Free prostate and testicular screening... why is there none?

lozenges

Prostate specific antigen is notoriously unreliable and not sufficiently accurate to be recommended as a screening tool. If a more accurate tool could be developed it would be worth screening for sure, as prostate cancer is pretty common.

Testicular cancer is much less common than the commonest cancers in Ireland which are lung, breast, colorectal and prostate. And an US cannot pick up precancerous cells. So the cost effectiveness of a testicular screening programme would be poor.

It is not correct that by the time a testicular lump is palpable it is too late. It depends on the type of cancer. Some are extremely responsive to treatment and others much less so.

Lyan

Why would anyone want to stick their finger up your stinky butthole for free?

Kidchameleon

Society worships women whilst men are deemed disposable & I say that as a woman.

El_Duderino 09

Kidchameleon wrote: »

Society worships women whilst men are deemed disposable & I say that as a woman.

Ah, you're claiming to be a woman for this post.

Just for context, this poster claims to be a man or woman in different threads

El_Duderino 09

Women have a powerfully lobbying movement which pushes women's issues to the fore. Whether you like them or not and whether they are right or wrong, feminism makes sure women's issues, like health screenings, have popular support and are addressed.

Anita Blow

Has been said above but may as well repeat it- based on what we know about the natural history of these diseases and the investigations available for them there is no justification for screening programmes in prostate/testicular cancer. Specifically:

1) Some prostate cancers can be rapidly progressive, but the vast majority are indolent cancers (you die with it rather than of it). We have no way of differentiating who will have the less common aggressive course, so to screen would lead to over-investigation and treatment of the vast majority of prostate cancers which would otherwise have never affected the person's quality of life or life expectancy. As much as 1 in 10 men who undergo prostatectomy will experience long-term urinary/faecal incontinence or sexual disturbance and a smaller number will experience significant damage to other structures.

2) PSA is not a reliable marker for prostate Ca. It's not specific for prostate Ca as it can be raised in other conditions, and 20-40% of local prostate Cas will have a normal PSA. It's essentially useless unless you're interpreting the result in the context of reasonable clinical suspicion of prostate Ca. A positive result would have to be followed-up despite not likely reflecting actual cancer, leading to needle biopsy which itself carries risk of sepsis in 1% cases.

3) Testicular Cancer fails the first test of any screening programme- it doesn't occur in sufficient numbers to justify mass screening. Additionally, most occur in young males and even if advanced usually responds excellently to treatment. US is not capable of identifying pre-cancerous cells. Only a biopsy can do that.

mc25

Did anyone bother to do even the slightest bit of research before jumping in with the replies?

There have been numerous studies, some specifically on the Irish population about screening for prostate cancer. And as others have said, the screening that does exist is not the best.

As for the problem of companies not going blue for male specific cancers, yes that is an issue, although I thought Movember was a thing now?

There are also plenty of issues surrounding the whole "pinkification" of breast cancer which we should be talking about too.

Also may be worth mentioning that men can get breast cancer (though very rare) whereas women will never get prostrate/testicular cancer.

Galwayguy35

johnnyskeleton wrote: »

You can check for signs of testicular cancer yourself, and prostate cancer is low risk for younger people. Older people tend to get prostate checks from their GP if they want it.

Compared with cervical and brest cancer requiring special equipment to check and affecting younger people.

So in reality the only people discriminated against are those too lazy to check their own testicles

Wow thats a very dismissive post about something that could affect us all, I'm guessing you are male going by your username.


Making this a free service would be pocket change in the grand scheme of things and considering the crap the Government spends our money on like sending millions over to tin pot countries it could be spent on this instead.

Wesser

There is no evidence that prostate screening by using PSA reduces the risk of dying from prostate cancer.

Ie.

If you have 1000 men who have regular psa testing and 1000 men who do not the chances of dying from prostate cancer is the same in both groups.

Check out wilsons criteria for a screening test.

Better Than Christ

Hairy Japanese BASTARDS! wrote: »

All the more reason to make it available.
And campaigns etc.

Why do companies go pink for breast cancer and never blue for male cancers?

The cervical screening is just as invasive as the prostate one, if not more.

If men want these things, we need to fight for them. Just like women had to. No use moaning about it online and pretending to be the most oppressed people ever.

As for publicity campaigns, they tend to die a death because most men aren't interested. Did you ever grow a moustache for Movember? Me neither.

spurious

Hairy Japanese BASTARDS! wrote: »

Again, we have to pay when women get their equivalents for free

So start a campaign and demand it for free.

Better Than Christ

spurious wrote: »

So start a campaign and demand it for free.

