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Old 10-04-2014, 04:49 PM   #21
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I had a bad experience with a PSA test on an annual physical, recommended followup with biopsy......

A search online turned up, your PSA score will be elevated if taken after a digital exam!!!! Guess what the next PSA was fine.
Unfortunately, this is a common story. Makes me wonder if many false positives in some of these studies were due to this.

The other issue with evaluating prostate screening is that all prostate cancer does not act the same. It tends to be more aggressive in younger men.
Prostate Cancer More Aggressive in Younger Men : U.S. Medicine
I wonder if future screening 'guidelines' may include more age-specific testing after taking this into consideration.
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Old 10-04-2014, 07:17 PM   #22
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Dad had PCa brother had it, go figure, I was diagnosed with "prostate cancer" age 62. i have been on a plant based diet for 20 years, 10 years after my first PSA test. PSA went from 1.0 to 4.5 in one year. Biopsy 1 little spot of non normal cells. Second biopsy same like as the first. I just came back from my 6 month visit after a PSA test of 2.7. My urologist says, in his words "you don't have cancer". you have some non normal cells that need no treatment. But I will continue on Active Surveillance. Get PSA test and DRE every 6 month and a PSA test every 2 years unless my PSA goes through the roof. I am a pretty happy camper.
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Old 10-04-2014, 07:23 PM   #23
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A long time ago, when I was a few years into the computer industry, I had a physical. I saw that they were doing a "digital test". I just assumed it was a computer screening, some digital test.

Little did I know what was about to happen... When I joined the service I had one, but it was a bit of a shock the first time.
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Old 10-04-2014, 08:29 PM   #24
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The prostate biopsy almost killed my brother too. He developed sepsis and was hospitalized for 10 days.
Probably the most terrifying event of my life. Every time a Dr came into the hospital room, I was afraid he was going to tell me "we tried everything and nothing is working"...in the end I got the right antibiotics and came out ok, but...for a few days, it was pretty scary.

On the plus side, DW went on a 'life is short' crusade and made me buy a new car!
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Old 10-05-2014, 04:16 AM   #25
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7 Non-Cancerous Reasons Your PSA Levels May Be High - Prostate Cancer Center - Everyday Health
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"Ejaculation can cause a mild elevation of your PSA level, and so can having a digital rectal exam," explains Milner. "These types of PSA elevations are usually not enough to make a significant difference unless your PSA is borderline. PSA should return to normal in two to three days." Doctors will usually draw blood for a PSA level before doing a rectal exam. Ask your doctor if you should avoid ejaculation for a few days before a PSA test.
"Mild?" No "significant difference?"

Last year my PSA level dropped from 4.38 to 1.37 when I eliminated DRE (and sex?) before the PSA blood draw just to put some actual numbers to the text, albeit only one example. I was unnecessarily left worrying if I had PC for months, DW was even more worried, not fun.

He never commented or acknowledged my "surprising" PSA retest last year, so my GP and I may have a "debate" when my annual physical comes up in Dec, but I won't allow them to draw blood for a PSA after a DRE again. FWIW
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Old 10-05-2014, 06:55 AM   #26
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I was going to mention the current guidelines that recommend against PSA testing but Rich's post covers the ground much better than I could. My doctor routinely includes PSA in the labs and says we would switch to watchful waiting if I got an elevated score. I can't decide whether there is much value in that or if that is just courting anxiety if a test comes back high. Maybe watchful waiting (for symptoms with no PSA numbers) is the better overall approach. Better yet would be an accurate screen. Maybe someday.
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Old 10-05-2014, 10:27 AM   #27
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My PSA was on a gradual rise over a couple years. After the third test showed an increase, (to 2.8), my GP's assistant referred me to a urologist in the medical group. Naturally, he wanted to do a biopsy (it's what they do). Results: 5% "cancer" in one of 12 cores. Urologist immediately wanted to talk about surgery -- instead we got a second and third opinion. Both said I should just watch my PSA closely as part of "active surveillance." Both also hinted that my biopsy was not warranted with a 2.8 PSA.

Since my diagnosis, my PSA level has declined -- the last reading was 2.0. The experience has taught me that it's easy to get caught up in the machinery of the medical industry, and that it can be a lifesaver or a meat grinder.
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Old 10-05-2014, 02:20 PM   #28
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...The experience has taught me that it's easy to get caught up in the machinery of the medical industry, and that it can be a lifesaver or a meat grinder.
I would think that a majority of guys would prefer to keep their meat out of a meat-grinding machine. On the other hand, if we are talking about a different sort of meat-grinding machine--like Marci back in college...
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Old 10-05-2014, 07:05 PM   #29
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I would think that a majority of guys would prefer to keep their meat out of a meat-grinding machine. On the other hand, if we are talking about a different sort of meat-grinding machine--like Marci back in college...
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Old 10-05-2014, 07:15 PM   #30
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Better yet would be an accurate screen. Maybe someday.
That would be super. And while we are hoping/wishing: Treatment options without the side effects of those available at present. I know several guys who had treatment and, with the benefit of hindsight, now wish they hadn't due to the adverse consequences.
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Old 10-05-2014, 07:52 PM   #31
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I had prostate cancer and opted for the surgical removal. I was monitored for several years beforehand. Twice in that interval my PSA jumped significantly, and each of those times had a biopsy. First one was negative, second was positive in 10 of 12 samples.
There are anecdotes aplenty about PSA, treatment or not, etc. Of course it ends up being an individual decision. I researched this fully during my observation phase and after the diagnosis, and chose surgery fully informed and comfortable with the decision. I wish I didn't have that cancer, but that wasn't one of my choices. All in all I've had an excellent recovery. I'm not 100% the man I was before, but close enough.
Each man needs to do his research, assess the test results, get second or multiple opinions, and make an informed decision he can [perhaps literally] live with.
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Old 10-06-2014, 05:08 PM   #32
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but I won't allow them to draw blood for a PSA after a DRE again. FWIW
I always insist no DRE prior to blood test. In addition, I stop riding my bike for 2 weeks prior to test. Too many false positives and one unnecessary biopsy.

Another thing to keep in mind is when your Dr. is also a surgeon his solution to most problems is surgery.
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Old 10-06-2014, 05:31 PM   #33
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First PSA was in 1992, and the reading came back @ 29... not 2.9, but 29...
call from doctor to go for a biopsy the same day... Because the guy who did the biopsy didn't see any "suspect" places, he did 7... yeah 7 biopsies.
If you've ever had even 1 you'll understand. I'd take a root canal without anaesthesia before I'd ever have another biopsy if there was a choice. Don't know how they do it now, but not only did ya "feel" the biopsy, but you could hear the "pop:.

Of course, the reading was an error. Doctor said "sorry"... Didn't help.
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Old 10-06-2014, 05:45 PM   #34
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Because the guy who did the biopsy didn't see any "suspect" places, he did 7... yeah 7 biopsies.

Got you beat, 8 biopsies. Ouch!, Ouch!, Ouch!, Ouch!, Ouch!, Ouch!, Ouch! Ouch!
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