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Just wondered what you guys would advise me to do about psa testing

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Posted 5/28/2012 4:49 PM (GMT -8)
I have been getting my psa for about 10 yrs im 52 now..it comes back .98 or .99, once 1.01 then back to .99...I have an enlarged prostate, uro says "its not HUGE, but it is enlarged"

I get the digital every year and I have had what he thinks is a prostitus infection or irratition the last few months.

I have been on cipro for 20 days and am off it now and doing ok. I had a digital tice in the last two moths, he said my prostate feels "boring" which means normal

Urine test is clear, no blood pus etc...

Do I keep getting the yearly PSA ? Im due at the end of June...im thinking about blowing it off

Posted 5/28/2012 5:02 PM (GMT -8)
Do I keep getting the yearly PSA ? Im due at the end of June...im thinking about blowing it off

why is that?

ed

Posted 5/28/2012 5:05 PM (GMT -8)
I'd keep getting. PSA is just an indicator that 'something' is wrong. Could be BPH, could be an infection, could be PC, could be nothing.

Hopefully better tests are on their way but until then we got PSA with all it's issues and indications.
Posted 5/28/2012 5:16 PM (GMT -8)
well because even my uro has questions about weather or not its important for me to be tested yearly, also with all the "new" info....

Posted 5/28/2012 5:35 PM (GMT -8)
Continue to test...
I posted low numbers until 54 at which time I was diagnosed with cancer.
Be proactive!
Posted 5/28/2012 5:38 PM (GMT -8)
well because even my uro has questions about weather or not its important for me to be tested yearly, also with all the "new" info....

that's the harm being done by this recommendation.  it really is a simple matter of whether to test or not to test, all the shades of gray in between are meaningless.

it's your call man.  i know i will be having regular PSA tests for the rest of my life.

ed

Posted 5/28/2012 5:43 PM (GMT -8)
If it is inexpensive, or your insurance covers it, it is a no-brainer for me. But that is from a guy who did not have the first one until it was too late, because I didn't do yearly checkups. If I had gone to the free yearly men's screening at the local hospital - what might be different today?

The "new" info is talking about poorly-informed/ unprepared patients and resulting "overtreatment". Looks like you are informed, or at least have been around here for coming up on 4 years.

Why stop?

Posted 5/28/2012 5:51 PM (GMT -8)
142, ok lets say you DID get yearly check ups and saw the psa rising, what would have been any different ?

Posted 5/28/2012 6:25 PM (GMT -8)
I get so worked up every year waiting for the results...noone in my family ever has pc so I guess thats good but I still worry

Posted 5/28/2012 6:35 PM (GMT -8)
If it (PSA) had been rising slowly I would have gotten a first DRE earlier. Since mine was really ugly when first noticed (i.e. first tested), it likely would have shown up earlier. I would have chosen seeds if it had been early on, and my job might not have been destroyed. If it had gone from 1 to 7 in a year, I would be exactly where I was.

Best answer? Your guess is as good as mine, but the wondering about "when did it really start" would be less of an issue.

Posted 5/28/2012 6:51 PM (GMT -8)
cvc,

curious about a point. you said you were 52, and you have been getting PSA tests done for about 10 years. that would mean you were around 42 when you first started getting testing. why? most family doctors and GP's don't start testing men for PSA until they hit age 50 (unless you are african-american or have PC in the family). So why were you having PSA tests done at such a young age?

with your current age of 52, and your PSA reading at 1.00 or below, even with an infection in place, it would seem highly unlikely that you have PC or even close to it. Not a medical opinion, just a personal opinion.

as far as what you asked 142, i will answer. i started PSA testing right at age 50, and it was over 2.x something at the first, and rose every single year. at age 54, it went over the 4.x mark, so off to the urologist. at age 56, it nearly tripled to 12.x, and then 2 months later, jumped to 16.x, when i was diagnosed. my point, regardless of the number, if you are seeing a PSA rise of .35 or higher per year, then that is a danger signal for PSA velocity, which could be an indicator of not only having PC, but having an aggressive strand.

but back to you, should you or should you not continue? your call, it's not hurting you to be tested, just a simple blood test. if the stress is too much for you, then don't do it, or do it every other year, or not at all. this is the decision that each man has to make for himself.

david in sc
Posted 5/28/2012 7:41 PM (GMT -8)
Testing and screening are two different things. I think that gets overlooked or confused at times.

The screening question is about mass screening of otherwise healthy men, just like most people get a screening colonoscopy at 50, and women get pap smears and mammograms, etc.

Testing is when I went in with symptoms and got a PSA. *That diagnostic* use of PSA is not in question by the USPTF, nor is post-surgical use of PSA to monitor for recurrence. I was never "screened". My physician never said "you know, you're x years old and it's time for you to get screened." I was way too young for the guidelines in place then, and even now I would have been too young. But I was *tested*, and got a DRE, and that started a chain of events that led to my diagnosis 5 years later.

I would keep getting tested, but that's your decision. You've been doing it for 10 years now.
Posted 5/29/2012 2:37 AM (GMT -8)
You've already given the best reason to continue testing for PSA....."I STILL WORRY"



Rodney...
Posted 5/29/2012 3:50 AM (GMT -8)
I have not had a car accident in 30 years, yet every year plunk down a fairly hefty amount to the insurance company. Same with life insurance.

It makes me feel better. Even tho everything is fine,.

