Prostate test causing unnecessary distress

The UK National Screening Committee says after weighing all the evidence, screening for this male cancer using a blood test called PSA is not advisable, saying its potential harms would outweigh any benefits.

PSA screening has been contentious because of concerns about over-diagnosis.

Prostate cancer is the most common cancer and the second most common cause of cancer deaths in men in the UK. Each year in the UK about 35,000 men are diagnosed with prostate cancer and 10,000 die from the disease.

This advice is based on the latest research evidence, and informed by a range of groups including healthcare professionals and patient representatives

John Neate, chief executive of The Prostate Cancer Charity, says: " ... the evidence points to the potential risk of over diagnosis and over treatment through large scale PSA testing ..."

A raised PSA (prostate specific antigen) level may mean a man has prostate cancer. However, other conditions which are not cancer, such as a benign enlargement of the prostate or a urinary infection, can also cause higher PSA levels in the blood.

Likewise, a normal PSA test result does not guarantee that a man does not have a tumour. It can miss cancer and provide false reassurance.

Because of these limitations, experts estimate that 48 men would undergo treatment in order to save one life based on PSA testing.

Making the announcement, the screening committee director Dr Anne Mackie said: "I am confident that this is the right decision".

See BBC News: Prostate test 'causes distress'

This graph show the daily results of the haem tests for 2009 until Aug 31st

Half monthly averages with a 'Power'trend line.

Half monthly averages shown as square root of above to indicate area that could be the source of blood.with a 'Exponential'trend line.

More Graphs

October-November
Shelly has shown the pictures to colleagues at Exeter, but has urgent family issues to deal with. So I'll be waiting a while.

October
Have had a quick look at the reports and pictures with Shelly, and she intends to take them to her work colleagues for further views. Thence we will look at the slides.

September 19th
Spoke to Shelly and will call her when I get the piccies.

September 17th
Spoke to Laura and she said the loan of the slides is to avoid them lending me the microscope etc.

September 16th
Yesterday I paid to have pictures taken of the dodgy cells in my June tests.

The option will be to:

• Take more pictures of the slides: Must check my compact flash cards are viable.
• Take the slides to Exeter for further analysis.
• Do another cytology test. Have to chase up the staining procedure.

I wondered my urine pH is frequently low at 6.

The following extract states that the common pH level is 6 and that a vegetarian diet is likely to produce a more alkaline urine. Further that early morning urine is relatively acidic due to lack of oxygenation following lower respiration whilst sleeping .

So if I test later in the day, say about noon and its generally above 6 then that may be fine. I am a bit concerned about the 'Mission' sticks giving a lower reading that UriTest and must get in contact with the suppliers and manufacturers. Will also ask Dr McCormick for half a dozen of the ones they use.

My concern was that I read somewhere that cancer cells create an acidic environment.

From: BBC News

Bicarbonate 'could detect cancer'

The naturally-occurring chemical bicarbonate, used to make baking soda, could help detect cancer using sensitive scanning, research suggests.

Bicarbonate is involved in the body's balancing of acid and alkali.

But cancerous tissue is known to turn it into carbon dioxide.

The Cancer Research UK team found MRI scans were able to track changes in the chemical and therefore identify cancers even in the very early stages.
Almost all cancer has a lower pH, meaning it is more acidic than surrounding tissue.

2008/05/28

From: rnceus.com

"The glomerular filtrate of blood is usually acidified by the kidneys from a pH of approximately 7.4 to a pH of about 6 in the urine."

"A diet rich in citrus fruits, legumes, and vegetables raises the pH and produces urine that is more alkaline."

"During sleep, decreased pulmonary ventilation causes respiratory acidosis. As a result, a first waking urine specimen is usually highly acidic."

For more on the diet see:
ACIDIC URINE - A MUST FOR THE UROSTOMATE NOTE:This site seems to have closed (19th July, 2009)
Please try this site: ctds.info/acidic-foods.html

"Very often a person with a urostomy is told not to drink orange juice, but is not given an explanation as to why. The rationale behind the advice actually applies to anyone who ever has had a bladder infection. Acidic urine tends to keep bacteria in check, thereby reducing the incidence of infection, and decrease crystal formation. But oranges and most other citrus fruits are not used by the body as acid but as alkaline."

