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Routine P.S.A. testing as a form of screening for prostate cancer is controversial and there are those both in favour of it and those who oppose it. Within this Support Group, it is acknowledged that this test has its limitations and can give false positive results as well as false negative results but in the majority of occasions it can give an experienced Consultant Urological Surgeon an indication of prostate disease which could need further investigation. Kidderminster General Hospital was one of the first hospitals in the West Midlands to regularly use the test to help in the diagnosis of prostate cancer and as a way of monitoring response ( or otherwise ) to treatment. This test has now been used locally for nearly twenty years. To help with “borderline” PSA values a free/total ratio is obtained prior to a possible biopsy. As the President gives talks to men’s groups ( see Aims pages ) on men’s health and in particular prostate diseases and advocates men over fifty should have an annual PSA test, the committee decided in 2004 to use some of its funds to provide such a service to the general male public. It was acknowledged that some men were in a position to have regular Men’s Health checks ( which included a PSA test) carried out at local Private Hospitals but it was felt this service should be offered to any man concerned about his health. Its limitations were recognised but, until something better and more accurate is available, the PSA test should be offered to all in spite of the government recommended guidelines to the contrary. With the co-operation of the B.M.I. Droitwich Spa Hospital, P.S.A. blood testing is now offered at many of the Kidderminster Town Hall meetings. Prior to the meetings appropriate advertising / marketing is carried out with the help from the local press, radio and television. Local general Practices are notified and posters placed in appropriate places in the community. Public talks by the President are given just prior to each session in which he counsels men about the advantages and possible disadvantages of the test. Men requesting the test are then given written information about the test and asked to provide their name, date of birth and address prior to signing a consent form. Professional Phlebotomists from the B.M.I. DRIOTWICH Spa Hospital then carry out the blood tests. The tests are quite free of charge but men are invited to make a contribution if they wish. The results of the tests are dealt with confidentially and are seen by the President, Mr D.C.Baxter-Smith a Consultant Urological Surgeon. Within a fortnight, he writes to all the men advising them of their result and any appropriate action that should be taken. The letters they receive are described as “green”, “amber” or “red”. A “green” letter advises a man that his P.S.A. was in the normal range for a man of his age, but if he suffers from frequent voiding by day or by night, has urgency or hesitance on visiting the toilet, a poor stream or passes blood he should see his General Practitioner. An “amber” letter advises a man his P.S.A. was “borderline” and he should see his General Practitioner in three months time for a further test; in that time it may go up further indicating a need for investigation or it could fall back into the normal range. A “red” letter suggests that the P.S.A. was significantly elevated and the man would be advised to see his General Practitioner soon as he may need further investigation. Up to one hundred and sixty men attend each of these sessions during which ladies from the Widows Support Group help with much of the paper work and organisation. The President keeps an accurate and up to date audit of the results which show that approximately 90% are in the normal range with 5% “borderline and 5% significantly elevated. Men in the latter group are written to by the President, usually within twelve months of the test, to enquire as to the outcome. The majority of this group are found to have early prostate cancer and have been treated by either radical surgery, external beam radiotherapy, brachytherapy or active surveillance. Although this service has been received with some reservations from local health managers, it has been welcomed by many General Practitioners, the local press and radio. Many men who have benefited from this service have contacted members of the committee to express their gratitude. It is intended to continue this service for the foreseeable future.
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