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PSA Test? AARP says "Skip it."

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Posted 3/31/2009 11:32 AM (GMT 0)
May-June 2009 AARP magazine, page 33:

"Medical Tests You Need...And Tests You (Probably) Can Skip"

They have PSA listed in the "You Probably Can Skip" column. They say "evidence for routine testing for men 50 through 74 is inconclusive." And they say, "Consult your doctor, especially if you have symptoms, such as painful urination or blood in the urine."

And if you have no symptoms at all (like me) and you just happen to have an aggressive form of prostate cancer, well then, you can just die a long, painful, cancerous death.

Once again, my personal opinion is, skipping the PSA test is not a good answer. What you do with the information is strictly your decision, but not knowing can literally kill you.

Just my 2 cents.
kcragman
Posted 3/31/2009 12:23 PM (GMT 0)
I get the AARP magazine myself. They have wide respect and readership in the millions. What absolutely terrible advice to start spreading around. I view things like this as a major step backwards in the detection and treatment of Prostate Cancer, and in saving the lives of almost 30,000 men a year. I think the magazine was irresponsible for publishing it, and may write a formal complaint to the editor. It pissed me off big time.

David in SC
Posted 3/31/2009 12:25 PM (GMT 0)
P.S. I don't understand, it's almost like anti-PSA testing campaign going on in the media now, where before, there was a lot of push. The PSA test, we all know, is a simple, quick, blood test, non-invasive as far as I am concerned.
Posted 3/31/2009 1:57 PM (GMT 0)
This is the standard "media and medicine" relationship. The media gets hold of a "hot" idea or announcement, they partially report it - right or wrong - and then they drop it. As far as the media is concerned, the follow-up details are not exciting enough.

Like salt. I think the NEJM reported in the 1950's that there was evidence that salt might increase your blood pressure. The media picked it up, and all of our mothers picked it up, and general pratictioners picked it up, and that's all you've heard since you were born. But sometime later, the NEJM quietly came out and said there was no empirical evidence that salt actually increases your blood pressure. Well, that was not exciting enough for the media, they never reported it, and we've all believed an inaccuracy for 40-50 years.

To be fair, my wife (the medical scientist) now says there have been recent studies that indicate that salt can - in some cases - increase your BP. I have not seen the studies, but the point is, the media injects some "sound bite" medical ideas into the population - and they are not always accurate. All the public is going to remember from this media blitz is "I don't need the PSA test." Sad.

Personal note: My father battled high blood pressure all his life until he died of heart attack - and rarely ever used salt on anything (of course the smoking and the drinking did not help). My mother's family (the farmers) have always salted their food like crazy people - never had a issue with high BP, but they die of cancer.

I might write a letter to AARP also.

kcragman
Posted 3/31/2009 2:13 PM (GMT 0)
Easy for AARP to say such a stupid irresponsible thing....IT hasn't been diagnosed at 50 with prostate cancer! The mag can say whatever it wants. The small fraction of men doagnosed at an early age represented here alone says "skipping" a routine PSA can lead to a death sentence.

Swim
Posted 3/31/2009 2:55 PM (GMT 0)

 ...man-o-man fella's I don't know....I run around and when asked always advocate testing....earlier better than later, and I'm in a hospital setting telling these guys to make sure the Dr has written orders to include PSA on their respective blood test.......just another reason why AARP doesn't get any of my money, I too think I'll send a little note highlighting this topic....

    Blue

Posted 3/31/2009 3:32 PM (GMT 0)
Swim, you said it right. Our group here just represents a tiny drop on the head of a pin with men with PC, can only imagine the number of advanced cases there would be one day if PSA tests were discontinued or discouraged. People tend to forget how many people are suspected of having died of different cancers in the "old days" simply because there weren't tests to know.
Posted 3/31/2009 3:58 PM (GMT 0)
The AARP magazine was founded by an insurance company, United Healthcare, I think. They are frequently on the "get someone else to pay" bandwagon. They wrote an article several years ago touting a federally sponsered healthcare system, administered by private insurance companies.

