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What did you know about screening?

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Prostate Cancer
Before you were screened I knew...
I had high risk factors so I started screening early. - 10.3% - 3 votes
I didn't know my doctor screened me. - 34.5% - 10 votes
I heard screening can save lives. - 0.0% - 0 votes
I went to an event and decided what the heck? - 3.4% - 1 votes
I talked with my doctor about my health and he recommended I have a PSA test. - 34.5% - 10 votes
What's a PSA test? - 17.2% - 5 votes
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Posted 8/12/2013 6:19 PM (GMT 0)
I wish I could put a questionaire together for this thread. But here goes...

Before you were ever screened, what did you know about screening? Just a fun pole to see what the responses are.

Some of my sub questions would be:
...How old were you when you were first screened?
...Were you actually screened or were you given a PSA test after complaining about ED, urinary issues, etc.

Have fun. There should not be any controversial discussion here.

Tony
Posted 8/12/2013 6:25 PM (GMT 0)
I didn't know what a PSA test was and my PCP doctor screened me without my knowing. I was 44 at the time. I went to the doctor for an unrelated issue. I was more of the, I don't want to go sit in a doctors office with sick people, kind of guy...

Tony
Posted 8/12/2013 6:30 PM (GMT 0)
I was 53. My doctor gave me the option, and was clear that I didn't need to have the test if I didn't want it. I chose it, never thinking in a million years I would come up with a 6.4!
Posted 8/12/2013 6:33 PM (GMT 0)
I'm quite embarrassed to say this, but I knew nothing about PSA tests. I'm not even sure when I was first screened, but it was part of a routine physical sometime in my early-to-mid 40s. It was just always there as part of the blood work that my doctor reviewed with me. No symptoms of any kind, nor was there a family history.
Posted 8/12/2013 6:36 PM (GMT 0)
I was 40 and I knew nothing about it.

I should also add that I'm one of those guys that will dive through hoops to avoid any type of medical visit.
Posted 8/12/2013 6:37 PM (GMT 0)
Shoot you knew more about it than I did Michael. I never heard of a PSA test when my first ever came back at 19.8.

Tony
Posted 8/12/2013 6:41 PM (GMT 0)
DavidG your response is what I know to be true. Even with family history no one even in your only family stepped up and mentioned getting screened?

That's really rhetorical in nature because I know what you say is in fact common place. For many years our fathers or family members fought prostate cancer and never told anybody.

I think we are seeing a change there but it's still prevalent. Ruth's father was diagnosed and treated several months before he ever spoke to me about it even though I was already running a support group and moderating here and traveling around for PCa and he even knew about my work. He never asked me a question about it to this day other than to tell me he was G9 and it was early.

Tony
Posted 8/12/2013 6:42 PM (GMT 0)
Prior to having the blood draw for PSA test I didn't know, it was explained to me when they drew it.
Posted 8/12/2013 6:43 PM (GMT 0)
I've told this story many times over the years and recently...

I went to a free health screening for men one Saturday morning. I hadn't had a physical in years and didn't have a PCP since I really didn't need one. (i used the little Med Stop type of clinics)

Yes I had a general knowledge of PSA...

At the screening, the URO that did my DRE found nodules. I then found a PCP for a follow-up. He couldn't feel the nodules so he sent me to a URO who could feel the nodules.

To this day, it bothers the heck out me when I think about what things might be like had I seen the PCP first. He happens to be Asian and is small in stature....

My PSA never got over 1.3 .
Posted 8/12/2013 6:47 PM (GMT 0)
I was 57, 6-month blood tests for other issues. Nurse noticed there was no PSA test in my file, asked if I wanted one. Since it didn't add much to my bill (already paying for the draw), I said yes. Knew already what it was, but had no thought of any problems to come. It was more just to get it on the record.

Boy was I wrong. Two days later I was at the uro with him making very unpleasant comments about my prostate during a DRE. All downhill from there.

No, I did not attend a day-long seminar about PCa before getting the test.

Posted 8/12/2013 6:47 PM (GMT 0)
I never heard of PSA until two years ago when I applied for a new life insurance policy and was denied because I exceeded the PSA max of 3 for my age and was advised to see my GP.
Posted 8/12/2013 6:50 PM (GMT 0)
I didn't check any boxes, because none of the suggested responses really reflects my situation.

My internal medicine PCP started including the PSA test in my blood workup when I turned 50.  He always did a lipid panel (which eventually disclosed other conditions, including high cholesterol and high blood sugar......and no, there was no extensive education on the ups or down of any of this).  PSA wasn't included, as I've said, until I turned 50.

