In one of the early Corner Gas episodes, Brent’s parents pressure him to go to the doctor. He doesn’t wan’t to, because he knows he’s due for a prostate exam. Eventually he goes.
That night, in the bar, he’s still grumbling about it, and Paul the barkeep says, “So did he…?” And Brent replies, “Yep, like he was going after the last pickle in the jar!”
Then he looks over and sees another patron, about to crunch into a big dill pickle, who has obviously been put off by the image he got from the conversation, and mutters, “Sorry.”.
All of which is a long intro to the fact that this is Prostate Cancer Awareness Week (in Canada, at any rate). Prostate cancer is the third most common cause of cancer death for Canadian men, but like all cancers, the earlier it is detected, the better the survival rate.
So guys, if you’re over 40, go get that pickle checked out!
Brent Butt and Red Green will both be rooting for you! (Sorry - another disturbing image. :eek: )
And yes, I’ve taken my own advice. I’m fine, thanks.
Now, if you’ve got a significant family history of prostate cancer, or are a member of an ethnic group with a higher risk for prostate cancer, there is solid evidence that screening helps. But at this time, the evidence is not yet solid to recommend screening on low-risk asymptomatic men just because they turn a certain age.
Perhaps soon we’ll see more data which will make for more firm recommendations one way or the other.
I keep hearing and reading about this, Dr. **Qadgop **, but my question is, “What’s the harm?” To me, regardless of the risk factor, if anybody feels it would be wise to check it out, they should.
[From a 5.5-year prostate cancer survivor who is glad he went. who does, however, admit he is well over 40!.]
A lot of people take the view that you are better off getting whatever test at a younger age, since if you detect whatever sooner, you can treat it and you’re better off.
But it’s more complicated than that – even if talking about mammograms in 39 year old women, business executives paying for full body CT scans in case there is a cancer somewhere, or getting a prostate exam or PSA test, or doing a self breast exam.
There a several reasons why. The intervention may not be good enough to reliably detect disease; there may not be proof early intervention is helpful; the test may detect benign things, lead to unneeded treatment and then added stress and complications; the test may give false reassurance if negative; the tests and extra visits may be expensive.
Early mammograms are good at detecting DCIS (ductal carcinoma in situ). These are often treated aggressively as “precancer”, but the jury is still out on whether this is warranted – surgeons often think it is, epidemiologists are less sure. Digital rectal exams and PSAs both miss cancers. Women may “get in touch with their body” by doing self breast exam, but does it reduce mortality? More tests mean more false positives – you may not have a significant lesion, but if you are told you do, you’re going to worry about it.
Tests have their place, of course. But there’s more to it than most people think about. Examination of prostates from cadavers show pre-cancerous lesions in the vast majority. And prostate cancer didn’t kill most of them. But prostate cancer kills some, and many people have bad complications from treatment – pain, impotence, infection, etc. Weighing the risks and benefits can be tricky.
Well, in the case of PSA exams, weighing risks and benefits doesn’t seem to me to be tricky at all.
I have a cousin who died of prostate cancer. He didn’t believe in annual check-ups, so by the time they found the cancer, there was nothing that could be done. His death was long and painful, both for him and for his family, with him bed-ridden for almost a year. And the consensus of every doctor was that if had had annual medical exams, this would probably have been found early and almost certainly been curable. Sure, there’s a “probably” and a “almost certainly” – but there’s no downside to the test.
My doctor looked at my PSA scores last April and was suspicious, so sent me for a biopsy (not pleasant) which detected slight cancer. I had a labroscopic prostatectomy in June; the cancers were entirely contained in the prostate, so presumably I am now cancer-free. I am very grateful to my doctors for catching this early.
Yes, prostate cancers can be very slow-growing. “Wait and watch” is a legitimate approach. That didn’t seem reasonable for me, based on my age and the early detection: I didn’t see any advantage in waiting to see whether the cancer spread.
So my very strong message to every male after age 40: get a check-up. There are a number of diseases that are fatal, but can be treatable if caught early, such as skin cancer, prostate cancer, some types of heart problems, etc. The cost/inconvenience of an annual medical check-up seems a small price to pay compared to, say, death.
I think this makes QtMthe Pickle Man. This would beQtM on the left, packing a gallon of his Kosher Extra Sour finest whilst explaining patiently to the ravenous tourist that no, he isn’t interested in opening a branch on Fisherman’s Wharf and yes, these are those real " Jewish Pickle Things " that she heard about back in Oregon.
I had the PSA this year and at 44 is two years overdue since last Pickle Check. :eek:
" How can you check my pickle when I’m hung like a gherkin? "
I am known for trying to scramble away when the doc conducts this exam. Therefore, he grabs hold of my shoulder with his free hand (to restrain me). Once I commented that it always makes me nervous when I feel his hand on my shoulder. His comment: “You don’t need to worry unless you feel both my hands on your shoulders.” :eek: To which I laughed: “Haaa haahhahaaa… AAAAUGH ha ha…”
Weighing risks and benefits for PSA may not be tricky for you. I do PSAs on my patients too. But with some reservations. According to http://www.medscape.com/viewarticle/512482
I’ve had one of these tests once for a 1st class flight physical. He was in, he was out. What exactly are they looking for? (and, if I so chose, can I do it on myself?)(I mean, not that I want to, but if I did)(or maybe had the dominatrix I visit do it, y’know “Oh please mistress, don’t do that! But if you do, could you check for any irregular bumps while you’re at it?”)
I am not a doctor, but I have had plenty of education on the prostate in the last six months. The prostate gland is located way in the back, near the rectum, so it’s easiest to get at from that direction. They do a biopsy that way, too. With the digital exam, the doctor is feeling for any irregularities in shape, hardness, etc that might imply a tumor or other abnormalty.
Amount of activity has no relationship to whether you get cancer there, kezami, just like people who breathe regularly still get lung cancer.
And, for my personal experience, my PSA score was low – 3.5 – which is below the standard for further checking. But my doctor (bless him!) had noticed an increase from year to year over the last five years – an advantage to annual physicals with the same doctor – and we discussed whether to do a biopsy. I thought it made sense. When they found a cancer, the urologist said very honestly that if I had been his patient, he would not have done a biopsy based on PSA score and digital exam.