Sorry, I have to go out and check on the black helicopters buzzing my house.
Posted 3/31/2009 4:14 PM (GMT 0)
Actually they are somehow connected to The Hartford Insurance Company. Which gives me the best rates on my Truck Insurance by far through aarp and Ive had them for awhile now.
Posted 3/31/2009 4:39 PM (GMT 0)

Purgatory said...
P.S. I don't understand, it's almost like anti-PSA testing campaign going on in the media now, where before, there was a lot of push. The PSA test, we all know, is a simple, quick, blood test, non-invasive as far as I am concerned.

This is the same  AARP  who's support help pass a "flawed" Medicare part D legislation.  Those laws were set up to provide millions, maybe billions of dollars in excess profit for the insurance and pharmaceutical Giants.  While I appreciate some help with my drug costs, the plan was set up to benefit big business, not poor retirees.  It never would have passed in that form without AARP support.

I too wonder about the irresponsible reporting regarding PSA tests.  30,000 lives a year is worth something.

Posted 3/31/2009 4:48 PM (GMT 0)

realziggy said...
Actually they are somehow connected to The Hartford Insurance Company. Which gives me the best rates on my Truck Insurance by far through aarp and Ive had them for awhile now.

AARP is a major marketer of many different insurance packages.  Currently, they are selling United Healthcare's 'Secure Horizons Medicare HMO' under their own name.  (Which I buy)

If we understand that they have a profit motive, we can better understand their various positions.

Posted 3/31/2009 5:28 PM (GMT 0)

Regardless of what we may think about AARP's opinion, their opinion is a huge indication that the momentum is shifting concerning diagnosis and treatment of PCa.

I think having subjected ourselves to treatment we'd all like to believe we did the right thing.  Particularly when the side effects of that treatment impact the lives of many of us on a daily basis.  But, we are a biased group here.

I wonder, if I hadn't been diagnosed,  would I want to have a PSA test.  No family history, no symptoms.  I don't know.  I have trouble getting my mind around it without being biased.


Posted 3/31/2009 6:05 PM (GMT 0)

kcragman,

Great catch and post...Here's the online version:

http://www.aarpmagazine.org/health/health/medical_screenings_you_cant_live_without.html

This is a rediculous suggestion, IMHO...We still need the data even if we have uncertainty.  But I know for a fact that lives can be extended.

Tony

Posted 3/31/2009 7:08 PM (GMT 0)

lifeguyd said...

Purgatory said...

P.S. I don't understand, it's almost like anti-PSA testing campaign going on in the media now, where before, there was a lot of push. The PSA test, we all know, is a simple, quick, blood test, non-invasive as far as I am concerned.

This is the same AARP who's support help pass a "flawed" Medicare part D legislation. Those laws were set up to provide millions, maybe billions of dollars in excess profit for the insurance and pharmaceutical Giants. While I appreciate some help with my drug costs, the plan was set up to benefit big business, not poor retirees. It never would have passed in that form without AARP support.


I too wonder about the irresponsible reporting regarding PSA tests. 30,000 lives a year is worth something.

It made no difference Dave, that was the bill passed through a republican congress. This was the same congress that forbid medicare negotiating a volume discount from the drug companies like the VA does. With ascent of a democratic congress in 2006 one of the first bills passed was correcting that scheme. The original bill would've passed without aarp support.
Posted 3/31/2009 7:12 PM (GMT 0)

Dave7 said...
Regardless of what we may think about AARP's opinion, their opinion is a huge indication that the momentum is shifting concerning diagnosis and treatment of PCa.

I think having subjected ourselves to treatment we'd all like to believe we did the right thing. Particularly when the side effects of that treatment impact the lives of many of us on a daily basis. But, we are a biased group here.

I wonder, if I hadn't been diagnosed, would I want to have a PSA test. No family history, no symptoms. I don't know. I have trouble getting my mind around it without being biased.

