Urology group stops recommending routine PSA test

iSpark,
So actually you would agree with Statement 1? Or are you saying to just get a baseline PSA at 40?

The AUA document does not rule out either.

Tony

I think it is time for a poll.  Will it be 95 or 96% not in favor of the new guidelines?

iSpark,
You have to toss out that newspaper article. It's poorly reported.

Please read the official press release from AUA. You don't have to read it all, just read the Statements.

www.auanet.org/education/guidelines/prostate-cancer-detection.cfm

As you can see the statements are actually reasonable.

Tony

Post Edited (TC-LasVegas) : 5/6/2013 6:39:11 PM (GMT-6)

David (purg),

But I'm hearing about all these unneeded surgeries, etc.... It would be interestng to see a number on that in our little corner of the world. There may be more out here than I think that feel they were sort of forced into a treatment...a reason given for the new guidelines.

The question in the poll would have to be thought out properly.

JL

Thanks adjust. I hadn't read Dr. Samadi's official response but have spoken to him about this and heard him say the same thing many times over long before this rubbish controversy.

Dr.Samadi is 100% and a great great advocate and doctor.

" Are you under age 40? The AUA says you should not be screened.

Dr. Samadi says:

"With blanket recommendations we run the risk of letting younger men fall through the cracks. Men under 40 need to be educated about prostate cancer and given a clear understanding of how risk factors apply to their individual status. This is a critical time in a man's life for establishing a healthy lifestyle that optimizes disease prevention. It's also primetime for baselining a man's PSA level."

David,

I have not been around long enough to get familiar with all of the PC docs out there, but I will say after reading his position on this matter, he has gained my full respect for standing firm in his beliefs... Hope more like him will begin to surface!!!

davidg, it could be reasonably argued that it is somewhat self-serving for a big name, high production surgeon like your guy, but he still speaks the truth about screening regardless. I am a big fan of Dr. Walsh and have been from the start, and many accuse him too of being self-serving, but he too speaks the truth.

david in sc

I don't know. I don't think it's the right way to go.
Some of you know my story and how it came to be that I was tested and ultimately treated.

With the new guidelines and you only had the following information.
What do you think would be the most likely outcome?

Age: 47
Race: Caucasian
Family History: None/Negative
Urine ability: Some delay in starting and slow stream.
Health: Average
No PSA
No DRE

When would the cancer show up?

Had an opportunity? Not if the doctors never mention it.

Question: What guidelines do life insurance companies use? I can't imagine them not doing a psa test.

Most guys buy some life insurance and will need to be screened?

tud: you bring up what I keep saying to deaf ears. if overtreatment is the problem, then work on overtreatment. its like they are saying, too many men are being treated for PC, that cost lots of money, so therefore, avoid testing and screening, and it will reduce the amount of men diagnosed with PC, therefore they won't need treating because they won't know they have cancer, and that will save billions. it could be that simple.

and for those pushing/promoting these new standards, it wouldn't take much of a jump in imagination, to assume that they are no longer advocates for the PC men, but are becoming advocates for the industry instead. this also fits the conundrum at hand.

david in sc

This never ending topic / discussion never ceases to amaze me.

IT
IS
NOT
about
OVER DIAGNOSIS
IT
IS
about
OVER TREATMENT

We all need to be our own health care advocate - educated, learned, in touch with our medical condition(s), whatever that may be, PCa of course included. IMHO I WANT to be tested, and I - after being fully educated, learned and in touch with what the results of the respective tests are - will make the decision as to whether or not, and if so, how I will be treated. My personal physician works very closely with my health and well being, and has done so for over 15 years - including PSA testing starting at age 50 and then annually after that; I also have annual blood draws for the full lab work including cholesterol levels, triglycerides and all of the rest; I monitor my blood pressure on a regular basis and keep my doctor aware of the results. And through all of this I decide on what to do about the results of these tests.

So then my doctor suggested starting PSA at age 50 to develop a base line and monitor; I could have said "no thanks" but I was in tune enough about male health that I agreed. At age 55 when my PSA reached 5.8 after a slow progression over time, my doctor recommended a biopsy - and because I was in tune with what that meant, combined with the results of testing, I agreed. After the biopsy and reads of my slides by two seperate/qualified labs I continued my research and understanding of PCa and the various treatment approaches and made my decision, was treated, and am not looking back.

I have to say that I honestly don't get all of this - to me, it really is as simple as I believe and have stated here....... and to anyone that blindly goes along with something that they don't understand, then shame on you - then YOU have become the problem, not over-diagnosing nor over-treating.

Whew, glad I finally got that off my chest!

Edited to comment that I posted a very similar comment to the "Official Statement from the AUA" thread.

Hi Mel - not preaching to the choir (although I can see your point), and it's not about someone contradicting me as I didn't start the thread or weigh in until now so there hasn't been anything contradictory - rather it's about what, to me, is a pretty black and white issue. 

IMHO there is no risk in overtesting, unless the individual allows themselves to be overtreated.  I see no issue within what the normal guidelines have been for when to do a PSA test - how can anyone argue that testing under those guidelines is bad?  

Again, bottom line, the problem - if one allows it - is overtreating, not overtesting.

And I do apologize for "yelling" - i.e. using all CAPS is bad grammar when posting!