For a more detailed explanation and list of foods:
Your Body pH Affects Everything:

" WHAT CAUSES ACID IN THE BODY

The primary cause of an acidic condition in your body is from what you put in your mouth. In other words, what you eat and what you drink. And it isn't how "acid" something may seem when you eat or drink it. It has to do with what is left over when you digest it.

Specifically, does eating or drinking something leave behind an acid or alkaline "ash". For example, I don't know about you but I love seafood. Scallops are one of my favorites. However, when your body digests scallops, it leaves an extremely acid ash. In fact, scallops are one of the most acid foods you can eat.

Unfortunately, a lot of the things most people put in their mouths create an acid ash. These include alcohol, coffee and a lot of flesh protein in your diet. Interestingly enough, stress also tends to create an acid condition in the body."

From : Roger Lovejoy
User-Agent: Thunderbird 2.0.0.14 (Windows/20080421)
To: plamkom@labcore.com
Subject: cytology and haematuria

Hi. Matthew

I just spoke to you from the UK about the ability to assess the origin of red blood cells by microscopic analysis. I had found this option via an associated website of yours: http://www.carepathonline.com/Topic.aspx?Nav=0&Rel=166

"If red blood cells are present in your urine sample, the pathologist will examine them closely with a high-powered microscope to observe their shape. The shape of the cells tells the pathologist whether they came from the kidney or from another part of your urinary tract."

As I mentioned the common options available to the punter, here is rather sketchy and it has taken me some months to get this far. Even the medical professionals seem to be bemused at my discoveries. (BTAStat, NMP22) and now this. The only view on cytology that I have extracted locally is being used to find cancer cells. My query is to know where the blood is coming from at this stage.

My queries are:

1. Is the analysis by an optical microscope or it some other higher tech. apparatus needed.
2. Can you provide me with any examples of how you discover the source, i.e. the differences in red blood cells. A description and/or images would be great. If it is done using an optical microscope I am thinking of buying one and doing regular checks myself.

Please let me know you get this so I can confirm I have the correct email address.

All the best

Roger Lovejoy

Subject: Haematuria and Cytology
From: Roger Lovejoy
Date: Fri, 06 Jun 2008 13:16:34 +0100
To: martina.hornby@phnt.swest.nhs.uk
User-Agent: Thunderbird 2.0.0.14 (Windows/20080421)

Dear Martina Hornby

Thank you for the time you spent helping me with my cytology queries regarding haematuria.

Re: Recommended Procedure for samples
You mentioned the recommended procedure is for three samples be taken, mid-morning, on consecutive days.
As the local surgery has samples collected at 11am I'm wondering what
condition the samples need to be in when they arrive at Derriford. Do
they have to arrive separately each day, so they are 'fresh' or can
they be stored locally, refrigerated or otherwise and then sent as a
batch?

On the subject of 'screening' for types of red blood cells
I can refer you to two web site pages. I have emailed the second and am about to call the first:

On reading the first again, I note doesn't specifically say that the cytology is the method for assessing the source of blood, its just the way its written in the same paragraph. It was very useful talking to you as it became clearer that using cytology to find the source of
haematuria may be a red-herring

1. From: http://www.carepathonline.com/Topic.aspx?Nav=0&Rel=166

"Your doctor may order urine cytology if you have blood in
your urine and a definite cause of the bleeding has not been identified. The medical name for blood in the urine is hematuria. It has many causes, including strenuous exercise, too much stress, infection, kidney and bladder stones, and even cancer. When there is blood in your urine, it is important to identify what part of your urinary tract the blood is coming from so any problems can be properly diagnosed and treated."

2. From: http://www.wisegeek.com/what-is-cytology.htm

"Another important aspect in the discipline of
cytology is
examining
cell interaction. By studying how cells relate to other cells or to the
environment, cytologists can predict problems or examine environmental
dangers to cells, such as toxic or cancer-causing substances. In humans
and other multi-cellular structures, cytology can examine the presence
of too many of one kind of cell, or the lack of enough of a certain
kind of cell. In a simple test like a complete blood count, a
laboratory can look at white blood cells and identify the presence of
an infection, or it may examine a low level of certain types
of red blood cells and diagnose anemia."

All the best

Roger Lovejoy