Health inequality - Chris Hoy and prostate cancer

[Pebbles16]

I work in healthcare and realise there is enormous health inequality which often disadvantages women. However, Sir Chris Hoy is highlighting a very important deficit in screening for health conditions amongst men. As women, we "enjoy" screening for cervical and breast cancer but prostate screening is woeful.
It's a simple blood test for PSA levels which should be offered from 40+ as a minimum. Men are notoriously tricky when it comes to seeking health advice, so simple monitoring (not qualified enough to suggest a frequency) rather than an invasive procedure really might help them to come forward for monitoring.
My Dad had prostate cancer in his early 60s which was - thankfully - spotted early and he received an experimental treatment which eliminated those cancerous cells.
I want to protect the men we love from this insidious disease which often gets to stage 4 without notice.

DH has become worried about this. So instead of throwing money at a full medical (which we could afford) he orders a test off the internet.
I think the last one was 11 months ago.

His dad had it at the age of 75ish, my dad & his brother like most men died with it not because of it in their 80s.

DH hasn't even bothered to look up other symptoms or reconnect with a friend that approached him several months ago, rather randomly, to talk about it.
He's an idiot but they can't apparently test for that either.

If you want to be really angry about the shear amount of research that is done on men not women or for women or by women, read Invisible Bodies.

A research study proved that PSA screening the population did not change the mortality rate from prostate cancer. Whereas breast screening and cervical screening does change the mortality. Unfortunately with PSA screening you just end up treating more prostate cancers which were unlikely to cause problems within the man's lifetime, and leaving the patients with debilitating treatment side effects. We need to find a way to identify the 'dangerous' prostate cancers so we concentrate on treating them only. PSA cannot do this.

Absolutely more PSA testing, not that it's the sole way to be informed but gives a good indication.

If only my Dad had had this available it would've saved his life and prevented spreading of cancer to bones. Others had it detected earlier and after treatment are fine now.

Don't let a shit GP who has been told to not refer men for scans and tests to save money when patients complain of years of backache.

Despicable and unforgivable, these are our parents who deserve the best and have paid into the NHS all their lives. If only we had known and these tests were a normal request, like breast scans, so many lives could have been saved. Too little too late for many so don't let this happen again.

My Dad died of prostate cancer. He was diagnosed in his early 50s with a high grade tumour. He also developed another primary cancer before he died which hints at a possible genetic aspect. He used to rail against the lack of national screening for prostate cancer. I took the time to read the national screening programme’s evaluation & there are good reasons why it isn’t offered routinely, as others have explained.

Another really important factor in screening, as well as reliability and validity of the test, is uptake at population level. Even if the test is bang on, you need enough of the target population to go for screening for a national programme to save lives at population level. I’d be interested to know what men’s uptake of the age 50+ bowel screening test is like. I don’t think enough men seek timely medical advice when they should & I’d worry about this also being the case for a national prostate screening programme.

I am already talking to my teenaged sons about prostate cancer symptoms and their grandfather’s diagnosis so they know to seek help early & raise it with doctors when relevant.

Agree.

I understand Sir Chris wants to make a difference but this isn’t cut and dried - it’s not a very reliable test as it can be raised for other reasons and likewise you can have prostate cancer and it won’t be that high.

b) Their health is less valued by society

I would suggest men’s actions show that their health is not valued by men themselves in the first instance. I remember a guy on 24th in A&E who had had a go at his wife for calling an ambulance… when he had chest pains which turned out to be a heart attack! The camera crew got a begrudging “I suppose she did do the right thing”, but there was absolutely no gratitude.

Margaret McCartney has a really good thread on why increased screening isn't necessarily the right answer https://x.com/mgtmccartney/status/1853823872585302308

Also CRUK https://www.cancerresearchuk.org/about-cancer/prostate-cancer/getting-diagnosed/screening

It is a very complex issue. People like CH with a high risk family history should obviously be tested. But this pictogram demonstrates why it is less straight forward for most men.

The night before my dad died he complained of back pain and coudnt lie down. He spent two hours asleep while sat on the side of the bed hunched over.

That's what stood out for me today in his interview. The genetic propensity. ( right word??). Similar perhaps to the strong genetic link for some breastfeeding cancers.

Prostate cancer can be linked to the BrCa2 breast cancer gene.

I think the fathers of both Kylie Minogue and Julia Bradbury had prostate cancer

Whilst I sympathise with Sir Chris's view, because he had a clear family history, it is generally accepted that prostate screening across the board creates many more problems than it solves. Most older men can (and do) live with prostate cancer for many years, and treatment is not always necessary.
Similarly, screening for women is also not a universal panacea, and has its drawbacks.

I read and reread this, convinced that I was misreading b. But no, it's one of the most foolish posts I've ever seen on mumsnet. We've only just started to give a shit about menopause, and that affects ALL women. Endometriosis, pmdd, post birth injuries... I could go on. Women are left to suffer routinely.

https://patient.info/doctor/screening-programmes-in-the-uk

Here are the criteria for a good screening test.

Screening is not benign. Risk of harm can outweigh benefit.

Hopefully in the future there will be a reliable screening test for prostate cancer, so that a screening programme can be made available.

I think it's great that Chris Hoy is using his diagnosis to raise awareness, but very surprised that no one has mentioned the hugely increased risk of prostate cancer for black men (1 in 4, as opposed to 1 in 8 for white men).

This is an incredibly raw topic for me at the moment. My DH was diagnosed via a health check offered by his work several months ago. He had absolutely no symptoms at all & has no family history. His PSA reading came back as high and he was referred for biopsies, bone scans etc, he underwent a prostatectomy a few days ago.
We watched Chris Hoy's program in tears this evening. I wouldnt want to wish prostate cancer on anyone and I am pleased Chris is raising awareness of it. I lost my uncle to prostate cancer several years ago. Men arent offered enough health checks & I believe all men over 40 should be tested.

No, I don’t think we need more people who are scientifically illiterate making decisions about screening programmes.

There are existing screening programmes that have not saved any lives but remain popular and so money continues to be sunk into them.

The vast vast majority of men with prostate cancer die with it, not from it.

@Itsnotallaboutyoulikeyouthink I do agree with you on some level.
My Dad also has a persistent brain tumour (prostate cancer was related due to hormone levels). Not the wretched gioblastoma - thank goodness for him and us. That is the cruellest brain tumour.
However, I truly believe that "celebrities" (or people who have a profile) have an important role to play in raising the profile of disease awareness, testing and campaigning for treatment.

Yes, they do. But reducing the number of people who die "from it" because of lack of early intervention is part of my original post.

I feel my female health privilege as a woman with several chronic health conditions. At almost every consultant appointment I have, it hasn't mattered what my age is, they send me back to the GP because it's just my (female) hormones and they don't know about that (apparently) so I'm frequently in pain and then 5-10 years later something serious happens and it's revealed to be wholly unrelated to my female hormones, but now impossible to totally resolve because the damage is now done.

Yeah, so much privilege.

I once had the same condition as my husband. Rang the GP on the same day - he was seen by GP a week before me, consultant two months before me, he had surgery I had to go back and forth before surgery a couple of years later and the notes show my condition was at a worse stage even at the start.

Privileged!