Dave you're 100% correct. I understand the bias. I'll also admit my treatment being far less radical makes it somewhat easier to say maybe I never needed it. Let see in about a year how many here would still recommend new dx patients do as they did.
Posted 3/31/2009 7:26 PM (GMT 0)
Dave7: You are right, we are probably biased. But what I tell my friends and relatives is this: In this one particular case, you have the power to save your own life right in your own hands. Why would you not at least check to see if you needed to use that power?

As I've said before, this is not altzheimers' (sp?) where, if they know you have the "gene" you are supposedly going to get it, and once you do there is just not much they can do about it. In this case you can choose to take a variety of actions - or none at all.

It just seems like common sense to me.
My opinion,
kcragman
Posted 3/31/2009 7:51 PM (GMT 0)
We are still talking about 30,000 men directly dying a year from PC, and that doesn't count the thousands of advanced cases that will take their places in the statistics further down stream. I can only speak for myself. I volunteered to start getting my PSA drawn at my yearly physicals at age 50, because that is what the common wisdom was at the time. I never had it earlier than 50, because there was no known cases of PC on either side of my family, at least not dx. Had I not been taking it yearly, and then ultimately it tripled and ended up with my dx. last August, I would have never known I had an agressive killer inside me. With no prostate trouble symptons, no other weird symptons going on, never would have known until ultimately it would have been too late, or at the best, a very advanced case. A biopsy is somewhat expensive, I can see not taking biopsies without good cause or reason, but to include PSA testing as part of an annual blood work test only makes common sense to me. It's not going to hurt any man to have a baseline PSA done, even at age 40, just to have a reference point. All I am saying, that without my own common sense at being tested on my own, having a good GP that was monitoring me closely, and having regular PSA tests, I very well may have been in a future group of dead 30,000 men from prostate cancer.

David in SC
Posted 3/31/2009 9:50 PM (GMT 0)
David I am with you 100% on this one. My GP followed the protocol of not testing PSA and so I never knew what it was or what mine was. He still doesn't believe it has relevance for the average man in his 40's or 50's unless there is some obvious reason to check it. I was referred to a urologist for a different issue who DID have it checked and that's when the whole saga of my PCa began. After being told by my surgeon that waiting one more year may have allowed the cancer to escape the prostate (positive margins) I am extremely grateful that my original urologist had such particular standards about when to test and when to biopsy. Isn't it obvious that in the absence of testing the number of late stage cancers is only going to increase? Even if you believe that overtreatment is rampant (which I don't necessarily), just the fact of knowing your own personal PSA number does not mean that you HAVE to have treatment, and it does give you information that will tell you whether you should check things out more definitively or not. My uncle who has melanoma, as well as my wife who has breast cancer would both love to have a simple blood test that could give them some idea of the relative condition of the diseases they have, and that if administered earlier in life may have let them fight these diseases sooner. I don't understand how anyone could know of the gift of PSA and not want to use it to find this cancer early, when it can still be successfully fought.
Posted 4/1/2009 12:00 AM (GMT 0)
I can say without doubt a PSA test probably saved my life. I had no symptoms, was not enlarged, routine part of a physical forced on me by my wife. The logic isn't there not to test, it may not be conclusive, but it is another tool,  a non-invasive one at that.
Posted 4/1/2009 2:17 AM (GMT 0)
Although I had been having symptoms I was lulled into believing it was just an enlarged prostrate due to aging. My GP performed a DRE and said it felt soft and smooth. Not likely to be cancerous. He said because of its size it might be a good idea to get a PSA test, but he felt that it probably wasn't important.

Imagine my surprise when the PSA test results came back with a reading of 7.8! Without the PSA test results I got I would have never been referred to a urologist and I never would have considered getting a biopsy, which of course led to surgery and my current situation.

Where would I be in the next few months if I didn't have the surgery? I can't really say for sure, but based on my stats it didn't look good. The PSA test was the tipping point for further investigation which turned out to be absolutely necessary.

I can only reiterate what others have said, the PSA test is a simple test that can provide additional information to help decide what the next course of action should be.

