Latest NY Times on PSA screening

[Guest]

This article comes from the scientist who pioneered the test:

http://www.nytimes.com/2010/03/10/opinion/10Ablin.html?src=me&ref=general

[Guest greatness]

well

 

Maybe he is upset because other scientists are frequently mentioned as discoverers of PSA. Just kidding. Dr. Chu has been widely mentioned as the discoverer of PSA and I wonder why that is because there were others prior to him. Any ideas?

 

http://www.prostatepros.com/about/man-behind-psa-test

 

 

 

This article comes from the scientist who pioneered the test:

http://www.nytimes.com/2010/03/10/opinion/10Ablin.html?src=me&ref=general

[OneFinger]

Personally, I think he brings out some great points in the article. I specifically liked the his comment that "...American men have a 16 percent lifetime chance of receiving a diagnosis of prostate cancer, but only a 3 percent chance of dying from it."

 

In my mind, that really puts things in perspective. Prostate cancer is a very slow growing cancer. And, even after diagnosis, you're more likely to die from something else. In some cases the best thing to do is NOTHING.

 

My father and his 7 brothers all had prostate cancer. They listened to their doctors and had surgeries that really affected the rest of their lives. Most were left with sexual dysfunction and required to use catheters for the rest of their lives.

 

Currently, I'm the oldest male in the family NOT to have prostate cancer (thank goodness). I religiously get my PSA test just so I can be AWARE of my status. As stated in the article, "...men with a family history of prostate cancer should probably get tested regularly. If their score starts skyrocketing, it could mean cancer."

 

But, like all younger cousins who have prostate cancer, I'll probably take a much less aggressive approach to the disease. I can't imagine having radical surgery or the type of radiation my father and his brothers endured.

 

There are a lot more options for guys today who are diagnosed with the disease. To me, the most important point is that there is no need to make hasty decisions and take drastic measures. Consider all your options and remember that there is only a 3% chance that you'll die from prostate cancer.

[justaguy]

Thanks for posting this. New information for me and lots of food for thought.

[Luv2play]

remember that there is only a 3% chance that you'll die from prostate cancer.

 

That may apply to the general population, but once you have been diagnosed with prostate cancer, you chances of dying from it go up significantly. That is what concentrates your mind once you receive the diagnosis. Before that your chances sound very good and most don't get too concerned.

[Guest Tristan]

That may apply to the general population, but once you have been diagnosed with prostate cancer, you chances of dying from it go up significantly. That is what concentrates your mind once you receive the diagnosis. Before that your chances sound very good and most don't get too concerned.

 

Note that OneFinger stated that even if you're diagnosed with prostate cancer, you have a greater chance of dying from something else because most prostate cancers are slow going. While it's true that early diagnosis has saved lives, it's also true that aggressive treatment has ruined lives. There are serious consequences for both your sexual and urinary functioning - ED and incontinence, or worse.

 

Now the good news. I saw a medical report about a new treatment procedure. It's involves focused radiation. I don't know which hospitals are now doing it, but it's something that anyone having to make a treatment decision should track down. Basically, the new procedure targets the cancer cells, but spares the nerves that affect sexual and urinary functioning. The odds of having sexual dysfunction or incontinence from this procedure are very low.

[Guest]

Personally, I think he brings out some great points in the article. I specifically liked the his comment that "...American men have a 16 percent lifetime chance of receiving a diagnosis of prostate cancer, but only a 3 percent chance of dying from it."

 

In my mind, that really puts things in perspective. Prostate cancer is a very slow growing cancer. And, even after diagnosis, you're more likely to die from something else. In some cases the best thing to do is NOTHING.

 

My father and his 7 brothers all had prostate cancer. They listened to their doctors and had surgeries that really affected the rest of their lives. Most were left with sexual dysfunction and required to use catheters for the rest of their lives.

 

Currently, I'm the oldest male in the family NOT to have prostate cancer (thank goodness). I religiously get my PSA test just so I can be AWARE of my status. As stated in the article, "...men with a family history of prostate cancer should probably get tested regularly. If their score starts skyrocketing, it could mean cancer."

 

But, like all younger cousins who have prostate cancer, I'll probably take a much less aggressive approach to the disease. I can't imagine having radical surgery or the type of radiation my father and his brothers endured.

 

There are a lot more options for guys today who are diagnosed with the disease. To me, the most important point is that there is no need to make hasty decisions and take drastic measures. Consider all your options and remember that there is only a 3% chance that you'll die from prostate cancer.

 

In addition to the family history of prostate cancer, it's probably crucial to know whether those who had prostate cancer actually had metastatic (i.e. symptomatic) cancer. A close relative who died OF prostate cancer is far more concerning than a close relative who died WITH prostate cancer. As for me, if any doctor every suggests PSA screening for myself, I will paraphrase General William T. Sherman: "If the blood test is offered, I will not let myself be tested. If I knew I had a positive PSA, I would not allow a biopsy. If I had a suspicious biopsy, I would not allow any surgeon to touch my prostate."

[instudiocity]

If I had a suspicious biopsy, I would not allow any surgeon to touch my prostate."

 

What about a Hung, Total Top?

[Luv2play]

Note that OneFinger stated that even if you're diagnosed with prostate cancer, you have a greater chance of dying from something else because most prostate cancers are slow going. .

 

While what you say is true as far as it goes, what you don't mention is at what age you receive a diagnosis of prostate cancer. If you are over 75, then chances are good something else will get you first before the prostate cancer does. But if you are in your 50's, then that is a long time before you reach 75. Left untreated, the cancer will grow and eventually will mestasisize. Then you are looking at a very bad outcome indeed. Like cancer of the bone or brain.

