Hastings Forum

My knowledge is limited – but here goes, with an emphasis on male prostate cancer:

Cancers may be influenced by several factors:
1. External i.e. smoking or obesity.
2. Internal - Genetic make-up, if your relatives had a certain type of cancer then you may (or not) have a higher chance of developing cancer (or other medical issues) but it's not straightforward as mutations (some of them cancer-causing) are not always passed on directly.

Two common types of cancer (breast and prostate) feed and grow as a result of male and female hormones - Oestrogen and Testosterone, respectively.
There is more than one type of prostate cancer, some are slow-growing whereas others are very aggressive and strike quickly,
Because cancer of the bowel/colon is relatively common and straightforward to test and diagnose prevention schemes are being run using the 'blood in the poo' test to analyse signs of potential cancer.
Prostate cancer is a little more difficult as the 'PSA' test, done by taking a simple blood sample, is a broad-brush approach and not terribly reliable. Low scores being reassuring but high numbers are a cause for greater concern.
The only current, better test, is by the old digital rectal examination (DRE) 'finger in the bottom' performed by the GP (who is generally less experienced and probably dislikes the procedure as much as the patient) or a consultant at hospital who is much more experienced and so can make a more accurate diagnosis.
Different examinations by medics with various experience may result in results that are not always in agreement.
Men do not like going to the GP at the best of times and to have a 'finger in the bottom' test is so invasive and unnatural that it prevents many from seeking help until the cancer or non-cancerous but swollen prostate, presents much more serious symptoms.
As far as I understand the prostate sits below the bladder and has biological connections with the urethra which then passes urine from the bladder to the outside world.
Any problems with passing water (peeing) or flow rate may, or may not, be causes for concern.
Clearly if men experience issues with passing water then they should see their GP and rule out prostate issues of any kind.
Sometimes the prostate is just enlarged with age and needs surgical reduction in order to be able to relieve oneself normally - at full flow rate!
If prostate cancer is eventually diagnosed and according to type and whether it has spread outside the 'capsule' of the prostate, there are then several options, removal of the prostate with the risk of damaging nearby nerves which control the ability to 'perform' or by zapping the cancer with radioactive isotopes over a number of weeks.
If the cancer has spread out beyond the prostate, (by metastasis) typically seeking routes via the bone-marrow, then we are into more difficult waters.

Men are not subject to regular screening for prostate cancer but women have tests for cervical and breast cancers and early detection, as with all cancers, is the key.
We are encouraged to do our bit by not doing anything that may encourage the 'external' cancers, such as those influenced / provoked by smoking, excessive lifestyle etcetera.

I am a prostate cancer survivor. It was detected only because I decided to have a "well man" check-up at the age of sixty that included a PSA blood test. Fortunately, the cancer was in its early stages and was treated successfully.

The treatment that I opted for, and everything that goes with it is prolonged, unpleasant and embarrassing, but I would strongly urge all men from the age of fifty to have regular health checks, especially if there is a family history of prostate cancer. Even though it killed my father many years before my diagnosis, it simply never occurred to me that I might also be a victim.

Get yourselves checked!

Hello Derek,

I don't know where you are now based but from my experience of attending GP surgeries in Hastings I am not aware of the promotion of any 'well man' check-ups' at any NHS Practice I have ever attended.
I do know that NHS GP's commonly use computer-based statistical analysis, after standard questionnaires re- smoking / alcohol consumption and blood-pressure tests in order to pronounce upon risk factor for cardio-vascular 'stroke' events as a priority issue.
GP's or their practice nurses, also use thumb-prick blood samples to gauge blood-sugar levels for diabetes but nothing much beyond that.

I was told by my GP that cancer is not easy to detect generally and without serious evidence and that the 'Star-Trek' idea of using a 'tricorder' instrument to determine such issues is still the stuff of science-fiction.
I know that many private clinics offer costly broad-spectrum tests but the results are often inconclusive and prey upon patient fears.
The NHS do not offer or promote comprehensive testing as a standard measure.

If you know your risk factors from family history then specific testing may reap some rewards but beyond that there are many false-positive alarms, yet private companies are happy to promote a bespoke service and more than willing to make money out of it.

Most GP Centres in Hastings register you to a nominated GP, who cannot be seen unless booked about 3 weeks in advance and several salaried (more junior) GP's who may be available in about a week or 10 days time.
If you want to see a 'locum' on the day you have to book in as an emergency patient at 8:30 a.m. and be available to jump at whatever time-slots they can offer you on the day.

I will certainly ask for a PSA blood test next time I manage to book a visit but I can say little is being done to make the general public aware of this sort of testing, despite the huge numbers of males that go on to develop Prostate cancer in one form or another.
Early detection is key and yet we are failing to prevent many potentially curable medical problems from becoming much more serious, or even deadly, I feel that this is totally unacceptable.

You're correct Richard, there is no "well man" scheme, or project - I used the phrase for want of a better one to describe the check-up that I underwent.

By far the biggest problem is the male attitude of invulnerability. Many men wilfully ignore adverse symptoms in the hope that they will just go away. What is needed is improved healthcare education and a sea-change of attitude.

You are quite right Derek,
My brother died from an aggressive throat cancer, mainly because he repeatedly ignored the symptoms, thinking that they would eventually just go away.
Even when his wife dragged him to see the GP he was kept waiting for months before he could see a consultant. His pain management was inadequate and basically he was neglected in hospital such that his wife took the medics in charge to task and had them apologise formally for inadequate care and change their procedures in future so that others would receive better attention and treatment.
The delays in getting attention and the attitude of some lofty consultants, who often hide behind incomprehensible medical terms and look down on mere mortals, in an arrogant and patrician manner, is sometimes quite alarming.
Having said that, many hospitals are brilliant and 'on-the ball' but others just try to dismiss concerns and play things down.
I had friends in London, where the partner took his wife to a different hospital, where she was admitted as an emergency case, when the first hospital said there was nothing seriously wrong with her and dismissed her as a bumbling time-waster!
The lady had a cancer of the colon and recovered after surgery but only because they had the wit to go to another hospital. (Easier in London but maybe not so in remote rural areas.)

Between male patient resistance to see the GP and incompetent hospital consultants at a particular hospital, you may have a lot of ground to cover at the last minute and so I agree with your comments - it would be better not to sit for too long on a problem but always to seek attention at the earliest possible signs of trouble.

GP's seem to have found a new trick lately, when you go to see them with a problem they tend to say "I don't think it is serious but if it gets suddenly worse then go to A & E and let them deal with it".
That would be a better way of getting admitted without waiting months to see a consultant but you have to know how to 'play' the system...