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G4EBT > PARITY 08.10.05 23:56l 174 Lines 6828 Bytes #999 (0) @ WW
BID : E90855G4EBT
Read: GUEST
Subj: Re: Cancer m & f.
Path: DB0FHN<DB0RGB<OK0PPL<DB0RES<DK0WUE<GB7FCR
Sent: 051008/2154Z @:GB7FCR.#16.GBR.EU #:5695 [Blackpool] FBB-7.03a $:E90855G4E
From: G4EBT@GB7FCR.#16.GBR.EU
To : PARITY@WW
Ian, G0TEZ wrote:-
> I don't know just what the rate of incidence of testicular and prostate
> cancer is but I believe it is extremely common.
27,000 cases a year are diagnosed in the UK, mostly in men over 70. This
is a fifth of all new male cancer cases. 10,000 deaths a year ensue, but
five-yr survival rates are high - typically over 85%.
> It is not taken seriously by our National Health Service even though it
> is almost 100% fatal.
Life's a fatal disease - we all die of something. Indeed, most men over 70
die *with* prostate cancer in its early stages, but don't die *from* it.
The NHS does take it seriously, but in contrast to breast and cervical
cancer screening for women, doesn't advocate routine testing for prostate
cancer.
That isn't due to cost pressures or placing less value on men's lives
compared to women, but due to the fact that the standard test - a blood
test to check for the presence of PSA - prostate specific antigen, is
far from 100% reliable.
On the one hand the PSA test can give false positives, resulting in
needless anxiety and unnecessary biopsies, but on the other hand can
give false negatives. For every 100 men with raised PSA levels, only
a third will have cancer cells developing.
> I have had the embarrassing experience of the rubber glove and, like
> most men, I don't go back once a year as I should.
And therein lies the problem!
Men are notoriously reluctant to seek medical help or even discuss
their health worries and symptoms with loved ones, let alone a doctor.
That's especially so when it comes to ignoring symptoms which many be
benign, but which may in fact be sinister.
The logic of expressing concerns about unequal treatment of men and women
yet not going to your doctor eludes me. If you do go to your doctor about
prostate problems and he's concerned, he'll refer you to a urologist
within weeks.
> Naturally, I feel unhappy that men don't get treated.
But they do!
There are two aspects to this:
1) Diagnosis.
2) Treatment.
Neither are as straightforward as, for cervical or breast cancer in women
and it's inappropriate to contrast the diagnosis of male and female
problems.
Even if prostate cancer is confirmed by a biopsy, there are several
options, especially if it's slow growing, as is often the case, when
the favoured option is "watchful waiting", where doctors monitor and
give no active treatment.
That way you can get on any enjoy the rest of your life, and will most
likely die from something else such as a heart attack or stroke, which
I must say is a better outcome than going steadily ga-ga on packet -
symptoms that some of us so manifestly display.
Other options (for prostate cancer that is - not for going ga-ga on
packet), such as surgery or radiotherapy, are quite drastic and have
unfortunate side effects. The condition can take many years to develop,
and men often don't need to make quick decisions about which treatment
option to choose.
Many men end up regretting the option they choose, and doctors often feel
pressed into recommending the most radical treatment. The most natural
reaction is one of panic, evoking a desire to "have the best man on the
case right away" but in fact many men could take a less drastic approach
with fewer life-changing side effects, such as impotence or urinary
incontinence.
You can't just "whip it out" like a dodgy tooth.
In addition to "watchful waiting", men can choose to keep their cancer
under control using hormone treatment.
Each treatment has different benefits and potential side effects, so
what's right for each man depends on factors such as how aggressive the
cancer is, how old the patient is, and what's important to him.
Prof Roger Kirby, head of urology at St George's Hospital, London has been
involved in developing a "Vitality Index" - a questionnaire which ranks
side effects and assesses a patient's willingness and ability to cope with
them.
> I don't know what happens in the rest of Europe, especially Italy.
> The European health services range from free to subsidised to varying
> degrees.
Others may answer that, but you might like to know that the University of
Sunderland Pharmacy School and Sunderland City Hospitals NHS Trust has
developed a urine test could be more accurate and faster. The researchers
are planning to expand their clinical trials to confirm the accuracy of
the test.
The urine test - which is being developed for GPs, measures the levels of
a biological marker, which the team believes gives an indication of the
likelihood of the cancer developing.
> If anyone from any of the other European countries, especially Sweden,
> can let us know if the prostate detector is in use in their country, I
> would be interested to find out - seriously. It would be a great help
> to know which country to go on holiday to and book a private
> appointment.
You might find it reassuring to know that deaths per 100,000 population
from all cancers the UK is the lowest of 16 countries:
Rank Country Deaths/100,0000 pop'n
1 Netherlands 433.0
2 Italy 418.0
8 NZ 327.3
9 USA 321.9
10 OZ 298.9
12 France 286.1
14 Sweden 268.2
16 UK 253.3
There are many reasons for these variances - lifestyle, (obesity, smoking
drinking) genetic, racial background etc. (The prostate cancer rate for
black Americans for example is 180.6 per 100,000 - more than seven times
that among Koreans - 24.2).
Indeed, blacks in the U.S. have the highest rates of prostate cancer in
the world. Hence, it shouldn't be inferred that better diagnosis or
treatment is the only significant factor.
Source:
http://www.nationmaster.com/graph-T/hea_dea_fro_can
>In the UK we had the new Viagra refused in 1998 because the person in
>charge of prescribing, a Ms Connelly thought it was only a "recreational"
>drug.
One of the problems with the NHS is that it is often called upon to treat
"conditions" rather than life-threatening ailments which was its original
mission.
Impotence and infertility are two such conditions - both immensely
distressing, but at the inception of the NHS in 1948, would not have
been seen as a core objective.
Neither viagra nor IVF were available back then - any more than were heart
bypass operations and many other surgical procedures, but the latter is
more in keeping with the core NHS objectives.
That's a separate debate of course.
Hope that's of interest.
73 - David, G4EBT @ GB7FCR
QTH: Cottingham, East Yorkshire.
Message timed: 22:53 on 2005-Oct-08
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