What did you know about screening?

iSpark,
Keep in mid that they state they do not recommend routine screening in "normal" risk men, but that does not mean they recommend against screening these men altogether. They are open on baseline screening saying that it should not be a part of protocol to automatically screen men but men concerned about risks should be advised about the pros and cons of screening. This is reasonable.

I seriously doubt any man outside of this forum knows anything about these statements, but those that do know that it's their choice that if they desire a screening they can still get it.

You can test me on it. Walk up to any man and ask what do you think about the AUA guideline #2? Try it a few times. I bet you can do it a hundred times and never get an accurate answer on what the guideline actually says. I bet you could blindly walk up to a hundred HW members and get lucky with 10% who could rattle off these guidelines.

The recommendations that are in the AUA guidelines are not intended to be patient facing. They are intended to educate PCP's about the level of evidence in screening. The guidelines in your PCP's office are all that matters when it comes time for an opportunity. My PCP knew so little about prostate cancer that I caught him several times with wrong information about my illness after I had already spent a year in forums. One of the gems was after I told him I was on Lupron he asked "do you still have a pair?". My response was yes that's why I'm on Lupron. I still today don't think he got that one.

Tony

Post Edited (TC-LasVegas) : 8/12/2013 2:05:15 PM (GMT-6)

Gedman,
Did you have any other symptoms? How about risk factors such as family history? Since you were a symptomatic man your reference to the AUA guidelines missed the point they make about risk factors. You had symptoms of bladder issues that you noted to the physician and in that case they recommend testing (as opposed to screening an otherwise healthy man). Good move. A bad move would be to withhold that information. And do that and it won't matter where any guidelines are.

Tony

Post Edited (TC-LasVegas) : 8/12/2013 2:06:18 PM (GMT-6)

Montee said:
"We need to ask the Ladies."

Amen to that. But wait. I am flashing back to my high school days. I remember my Health class that the girls went one way and the guys stayed and talked about football. The girls went to read that book I snuck from my sister "Our Bodies, Our Selves"

Where is that book for the high school boys? What did any of us learn about prostate cancer or testicular cancer when the girls went and talked about PAP smears and breast examines?

I don't ever recall hearing a word about prostates...

Tony

Went to uro bacause of urination problems, urgency, stop-start, etc.  He put me on Flo-max and it was a wonder drug.  He also wanted to do a Psa, which I'd never heard of, and the first one came back at 13.5.  He re-tested the next week and it came back 14.5. That's when he did the Dre and declared my prostate to be "quite generous."

From there it went to the biopsy and the rest is history.  Fortunately, my Psa has been .1 for a few years now.  I'm happy he was proactive in my situation.

Bob

I had my first psa test at 41 as part of an executive physical at scripts. It was 0.1. As part of an annual physical in 1998 when I was 54 my doctor gave me a PSA test because she said I was over 50; it came back at 4.4 and that was the start of my 10 year process. I also had psa tests required by the VA as part of my annual physicals after that. I have had PSA tests on the average of every 2 months from 1998 to late 2008. Screening at 40 did absolutely no good in my case, but screening at 54 did.

From Tony's first post:

"..Were you actually screened or were you given a PSA test after complaining about ED, urinary issues, etc."

Yep, that's me. My signature below pretty much tells my story. Severe BPH with urinary obstruction, resulting in the TURP, and then ongoing high PSA results afterwards (higher than would have been caused by the TURP, according to my uro), prompted him to recommend a biopsy, and I agreed, and the rest, as they say, is history.

ralfnaz said...
"What is telling in this thread is than in more than 20 years of commercial use the PSA test remains an unknown."

Ralph,
That's a big bullseye sir. The 20 years in which the PSA has been around and most guys are letting the doctors decide for them. This poll shows us that the bickering about when and whom to screen is hugely shadowed out by those who never knew they were screened, what a PSA test was, or who let the doctor decide for them.

Our problem is NOT the screening method. It's the aware patient, the one who takes control of their health, the patient that fully understands, that is lacking in this big and serious question ~ Should I be screened?

