Getting a prostate PSA test directly

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ER_Hopeful

Recycles dryer sheets
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just found out I can order a PSA test directly on Quest Diagnostic on my own without a doc's order. any downside to this? Also, it is making me sign a HIPPA form that says



"For Quest Diagnostics labs to provide details about you and your lab tests to Quest Consumer, please review and agree to the HIPAA Authorization below. Once signed, this authorization is valid for 2 years. blah blah blah "


I think that's just standard stuff, right?


BTW, My doc wouldn't order one for me, said I'm too young and just gave some prostate med and sent me on my way.
 
ER_Hopeful said:
BTW, My doc wouldn't order one for me, said I'm too young and just gave some prostate med and sent me on my way.
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You mean like "Tamsulosin (Flowmax)"? If so I would think he would have done a PSA test too.
 
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I don't get the angst about getting the test, it is pretty routine. It has been included in my normal "bloodwork" as long as I remember. I had a weird spike not too long ago, got referred to a urologist, did some follow-ups and everything was fine.

The point being that a high result does not mean you have cancer - it means you may (or may not) have cancer. As I understand it, active monitoring has become the normal response to one high result. Seems reasonable to me.
 
Go ahead and get the test from Quest. If nothing else, it establishes a baseline. I've been tracking mine on an excel file ever since I had a spike years ago.
 
I just got my PSA tested at Quest last week. I ordered it along with a bunch of other tests through Jasonhealth.com. I needed the more comprehensive PSA test that showed PSA, free and total because of another test I did recently that showed my total PSA was boderline high. I've found ordering individual tests through Jasonhealth.com was cheaper than ordering directly with Quest or other online test sites.
 
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Ian S said:
If your doctor is giving you meds, it suggests you are having symptoms. Odd that he wouldn't want a PSA test done. Anyway, the test is controversial. Here's an explanation of the issues: https://www.menshealth.com/health/a19528922/psa-testing-0/?utm_source=google&utm_medium=cpc&utm_campaign=arb_ga_mnh_md_pmx_us_urlx_17889802313&gclid=CjwKCAiA9ourBhAVEiwA3L5RFhSPCGFUrXXjDO34XDDewE9EzCyUIcoIOxwPycoWmNE7fjf-uTSYLhoC4h8QAvD_BwE
Click to expand...

This is a great article. Thanks for sharing. My recovery from my test was worse than my recovery from surgery that I had years later as a result of my continued prostate growth. In both cases, no cancer. Dad did have prostate cancer.

It seems OP doc is well informed. He may not have explained his rational or the change in approach is still so new that convincing a patient is difficult. If PSA provides piece of mind, I suppose it is worth doing. Having a doctor that limits testing in my judgement is worth keeping.
 
All I can say is that this forum is NOT the place to get medical advice.
 
We have a few prostate threads here. Search for "BPU". Many doctors are leery of PSA tests due to a high degree of false positives. My PSA was at 17 for 20 years (normal is under 4) but I did not have cancer. But I did have a biopsy performed which almost killed me--literally-- with a sepsis infection as a result.

Your doc is likely trying to avoid unnecessary worry for you but you should be able to demand the test especially if he's put you on meds...
 
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If you have a high PSA and they want to do a biopsy find a place that will do MRI first to make sure you really need a biopsy then will blend the MRI and US to do a targeted biopsy sampling the lesions seen on MRI.
 
joesxm3 said:
If you have a high PSA and they want to do a biopsy find a place that will do MRI first to make sure you really need a biopsy then will blend the MRI and US to do a targeted biopsy sampling the lesions seen on MRI.
Click to expand...

This was years ago and that's what I did. It still almost killed me. Had the prostate removed in June.
 
I've recently used Ulta Labs for inexpensive tests that I didn't want to go through my doctor for. They've worked well and are not expensive. They even have black Friday sales still available today.

