Interesting Conversation With New GP

Donna here. I just went to my first visit with a new GP. I really liked her. As part of the initial visit, she asked about my family and lifestyle, job, etc. I told her about Randy's PCA journey. Near the end of her visit, she asked about how we found out he had cancer.
Doc: Just curious, how was his cancer detected?
Me: PSA
Doc: Interesting. When I was in Med school, we were told the standard of care was to test every male of 40. Then we were told that men were being overtreated and to never test unless there were symptoms or he was high risk. If a man asked for a PSA they were to discuss the pros and cons of the test and use "shared decision making". Last month, I went to a dinner where the speaker was a urologist. He was saying they were now seeing way too many men who had advanced PCA upon diagnosis. He urged GPs to include PSA in routine bloodwork.

Just a note. Randy has no family history and no risk factors for PCA. Without testing, there's no telling when he would have been diagnosed, and how much further it would have progressed. I know this has been discussed on this forum many times and one man's experience is only anecdotal. But we do believe that it would have been so much worse had the disease been allowed to progress unchecked. We have encouraged everyone we know to get a PSA. We've had friends and family members who have been discouraged from PSA testing by their GPs. When routine testing was curtailed, my though was that there would be lots of men who would be diagnosed late, although some folks poo-pooed the idea. Overtreatment is an issue, IMHO, that can be laid at the door of doctors, who fail to properly advise their patients of their risks and options. I, personally, am glad to see the return of routine testing. Thoughts?

My PCa was discovered as a result of a PSA test for my annual checkup, and the results from past checkups. I am so thankful that my doctor took note of it and referred me to a urologist. I was asymptomatic but had an extra-capsular extension, which likely would have led to serious problems down the road had I not had the PSA test history.

I believe I was 45 years old when my GP added PSA to my annual bloodwork. At 47 I was around 1, but it doubled each year the next two years and it hit 4.2 when I was just shy of 50. I was on a low dose of finasteride for hair loss, so my number was probably closer to 6. My GP probably should’ve caught this increase a year earlier, but he didn’t. In any event, the testing most certainly saved my life, as my biopsy uncovered G9 cancer.

I don't remember if my uro/surgeon said age 30 or 35 for first PSA test for men with a family history.

Djin

Post Edited (DjinTonic) : 5/16/2022 12:15:22 PM (GMT-6)

Looking at MyChart, I guess I was 41 when my PCP started testing and I had 5 tests between then and my troubling PSA level at age 61. Well worth the money spent.