(UK)Prostate Cancer Risk Management Programme

This relates to the post 'New guidance for tests to help detect prostate cancer' and the seven points in the Prostate Cancer Risk Management Programme.

The Real PCRMP Leaflet

The Real PCRMP Leaflet sets out the basic facts about the PSA Test, in particular its advantages and its shortcomings as a test for a man's risk of having prostate cancer.

Unlike the 'official' PCRMP, which runs to 30-odd pages, it outlines, on one A5 page, seven key points that should be explained to a man who is considering, either at his own request or on the suggestion of his GP, having a PSA Test. These points are:

1. The PSA test is a simple blood test which is used to help detect prostate cancer. In its early stages, prostate cancer generally produces no symptoms, so it is important to diagnose the disease before any symptoms arise and while it is still potentially curable. Recent results of a major European trial suggest that treating prostate cancer may significantly prolong a man’s life.

2. A high level of PSA (usually 10 ng/ml and above) is likely to be an indication of prostate cancer and should therefore prompt further investigation. *****My view on the "prompt further investigation" would be to at least have one or more PSA tests before any invasive tests are carried out but just my opinion.*******

3. A moderately raised PSA level (usually 4 ng/ml and above, but this depends on age), means that other factors, including digital rectal examination, ethnicity, family history, prostate volume, PSA history, and free-to-total PSA ratio, should be considered in determining whether to send a man for further tests such as biopsy.

4. However, in three-quarters of such cases, further tests do not detect cancer. There can be other reasons for a moderately elevated PSA (eg urinary infection, enlarged prostate) and these may need treatment.

5. Prostate cancer is not always aggressive or life-threatening. Even if further tests do detect early-stage prostate cancer, a specialist may not be able to tell whether the condition is life-threatening or harmless. This may make treatment choices difficult for both patient and clinician.

6. A low level of PSA (usually below 4 ng/ml, but this depends on age) does not guarantee the absence of prostate cancer. This is because localised prostate cancer does not always produce a raised level of PSA.

7. All these factors have led to the current controversy over the value of the PSA test. However, the uncertainties may be reduced by men having a regular test, ideally on an annual basis. Regular monitoring of PSA levels can highlight any significant or gradual increase, so that even when the PSA is within the ‘normal’ range, one may be alerted to the need for further investigation. ****My View-I agree 100% with this statement but I would then add that further investigation would be by PSA/DRE testing say in six months time unless the readings were very high then much sooner but just my opinion.....**************

The Leaflet can be downloaded as a "pdf" file which can be displayed and printed by the use of a "pdf" Reader. If your computer does not have a suitable Reader, you can download the Adobe Acrobat Reader, which is free, by clicking here.

The Real PCRMP Leaflet is being printed in sufficient quantities for a copy to be held in every GP's surgery in the UK. We do not have the resources, or to be frank, the authority, to mail it to them all ourselves. We therefore rely on patients to pass this information on to their GPs. If you can help in this, please send us an email saying how many copies you want and we will post them to you.

Prostate Cancer Risk Management Programme UK-9th April 2009