Much easier to whinge about it and pretend to be a victim of discrimination.

lozenges

As I think has been mentioned upthread, colorectal cancer disproportionately affects males and is the third commonest cancer in Ireland. It is the second commonest cause of cancer related death (lung is the first)

There is a screening programme available with a reasonably accurate test but uptake is very poor, and worse in males than females.

Participate in Bowel screen if you're eligible!

mc25

Galwayguy35 wrote: »

Making this a free service would be pocket change in the grand scheme of things and considering the crap the Government spends our money on like sending millions over to tin pot countries it could be spent on this instead.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773135/

"Conclusion
The cost-effectiveness of prostate cancer screening is unclear. There was no consensus on the optimal model type or approach to model prostate cancer progression. Due to limited data availability, individual patient-level modelling is unlikely to increase the accuracy of cost-effectiveness results compared with cohort-level modelling, but is more suitable when assessing adaptive screening strategies. Modelling prostate cancer is challenging and the justification for the data used and the approach to modelling natural disease progression was lacking. Country-specific data are required and recommended methods used to incorporate quality of life. Influence of data inputs on cost-effectiveness results need to be comprehensively assessed and the model structure and assumptions verified by clinical experts."

Picture is still very unclear it seems

Sarcozies

Better Than Christ wrote: »

If men want these things, we need to fight for them. Just like women had to. No use moaning about it online and pretending to be the most oppressed people ever.

As for publicity campaigns, they tend to die a death because most men aren't interested. Did you ever grow a moustache for Movember? Me neither.

I find this reasoning so weird. Testicular cancer? People with balls need to fight for it. Prostate cancer funding? People with prostates need to fight for it.

Do ye all not have any father's, brothers, uncles, grandfathers, boyfriends, husbands? If you do, fight for them even if what is between your legs doesn't match the cause you are fighting for.

Not to mention all the men who have fought for women's right. Again, so weird.

Balmed Out

https://www.youtube.com/watch?v=

Hairy Japanese BASTARDS! wrote: »

There are almost the same incidences of testicular cancer as breast cancer.

In men?
1 in 250 men get testicular cancer one in 12 women get breast cancer.

El_Duderino 09

Sarcozies wrote: »

I find this reasoning so weird. Testicular cancer? People with balls need to fight for it. Prostate cancer funding? People with prostates need to fight for it.

Do ye all not have any father's, brothers, uncles, grandfathers, boyfriends, husbands? If you do, fight for them even if what is between your legs doesn't match the cause you are fighting for.

Not to mention all the men who have fought for women's right. Again, so weird.

That's where awareness comes in. People only campaign for things when they know about them. Gaining popular support is very important and the way to achieve that is to push the issue to the fore of public consciousness.

Pushing these things on the Internet is one useful approach. But just whinging on the Internet is useless. Case in point, 'International Men's Day' gets more hits on international women's day when men whinge and ask why there's no men's equivalent. But on men's day, the same men are more likely to ridicule it than support it, let alone take part in it.

Sarcozies

El_Duderino 09 wrote: »

That's where awareness comes in. People only campaign for things when they know about them. Gaining popular support is very important and the way to achieve that is to push the issue to the fore of public consciousness.

Pushing these things on the Internet is one useful approach. But just whinging on the Internet is useless. Case in point, 'International Men's Day' gets more hits on international women's day when men whinge and ask why there's no men's equivalent. But on men's day, the same men are more likely to ridicule it than support it, let alone take part in it.

I don't know if you quoted me incorrectly or not but you this has nothing to do with what I said.

I find it bizarre that people are saying people with x genitals need to fight for it, as if that's the biggest factor. We're talking about a cancer screening here for our dads, granddads, brothers. The lack of compassion is weird.

If someone came to me saying we need a woman's cancer screening, the first thing out of my mouth wouldn't be "well, people with vaginas need to fight for it"

notobtuse

USA here. I had prostate cancer, currently am in remission. Got it around 50. I’ve found they only test for it here when guys go to the doctor as there are telltale issues even in the early onset (and guys WILL go to the doctor for those issues) and usually there's plenty of time to tackle the cancer effectively.

Galwayguy35

mc25 wrote: »

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773135/

"Conclusion
The cost-effectiveness of prostate cancer screening is unclear. There was no consensus on the optimal model type or approach to model prostate cancer progression. Due to limited data availability, individual patient-level modelling is unlikely to increase the accuracy of cost-effectiveness results compared with cohort-level modelling, but is more suitable when assessing adaptive screening strategies. Modelling prostate cancer is challenging and the justification for the data used and the approach to modelling natural disease progression was lacking. Country-specific data are required and recommended methods used to incorporate quality of life. Influence of data inputs on cost-effectiveness results need to be comprehensively assessed and the model structure and assumptions verified by clinical experts."

