In message <[log in to unmask]>, Amrit
Takhar <[log in to unmask]> writes
>I have a 54 yearold patient who has asked to be screened for cancer as he has a
>family history of colon and lung cancer. He is also concerned about prostate
>cancer. He has no symtoms other than an intermittent dry cough over the past 4
>years (PFR 640, lungs clear) Physical exam normal
>
>What do other GPs do in this situation?
>What screening tests would you offer if any?
>He is happy to pay for any tests if not available on NHS
>
>DR Amrit Takhar
>Cambs UK
>
Hello Amrit-
--IMHO the difficulty here is that in general screening tests for common mens'
cancers are so lacking in sensitivity and specificity or,failing that,to
invasive to be practical.For example,no-one would have a screening
bronchoscopy.We thus risk giving false reassurance that all is well and this can
rebound.All I would do with this man is refer him for colonoscopy if the FH of
colonic Ca suggested polyposis coli.I'd try to stop him smoking,maybe do a PSA
even though I can't justify it on theoretical grounds but we're always looking
over our shoulder.That's as far as I'd go I think.
Best wishes,
Peter Glover
Rayleigh
Essex
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