PSA, prostate exam? What would you do?

I certainly would have started testing years earlier.

I certainly would have started testing years earlier.

both. earlier. my disease was pretty advanced and would have been easier to treat years earlier.

ed

very prominent experts suggest a baseline at 40.

Not to sure to many people are following the USPSTF guidelines. Nobody on that panel was an expert on PCa.

I like the advice provided here by experts:

" Consensus Statement 4: Baseline PSA testing for men in their 40s is useful for predicting the future risk of prostate cancer. Although these men were not included in the two main randomized trials, there is strong evidence that this is a group of men who may benefit from the use of PSA testing as a baseline to aid risk stratification for their likely future risk for developing prostate cancer [7], including clinically significant prostate cancer. Studies have shown the value of PSA testing in this cohort for predicting the increased likelihood of developing prostate cancer 25 years later for men whose baseline PSA is in the highest centiles above the median [8,9]. For example, those men with a PSA below the median could be spared regular PSA testing as their future risk of developing prostate cancer is comparatively low, whereas those with a PSA above the median are at considerably higher risk and need closer surveillance. The median PSA for men aged 40–49 ranges from 0.5–0.7 ng/ml, with the 75th percentile ranging from 0.7–0.9ng/ml. The higher above the median, the greater the risk of later developing life-threatening disease. We recommend that a baseline PSA in the 40s has value for risk stratification and this option should be discussed with men in this age group as part of a shared decision-making process. "

www.bjuinternational.com/bjui-blog/the-melbourne-consensus-statement-on-prostate-cancer-testing/

Start at 45, as I did, and EVERY year after.

Inchoation, how early to start can be controversial, but I agree that earlier is probably better.

My sons are at risk due to the severity and age of my diagnosis.  I've suggested they consider a baseline PSA at 35, follow up at 40 and decide at that point what rate to be tested after that (annually or whatever).  I'm really hoping by 10 years from now we'll have some kind of definitive tests for PCa, both to detect and to decide on treatment and when.  We still are living in an age of a certain ignorance, with PSA as about the only screening tool.

My sons are at risk due to the severity and age of my diagnosis. I've suggested they consider a baseline PSA at 35, follow up at 40 and decide at that point what rate to be tested after that (annually or whatever).

so 35 for your kids and 45 for everyone else ?

ed

Dear Colbran's Husband,

We, the several random guys on the internet she asked about it, are writing you this note to tell you that when she asked about it we all agreed that 47 is not too young for you to get a PSA test to screen for prostate cancer. Of course, since she found us on a prostate cancer support site, we have all had prostate cancer and most of us wish we had been tested sooner. But, really, there isn't much down side to the test.

The only real harm the test can do is that in the unlikely event that something is found and you are diagnosed with a low-risk cancer that you will run off in all directions and wind up getting treatments that have side effected worse than the disease. But if you promise us that if your doctor says "Gleason 6" to you you will be a hard sell for treatment then you will do OK.

Yours sincerely,

The Internet

F8 said...
My sons are at risk due to the severity and age of my diagnosis. I've suggested they consider a baseline PSA at 35, follow up at 40 and decide at that point what rate to be tested after that (annually or whatever).

so 35 for your kids and 45 for everyone else ?

ed
===================================================
What deserved the snarky comment? Geez, I don't appreciate being accused of hypocrisy. I think I've reached my limit with this forum.

Please reread what I posted. I said 35 for my kids *because they're at risk*. They have a major risk factor: me. If one of you guys was diagnosed with high volume T3 G9 at 55 years old, and has male kids approaching that age range, I'd recommend the same.

For the general population, WITHOUT such risk factors, yes, I think 45 is ok for the general population, maybe 40, especially with the crummy screening tools we have available today.

Have a nice day.

redwing -- whoa man! I was kidding but also trying to make a point.

my dad was the youngest of 10 kids. his oldest brother was 32 years older than him. my dad was 32 years older than me. I met his family once when I was seven. my mom is from japan. I never met her family.

I don't know anything about my family's medical history. was I "at risk"?

my point is i'll bet most of the "advocates" for PC -- especially the ones afflicted themselves -- don't practice what they preach -- i.e., they get tested and they recommend it to their familes and friends. when it comes to family and friends I'll bet anything they aren't saying to wait till you are 54 to begin screening.

that's the real hypocrisy that I see.

ed

Guys,

How do you manage to get into an argument when you are all on the same side??

Colbran,
Please have your husband get a PSA test. Prostate cancer has no symptoms until it is "advanced"..I see little difference between BC & PCa screening...Hopefully there will be a better test when your son is 40. In the interim, John T's advice makes sense to have a "baseline" at age 40.
Of course, if your husband is African American his chances of dying from prostate cancer are 21/2 that of Caucasians..New tests are being developed and there are a few of us trying to have the task force's "Not Recommended" invalidated. For your peace of mind have hubby get a PSA test.
Bill

My son got this base line at 35 due to the long family history. He discussed it with his Dr and the
Doc said he thought it would be important and a very good idea to have a baseline.

F8 - I guess when someone has not idea about family history then the decision of the starting time should be discussed with the Dr.

I had such a long history on my fathers side that I felt fairly certain that sooner or later I would go down the same road. So I kept a fairly close eye on my PSA.