Comment by pugworthy
4 days ago
A few comments based on having gone through prostate cancer as well as observing how others deal with it (or don't).
As much as you need the health care system to make decisions and act, you need to do the same. And there are some kinds of cancer where talking about it is embarrassing, or fear of treatment keeps the patient from proceeding - not the doctor.
Prostate cancer detection for example has it's basic roots in the PSA test (easy enough), but also DRE (Digital Rectal Exam). As things go for exams, it's not many people's favorites and some will put it off.
Next up, say you have higher PSA. You probably will get sent off for a biopsy. Guess where they have to go to get core samples? There are a few routes, but none of them are what one might call fun at all.
So just to get diagnosed, you're going to find people who will put it off or not do it simply because they have anxiety or otherwise are uncomfortable about it.
Then there's the outcomes of the treatments - of which there are many types of treatments. The two big negatives of treatment can be incontinence and erectile dysfunction. That and your penis might be shorter post surgery if you go that route.
What that does is get people who need treatment going from doctor to doctor to find the one that tells them what they want to hear (no side effects). It's paralysis by analysis combined with fear of the not necessarily guaranteed side effects.
But there is one side effect if you do nothing for long enough - you'll die.
So do something - don't let the blocker to treatment be you.
Before getting an actual prostate biopsy you should get an MRI. This is common outside the USA, I had to ask for this before my biopsy. The biopsy itself carries a somewhat high risk of serious infection which is why a MRI first is more prudent. MRI can rule out cancer or be used for a targeted biopsy if it says you might. Targeted biopsies are much more effective at catching the cancer verses the random poking method without the mri. If you end up testing positive you also get a PET/CT scan to find other traces of PSA in you body to see if the cancer has spread.
Not that the finger test is not used so much anymore because it’s very poor at detecting cancer for much of the prostate.
I went thru all this a year ago and the MRI was 95% certain I had cancer! Turns out the biopsy showed I didn’t have cancer but another benign condition that was a rare complication of a immunotherapy treatment for bladder cancer that I did have…which is a different story.