Just wondered what you guys would advise me to do about psa testing

The study that the new recommendation (against testing) is based on followed a group of men randomly assigned to treatment and active surveillance for 12 years. It says that doing nothing is just as good as getting treatment for localized, low-risk cancer (Gleason 6 or lower). A government commission, based on this, make the nonsensical recommendation that men shouldn't be screened at all, because it was leading to over-treatment and side effects. Better advice would have been to get the tests and then respond appropriately.

For Gleason 7 or higher, the same study indicated a benefit for treatment, but it was not statistically significant -- but that my be due to a much smaller sample of men in that category.

Also, the gap between the treated and the untreated is likely to grow over time, so if (like me) you hope and expect to live 30 years or more, this study is not adequate to justify not treating cancer let alone not even screening for it.

So, if I were you, I would continue to get tested. Also, relax and enjoy your good health! You sound like you're in pretty good shape!

Me: Age 53, Gleason 7 in one core, PSA 3.9 (doubled in 2 years)
Scheduled for surgery 6/14/12. Wish me luck.

CVC,
The USPSTF recommended against the PSA test because many doctors and patients are under informed and that this leads to over treatment.

You are a very informed PCa researcher on the lay aspect of the disease. You've been here asking questions for years and have not as yet had that fateful diagnosis. This is a personal decision that you must make. But I feel pretty good from what I have observed that you would not over react if your PSA takes a sudden jump, and that you are educated about treating versus not treating the disease.

I also believe that if all patients did as you have done, good research, and the willingness to learn before acting ~ the USTSPF would never have released their recommendation to end prostate cancer screening.

Tony

cvc,

I think (hope) we are in agreement that an informed patient can decide if he wants to live with the information that a PSA test provides him, and then ask for/ agree to the test. You have already made that choice. If I were on the same path as you, I would say that the conversation is no longer relevant. The Pandora's box of PCa that hovers over every male's head is open for you and me, and even if it meant using a June PCa event to get a free test, I would be doing it (in fact I will do that in a few days - will be free and give me an annual test from a known lab to compare to my normal monthly test at another). But, as I implied before, hindsight is 20/20 for me in that respect.

The bruha is over screenings (that does not include diagnostic tests)that sweep in numbers of men that may not even know the test is being done. This doesn't even apply, in my opinion, to men's health events, since in those events, you must decide to participate.

I can see it being a life-changing-event for someone who discovers it due to an insurance application or job-related test, when they didn't even know it was being run. In those cases, panic could easily take over, and give "overtreatment" the opportunity to happen.

Maybe I just have a good GP, but he goes over all the tests he orders, and tells me why. Even that does not eliminate the possibility that he will find something completely unexpected on another front, and I'll be thrown in yet a different crisis. One day at a time -

cvc, that's the whole problem with ultra sensative testing, it really does make some men freak if they get some microscopic increase. i don't see any value in the test reading more than x.xx. the ones that can test x.xxx or x.xxxx (which i have heard exists), serves no useful purpose in my opinion. if you have a failed primary treatment, the x.xx readings can be very important to see if there really is BCR taking place.

good luck, and hopefully, the numbers in your case will always be favorable. just think of it as just another blood test.

david