How dependable are blood assessments for prostate most cancers? Ask the GP Dr Martin Scurr

Concerned about my frequent visits to the john, a GP gave me a PSA blood check. This was regular for my age of 73 (1.4) however an examination discovered a small, arduous lump and an MRI scan recognized prostate most cancers. How dependable are PSA assessments?

David Fisher, Nottinghamshire.

Prostate most cancers is the most typical most cancers in males — one in eight might be recognized with it. There have been requires males to be screened for the illness from center age, primarily utilizing the prostate particular antigen (PSA) blood check, which you had.

PSA is a protein made by the prostate, the walnut-sized gland situated beneath the bladder, and the quantity shed into the blood can provide docs an thought of how wholesome it’s. However, this check is much from excellent as PSA ranges may be raised by a spread of things, together with train, sexual exercise, an enlarged prostate, constipation and an infection — in addition to most cancers.

Prostate most cancers is the most typical most cancers in males — one in eight might be recognized with it. [File image] 

As you found, it’s additionally attainable to have a false destructive outcome — the place the check suggests there isn’t any most cancers, when there’s. This is why bodily examination is important.

In your case, the most cancers was detected since you’d had urinary tract signs that your physician fairly rightly wished to research additional.

However, a DRE (digital rectal examination) can solely detect tumours in the back and front of the prostate — and 25 per cent of tumours happen elsewhere within the gland.

As far as screening goes, probably the most dependable choice is magnetic resonance imaging (MRI), as a result of it lets you see into the gland. But one situation is its restricted availability on the NHS.

Separately, researchers are assessments to detect DNA fragments of most cancers within the bloodstream. My recommendation when you’ve got signs or are 50 or over and determine you need to have your PSA ranges examined, see your GP.

There have been requires males to be screened for the illness from center age, primarily utilizing the prostate particular antigen (PSA) blood check. [File image] 

The finest coverage is that solely these at greater danger are screened: this consists of males with a first-degree relative (i.e. a father or brother) who’s been recognized with prostate most cancers beneath the age of 65, and black males (who, for ill-understood causes, are at greater danger).

I hope that your most cancers is confined to the prostate, as is the case for no less than 78 per cent of sufferers on the time of analysis.

If that is the case, the probably therapy is an operation to take away the gland. I want you a speedy and clean restoration.

Is a day by day calcium complement a good suggestion following a analysis of osteopenia?

Liz Landau, South London.

This is an efficient query as there’s a lot confusion concerning the time period osteopenia (versus osteoporosis), and much more about whether or not calcium dietary supplements are advisable.

Osteopenia refers back to the lack of bone mineral — primarily calcium — that we should all count on as years move. It is a traditional a part of the ageing course of, attributable to the physique reabsorbing calcium quite than it staying in bones the place it retains them robust.

There is way confusion concerning the time period osteopenia (versus osteoporosis), and much more about whether or not calcium dietary supplements are advisable, writes Dr Martin Scurr 

It isn’t a medical analysis as such however quite a warning signal that your bone density is falling. This can progress to osteoporosis, the place bone mineral density turns into decrease than anticipated for somebody of your age, rising the chance of fractures.

Risk elements embrace being feminine (because of the drop in oestrogen throughout menopause)in addition to age, physique dimension, household historical past and drugs akin to glucocorticoids. A food plan poor in calcium and vitamin D is one other issue.

A day by day calcium complement can assist, significantly if it’s taken alongside a vitamin D complement as this promotes the absorption of calcium. The suggestion is 1,000 mg of calcium and 600 IU of vitamin D.

There is powerful proof these dietary supplements decrease bone turnover by a fifth — a robust mechanism to restrict progress from osteopenia in the direction of osteoporosis.

However, research have proven taking calcium dietary supplements long run might enhance the chance of coronary heart illness in some individuals. Therefore it’s a choice to be taken after a session along with your GP.

Eating a food plan wealthy in calcium-containing meals — milk, cheese and inexperienced leafy veg — doesn’t have this destructive impact, so must be a precedence for you within the meantime.

In my view … Patients must be prioritised over pay

Each time I’m going grocery purchasing I discover myself querying if I’ve learn the costs accurately. They appear to rise weekly.

The price of dwelling is costlier than it was; there may be little doubt about that. So on the one hand I perceive why junior docs wish to enhance their wages — the premise of their ongoing industrial motion.

A health care provider beginning their basis coaching might be on round £29,384 — not significantly nicely paid. However, in contrast to different jobs the probabilities of development and a pay rise are assured. [File image] 

A health care provider beginning their basis coaching might be on round £29,384 — not significantly nicely paid. However, in contrast to different jobs the probabilities of development and a pay rise are assured. While I settle for that their pay has not risen according to inflation, I’ve considerations that individuals who prepare as docs are ready to launch day after day of strikes, which up to now have led to 196,000 cancelled appointments for sufferers.

Recommended studying for anybody aspiring to be a physician has all the time been the work of William Osler, who turned a professor of drugs on the University of Oxford. One of his mottos was ‘Do the sort factor and do it first’. Indeed.

Write  to Dr Scurr 

Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London W8 5HY or e-mail: [email protected] — embrace contact particulars. Dr Scurr can’t enter into private correspondence. Replies must be taken in a common context. Consult your individual GP with any well being worries.