It was clear to me all along that the purpose of the test was to look for irregularities in the prostate, which might include infection, enlargement, or even cancer.

Yet, in spite of being married to a very knowledgeable R. N., I watched my number creep up into the upper-two range, then over 3, over 4, over 5, and finally over 6, at which point I finally followed his advice and made an appointment with a urologist.

Like a lot of men, I behaved very stupidly, and it's only through luck and God's grace that the cancer was found to be contained, and the surgery seems to have been a success.

What would be my situation if I didn't have annual physicals, if my doctor didn't insist on the PSA test, if I were the kind of guy who avoided the doctor?  Guess I don't like to think about that.

And so, for a variety of reasons, I think the PSA test, which is as good as we have at the current time, needs greater visibility and accessibility, not less. so that other  men who are stubborn like me might get tested, and that just might move them toward an appropriate treatment.

Posted 8/12/2013 6:53 PM (GMT 0)

TC-LasVegas said...
DavidG your response is what I know to be true. Even with family history no one even in your only family stepped up and mentioned getting screened?

That's really rhetorical in nature because I know what you say is in fact common place. For many years our fathers or family members fought prostate cancer and never told anybody.

I think we are seeing a change there but it's still prevalent. Ruth's father was diagnosed and treated several months before he ever spoke to me about it even though I was already running a support group and moderating here and traveling around for PCa and he even knew about my work. He never asked me a question about it to this day other than to tell me he was G9 and it was early.

Tony

My Grandfather had 5 types of cancer including PCa. He didn't die of any of them btw.

All I knew was that grandpa had PCa, that it was discovered in his 80s, and that he was told he wouldn't die of it. I knew he was monitoring it some way but no details passed down to me. I certainly never dreamed of having it and even when the urologist testing me first mentioned the very distant possibility that I had PCa I comfortably disounted it given my age.

I did not know of a test called PSA and assumed PCa was a disease for old men (sorry guys). When they told me it was just a blood test to measure PSA I naturally had no issue with it. When it came back high we assumed it was an infection and started antibiotics. I did two courses of those and 3 PSA tests prior to discussing a biopsy with my URO who said I was borderline. When I asked him what he would do if it was him (he was 43) he said "I'd do a biopsy".

The minute my PSA scores came back my education started via discussions with two urologists (from same practice), two oncologist family friends, hospital administrator I play tennis with, and a lot of Internet research which short of Yana data I found harmful at best.

All mention of near to certain ED and Incontinence and a 10 year prognosis was found online via very irresponsible sites in my opinion. Face to face talks with professionals filled me in on nunaces of age, health going in, doctor skills etc. Of course the rub here is that all docs thought they were skilled but the truth is some are more skilled than others. Anyway, long story short, all the education I needed/wanted was available to me but I knew NOTHING about it prior to the simple blood test. That day they drew my blood for a lot of different tests.
Posted 8/12/2013 6:59 PM (GMT 0)
What is telling in this thread is than in more than 20 years of commercial use the PSA test remains an unknown.

When diagnosed I had not the slightest idea what a significantly high reading meant. The same seems to be current for many men now. This with what we are told is the widespread use of PSA in this country. Sad indeed...

RalphV
Posted 8/12/2013 7:04 PM (GMT 0)
Davidg,
So then, Like many in their 40's you didn't know what a PCa screening was. That will be a common answer I receive today. So how do we get those guys to the "baseline at 40" check up?

Clock Bill,
Your answer says you didn't know your doctor initially screened you at 50. That he did in fact NOT tell you that you were screened until after the fact.

What I think I hear both of you guys saying is that PCa education had not as yet been in your throws and that came later after Dx. Same with me. How do we screen earlier if this is the norm?

Tony
Posted 8/12/2013 7:07 PM (GMT 0)
we have their doctors suggest they get one if they agree. And when the patient asks why, if he asks, tell them why.

btw, when i go in for visits I have numerous tests including blood tests. I have no idea what they're all for. I think most men operate like this. If there is suspicious, alarming or bad news we expect a phone call.
Posted 8/12/2013 7:12 PM (GMT 0)
There has to be greater awareness. More patient information inside and outside of the doctors office.

It's a catch 22 though.
You can't have greater awareness (more men asking questions about it) and the guidelines saying, don't worry about it, it's not recommended to test you.
Posted 8/12/2013 7:15 PM (GMT 0)
I was being treated for BPH for several years before I took any notice of my PSA. I think my GP was checking it but it was somewhere around 1.4 which, at 55 years old with a much-enlarged prostate, wasn't considered that alarming. I actually wound up in the hospital for three days with a prostate infection (that was when I acquired a urologist) and he was initially not that worried about my PSA either. It was only after he put me on Avodart to shrink my prostate and my PSA went up instead of down that he started to worry.

