Senior doctor says cyclists should tell GP about their bike-

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Senior doctor says cyclists should tell GP about their bike-

Postby Aushiker » Sun Mar 04, 2012 4:18 pm

to avoid unnecessary prostate cancer tests according to a posting at Road.cc.

Consultant urologist Chris Eden from the Royal Surrey County Hospital in Guildford says that cycling can temporarily raise levels of the glycoprotein prostate-specific antigen (PSA), potentially leading doctors to mistakenly recommend that the patient undergo a biopsy to test for prostate cancer, which may be indicated by excessive levels of PSA.

"Unfortunately some doctors may be unaware that cycling can spuriously raise a man`s PSA levels and so refer their patient for further and unnecessary treatment,” explained Mr Eden, “all because their cycling produced a false positive." he said.

He added that the heightened levels of the glycoprotein among bike riders did not in itself give rise to an increased risk of contracting prostate cancer.

"Cycling does raise PSA levels but only temporarily. So the way to distinguish whether cycling has caused a rise in levels is to refrain from getting on a bike for 48 hours and then having a second PSA test. The levels will have dropped if cycling was responsible for the rise," he said.


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by BNA » Wed Mar 07, 2012 4:39 pm

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Re: Senior doctor says cyclists should tell GP about their b

Postby Xplora » Wed Mar 07, 2012 4:39 pm

ANYTHING to avoid unnecessary testing in that area :shock: :shock: :shock:

:mrgreen:
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Re: Senior doctor says cyclists should tell GP about their b

Postby gorilla monsoon » Fri Mar 16, 2012 2:10 pm

Tell my doctor I ride? I cycle past the fat little bugger most mornings!
Some days you are a big, strutting rooster, some days you are a bit chicken and some days you are just a complete cocque. Roger Ramjet: 2009 Giant CRX3 Spockette: 2009 Trek FX 7.3 (WSD, property of Mrs Monsoon) Lady Penelope: 2011 Avanti Cadent 1.0 TdF
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Re: Senior doctor says cyclists should tell GP about their b

Postby sumgy » Sat Mar 17, 2012 8:48 am

Xplora wrote:ANYTHING to avoid unnecessary testing in that area :shock: :shock: :shock:

:mrgreen:


Umm you realise it is a blood test (from your arm).
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Re: Senior doctor says cyclists should tell GP about their b

Postby Aushiker » Sat Mar 17, 2012 8:59 am

sumgy wrote:
Xplora wrote:ANYTHING to avoid unnecessary testing in that area :shock: :shock: :shock:

:mrgreen:


Umm you realise it is a blood test (from your arm).


Protstate examantions/reviews are a two part test of which the blood test is only one part .... well unless my urologist has got it all wrong :wink: .

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Re: Senior doctor says cyclists should tell GP about their b

Postby petie » Sat Mar 17, 2012 9:16 am

Aushiker wrote:
sumgy wrote:
Xplora wrote:ANYTHING to avoid unnecessary testing in that area :shock: :shock: :shock:

:mrgreen:


Umm you realise it is a blood test (from your arm).


Protstate examantions/reviews are a two part test of which the blood test is only one part .... well unless my urologist has got it all wrong :wink: .

Andrew

Your doctor is correct. Gold standard is still a D.R.E.
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Re: Senior doctor says cyclists should tell GP about their b

Postby sumgy » Sat Mar 17, 2012 9:53 am

Agreed, but the 2nd part of the test is only usually pursued if something comes up in the blood test.
Unless your Urologist has something he needs to tell you. :shock:
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Re: Senior doctor says cyclists should tell GP about their b

Postby Aushiker » Sat Mar 17, 2012 2:54 pm

sumgy wrote:Agreed, but the 2nd part of the test is only usually pursued if something comes up in the blood test.
Unless your Urologist has something he needs to tell you. :shock:


Not in my experience. Both examinations are done at the same time ... has been my experience with my GP as I have a annual check and at the Urologist who funnily enough seems to have a hell of lot more knowledge than you are showing so I think I will stick with their expertise if you don't mind :wink:

Cheers
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Re: Senior doctor says cyclists should tell GP about their b

Postby sumgy » Sat Mar 17, 2012 3:39 pm

And I will stick to the 3 separate doctors that I have been to over the past 10 years or so that have all had me do the blood test and refrained from any additional form of testing.
But send me your doctor's name.
I will add him to my list of practitioners that I dont need to see currently. :mrgreen:

I will qualify this by saying I am under 50 (44) and I do understand that at 50 both tests are recommended.
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Re: Senior doctor says cyclists should tell GP about their b

Postby Aushiker » Sat Mar 17, 2012 5:26 pm

sumgy wrote:But send me your doctor's name.
I will add him to my list of practitioners that I dont need to see currently. :mrgreen:


I think your suggestion is a smart one ....

and for those who want informed advice .... the following is from the Victorian Government funded Better Health Channel which has a number of advisories related to prostates and prostate cancer ...

As the PSA test is not a reliable indicator of prostate cancer on its own, a digital rectal examination (DRE) is usually also recommended – the doctor uses their finger to check for enlargement of the prostate gland or other changes.
[my bold]

and there is also the Lions Australia Prostate Cancer Website

Many authorities advise that if you have a PSA test, you should also have a rectal examination. This is because not all cancers produce PSA. The rectal exam can pick up some cancers which are missed by the blood test.
- Source: Lions Australia Prostate Cancer Website

and of course the Urological Society of Australia and New Zealand

Although PSA testing is the best single test for the detection of prostate cancer, especially at low PSA levels (where the positive predictive value (PPV) of DRE in men with PSA < 3 ng/ml is only 4‐11%), the combination of PSA and DRE remains the most sensitive investigation for prostate cancer detection, especially for the detection of higher grade cancers. Based on ERSPC sub‐group data, the PPV of an abnormal DRE in the PSA 4‐ 10 ng/ml range is 48%, approximately twice as high as the PPV for PSA alone (5). The risk of missing a significant high grade cancer by omitting the DRE was estimated at 17% in this study. Therefore it appears appropriate that both serum PSA and DRE are used in the assessment of patients for prostate cancer, especially cancers of higher grade. [my bold].
Source: Urological Society of Australia and New Zealand PSA Testing Policy 2009

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Re: Senior doctor says cyclists should tell GP about their b

Postby Drenelin » Wed Apr 25, 2012 8:53 pm

Aushiker is on the money. PSA can be spuriously raised from other conditions such as Benign Prostatic Hypertrophy - which is pretty easy to pick up with a DRE. DRE + PSA together is more sensitive than either alone. Prostate cancer screening is a contentious issue among docs and public health officials though, so divergent opinions aren't exactly surprising.
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