I like knowing what my PSA is. I also have been having mine done since I was 40. It made me feel better. When I started to see slight rises, I was ready.

Some of the "new" philosophy is that it makes no sense to have testing if the man does not intend to do anything. Apparently statistically if you group all prostate cancer patients together, the mortality figures don't change a lot for the treated and untreated. Not sure how they get their untreated numbers, and I am really skeptical, but I would say if you would not seek treatment because the side effects of the cure sound too hard to bear, then eat, drink, and be merry, and be surprised when you start having bone pain, and contribute to hospice care in your community so it will be available when you need it.

I have an employee who's father is in the end stages of PC. He lies in bed most I'd the day zonked on morphine. He has developed bed sores, and is just waiting to die. He chose to wait.

Good luck, and hopefully, you will get tested at least yearly. It is a good thing.
Posted 5/29/2012 5:35 AM (GMT -8)
Since everyone should have yearly check ups, which usually includes a complete blood panel, why not just include the PSA test anyway. As a former Urology nurse, my opinion is, get it done. I wouldn't be a member on this forum with a young husband with advanced PCA, if my husband took my advice and had his yearly checkups. The earlier any disease is caught, the better. Just my opinion!

Good luck.

Zimac
Posted 5/29/2012 5:40 AM (GMT -8)
cvc:
First, as Galileo said, testing is different from screening. So, does cvc have any risk factors such as family history, african american heritage, or breast cancer among female members of the family, or others you can ask your doctor about? If yes, then this leans to additional testing.
If no, and with a psa of just 1 even with an enlarged prostate (how large?) then skipping a year seems reasonable to me.
The issue is not the test, it is what to do with the results of the test. If the test result goes up by some arbitrary amount (how much?) then what happens? If you are worried about a simple blood test, what will you think about a 12 core biopsy? More discussion with your doctor is likely to be helpful, if the doctor is following the "informed discussion with patient" part of the USPSTF recommendation. This discussion would also be good practice of medicine.
Posted 5/29/2012 8:39 AM (GMT -8)
CVC,
Your psa is perfectly normal for someone your age. psa has normal flucuations even daily of up to 10%. You can skip psa tests without a worry if that makes you feel better or if it makes you feel better you can get them yearly. A low baseline psa in your 40's is a very good indicator of not getting aggressive prostate cancer. Since you are in a not at risk catagory and have had low and stable psas for years there are many more important things in life to worry about than annual psa tests.
JT
Posted 5/29/2012 11:51 AM (GMT -8)

Ok heres the scoop; I started at 42 because my Dr was an old school Dr and I went in for yearly checkups and he would do the digital and as part of my blood work the psa.

I have NO history of cancer in my family other than an aunt that had lung cancer form the 5 million cigs she smoked. Mother is 81, healthy but hi blood pressure..2 older Bros, both healthy, i younger Bro and a younger sister.

I forgot what size my uro said my prostate was but I just had what he thinks was a uti or prostititus and I mentioned my enlarged prostate and he said " it isnt huge by any means"

I got my first colonoscpy at 45 due to having cdiff, and my second at 50. I get all my moles checked every year. I am a white male, 5'9" tall and weigh 142 pounds. I run 4 - 5 miles a day or bike 20 - 40 miles on the off days. My HDL is 102 my LDL is 72..I eat healthy, lots of fsh and salads. Not a big meat eater and when I do its usually venison.

So thas my story....I do get keyed up nd remember when my psa jumped from .98 to 1.01 I was having a fit, lucky my uro explained to me it was the same number as far as he was concerned..

Posted 5/29/2012 11:53 AM (GMT -8)
That's all good news. I would still feel, that you have no PC issue to worry about. So its up to you to continue or not to continue PSA testing at this point in your life. Whatever you are more comfortable with.

david
Posted 5/29/2012 11:53 AM (GMT -8)
My advice: floss
Posted 5/29/2012 12:08 PM (GMT -8)
I do floss everyday, thank you

Purg, you say "at this stage test or dont" isnt it usually after 50 that pc turns up ? So wouldnt I have been smarter testing now than before ?

 

Posted 5/29/2012 12:24 PM (GMT -8)
Galileo,
Sure screening and testing with PSA are different. Mass screening has never been available here, some organizations offer free PSA testing but the number of men screened that way throughout the years is miniscule. The USPSTF recommendation provided to physicians is for not testing any asymptomatic man with PSA. That would have included you before diagnosis.

Informed men and physicians will continue to test when appropriate even without symptoms. Waiting for symptoms is the wrong recommendation and one that would detract from reducing PCa mortality.

RalphV
Posted 5/29/2012 12:54 PM (GMT -8)
I suggest getting an RNA Molecular test. It is great at ruling out PCa and has been used widely in Europe. It's a simple non evasive urine test. I had the test done before the biopsy and the results indicated high probability of cancer. Sure enough the biopsy confirmed it. However, if the molecular test had came back low probability I would most likely not had PCa and would not have needed the biopsy.

Here's a link:

http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=29361

It's called PCA3 test.
Posted 5/29/2012 1:52 PM (GMT -8)
you suggest that est for me ??

Posted 5/29/2012 2:17 PM (GMT -8)
The DRE is just as, if not even more, important. MY PC was found by the DRE...my PSA never went above 2.2 and the were no other symptoms to make the uro/surgeon suspicious. Keep going for the PSA and DRE, they just may save your life.
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