In message <[log in to unmask]>,
Armando Brito de Sa' <[log in to unmask]> writes
>First, Amrit Takhar:
>
>>> family history of colon and lung cancer. (snip) prostate cancer. He has
>no >> symptoms other than an intermittent dry cough over the past years (PFR
>640, >> lungs clear) Physical exam normal
>>> What do other GPs do in this situation?
>>> What screening tests would you offer if any?
>
>
> Then, Patrick Atlas:
>>In France, we could propose him an Hemocult test then a colonoscopy for the
>>screening of colon cancer, a lung x-ray for the lung cancer. Anything else?
>>Biological markers are not available here for the cancer screening.
>
>-------------------------
>
>Here in Portugal we probably would do the Haemocult, the lung X-ray and a
>PSA for prostate Ca. All to reassure the patient, since neither have decent
>positive predictive values for asymptomatic patients, that is, for _screening_.
>
>As for colonoscopy, only faced with a history of family polyposis; it would
>be a violence to do it in an otherwise asymptomatic patient...
>
>There is a great paper on Canadian Family Physician (Dec 95, I think, or
>close) presented as a dialogue between a GP and a patient wanting to do a
>PSA test. The physician discusses all the pros and cons of prostate cancer
>screening while the patient makes the questions we regularly listen to.
>Beautiful. I can dig the reference if someone is interested.
Very.Thanks
Mary
>
>
>Armando
>
>
>
>=======================
> Armando Brito de Sa'
> Lisboa, Portugal
> [log in to unmask]
>=======================
>
--
Mary Hawking
Kingsbury Court Surgery
Church Street
Dunstable
Beds LU5 4RS
tel:01582 601289 (home)
01582 663218 (surgery)
fax:01582 476488 (surgery)
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