10 Tests to Avoid

[Rich_by_the_Bay]

OK, but let's say the tests, over a three year period, trend up to 7, 9, 11. (If that's even possible, I really don't know much about this stuff).

Not enough information, but generally that kind of strategy results in some benefit for the false positive population at the expense of turning up new patients each cycle. Now that you have a screened population, the likelihood of true CA is higher. And screening every 2-3 years rather than annually may be a good idea, though not rigorously tested yet.

Once an abnormal PSA is identified it is very hard to convince most men to defer doing anything. It is much easier and more accurate to discuss it before any results are obtained.

At the very least talk it over with your doctor to discuss all of your options and risks. Check my signature for the usual disclaimers.

 

[Rich_by_the_Bay]

It could mean cancer but what it most likely means your prostate is simply getting larger with age

PSA does not detect cancer. It just detects prostates

Well, not quite. PSA detects cancer pretty well esp at values > 10, but it also detects prostates well. The trick is to sort out which of those scenarios are true for the patients.

PSA "velocity" (rising PSA over time) is a general number which is a bit more specific and sensitive as a strategy but not enough so to change screening recommendations.

 

[razztazz]

Well, not quite. PSA detects cancer pretty well esp at values > 10, but it also detects prostates well. The trick is to sort out which of those scenarios are true for the patients.

PSA "velocity" (rising PSA over time) is a general number which is a bit more specific and sensitive as a strategy but not enough so to change screening recommendations.

Well, no it does not detect cancer. It detects prostate specific antigen. I was merely referring to comments made by the doctor who invented the PSA test who about 5 or 6 yrs ago renounced it as a routine screening mechanism.

I have had prostate issues since my mid 30s and have been over every square inch of this with more doctors than I can count. (and I keep doing it every year) If anybody thinks PSA can tell you "cancer/no cancer" by any manner of juggling or teasing numbers they fail to understand its fundamental nature

As far as PSA >10.. last I checked (a few tears back) 65% of psa >10 biopsies were negative for cancer. A 35% hit-rate is not very good. Even worse when you add in those killed and maimed from biopsies

 

[MBAustin]

I generally agree with the list, although my ob-gyn still does an annual PAP as part of my annual visit (which AARP says is still a good thing) - I just haven't had the guts to ask him about it. Although I don't have a full "physical" with blood work, etc., between the ob-gyn visit and an office checkin with my GP about my thyroid levels (where she also does a few other basic checks and asks a lot of questions), I feel that's enough.

 

[rodi]

These general recommendations are worthless without putting it in individual context including family history. If there's a family history of prostate cancer, especially detected younger, it makes sense to test annually. If there's a family history of breast or ovarian cancer - again - do a mammogram and pap annually.

I have the most frugal insurance available (Kaiser Permanente). Frugal in that they don't do extras - just bare bones. But given my family history they have increased the frequency of my mammograms. They also do a 5 year cycle on u/s of the reproductive system. And I'm on a frequent colonoscopy schedule since they found polyps when I was 40. My family history is pretty extreme though -My mom died of breast cancer, dad had prostate cancer then died of multiple myeloma (2 separate malignancies), brother had melanoma then died of a very aggressive and nasty neuroendicrine carcinoma (2 separate malignancies), 3 of my 4 grandparents died of cancer, I have 3 cousins - 2 have had cancer - one has had 2 malignancies... My family is it's own little cancer cluster.

They looked at my family history and modified the "recommended" frequency to fit my circumstances.

 

[grasshopper]

I have the family curse father and brother, and I all share the brotherhood of prostate cancer. I am lucky that mine is small and slow growing a second biopsy is identical to my first a year ago at age 62. Veghead diet really seems to make a difference in my case.

Sent from my Nexus 7 using Early Retirement Forum mobile app

 

[audreyh1]

My wife just had an annual physical, with chest X-ray, they found a small mass in the lung and it is cancer. So without the chest X-ray we would of not known. Sometimes early detection is a life saver.

I am not a big fan of Aarp either

Chest X-ray is not a normal part of an annual physical. What prompted that? Just curious.

 

[lynxville]

I requested the X-ray because she hasn't had one for a long time, otherwise your right they normally don't do that. The first thing the doctor wanted to know if we had another X-ray to compare it to and we did not. She quit smoking 19 years ago but that's no guarantee of future problems.

Smoking is a dangerous habit and has killed a number of my relatives and friends. I just hope it isn't to late for my wife.

 

[Turboslacker]

I'm surprised they listed PSA but not mammograms. I guess they wanted to avoid that controversy.

Good point

 

[Big_Hitter]

um yeah - at 50 with a family history, you can bet your *** that I'm getting my psa checked every year

 

[Al in Ohio]

I smell insurance lobbyist money funding throughout ....

 

[2035]

As a woman who has had abnormal Pap smears, I would not consider #6 an unnecessary screening (it's not a test)