for thought for next year.' Regardless of weather conditions come Sept. 14, Davis said it will be hosting a motorcycle ride to raise money for breast cancer. 'The fact that both the breast cancer ride and the prostate ride, we're very proud to be part of it because it's solely kept here in Regina and southern Saskatchewan,' he said. 'There's no overhead that's charged from it. Every donation that comes in goes to both of the assessment processes. That makes us really happy and the support from Prairie Harley-Davidson.' Organizers added that everyone is welcome to attend – no matter what type of motorcycle you ride.
Yahoo
02-07-2025
- Health
- Yahoo
Hospital staff and patients raise prostate cancer funds with walk
Sponsored walks have raised £190 for Prostate Cancer UK. Staff and patients from Cygnet Hospital Wyke and Cygnet Hospital Bierley took part in the March for Men event to raise awareness of prostate cancer. Cygnet Hospital Wyke is a 31-bed acute and PICU service for men, while Cygnet Hospital Bierley is a 62-bed acute and low secure hospital. Gavin Clark, hospital manager at Cygnet Hospital Wyke, said: "We are really proud to have raised money for Prostate Cancer UK as it is such an important charity. "Prostate cancer is the most common cancer in men, so all donations to this amazing charity really make a difference. "Everyone at Cygnet Health Care really cares for each other, and we wanted to do something that could help improve the lives of others too. "We are lucky that our registered general nurse and physical health lead, Olan Idowu, was able to arrange a great collaborative fundraiser for a worthy cause." Patients at Cygnet Hospital Wyke decorated t-shirts for their two-mile walk. Participants from Cygnet Hospital Bierley, also donning customised t-shirts, completed a three-mile route. Prostate Cancer UK funds research and campaigns against injustice in care.
Yahoo
17-06-2025
- Entertainment
- Yahoo
Joe Biden Surprises ‘Reacher' Star Alan Ritchson on Set, Actor Says Meet-Up Was ‘A Privilege and Honor'
Former President Joe Biden and his son Hunter paid a surprise visit Monday morning to the 'Reacher' Season 4 set in Philadelphia. Jack Reacher himself, actor Alan Ritchson, posted Tuesday on Instagram about the Bidens' visit, calling it a 'a privilege and honor to meet the Biden family.' Accompanying videos and photos of him with the Biden men, the 'Reacher' star wrote, 'So our 'Reacher' set got in the way of these legends.' He went on to have nothing but good things to say about the former U.S. president and his son. 'They couldn't have been more lovely. Kind, joyful, gracious and present,' Ritchson captioned his Instagram post. 'We chatted briefly about simple stuff, like string theory and quantum entanglement. Then Joe beat me at arm wrestling. All in a day's work.' According to an eyewitness who spoke to CBS Philadelphia Monday, Biden just so happened to be in the same area in Philadelphia at the same time as the 'Reacher' cast and crew. The eyewitness said that the 'Reacher' team was filming a police chase when several black SUVs suddenly pulled up. 'Out walked these men, that I thought they were actors, but then the entire cast and crew started clapping and cheering,' the eyewitness said of Biden's 'Reacher' set entrance. Former President Biden's surprising, real-life 'Reacher' crossover moment came less than a month after it was announced that he had been diagnosed with an aggressive form of prostate cancer. In late May, CNN anchor Jake Tapper also published 'Original Sin,' his book detailing the behind-the-scenes efforts that were made to cover up Biden's cognitive decline while he was still in office. Ritchson's comments, meanwhile, do not mark the first time the 'Reacher' star has dipped his toes into political waters. In February, Ritchson also blasted Matt Gaetz, the former Florida congressman who has been accused of child sex trafficking and statutory rape and who withdrew his nomination to serve as U.S. attorney general during Donald Trump's second presidential term. Gaetz was once a classmate of Ritchson's, and the actor called him a 'motherf—ker' and told GQ of his former schoolmate, 'We are adversaries.' Amazon's Prime Video has not yet announced a premiere date for 'Reacher' Season 4. The series' third season concluded its eight-episode run in late March. The post Joe Biden Surprises 'Reacher' Star Alan Ritchson on Set, Actor Says Meet-Up Was 'A Privilege and Honor' appeared first on TheWrap.
