Back in December I told you how my PSA had gone up. From a low of 0.2 last May it had crept up to 0.3 in August and then leapt to 3.2 in December. The question was, was this leap a blip or a trend? It wasn’t yet at a level to require additional intervention but was a bit concerning, especially if it were followed by a further similar increase.
So it did give pause for thought and reflection on ones own mortality although, as Holly Butcher put it ‘I like the fact that we are mostly ignorant to its inevitability.’ Even so you see comments like such and such drug extends life by an average of 5 months. Months! I would want it to extend life by 5 years. Talking to the daughter of another prostate cancer sufferer the other day she referred to it as being terminal. I prefer to think in terms of what a friend was told about his illness (I am not sure what it was, but it could well have been pc) when he was told “You won’t die of it, you will die with it“. Something that is born out by the numbers – more than four times as many men are diagnosed as die from prostate cancer. However it could be better.
Over the past few days there has been quite a bit in the press about the fact that deaths from prostate cancer have overtaken deaths from breast cancer and about the funding imbalance between prostate cancer and breast cancer. Of course it is more complex a picture than the one painted by the newspaper headlines. As Prostate Cancer UK says “Despite the alarming figures, the prospects for men with prostate cancer are actually better than ever, with men diagnosed today two-and-a-half times more likely to live for 10 years or more than if they were diagnosed in 1990. Yet due mainly to an increasing and ageing population, the number of men dying from the disease is growing.” One of the problems is that prostate cancer is more difficult to diagnose and in particular, unlike breast (or testicular) cancer, men can’t check for lumps that indicate a potential problem.
And following years of fundraising and the associated publicity there is far more awareness of breast cancer. How many men know where their prostate is – and what it does, let alone how to identify a problem?
If there were the prostate equivalent of a mammogram it could then provide the basis of a screening programme to equal the national breast screening programme where women between 50 and 70 are invited for breast screening every three years. That there is no equivalent for men and their prostates is down to there not being a reliable and simple test. So the challenge is to develop an affordable and reliable test that can then be included in regular screening (and then to get men to be screened). That would then lead on to earlier diagnosis and more effective treatment. A national screening programme would also raise awareness of the issue.
Back when I was working my company paid for me to have a regular check up which included a PSA test (which showed it bumbling along at a relatively low level). Had this continued after I retired the increase that indicated that I had a problem might have been picked up earlier. However it is not something that is normally done outside paid for medical check ups unless some other symptoms have been picked up; and even if it was, as I noted in Hang on, let’s just step back a bit. , a raised PSA doesn’t prove anything by itself other that shouting “have more tests – there may be a problem”. While the PSA test itself is not expensive (you can get a PSA test kit from Amazon for £10!) the follow up tests are more so. Something better and more reliable is needed.
Anyway I saw my oncologist last week and got the results of my latest blood test . My PSA was 0.54 which was way down from December’s 3.2 (although a small increase on August’s 0.36).
Whatever the trend in my PSA readings is, either the December figure or the January one was an inexplicable blip – arguably we need a few more figures to determine which result was departing from the trend, but with no other indicators of other problems we are taking it that the December figure is the blip and that I am comfortably under the level that would require further intervention. Why it had happened was a complete mystery. So, “onwards and upwards“, as they say; although in the case of the PSA hopefully as little upwards as possible.