Health Chat

Kiran Bhagat | Monday July 6, 2009 00:00

PSA testing and screening: The PSA test

Most men had PSA tests, either to help with diagnosis, or to monitor the impact of treatment. Most men were tested when they consulted their doctors with urinary symptoms. However, two men were tested because they were taking part in treatment or screening trials and one man had a PSA test as part of a health scheme at work.
Men knew little about the prostate before they consulted their doctors, and very few men were given information about the PSA test, or the implications of an abnormal PSA result, before the test took place. However, some doctors did warn men that the PSA test was unreliable.

Most men seemed glad that they had had a PSA test, and many thought that all men over 50 should be tested. Also, some men described how repeated tests could demonstrate the beneficial effects of treatment. One man was glad that regular PSA testing could monitor the situation, even though cancer had not been confirmed. However, two men were sorry that they had had PSA tests, and they regretted the anxiety caused by the abnormal PSA test result. One of these men did not have cancer diagnosed when he had a biopsy.

Signs and symptoms of prostate cancer
Over three-quarters of the men we interviewed consulted their doctors because of signs or symptoms, although a few men were diagnosed as the result of routine PSA tests. Before the diagnosis was made most men reported difficulty in passing urine, urgency, and passing urine more frequently than usual, particularly at night.Some men gave detailed descriptions of their symptoms. In some cases symptoms were quite mild while in other cases symptoms were much more severe.

Some men argued that they had not been given adequate information, and that health care professionals had failed to explain the treatment options. One man, who had had a radical prostatectomy, wished he had considered other possible options and side effects more carefully, and another man wished that his doctor had discussed self-help, alternative medicine and psychological aspects of care as well as physical treatments.

Complementary approaches
Men had used various complementary approaches - changing the diet, taking vitamin and mineral supplements, massage and relaxation therapies, and using herbal or Chinese medicines. Dietary changes that men reported since being diagnosed included eating less meat and dairy produce, drinking green tea, eating more fruit and vegetables, especially tomatoes and, in one case, consuming quantities of pumpkin seeds.

Media reports had encouraged men to try dietary change and to take supplements including selenium, Saw Palmetto and anti-oxidant vitamins. Some men made great efforts to research the evidence behind recommendations before using any complementary approaches. Aromatherapy, reflexology and reiki were all described as helping relaxation, others thought they had benefited from prayer, meditation and yoga.

Living with it

The initial diagnosis of prostate cancer was a devastating shock to most men. However, after the initial shock and emotional trauma, many men were able to lead fairly normal lives. Men were often able to continue working while they had their treatment, though some had to give up work when symptoms got worse, or because of stressful occupations.

Some men described continuing to enjoy many of their activities, including sports and travel. However, this was not always possible.

The diagnosis of prostate cancer made men more aware of their own mortality.
Some felt that it was important for their physical and mental welfare to try to continue as normal, while other men had reappraised their lives and decided to focus on quite different priorities.

The importance of staying active and living each day to the full was mentioned by many, even if previous activities could not be maintained because more rest was needed, or if symptoms were disruptive.
prof@cardiacclinic.co.bw