A Waimate man is "peeved
off" with the medical system, saying doctors are not
proactive enough in contacting men and getting them to go for
a prostate cancer check.
However, speaking as the general practice liaison for South
Canterbury, Aoraki Primary Health Organisation practitioner
Paul Keys said this was because the effectiveness of prostate
cancer checks was "somewhat controversial".
In response to an article in The Courier a fortnight ago, a
Waimate man - who asked not to be named - expressed a concern
that men were not being contacted by their GPs when they were
due for a prostate cancer check.
"All medical centres should flag men for a prostate check at
certain ages. The medical profession is not up to speed with
this thing," he said.
He also believed doctors should do a PSA [prostate-specific
antigen] blood test and a physical examination - where the
prostate is examined rectally - when checking men for
prostate cancer.
"It should be a full test, regardless."
Dr Keys said the reason there was no standard procedure for
contacting men for a check was because the National Health
Committee advised asymptomatic men not to be screened.
Screening included the PSA blood test and the physical
examination, which were designed for men without symptoms of
prostate cancer, to identify if they were at risk.
"There is a lack of proven benefit from screening, and the
potential for harm to arise from treatment."
Cancer Society of New Zealand (CSNZ) South Canterbury Centre
health promoter Kate Johnson said the adverse effects which
could follow screening included uncontrollable urinating.
The tests were inaccurate, sometimes showing false positive
and false negative results, she said.
Mrs Johnson said PSA blood tests had a low specificity rate,
and many men required further testing afterwards, which could
reveal no cancer.
The accuracy of a physical examination depended on the
experience of the clinician, and many tumours of the prostate
could be missed this way, she added.
"It should be an informed choice for men with a father or
brother who has developed cancer to have a prostate cancer
screening, with them knowing the potential risks and lack of
proven benefit."
CSNZ advised asymptomatic men discuss the benefits and risks
of screening with their GP, until there was evidence early
detection and treatment of prostate cancer would result in
increased life expectancy or an improved quality of life.
CSNZ is doing tests to examine the effectiveness of prostate
cancer screening, with the results expected to be available
in five years.
Dr Keys said if a man wished to have a screening, in most
cases his GP would agree to do one after discussing the test
with him.
Waimate Medical Centre owner and GP Sarah Creegan recognised
the "ongoing dispute" between specialists about how effective
prostate cancer screening was.
She said she would perform the tests if her patients asked
for them, although did not rush into doing physical
examinations.
"It's a very intimate and personal examination that I don't
jump to.
"The test is not foolproof."
- Cerisse Denhardt
