Interview 17

Age at interview: 40

Brief Outline: In 2003 had urinary symptoms for about three months, and so asked for a PSA test, which was found to be slightly raised. Referred to a specialist, who diagnosed a urinary infection. This was treated and the PSA returned to normal.

Background: Occupation' Psychotherapist, health consultant. Marital status' married. Number of children' 1. Ethnic background' Black African.

He had to pass urine frequently, so consulted his GP and had a PSA test.

Okay I suppose my, working in the field of cancer you, one becomes very much aware of what's going on. I suppose there's also an element of paranoia sometimes as well [laughs] but I noticed I was going to the bathroom, you know quite a bit, quite frequently, I thought oh what could it be? I thought it might be my intake of caffeine because I, I must say I do enjoy the [laughs] copious amounts of coffee every now and again. so I actually went for a while without coffee just to, just did some little tests of my own just to find out, check what was going on. And I still presenting with some of the symptoms so I popped into my GP. And this was two years ago, I popped into my GP and explained what was going on and he initially was rather reluctant to proceed with the PSA test on account of I was too young, you know he didn't think it was that, that you know I should sort of give it a while and then we'd check it out again. And I went along with him for a while but then I kept on presenting with the symptoms and I thought mm I'm a bit concerned about this. I obviously spoke to my wife about it and I think I popped back into the GP about three months later and said, 'Look still presenting, what do I do now?' So he did the preliminary PSA test which was quite straight forward, no problems about it at all, I talk to people about it quite a bit through my work here so I had no reservations about that at all, I suppose it was just the wait for the results. 

The results came back and the PSA was a little bit high so obviously that kicked in the other bits and pieces which were to do with a referral to urological, urology department at my local hospital. 
 

His PSA result came back from the hospital after about 10 days.

For people that aren't sure, can you say a little bit about what the PSA test is, what does it mean and what's involved?

Well essentially it's a blood test and when I had it, it was again a pin prick and the blood is taken for analysis at one's local hospital, well one's local haematology department and the results come back. Mine took I think about ten days all told. Now different GPs have different ways of working things out, some GPs say there's if nothing wrong they'll call you, some say if there's something wrong they'll call you [laughs] so it may be dependent on how one's GP works but I called into my GP to find out what the results were he said you know call back in about ten days' time and so I did that and he said it was a little bit high, that I should pop in. So I popped in and then he showed me the chart because it's all typed out, he showed me, it was a little bit high, I can't remember the actual figures now but it was a wee bit high and we, we did a few more tests as well and then he referred me to the urology department to actually have a digital examination.
 

Suggests that if a man has urinary symptoms a PSA test is a useful way to start investigations.

Okay yes for those who aren't in the medical field or field of cancer the term PSA, prostate specific antigen, test might seem rather foreboding, rather frightening, but essentially it's a blood test, it's from that blood, that blood sample that the prostate specific antigen is, the levels are checked, and as I said if a gentleman is presenting with symptoms of prostate cancer then the PSA test is a fantastic way to start things off, to start that process and just get things checked out. Now I'm not saying base everything on that but it's a good yardstick by which to measure things.

The GP told him to avoid sex and vigorous exercise before his PSA test.

Yeah okay I was actually given an appointment to come back for the test, so it wasn't on a day that I just walked in my GP. So we had a discussion, we'd agreed that right you will have the test and then a date was set, and I was asked, you know I was given a few bits of, pieces of information as to what to do, so there was no sex, I think you're right twenty, forty eight hours before the test and no, not to exert unnecessary physical energy, so it was always best first thing, well first thing in a morning. I think my appointment was about 9.30 or something like that so things like that.

So to avoid cycling?

Yes avoid cycling [laughs] so I had to drive to the GP that day. What else, what else, what else I was able to eat so there was no problem with that, but yeah it was, I think I was given most bits and pieces of information, it was quite straight forward yes.

The GP referred him to a consultant because he had urinary symptoms and a slightly raised PSA.

And I was given an appointment [with a urologist] possibly three, four weeks later. Popped in there and had to, I suppose we're moving on to the actual digital examination. But the PSA was fine, the PSA was fine, no problem at all. I did have a digital examination which was, as one knows [laughs] rather uncomfortable but you know thinking of my health and wellbeing it was just a minor inconvenience [laughs] so that wasn't a problem at all.

When happened when you got to the urologist, what did he say?

He continued, obviously looked through my paperwork, had a good chat as well again it was, I felt very comfortable with the gentleman, we developed some sort of rapport and he explained what was going to happen. Again it was going to be another digital examination so he just wanted to confirm that I'd had one before, I knew what the process was and he just made, tried to make the process as easy and comfortable as possible. We talked through a few things after, essentially he concurred with my GP saying that, eventually it just came out that I had an infection so that's what it made it [the prostate] slightly enlarged so I was prescribed some antibiotics but...

So it was an infection that was making you pass urine so frequently?

Yes, yes, yes, yes I suppose on the one hand that was the comforting result and but I didn't mind going through the process and I think in my mind I'd said well okay if it is this, I'm doing something about it early.
 

Says that it is important that the test is accurate before introducing a national screening programme partly because of the cost implication.

And to go back to the subject of screening as you said in this country we don't have a national screening programme using the PSA test for prostate cancer, what are your thoughts about that?

I think we should keep things a bit as they are for the time being. Obviously we need to really find out how accurate the tests can be because there is a cost implication and you know we shouldn't really mess around you know playing silly games with, no there is a cost implication so we need to bear that in mind and if we need a test, a national screening test then it's got to be pretty accurate, it's got to be able to pay for itself so to speak. So if we are going to test gentlemen from the age of fifty then it's got to give us really accurate results at least you know we've got to be looking in the area of possibly eighty, eighty five percent accuracy, we can't ask for one hundred percent you know [laughs]. But that's what we've got to be looking at, anything below that then it's almost like throwing money away and we all know the implication of that, the taxes go up and this sort of thing. But so may be we should leave it as it is for the time being until we can actually clarify how accurate the tests can be and then introduce it, possibly starting at 50 and obviously work is going on you know to check things out, a lot of work is going on, people are presenting possibly earlier but people are also more aware, there's a lot less fear, it's less of a taboo now, cancer, any type of cancer and people are willing to, to submit themselves for tests and go in for check-ups. So yeah I think we should keep it as it is for the time being but with the way work is going on at the moment I can see it becoming a national screening exercise possibly in the next five years.