Picture is still very unclear it seems

It shouldn't be down to cost effectiveness when its a health issue, like i said earlier the government are very quick to waste money on things that are lot less important.

lozenges

Galwayguy35 wrote: »

It shouldn't be down to cost effectiveness when its a health issue, like i said earlier the government are very quick to waste money on things that are lot less important.

Of course it's down to cost effectiveness. There is a finite amount of money. Therefore money spent in one area is money taken away from some other area. Mental health, supports for adults with dementia and learning disabilities, community health and outreach services, the list goes on.

It's not acceptable to deliberately spend money on things that are known to be not good value for money.

Galwayguy35

lozenges wrote: »

Of course it's down to cost effectiveness. There is a finite amount of money. Therefore money spent in one area is money taken away from some other area. Mental health, supports for adults with dementia and learning disabilities, community health and outreach services, the list goes on.

It's not acceptable to deliberately spend money on things that are known to be not good value for money.

So if it was cervical screening we were discussing would you be saying the same thing?

Doubtful.

One eyed Jack

[Deleted User] wrote: »

Meh - itd consider the topic on the right - and the topic on the left - and make my decisions on which one felt harder.

I didn’t get the original joke, went over my head, but dammmmn this is dark, and necessary in in a thread with such a heavy subject matter!

As for the point made that there is no HSE funded and provided prostate exam scheme, it’s simply a matter of economics - when the HSE budget is mostly squandered on administration, there is considerably less in the pot for providing actual healthcare services, and so priority is given to services based upon viability. A prostate exam scheme is simply not viable in that context. It’s nothing to do with prioritising women’s healthcare over men’s healthcare. The HSE are a public body with a mandate to serve the public.

Sarcozies

To answer OP anyway, it's because we care more about women than men in society. It's why men are the vast majority of workplace deaths, murder victims, violent crime victims, sentenced harsher in court and family court etc and yet the biggest gender headlines and initiatives are to get more women into tech and boardrooms. You have to go and find the above yourself but RTE etc. will let you know that only x% of CEO's are women.

Better Than Christ

Sarcozies wrote: »

I find this reasoning so weird. Testicular cancer? People with balls need to fight for it. Prostate cancer funding? People with prostates need to fight for it.

Do ye all not have any father's, brothers, uncles, grandfathers, boyfriends, husbands? If you do, fight for them even if what is between your legs doesn't match the cause you are fighting for.

Not to mention all the men who have fought for women's right. Again, so weird.

In many cases, it is women who fight for men's health. Unfortunately, that fight usually involves hounding their husbands, fathers, brothers, etc, into seeing a doctor when they have a health scare. In any case, I don't believe for one second that the OP (or others like him) really cares about free prostate and testicular screening half as much as he cares about pointing out perceived discrimination against men.

osarusan

Another day, another CA thread in the victimhood olympics.

notobtuse

Better Than Christ wrote: »

In many cases, it is women who fight for men's health. Unfortunately, that fight usually involves hounding their husbands, fathers, brothers, etc, into seeing a doctor when they have a health scare. In any case, I don't believe for one second that the OP (or others like him) really cares about free prostate and testicular screening half as much as he cares about pointing out perceived discrimination against men.

Agree with the bolded part 100%. That's the way is was in my case.

JP Liz V1

There should be free screenings for both sexes

El_Duderino 09

Sarcozies wrote: »

I don't know if you quoted me incorrectly or not but you this has nothing to do with what I said.

I find it bizarre that people are saying people with x genitals need to fight for it, as if that's the biggest factor. We're talking about a cancer screening here for our dads, granddads, brothers. The lack of compassion is weird.

If someone came to me saying we need a woman's cancer screening, the first thing out of my mouth wouldn't be "well, people with vaginas need to fight for it"

Yeah. What I said was "Gaining popular support is very important and the way to achieve that is to push the issue to the fore of public consciousness". By 'popular support' I mean people and not just one gender or the other. I didn't mention one gender of the other.

Buy it's always going to be the few most committed and passionate people who get the movement started. So it could be men themselves, people who have survived these cancers, family members of people who survived or died of the cancers or whatever else.

No need to make it about men or women. But popular support is essential.

El_Duderino 09

lozenges wrote: »

Of course it's down to cost effectiveness. There is a finite amount of money. Therefore money spent in one area is money taken away from some other area. Mental health, supports for adults with dementia and learning disabilities, community health and outreach services, the list goes on.

It's not acceptable to deliberately spend money on things that are known to be not good value for money.

That's precisely the way it works. Everything needs to be costed and the benefits need to be argued for. And ideas need to compete to even be considered at government level. If they don't have an effective lobby and popular support, then they're unlikely to even be considered, let alone piloted or roled out on a large scale.