PSA test really starting to take a beating, it saves many but it also leads to much overtreatment it

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Regular Member

Date Joined Jul 2007
Total Posts : 86
   Posted 6/29/2009 12:47 PM (GMT -6)   
appears, what a deliemma.
Age 45 at DX
DX 8/05 Gleason 5, Mayo clinic Second Opinion Gleason 6, PSA 2.8
Da Vinci surgery Dr. Dasari, Centennial Nashville 9/24/05
Pathology Report Gleason 6, 15 % on left side only very near to the edge of capsule, too close to call on margins, doc's said to watch it very closely, final decision T2A
PSA's have basically ranged from <.04 to .05 for two years.
no E.D. and no Incontinence, feel very blessed
PSA Nov 07 = .06
PSA Dec 10th 07 =.07
PSA Jan 4th 2008= .1
Started Guided IMRT on January 7th, 2008 to treat prostate bed and lymph nodes, completed on March 6th, 2008
PSA April 18th 2008 =.03
PSA August 18th 2008 = .01 or less, test only goes down to .01

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 6/29/2009 12:57 PM (GMT -6)   
I hate articles like this one, same old story, I think they are written by people that never had PC or knew anyone that had PC. You know they say, don't shoot the messenger, PSA testing is the messenger, and its foolish to generalize and say that its the fault of the test that so many more men are getting a PC dx. The PC is either there or it isn't. Burying you head in the sand and not testing doesn't solve anything, and its back to that big gamble in the sky. If you get a PC dx, we all know here, you want to catch it early, low gleason, low staging, low % of cancer in the cores if you get a biopsy, not knowing you have it and then ending up with a fatal or advanced case doesn't make any sense to me. Makes good news story I suppose, but sends the wrong message.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist

Veteran Member

Date Joined Aug 2007
Total Posts : 1015
   Posted 6/29/2009 1:27 PM (GMT -6)   
The way I look at regular PSA testing:

Those "few percentage points" of folks being saved (I think it is really higher) may represent thousands of people, including all those affected in the man's group of family and friends. If you are one of those people spared to have a longer life, the test is well worth it for you and for your loved ones.

Some doctors or other health-care professionals are concerned that the PSA testing and pouring over results put the man through too much worry that is not necessary if cancer is not really present. If we turned things around, doctors would certainly not ask women to stop have mammograms and pap tests. I would not ask them to stop.

Another opinion for what it is worth.

Barry ~ (a.k.a. "Idaho")


Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

Post-PSAs  09/07  <0.04; 12/07  <0.04; 03/08  <0.04;

06/08  <0.04; 12/08  <0.04;

06/09  =0.062 (doc says don't worry yet)

My web site:

Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 6/29/2009 2:23 PM (GMT -6)   
PSA testing is saving, not only lives, it is saving quality lives. So many men would otherwise endure unthinkable pain only to die from a disease that is often cured through early testing. There is evidence enough that PSA testing is a valuable tool. All men should submit to a baseline PSA as soon as age 30 IMHO, and every other year after.  Women have pelvic and breast cancer testing as soon as in our teens. This as a chemoprevention measure, not a cure. It provides more of an oportunity to prevent advanced cancers from developing by catching as many of cancers as early as possible. Men should have the same benefit. The way to get that benefit is;  MEN...ya gotta stand up and be heard!

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 6/29/2009 2:33 PM (GMT -6)   
I absolutely agree Swim...
It's not screening that's the problem, it's educating as to when is the right time to treat versus wait. But you can't make a decision in the blind, you need to be screened to have a choice. And that won't be a clear picture until we come up with a test that can differentiate indolent versus life threatening prostate cancer. So for those writing articles saying the value of screening is a problem, I say get smarter before you write. This sends a potentially deadly message that we should just forget about screening. Sweeping it under the rug per se. The fact is that there is a culture of don't screen and do nothing developing and it can only be proven wrong in time.

 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
My Journal is at Tony's Blog  

Veteran Member

Date Joined Sep 2008
Total Posts : 744
   Posted 6/29/2009 3:48 PM (GMT -6)   
I just loved this statement in the report:

"Almost half of prostate cancers detected by a blood test in blacks, and more than a quarter in whites, won’t cause symptoms or death and don’t need treatment."

So please, dear "experts" that the report refers to, do tell us what test that is available today, reveals which men need treatment for agressive prostate tumors and which ones don't???

I hate these type of "reports", they make me want to puke.

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 6/29/2009 4:10 PM (GMT -6)   
Greetings, everyone. So what about the other half of African-Americans and the three-fourths of whites that are diagnosed with prostate cancer and do need treatment? As we march down the socialized medicine path we all need to be prepared for this type of misinformation that can affect all of us.  David

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 6/30/2009 12:03 AM (GMT -6)   
It sunds like we are all in violent agreement. So, who are the people pushing this garbage (I mean both the reports like this and socialized medicine in general?). Are only people interested in "fixing" the US healthcare the healthy ones?

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA results:            1/8/2008-33.90, 1/11/2008-29.50, 1/31/2008-38.20,

2/21/2008-32.00, 3/13/2008-26.20, 4/3/2008-26.60, 4/24/2008-20.60

RRP at Duke (Dr. Moul) on 6/16/2008

Pathology:              Gleason downgraded 4+3=7,   Duke: T2c N0MX, one positive margin,

2nd opinion at Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516

IMRT to start mid-Aug

Veteran Member

Date Joined Aug 2007
Total Posts : 1015
   Posted 6/30/2009 1:02 AM (GMT -6)   
My observation is that these kind of reports are a result of physician "intellectualism." In most cases it seems their motivation is to "protect us" from unnecessary anxiety. However, protecting patients doesn't pan out well in reality.

I believe the majority on this forum believe in personal responsibility where we take charge of our own health care decisions. I think it is best for us to have all the information we need, even when it is tough to accept or causes anxiety to go through the tests and make difficult decisions based on the results. Being deprived of information or having someone else decide what I need to know and when I need to know it is not the right way to go (in my opinion).


Barry ~ (a.k.a. "Idaho")


Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

Post-PSAs  09/07  <0.04; 12/07  <0.04; 03/08  <0.04;

06/08  <0.04; 12/08  <0.04;

06/09  <0.1

My web site:

Regular Member

Date Joined May 2009
Total Posts : 121
   Posted 6/30/2009 1:14 AM (GMT -6)   
All these so called studies are based on 10 years max, sometimes less. I challenge anyone to name a cancer survuval program that would show significant results in a 10 year span. Lung cancer, melanoma, colon, these take decades to develop. Why this constant criticism of Prostate cancer when it is the #2 killer. I am 54, I am shooting for 94, not 64
Dx'ed 5/08 one core 2%  out of 12  3+3 gleason
DREs all negative
PSA was in the 3-4 range then jumped to 7
I have the enlarged prostate, on the order of 100cc.  After taking Avodart for 3 months  my
PSA was cut in half.
I did Active S for a year but concluded that I didn't want a life
of biopsies and Uro meetings so we have
scheduled surgery for end of June 09.
Coming up quick.

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