Discontinue PSA Test

Here we have an example of what is currently happening with some GPs. “PSA does more harm than good”. Obviously this comment ignores the “good” done by reducing prostate cancer mortality by over 40% with the use of PSA testing in the US.

Tomheu,
Presently there is no way to detect prostate cancer early without a PSA test and a biopsy. It is your option to request the test and to understand your options if this PSA result happens to signal a problem in prostateland. An elevated PSA is not necessarily an indication of cancer, but it is an anomaly that is worth investigating to avoid an advanced disease diagnosis.

Depending on age and stage at diagnosis some prostate cancers might not need to be treated, but from there to avoid testing with PSA is unwise and could result in a more advanced and more difficult to treat diagnosis.

RalphV

re-educate your doctor or fire him.  my cancer was detectable only through PSA test, and i have a high volume of G7 cancer.

ed

Echo the above.

I in fact fired my doctor when WE DID a PSA test that showed a big jump. I fired him because he had not done the test the previous year so I had no idea what the velocity truly was.

Sonny

There have been some studies that support your GP's position; but as you can see from all of the posts, ALL of us that have PC know this is the dumbest thing to come down the pike. The group of morons that came up with this lame brain idea were a bunch of academics, government bureaucrats, and a few doctors; but not even one urologist was asked to serve on this board. Because the US Preventative Services Task Force has a real official sounding name and was formed under the NIH, it sounds like they know what they are talking about. I say BS. You are absolutely young enough that you should have the opportunity to make a decision to treat PC or not, and to make a decision as to what type of treatment would best serve you. MY prostate was enlarged due to prostatitus but had no other irregularities noted by both DRE and TRUS. Enlarged prostates are quite common as you age, and I'm 59. What gave the warning sign is the PSA and only the PSA.

I honestly believe that this decision was based to save money. They save the cost of giving all of these PSA tests that show results similar to yours. You save on the treatments after it detects PC. You save on the amount of years the government pays Social Security. They win while we lose. Get another GP and tell him why you fired him.

I'm editing this in" Believe it or not but I sometimes do have trouble expressing myself. I also hope this is the last subject you ever need to start.
Good Luck

Have your doctor look at my PSA history.
Normal, normal, normal, etc. Etc. etc."............hmmm... Uh oh.

The decision if to have a psa test is up to you, as long as you are aware that early detection could lead to overtreatment as well as possibly save your life. An annual psa test with your previous stats may be overkill, but it's your decision.

Thanks Ed, I will ask him.

Probably the next shoe to drop in this story will be the insurance company refusing to pay for PSA testing beyond a certain age.

Goodlife

tomheu, I am so happy that you ARE questioning your doctor's decision.  If you trust and like this doctor, then please call and say, "I have made the decision to be PSA tested.  I'd like to make an appointment."  That puts the decision in your hands.  Actually, you won't even have to see him unless you want the DRE done.  For your peace of mind (and health) please contact his office!

Wishing the best,

Aimzee

Thanks goodlife and icecat.

PSa screening is now just as controversial as all the treatments (LOL). Since you mention aggressive PCa, there are more parameters to that than just psa level (generalization psa into multiple hundred or thousands is huge red flag), more than just Gleason scorings although 9's and 10's are the highest and (generalization) the worse prognosis and might be aggressive. Paact newsletter had an article showing that two patients with Gleason 9 can have very different results in actual aggressiveness (fyi). What helps determine actual aggressiveness is via specialize pathologies that only a select few I know about can offer and render such info......read this link to realize what your uro-docs and others are not telling you about the anomolies of PCa:

www.yananow.org/Mentors/BonkhoffStrum.pdf    (Dr. Bonkhoff- Germany is supposedly the worlds best specialist in molecular pathology) Dr. Rubin is another at:

www.nature.co/modpathol/journal/v21/n2s/full/modpathol200811a.htm  

Now read this 18-24 variants or more various types of PCa (your average pathologist might easily miss this, they struggle with gleason scores if you are listening):
www.yananow.net/24Variants.pdf 

18-variants with photos on some: www.webpathology.com/case.asp?case=23     (this was before they discovered the 24, now another one or two type just discovered, so over 24 types now)

Ploidy DNA analysis of the PCa cells can be done by some others, this also leads to possible clue of aggressivenes, the safest PCa DNA is called diploid (DNA in matched pairs, similar to your normal DNA being matched pairs), when they get into broken chains, uneven paris or missinig pairs....this is a clue about the PCa. Bostwick (patho-doc) years ago mentioned 3 types of ploidy analysis. Worst being really odd, broken, scattered like DNA chain....like random chaos for an analogy, the prognosis for such is worse and drug interactions can be worse on this too.

So if you thought Psa was confusing and non-simplistic.....wait till you jump into this jungel a little deeper.....the twilight zone looks like more realism than PCa sometimes. Ask this doc about the value of fPsa testings, or PCa-3 testings another way to short term avoid biopsies and look at those clues closely. Color doppler ultra sound can sometimes also detect areas of PCa, prior to get a biopsy. Hope you never need treatment....it is full of questions.

Post Edited (zufus) : 2/25/2012 5:35:46 PM (GMT-7)

Wow, that sort of blows me away.

One need look no farther than my husband's stats below, to see that our doctor made money off of the test, but thought the results were worthless.

We should have known he had cancer in 2006. Instead we found out in 2011, when it already progressed to his bladder.

Without the PSA test, we probably still wouldn't know and would have written off a weak stream as "age related."

I agree with Worried Guy... if your doctor knows his own PSA, do as he said. :)