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Posted 2/26/2012 1:57 AM (GMT 0)
I liked the suggestion of kicking the doctor in his nuts, sounds fitting to me!!!!
Posted 2/26/2012 2:15 AM (GMT 0)
I remember hearing about the study at the time it just came out and mentioned to my internist, and questioning if the test was necessary. He told me in no uncertain terms that it IS an important test and he has saved lives with it. I like his attitude.
Posted 2/26/2012 2:24 AM (GMT 0)
Hopefully, our great grand sons will have a better idea of what to do when they get their biopsy report. I say that because it will take that long to do the long term studies to prove the theories and ideas that come from people like Dr. Bonkoff in Germany. The issue is they cannot predict if your PC will kill you in 5, 10, 15, 20, or 25 years. If we knew with some certainty how long we had if we did nothing, active surveillance would become a more viable option more often than currently used. If we knew the cancer was going to let us live a good life until we were say 80 something, then why treat and loose two years of prime sex life after recovering from RP when we are probably going to die from the high blood pressure we currently have now. The great issue we face is making a decision with so little good information to make it with. The problem for the medical community is trying to make accurate long term 20 plus year studies that are based upon 20 year old technologies that are obsolete half way through the study. With that said, Dr. Bonkoff's work is certainly a step in the right direction.
Posted 2/26/2012 3:41 AM (GMT 0)
MsWorryWart, every time I look at your husband's stats, I am sadden by that neglectful doctor.  Did your husband ever contact him to let him know what a horrible thing he did?
Posted 2/26/2012 8:02 AM (GMT 0)
Aimzee... Once we got to MDA and they staged him, they asked for all doctors that we wanted on the list to receive updates. We let that first grim update go to the negligent doctor, then took his name off of the list. We don't feel he deserves or has earned the right to be updated about this nightmare. Once we get settled on this huge decision before us, he will be my next mission. If for no other reason than "GP, for the GP." Men need to warned about him. He said the last DRE was perfectly normal and about 8 doctors, NP, Interns, etc., all called T4 by DRE.

I am struggling hard to forgive him. His negligence forever changed our lives... My husband and I got married without knowing that he had cancer, so the only thing I can thank that doctor for was for not ruining our honeymoon.
Posted 2/26/2012 12:54 PM (GMT 0)
Tom, with your age, stats and family history the chances of you having PCa are low.  However, low does not mean non-existent.  The smart thing to do is to continue to have the PSA tests.  The rash of overtreatment is not a result of testing; IMHO it is a result of decision making.  If nothing else the PSA results will provide you with peace of mind...

Tudpock (Jim)

Posted 2/26/2012 3:56 PM (GMT 0)
I appreciate all the thoughts shared. Best wishes to all.

Tom
Posted 2/26/2012 10:37 PM (GMT 0)
In my case my PSA went from 1.5 to 5.25 in 18 months and with my family history my GP said no way to not have a PSA yearly. My DREs were all normal but only the PSA indicated that all was not normal. My post pathology showed I had G7 in 60% of my prostate which was fortunately all organ confined. My URO told me based on the pathology it most likely would have escaped the capsule in 2 years or so.  Fire your GP as many have said.
Posted 2/26/2012 11:04 PM (GMT 0)
I'm with majority on this one. In my view (and I'm no doctor) Annual PSA testing for guys over 50 is a prudent course of action, as long as you are educated on what the results actually mean. The test can provide an indicator of a possible problem and it does at least flags something that could have otherwise gone unnoticed.

I had symptoms of benign enlargement for years, but my PSA stayed fairly steady until the last couple of years when it to started to rise (although not excessively). My Uro finally decided to conduct a biopsy when my PSA reached 3.4 and had been climbing steadily over the preceding year. He remarked to me that he worried that he may have been overtreating me because he could never feel a tumour in his many DRE's.

Anyway, the biopsy came back positive with an aggressive tumour, which thankfully I had removed shortly afterwards and my prognosis, while uncertain, is far better than it would have been if I had not been PSA tested.
Posted 2/26/2012 11:15 PM (GMT 0)

Tom, As you can see the post have been overwhelming to continue the tests.  My history is below and I had no problems until I was over 65 and had a RALP just last December with a final Gleason of 4+5. Fortunately due to PSA plus biopsy it was found early enough to be gland contained. Your GP does not understand the importance of this major killer of men being discovered early by this very simple blood test.

Age 67: PSA 2 DRE normal
Age 68: PSA 4 DRE normal  Free PSA 6, Biopsy negative
Age 69: PSA 6 DRE normal, Biopsy negative
Age 70: PSA 8.5 DRE normal, Biopsy negative
Age 71: PSA 14 Saturated Biopsy negative, DRE normal
Age 72: PSA 20 Biopsy UCSF,  positive 2 of 10 G: 4+3
Age 73: RALP UCSF, Dec 9, 2011, T1c, neg margin, neg vesicle, neg nodes, G: 4+5
1/16/2012  Post Op PSA <0.9

Posted 2/27/2012 12:07 AM (GMT 0)
I guess I might as well throw in my two cents.  My internal medicine doc strongly believes in the PSA test and included it in every annual physical exam. 

