I don't recall if we have ever had a thread about
this particular question. Namely, at what age can we seriously consider stopping our regular PSA testing, on the theory that at some point, that is, at some age, it is no longer all that useful?
Granted this is getting into the area of testing-vs.-non-testing, a subject which has been addressed here on the forum numerous times, and usually developing into rather "spirited debates," shall we say, but that is not my intention here.
Rather, I want to pose the question, which is going to be a valid one whatever one's personal thoughts on the testing question in general, as to whether, at age 70 or 75 or whatever, one can just stop getting the PSA test and likely be no worse for it in the future for having done so.
It's more than an academic question for me, BTW, since, currently at age 73, I suppose I may need to address this very question soon, or at least in the not too distant future.
And those of you around my age will likely want to at least ponder this question as well, while those of you younger will eventually be faced with it.
A quick web search on this topic reveals a variety of opinions, some in favor of stopping testing at a certain age, maybe around 75 (some even saying 70), while others saying it should continue to 80 or even beyond. This article, which is short, seemed to cover some key issues:http://urology.jhu.edu/newsletter/2010/prostate_cancer_2010_18.php
In general, however, two points were repeatedly made in the coverage I did look at:
It is reasonable to consider stopping testing for a given man if
1. his overall health, including prostate indicators, is good
2. he has a probable life expectancy of 10 years or less.
But even those articles acknowledged the arbitrary nature of (1) and (2), leading to the reasonable disclaimer:
3. Talk it over with your doctor as to what's the best choice for you
It really is a consequential choice when you think about
it. PSA testing has been a part of my own life for the past eight years now, for example, and stopping it completely at some age leads me to wonder if maybe I would be putting an end to something that arguably provides reassurance when the test come back okay, in exchange for not having to worry about
the testing thing anymore, but now having to wonder if something may be starting to develop in me that I will have no way of knowing about
, because I no longer test.
Perhaps it all comes down to just playing the odds. If the numbers say not testing beyond a certain age won't matter all that much, then okay, go with that.
But if doing so just generates worry that something is now going to be missed that might have been caught if testing was still being done, well, then that's a problem too.
Is it actually possible that we may come to think of the PSA test as a kind of security blanket in this way? My!
Personally, I haven't put this question to my own uro yet, but I think I will at my next appointment with him in the fall, just to see what he thinks. I'll probably go with his recommendation, whatever he thinks best.
So what about
you? Whether your age will be bringing this question to the forefront for you now or pretty soon, or it will in your future, what do you think?
Chronic prostatitis (age 60 on)
BPH w/ urinary obstruction, 6/2011
Ongoing high PSA, 7/2011-12/2011
Biopsy, 12/2011: positive 3/12 (90%, 70%, 5%)
Gleason 6(3+3), T1c
No mets, PCa likely still organ contained
IMRT w/ HT (Lupron), 4/2012-6/2012
PSAs (since post-IMRT): 0.1 or lower