20 years later ~ no progress on this front...sigh...

I think the one good that came out of the USPSTF recommendation is that men are at least talking about the controversy.

Tony

remember David,
The doctor cannot recommend anything to an invisible patient. We're recommending a "Baseline at 40" or "Screen at 40" in a pool of potential patients that would do anything to avoid a doctors visit. If we really want to save lives we have to fix that.

What's more, most men don't even think about a PSA test when they don't know what it is or is they don't know the doctor screened them.

Very few men here knew about family history and what to do with that information. According to this poll, which matches others I have seen, men only really care about prostate cancer after they have been diagnosed with it.

So the best way to save lives is get as many men as you can aware of PCa and how to screen. You won't be able to do that at a board focussed on what to do after the Dx.

And you might not ever get there with men in general. It took my brother three years after my Dx to get a PSA test done. And when I asked him what the results were he said fine. I couldn't even get him to ask the doctor what the results were by a number. Today ~ he's fine!

Geez.


Tony

I didn't vote because none of the answers apply to me. I had a baseline PSA and a DRE at age 40, and annually thereafter. I knew that a PSA test was a screening test for prostate cancer, but my PCP did not discuss with me. He only said we would do a number of general lab tests to screen for good health. He did not talk about any specific tests, but along with PSA, I was tested for electrolytes, thyroid hormones, glucose, liver, heart and kidney function, blood counts, and fats like cholesterol and triglycerides. I was provided a copy of the results each year. In the 15th year my PSA quadrupled. We waited three months, then retested. A biopsy followed, which was positive (G6 confirmed by Dr Epstein at Johns Hopkins)and I had surgery four months later. Based on current treatment guidelines, Active Surveillance would likely have been suggested as a recommended option.

The difference between answer 2 and answer 6 is the doctor screened you both times without telling you, oh and after he did, he also had to explain what the PSA test was.

Tony

Well David Purg,
What box did you check? The question is before you were screened what did you know about it? If you were tested because of symptoms then don't answer because you were not screened.

I really agree with your second part. The biggest problem in prostate cancer screening is patient knowledge or willingness to participate. How are we going to reach them? We are not going to reach one that carries an unlisted number about their health ~ the average American male!

Pardon my comment but the context is right. We have bigger health care issue in America taking the most lives that are 100% avoidable and PCa isn't it ~ it's obesity.

LOL it's probably a waste of time talking to an obese man standing in line at McDonalds about prostate cancer...

Tony

tony, there really wasn't the exact box that fit, so I picked the "I talked to my doctor about my health...."

At age 49, had a regular yearly physical with him. At age 50, he said that now that I was 50, I needed to have my PSA checked on a yearly basis. I think I asked him why, and he said to look for PC, that's all I can remember. It was just another vial of blood to me

Until my PSA quickly rose to 4.x, I didn't question the decision or choice, and it was then, that he sent me to my uro for the first time recommending my first of 3 biopsies.

I had no symptons, so from that vantage point, I guess I didn't need being checked, if that is what you are wanting me to say. But glad I did, because the beast was surely already in me even at age 50.

I agree, obesity is a tragic and huge health issue, more than all the other ones combined, add smoking to that, and between the two, that would make up most of the health issues by percentage.

But most people are oblivious to these obesity thing. Living here in the deep south, it seems like a hopeless issue.

True story, recent. I rarely eat at Taco Bell (yuck). The other day, I watched this man eating lunch, he was alone. I would guess he weight275-300 lbs. easily. He ate 10 regular hard shell tacos, some kind of huge burrito, and 2 other Taco Bell offerings (not sure what they were), plus gulping down the largest possible side Coke product all at the same time. Gee, I wonder how he got that size.

Can you imagine the calorie content, fat content, salt content, of just that one lunch? Only in America.

David in SC

Gedman,
Yea it would be out of protocol to have been having annual DRE's as well. Can I ask when your doctor started those?

Tony