Over a period of about half a dozen years, there was a steady rise.  When it passed 4.0, he told me to see a urologist.  I did not.

When it went past 5.0, he said I really should see a urologist.  I did not.

After all, cancer couldn't possibly intrude into my life.  I felt I was immune.

When it went past 6.0, he was adamant.  I needed to see a urologist for a DRE and possible biopsy.  Finally, because of the reading over 6 and having seen two funerals for guys younger than myself who had died from prostate cancer, I agreed to see the uro, and the rest is history.

Fact:  I would have never had the DRE or biopsy by the uro without the PSA test results.  As you can see in my "signature," I turned out to be a Gleason 7, with a palpable tumor.

The PSA test is not perfect, but it's better than ignorance, and the results can motivate a guy to investigate further.  Just three weeks ago, I saw my internist and thanked him for insisting on the PSA test.  I feel as if he saved my life, and that may not be an exaggeration.

Posted 2/27/2012 12:50 AM (GMT 0)
Thanks for the new posts. All very informative and helpful. I've been doing much reading about PSA and PC and will have a thoughtful conversation with my doctor.
Posted 3/1/2012 8:45 PM (GMT 0)
My uro's office gave us pamplets explaining their stand on this,they were totaly for PSA'S and also Mamograms are facing same scrutiny.Insurances will save millions,while people will find out as indicated above.you have to be your own advocate for health care,my insurance allowed once a year, but everyone in my family has had pc ,both brothers and my father,my sister has breast cancer,my mother died of leukemia,so I had the second test done each yesr on my own,or at health fairs,sure enough I tested positive last year but got it early before it had spead.I would change Dr's who doesn't belive in prevention of any kind.I changed health insurance last year because Kiaser wouldn't replace my ankle,they said I was to young,but I couldn't hardly walk, I found a realy good ortho changed ins,then for the testing for the new DR I had them do a PSA and that's how I found out.I would not have found out till 8 months later if I stayed at KAISER.I had the ankle replaced Nov 16,in Lakewood,colo and 3 months later ,I have very little pain,walking great and will be skiing by the end of the month.Your the boss!!!! Tell them what you want!
gamms
Posted 3/2/2012 1:56 AM (GMT 0)

I firmly believe in PSA testing.  I am 52yo and just had a radical prostatectomy on 2/22.  The results were T2C and perineural invasion.  All other Pathology was clear including the bladder neck.  The DRE has been done yearly and was normal.

My father passed at 74 from PCA and I have my PSA screened yearly.  Given the recent logic of no PSA screening I was a ticking time bomb - I can only estimate how long before my PCA went further into my system and got the best of me but believe it would've been long before I am ready.

Although not perfect, the PSA saves lives period.

On another note, I am due to get the Cathether removed next week - only 14 days from the surgery.  I am suprised on the time needed for recovery for many who have participated in this thread.

Posted 3/2/2012 3:01 AM (GMT 0)
Welcome aboard, rasmi:  You'll be really relieved when the catheter is removed.  However, I wonder if you've been misinterpreting something.  You'll find guys who have their catheters removed anywhere from 5 days after surgery to two or three weeks.

The issue with "time needed for recovery" isn't really the removal of the catheter.  The issue is recovering the ability to control your urine afterwards.  That can take anywhere from days, to weeks, to months, and sometimes never.  Continence is the big worry, and I hope everything works out well for you in that regard.

Posted 3/2/2012 4:02 AM (GMT 0)
Thanks, that makes more sense to me. 

Posted 3/2/2012 5:05 AM (GMT 0)
No one who looks at this chart below could rationally question whether PSA testing saves lives. Widespread PSA testing was starting in 1994.


VIEW IMAGE
www.scielo.br/img/revistas/ibju/v30n1/1a02f01.gif
Posted 3/4/2012 4:11 AM (GMT 0)
I hate to think where I would be in a few years if it were not for PSA screening. I have always had good DRE's and no other symptoms until my PSA began rapidly climbing. I have clear margins after my RP but shudder to think what could have been if my family doctor were not determined to check it every year since I had a couple of 3+5's show up on biopsy.
Posted 3/4/2012 4:11 AM (GMT 0)
I hate to think where I would be in a few years if it were not for PSA screening. I have always had good DRE's and no other symptoms until my PSA began rapidly climbing. I have clear margins after my RP but shudder to think what could have been if my family doctor were not determined to check it every year since I had a couple of 3+5's show up on biopsy.
Posted 3/4/2012 3:33 PM (GMT 0)
I'm 68 and had a yearly PSA test.  2011 results showed a  high PSA and the subsequent biopsy indicated a need for treatment.  My signature tells the story.  I'd read the most recent buzz about "wait and watch" but was convinced by the doctor there was a probability the cancer would spread beyond the prostate and my current health (great) and projected life expectancy merited surgery.  This is my experience and you must weigh the options based upon your situation.  I'd suggest a visit to another doctor or a specialist. 
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