Interview 42

Age at interview: 68

Brief Outline:

Six months ago he decided not to have a PSA test, partly because he did not have urinary symptoms, and his GP was not in favour of doing it. Since then he has changed his mind, mainly due to peer pressure, and will probably have the test in the next few months.

Background:

Occupation: Retired. Ethnic background: White British.

Thinks he is at low risk for prostate cancer but is weighing up the pros and cons of having the PSA test.

Good material which lays out the pros and cons very clearly. I wasn't terribly impressed by the arguments that were put forward not to have the test actually, I think they're rather unconvincing arguments and on those grounds alone I think in fact I would today go round to the doctor and say I'd actually like to have the test. The only, the only reason that stops me at the moment is that I have read about a hormonal aspect to the onset of the disease and since I have a relatively low androgen out put or production, for chromosomal reasons, it seemed the risk factors in my case were somewhat less than might be otherwise in spite of my brother who would increase the risk factors [laughs]. And that's really where I stand at the moment, not having made a final decision but I think I'm more, I think I'm inclined to have it rather than not have it, I think it's more than likely that in the next few months I'll go back to my GP and say I'd like to have it.

His GP will do a PSA test if asked but made it clear that he prefers not to do the test unless a man has urinary symptoms.

Now when, when you went to see your doctor to say that you might be interested in having the test...

Mm

You say you got the idea he wasn't terribly keen on, or wasn't terribly keen for you to have it at any rate?

Yes.

Can you remember if he specifically said that?

He said that, he certainly said that it was not a reliable test unlike some tests one can have, it's not reliable and therefore one has to treat it with great care. He also said that, which is the point that I really don't agree with him on, that it can be a cause of great anxiety to patients. And it could be, it's possible it is but I don't think it would be for me, I don't think whatever the test said would make me particularly anxious. He didn't, I don't think he said anything about the unreliability of different forms of treatment, I think he concentrated more on the unreliability of the test itself. Certainly he said that he would ask for the test to be done instantly in the case of symptoms but in a symptomless situation he was not so keen on it. But he did, he did all the way along say, 'If you'd like it you can have it tomorrow'.
 

Argues that GP's should tell men about the PSA test because men may have prostate cancer without having symptoms and symptoms are confusing.

... I'm aware of the debate about screening programmes generally, the many other cancers like bowel cancer which I'm surprised that there is no national screening in fact for that, where the tests are much more accurate. What do I think about the fact that there are, it is still too inconclusive?

Well I, well I think from the evidence I've had, been exposed to myself I would seem to be, I seem to know people either who don't have the test and haven't considered it and people who have had the test and are glad that they did. I, leaving the cost side out of it altogether it would seem to me that screening would be desirable.

Yes indeed fair enough.

Or at the very least I think it's possible, I think what I would quite like is that after a certain age, like fifty or so, people on GPs' registers are told about the issue, told this is still controversial but that this is available if they wished without making it at all, without having it pushed at individuals.

Right

Because a lot of people just wouldn't know.

Because the argument that one shouldn't have the test unless there are symptoms is a bit tricky because no one really comes clean on what the symptoms are. My brother had no symptoms at all he says and of course the symptoms that are often quoted might be symptoms of something else altogether, a perfectly benign prostate problem.