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Posted 10/14/2023 8:22 AM (GMT 0)
My husbands dr prefers the Dre vs PSA.

I told my husband he should be getting both.


Is once yearly enough for the PSA unless it starts to rise?
Posted 10/14/2023 9:54 AM (GMT 0)
Girlie,

Please provide more information. Is this just for screening purposes, or does he have a known issue? How old is he? Does he have family history? Does he have other issues?
Posted 10/14/2023 4:58 PM (GMT 0)
I had both before I was diagnosed with cancer. After prostate surgery, I haven’t had a DRE since surgery. I know some doctor’s will still do both DRE / PSA after surgery. I only have PSA post surgery. if your husband still has a prostate and hasn’t had any treatment, seems he would have both but like Habert says, it would be good to get more information.
Posted 10/14/2023 7:09 PM (GMT 0)
"My husbands dr prefers the Dre vs PSA.'

i find that concerning on a couple of levels, and would be looking for a new doctor
Posted 10/14/2023 8:19 PM (GMT 0)

F8 said...
"My husbands dr prefers the Dre vs PSA.'

i find that concerning on a couple of levels, and would be looking for a new doctor


A DRE 'samples' only part of the prostate. Hence, it should be accompanied by (at the very least) a PSA test. How often depends on several factors. For instance, if his PSA level has been rising, more often than once a year might be insightful.
Posted 10/14/2023 9:09 PM (GMT 0)
I think that makes no sense, Girlie. I would push back, or find another doctor, never heard of this, especially if there are concerns, or if he was already treated
Posted 10/14/2023 11:52 PM (GMT 0)
Not right, hopefully he’s only using a hand digit and not some other appendage.
Posted 10/15/2023 1:27 AM (GMT 0)
When we all visit the lab, it's common to take blood for routine physicals.

It's not hard to add a PSA test.

From my vantage point, from afar, you are not being well served by your current doctor.

You must have already had those same doubts, based on the question in your posts.

I have kicked two doctors to the curb, since diagnosis ten years ago. The switch was beyond belief, in terms of expertise.

Be proactive and make that change. Make that call Monday morning. No looking back.

With my best ~
C-Y-C-L-O-N-E - # Iowa State University
Posted 10/15/2023 4:38 PM (GMT 0)
Girlie, you hubby is making a really bad decision. Most of us are diagnosed even though the DRE showed nothing. Once the DRE starts showing nodules there is a better chance that the cancer is spreading outside the capsule. Having regular PSA tests, and watching the trends, is the best way to make sure you catch the cancer early when it is more easily treatable and curable.

He needs to do both....full stop! I agree with the others who are questioning the judgement of hubby's doctor.

Jim
Posted 10/16/2023 10:21 AM (GMT 0)
DRE is a test depending on the skill and interpretation of the urologist. Moreover, it may give false positives and the true positives usually indicate a relatively high size. With all its faults, PSA is the most accurate and objetive test one may have.
Posted 10/16/2023 6:26 PM (GMT 0)

Sr Sailor said...

F8 said...
"My husbands dr prefers the Dre vs PSA.'

i find that concerning on a couple of levels, and would be looking for a new doctor


A DRE 'samples' only part of the prostate. Hence, it should be accompanied by (at the very least) a PSA test. How often depends on several factors. For instance, if his PSA level has been rising, more often than once a year might be insightful.


##########
my first DRE was totally unremarkable and very painful! but a concurrent PSA test showed high volume cancer -- all 12 cores positive!
Posted 10/16/2023 9:33 PM (GMT 0)

halbert said...
Girlie,

Please provide more information. Is this just for screening purposes, or does he have a known issue? How old is he? Does he have family history? Does he have other issues?


Yes, screening purposes. No known issue, no family history (but his father passed away at the young age of 69 years old - maybe had he lived longer - he may have developed prostate cancer)
Posted 10/16/2023 9:35 PM (GMT 0)

F8 said...
"My husbands dr prefers the Dre vs PSA.'

i find that concerning on a couple of levels, and would be looking for a new doctor

We have a shortage of GP’s so at the moment he is stuck with this one.

I’ll tell my husband he needs both - DRE and PSA
… and to talk to his dr about it.

