DR ELLILE CANNNON: My GP is refusing to test my son for prostate cancer - is ... trends now
My 50-year-old stepson has twice requested a PSA test from his GP to check for prostate cancer, but has been turned down. Both his father and paternal grandfather had the disease. He has no symptoms, but neither did his dad when he had his first PSA test at 50, which showed raised levels, and even when he eventually required treatment he didn’t suffer any symptoms. What do you think my stepson should do?
Raised levels of prostate specific antigen, or PSA, in the blood is a sign there is something wrong with the prostate. It can be caused by cancer, but it can also rise due to a range of benign conditions, such as infections or even after sex. In fact, most men with a raised PSA level will not have cancer.
For this reason, PSA testing is not employed as a routine screening tool, as opposed to mammograms or cervical smear tests that are usually offered to large numbers of healthy, asymptomatic women in order to pick up early stage breast and cervical cancer. If it was, many men would end up having unnecessary and invasive procedures to rule out cancer.
Today's reader asked DR ELLIE CANNON whether her GP was wrong to refuse to test her middle aged son for prostate cancer despite a family history of the disease
Men over 50 can request a PSA test from their GP for any reason, however, as long as they understand the potential outcomes, including the risks of false positives and other drawbacks. Before undergoing the test, patients should talk with their GP to weigh-up the pros and cons, then they can opt for the test if they wish to proceed.
This approach is particularly relevant for individuals with a significant family history of prostate issues. It’s surprising the GP doesn’t know about this – the recommendations are mapped out in the Government’s Prostate Cancer Risk Management Programme published in 2016.
Prostate Cancer UK (prostatecanceruk.org) and the NHS (nhs.uk) both offer valuable resources to facilitate these discussions and provide men with comprehensive information.
Why is it so difficult to get a Vitamin B12 deficiency diagnosis? I have all the signs and symptoms but my GP says my blood tests are normal. I just don’t believe it and I’m getting worried. I’m considering buying B12 injections online so I can treat myself. What do you think?
Vitamin B12 deficiency causes a range of symptoms, including tiredness, a sore tongue, brain fog, palpitations and headaches. There may also be nerve problems, including pins and needles and numbness.
We see low levels in people on vegan diets – as B12 is mainly found in eggs, milk, meat and fish – and also those with bowel disease who do not absorb nutrients properly. It is also the side effect of some medications, including those which treat diabetes, stomach acid and gout.
But blood tests offered on the NHS to check for low levels are very accurate. If they’re coming back normal, then there is no indication of deficiency and no reason to treat it.
Low levels of B12 can be seen in people who are on vegan diets
So I would look to see what else could be causing these symptoms.
Other tests can look for issues such as iron deficiency anaemia, folic acid deficiency and thyroid problems, as these cause similar problems. The perimenopause and menopause can also be a factor in middle-aged women.
Anyone questioning the diagnosis a GP has made should go back and ask for a better explanation or seek a second opinion, either