So, I guess I was screened and didn't know very much about it but, as it turned out, the screening doesn't seem to have made much difference.
Posted 8/12/2013 7:16 PM (GMT 0)
At age 50, my PCP started checking off the PSA box on the blood work form. He simply told me that I needed to. I had no reason to disagree. Also had no idea where my prostate was located, or what its function was, and my only vauge notion of PC, was that it was a real old man's disease.

I am glad he started checking when he did, considering the rest of my PC case and journey. Had he not, I may have never known to have it done and can only imagine the condition I would have been in now as the result.

david in sc
Posted 8/12/2013 7:17 PM (GMT 0)
Having a yearly PSA since 45 due to chronic prostatitis and was going to urologist when flared up. Didn't really know what good numbers were, he just said under 4 so no problems. Just knew he was checking really never thought anything about it. I guess you could say I was pretty ignorant about it!
Posted 8/12/2013 7:20 PM (GMT 0)
But ISpark,
We have to have realistic discussion. Only the USPSTF says don't test. The AUA sets guidelines but of the 67 million not yet diagnosed probably less than a few hundred could explain the AUA guidelines or any guidelines for that matter. We, the diagnosed, take these things to heart more seriously than any undiagnosed man. These guidelines mean nothing to the diagnosed man.

How do we educate men who don't even know of or have never heard of screening guidelines ~ the majority of men out there...

Tony
Posted 8/12/2013 7:27 PM (GMT 0)
Great idea for a post Tony, thanks for putting it out here.

For me - I have always been a "health nut" in terms of staying active in sports as well as fitness - including cardio and weight training. Also been a fan of vitamins and supps when/as they make sense, and only when under guidance of my nutritionist and my PCP.

When I got into my 40's I ratcheted all of that up and hooked up with my still current PCP, and together we created quite a game plan. I started annual physicals in my early 40's, added DRE in my mid 40's and then PSA in my late 40's. Because of my PSA testing in my late 40's and into my early 50's I was not only able to develop a baseline, but also a very clear and statistical representation on what was going on with my prostate - also of course including the DRE's although they all came back good.

Because of this approach we continued to chart my PSA (including slope, doubling time and velocity) and started to pay real close attention as those indicators started to show us signs - that led up to us deciding it was time to do a biopsy.

So then was I "lucky" to find a PCP that took that approach, yeah, sure I was. But at the same time I also cared enough about my own health to first find and engage that PCP, and then to educate myself as I progressed down this path with her.

When she suggested DRE's she gave me an overview of why; I then went out and learned more - lots more about it all. Same thing when it came time to PSA testing, which I was already somewhat up on do to my learning process with DRE. She gave me the overview of PSA testing and why she felt we should add this to our bag of tools; I then went out and educated myself on what it all meant.

Same path when it came time to biopsy so I won't bore you all with more details as I'm sure you've gotten the drift in my approach!

And then for the big one when I was DX'd - the amount of research I did into understanding the biopsy and staging results, the beast itself, and the treatment options, results and practitioners and voila, here I am.

Sorry for the lengthy diatribe - but perhaps it also goes along way towards explaining my stance on things....... in my opinion, to go about this any other way is unfathomable.
Posted 8/12/2013 7:30 PM (GMT 0)
I didn't say not to test, I said it is not recommended.

The AUA said it is not recommended for average risk men under 55 years of age.

The AUA said...
Guideline Statement 2: The Panel does not recommend routine screening in men between ages 40 to 54 years at average risk. (Recommendation; Evidence Strength Grade C)

For men younger than age 55 years at higher risk (e.g. positive family history or African American race), decisions regarding prostate cancer screening should be individualized.[quote]

Posted 8/12/2013 7:31 PM (GMT 0)
We need to ask the Ladies. They have taken mammograms breast cancer awareness to a different level than just about any other disease. Pink everywhere in October. Only time I really heard anything about September being Prostate awareness was MLB keep dad in the game promotion.

Ron
Posted 8/12/2013 7:45 PM (GMT 0)
I was 41 and casually mentioned to my doc during a checkup that I often awoke once per night to urinate. He did a DRE (negative) and a PSA test (8.3).

If not for that casual mention, I wouldn't have been screened until I was 50 (thanks to AUA) or until I had bone pain due PCa mets, whichever came first.

Turns out my PCA had nothing to do with the nightly urination thing.

-Gedman
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