How often for each?
Posted 10/16/2023 10:07 PM (GMT 0)
I had both the DRE & PSA tests more or less yearly prior to my diagnosis. My PSA tests detected what the DREs didn't. I strongly advise to get both.
Posted 10/16/2023 10:21 PM (GMT 0)

Fauntleroy said...
Not right, hopefully he’s only using a hand digit and not some other appendage.

😳
Posted 10/16/2023 10:27 PM (GMT 0)

patrickm said...
I had both the DRE & PSA tests more or less yearly prior to my diagnosis. My PSA tests detected what the DREs didn't. I strongly advise to get both.

I just had a talk with my husband - and he said he will talk to his doc about having both done yearly.
He said he thinks the doc won’t have a problem with that.
He’s in his good books now - since he lowered his blood sugar (A1C ) and his cholesterol in the past six months.

Thanks guys - I appreciate your input.
Posted 10/17/2023 2:09 AM (GMT 0)
His age and current PSA guides the screening. I had DRE and PSA annually during my 60’s due to family history. Does not take much to make annual testing a good idea when older. Getting a baseline is really important to know when things are changing.
Posted 10/18/2023 1:24 AM (GMT 0)
I suspect most of us were diagnosed following PSA testing--I had annual PSA for over 5 years then a climb began that ended with diagnosis. DRE doesn't diagnose much PC.
Posted 10/18/2023 11:00 AM (GMT 0)

halbert said...
I suspect most of us were diagnosed following PSA testing--I had annual PSA for over 5 years then a climb began that ended with diagnosis. DRE doesn't diagnose much PC.

I may have been an exception. I had a long series of (negative) biopsies for a slowly increasing PSA (from BPH) over many years with yearly uro visits. My uro noticed an induration on one side that he said did not require another biopsy, but did need to be followed, and he changed me to 6-month visits. A few visits later he noticed a new nodule on one side along with a PSA increase slightly higher than expected from my BPH (the induration on the other side had disappeared BTW) .

The biopsy found that the nodule was not cancer, but G9 and G10 cancer was found in 2 cores in other zones (14 cores total). Some time after my treatment (RP) I asked my uro/surgeon if he would have insisted on that last biopsy if I had just that size PSA increase (3.6 to 4.3 on finasteride) but no nodule. He looked at my history on his laptop screen, shook his head side to side, and said "We certainly would have discussed it."

Knowing myself, I would have said yes (as I always did over the years) to any of my uros suggesting I should have another biopsy. This is why I say that I may have been an exception.

Monitoring men with a history of BPH and a rising PSA for PCa can be tricky.

Djin
Posted 10/28/2023 6:29 PM (GMT 0)
I've had annual PSA with unremarkable results for many years. DRE only occasionally. But I'm a cautionary case:

February of this year my routine PSA spiked from 2.7 to 4.8, so I saw the Urologist to investigate. The subsequent DRE was "normal" / negative, yet the PSA re-test in March was 5.9. This PSA "velocity" was alarming so I had a MRI & biopsy. Positive (G7, 3+4, PNI). My surgery in June caught the PCa just in time, with several high-risk characteristics such as EPE. My post-op pathology elevated me from Stage 2 (biopsy) to Stage 3.

But we caught it "early" with negative margins, and my 90-day post op PSA was "undetectable."

If I'd only been relying on DRE I'd be sitting here, asymptomatic, utterly ignorant of the tiny horrible bomb going off in me.

So I'd definitely prioritize an annual PSA ahead of a DRE for screening purposes. It's a blood test; Just Do It.
Posted 10/29/2023 12:23 AM (GMT 0)
The DRE and PSA go hand and hand (um, hand and needle). They are both imprecise tools, but we should be very thankful that we have them. Other cancers can give no warning until they are very advanced or metastatic. Roughly 25% of PCa cases are high-grade disease. Fortunately that number is a low as it is, but it's also high enough that you should investigate when the DRE or PSA warning lights start to blink.

Djin
Posted 10/30/2023 10:48 PM (GMT 0)
To add one more example, I had my DRE done by a nurse practitioner, and she found nothing abnormal. But PSA was high, so off of the urologist I went. He performed a DRE and found abnormalities on my prostate and then scheduled me for a biopsy, which was positive for prostate cancer. Summing up the moral of the story, all medical people are not equally good at a DRE, and some will miss cancer. Better to do both DRE and PSA.
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