My first post-op PSA test was undetectable. My next is coming up in a couple of weeks. Whew!

Bob
Posted 4/1/2009 3:30 AM (GMT 0)
smhair  The AARP article just puts salt in my wound I can tell you. So here's the deal, 30,000 men die from prostate cancer each year but the studies show no improvement for 10 year survival whether or not you have PSA testing. So my brothers that means it doesn't matter if we do surgery, radiation, cryo, proton, HIFU, salvage radiation, or chemo. It changes nothing.  It means if you get prostate cancer either you're going to die of prostate cancer or you aren't regardless of what you do.  No treatment helps statistically. It means the gleason scoring on the biopsy or stage is meaningless because nothing we do affects our final outcome, we are doomed to live or die from prostate ca without any control over this disease.  So lets forget about PSA testing all together. I am super pissed about this conclusion since I am now impotent and have to have injections for sex (I guess for absolutely no point) but there it is. If somebody else has another take on these numbers I'd love to hear it.......................BIG mistake looking for prostate cancer, better to not be tested
Posted 4/1/2009 3:51 AM (GMT 0)

Statistics can prove anything.  I think it is irresponsible to conclude from  recent studies that men should not be PSA tested.

There are three kinds of lies: Lies, dam'ned lies and statistics.   Mark Twain

 

The most outrageous lies that can be invented will find believers if a man only tells them with all his might.                                         Mark Twain

 

 

Posted 4/1/2009 3:53 AM (GMT 0)
Whoever wrote that information for AARP is an idiot and should be fired. I am sick and tired of the media downplaying the PSA test. Is it perfect? No but it has sure saved millions of men including me. Next AARP will tell everyone not to get cholesterol tests and blood tests for diabetes. I was considering joining AARP but after hearing this I must question the decision to join.
Posted 4/1/2009 4:01 AM (GMT 0)
Yea well, now with the old congress and our new leader we will have "free" health care and I will be able to dump my $12,000 a year health insurance premiums. In my dreams. realziggy said... lifeguyd said... Purgatory said... P.S. I don't understand, it's almost like anti-PSA testing campaign going on in the media now, where before, there was a lot of push. The PSA test, we all know, is a simple, quick, blood test, non-invasive as far as I am concerned. This is the same AARP who's support help pass a "flawed" Medicare part D legislation. Those laws were set up to provide millions, maybe billions of dollars in excess profit for the insurance and pharmaceutical Giants. While I appreciate some help with my drug costs, the plan was set up to benefit big business, not poor retirees. It never would have passed in that form without AARP support. I too wonder about the irresponsible reporting regarding PSA tests. 30,000 lives a year is worth something. It made no difference Dave, that was the bill passed through a republican congress. This was the same congress that forbid medicare negotiating a volume discount from the drug companies like the VA does. With ascent of a democratic congress in 2006 one of the first bills passed was correcting that scheme. The original bill would've passed without aarp support.
Posted 4/1/2009 10:58 AM (GMT 0)

Friends,

I just posted this note to Tony's (TC-LasVegas') site. 
Swimom's brief note says it best:
Such irresponsible use of data can be a death sentence.

Mr. Tony & Ms. Ruthie,

I just read an article in the latest Newsweek using all these "studies" to trash all screening for Breast & Prostrate Cancer - and impuning many other cancer treatments.
All of this based on studies with questionable statistical significance for anyone planning to live more than ten years.
The insurance companies are certainly eating this up as their eye$ $ee dollar $igns for all the expense$ they can avoid as they push any stage three cancers that might have been prevented into the realm of 65 year old patients on Medicare.
I wrote Newsweek that - based on their eager endorsement of this position with such a (not just incomplete and skewed - but REALLY) slanted collection of data - I wrote that their editors should  not be allowed any testing or informed options for cancer treatment until they are 65 and dependent on the Government "legacy" program.
Tony & Ruth - Keep fighting the good fight.  Keep running the good race.  God Bless You for your kindness and concern.

Cedar

ICTHUS!
CCedar

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