annual physical, no more prostate exam

[donheff]

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.

 

[Mr._Graybeard]

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.

 

[redduck]

...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...

 

[Mr._Graybeard]

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...

 

[samclem]

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.

 

[mystang52]

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.

 

[Bikerdude]

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.

 

[imoldernu]

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.

 

[Bikerdude]

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!