 

I would like to see statistics that only isolated individuals diagnosed with prostate cancer under the age of 60. If you eleiminate all the older guys, many of whom will develop prostate cancer in their 70's or 80's, than the statistics I am sure will not look so promising for survival without treatment of some sort.

[KMEM]

L2p-

 

I agree with what you post and, not only that, but prostate cancer found in younger men tends to be more aggresive than that found in older gents.

 

So, if you find you have prostate cancer at a very young age, you have two chances to die from the complications thereof; one, you will live long enough for even slow growing cancer to get you and,two, you likely have a fast growing version. I don't like either option.

 

Best regards,

KMEM

[uwsman2]

by the numbers

 

So when I first read about the PSA test, back in the 1990s, I asked my doctor to give me the test. At that time my score was slightly elevated above normal, so the doctor said watchful waiting was appropriate and annual testing. The next few years of annual tests the score stayed the same and eventually I stopped getting tested.

 

Then a few years ago after hitting my early 50s I thought I should get tested again, and it was like off the charts - way above normal. My doctor sent me to a urologist. We've now been through quarterly PSA testing, two biopsies, an MRI, and special urinalysis that was such a new procedure the doc thought my insurance might not cover it (but it did), and so far we've found nothing. Now I'm 58, have a persistent high PSA test, and no signs of cancer. I do have an enlarged prostate, which probably accounts for the high PSA test, but digital exams show no lesions or bumps. What to do? I think another biopsy is a waste of time. If I have prostate cancer, it is the slow growing variety, since it has remained undetectable and my PSA score is stable, albeit high.

 

I told the doctor last summer that I think we should go back to semi-annual exams, as quarterly seems excessive. But after reading this new op-ed by the doctor who discovered the test, I'm thinking maybe annual is enough unless I develop active symptoms....

 

Do any other readers of this forum have similar experiences that might be helpful to share?

[KMEM]

As you no doubt know, an enlarged prostate can cause an elevated PSA. As long as the DRE seems normal and the PSA doesn't suddenly start rising, I think you would be OK doing annual tests. If either test shows a change, another biopsy would be in order, just so you know. Then the difficult part begins, what to do about it. First you need a confirmed diagnosis of cancer before worrying about any next step other than annual DRE and annual PSA.

 

There are least a couple of MD's who post on here. Maybe we will hear from one or more of them.

 

Best regards,

KMEM

[OneFinger]

While I'm not a doctor, I do know that there are many other variables that can cause a spike in your PSA results.

 

Since you've had the biopsy, DRE, and other forms of verification I think your idea to go back annual exams is prudent. You've established YOUR PSA baseline and probably don't need to be concerned unless it start rising above that level.

 

Again, discuss with your Dr. But, there are other variables (besides prostate cancer) that can cause spikes in your PSA readings.

[Guest greatness]

I agree

 

Good point!

 

 

Again, discuss with your Dr.

[Guest greatness]

lol

 

What about a Hung, Total Top?

[Guest]

So when I first read about the PSA test, back in the 1990s, I asked my doctor to give me the test. At that time my score was slightly elevated above normal, so the doctor said watchful waiting was appropriate and annual testing. The next few years of annual tests the score stayed the same and eventually I stopped getting tested.

 

Then a few years ago after hitting my early 50s I thought I should get tested again, and it was like off the charts - way above normal. My doctor sent me to a urologist. We've now been through quarterly PSA testing, two biopsies, an MRI, and special urinalysis that was such a new procedure the doc thought my insurance might not cover it (but it did), and so far we've found nothing. Now I'm 58, have a persistent high PSA test, and no signs of cancer. I do have an enlarged prostate, which probably accounts for the high PSA test, but digital exams show no lesions or bumps. What to do? I think another biopsy is a waste of time. If I have prostate cancer, it is the slow growing variety, since it has remained undetectable and my PSA score is stable, albeit high.

 

I told the doctor last summer that I think we should go back to semi-annual exams, as quarterly seems excessive. But after reading this new op-ed by the doctor who discovered the test, I'm thinking maybe annual is enough unless I develop active symptoms....

 

Do any other readers of this forum have similar experiences that might be helpful to share?

 

Another test which can be done (if it hasn't already) is free PSA. Those with cancer have very little free PSA. Anything above 15% is comforting, and above 20% is even more so. Try to ejaculate as often as possible. Although good studies haven't been done, it appears that holding it in may make the prostate unhappy....

[Guest Tristan]

Another test which can be done (if it hasn't already) is free PSA. Those with cancer have very little free PSA. Anything above 15% is comforting, and above 20% is even more so. Try to ejaculate as often as possible. Although good studies haven't been done, it appears that holding it in may make the prostate unhappy....

 

Good point on the free PSA. A lot of people don't know about this test.

 

Actually, there was a study of gay vs. str8 men. Str8 men had a significantly higher incidence of prostate cancer. The study concluded that gay men have a lot more sex, preventing prostatic fluid buildup. I don't think it matters whether you have sex with someone else or you masturbate. The point made by Unicorn appears to be an important factor.

[Guest greatness]

oh my

 

I should do more sex..

 

Good point on the free PSA. A lot of people don't know about this test.

 

Actually, there was a study of gay vs. str8 men. Str8 men had a significantly higher incidence of prostate cancer. The study concluded that gay men have a lot more sex, preventing prostatic fluid buildup. I don't think it matters whether you have sex with someone else or you masturbate. The point made by Unicorn appears to be an important factor.

[Luv2play]

.

 

Again, discuss with your Dr. But,

 

 

I always think it is wise to have a doctor named "But" if you are going to have your rear end examined!