You select the test you want and they show you a list, and cost, of local places to have the blood drawn.
 
marko said:
We have a few prostate threads here. Search for "BPU". Many doctors are leery of PSA tests due to a high degree of false positives. My PSA was at 17 for 20 years (normal is under 4) but I did not have cancer. But I did have a biopsy performed which almost killed me--literally-- with a sepsis infection as a result.

Your doc is likely trying to avoid unnecessary worry for you but you should be able to demand the test especially if he's put you on meds...
Click to expand...

Thanks for sharing your experience.
My urologist wanted me to consider a biopsy, but I hesitate to allow invasive prostate test (snipping) and currently prefer active surveillance.
 
Getting a PSA test is simple but it's what you do with the results. If it's a low number that's one thing but if it's high then what, a biopsy? My FIL nearly died from sepsis following a prostate biopsy. The problem is the method typically used which is called "transrectal biopsy" (sarcastically called by some "transfecal") where there is significant risk of contamination by pathogens found in the rectal area the needle passes through. There is an alternative called "transperineal biopsy" where the risk of infection is greatly reduced. Apparently, the latter method is starting to be used more often especially in Europe. I'd insist on it if I required such a biopsy. A Mayo Clinic explanation of the procedure: https://newsnetwork.mayoclinic.org/...psies-virtually-eliminates-risk-of-infection/
 
foxfirev5 said:
All I can say is that this forum is NOT the place to get medical advice.
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Yes. It seems very odd to consult SGOTI when the posters (apparently) don't trust their own doctors. The logical solution is a different doc or at least a second opinion, not a bunch of random anecdotes from random SGOTIs.
 
I went through some issues with PSA 8 years ago in 2015 when I was 62. PSA results came in at 5.01 and after a retest after 30 days it was still 4.96 so my VA doctor referred me to Urology. I saw a young doctor there who told me she was going to refer me for a biopsy from looking at my records but after talking with me decided to prescribe a course of antibiotics and retest after 90 days.

The retest results showed PSA of 3.75 and the much older doctor I saw for my Urology follow up did his own finger wag and told me I was just experiencing enlarged prostate and watchful waiting was the deal for the day. Spent the next several years testing every 3 to 6 months with satisfactory results, keeping everything between 2.5 and 4.06. Now testing annually but with somewhat relaxed standards as I'm now 70.

I had done some research and was not really eagerly anticipating any biopsy but not being a medical professional myself, would have followed medical advice if necessary. It did take me quite a while to mentally get over the possibility of a "C" word diagnosis. If a PSA test at a Quest lab would put your mind at ease, then I would say go for it.
 
joesxm3 said:
If you have a high PSA and they want to do a biopsy find a place that will do MRI first to make sure you really need a biopsy then will blend the MRI and US to do a targeted biopsy sampling the lesions seen on MRI.
Click to expand...
As I understand it, the new gold standard for detecting any PC is a PSMA PET/CT scan. Both in the prostate and anywhere that it may have migrated to in the body. I'm not an expect but it seems to me it may negate the need for biopsies. Supposedly super accurate/sensitive... And expensive. :)
 
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OldShooter said:
Yes. It seems very odd to consult SGOTI when the posters (apparently) don't trust their own doctors. The logical solution is a different doc or at least a second opinion, not a bunch of random anecdotes from random SGOTIs.
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The problem is that doctors often don't have time to explain nuanced details of the pros and cons of something like the PSA test where recommendations have gradually changed over the years. Several commenters including myself have provided useful links to explain how the thinking on the test has evolved. The O.P. sounds like a patient who wants to become educated on a simple test and its ramifications for going forward in an area where things are not cut and dried and there may be risk involved in whatever the doctor and patient decide to do based on a high PSA number.
 
ER_Hopeful said:
yes, exactly, gave me Tamsulosin, but no exam/test whatsoever.
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I see that as malpractice.

It might be worthwhile to find another doctor. I've had many PSA tests, along with biopsies.

Our insurance was never an impediment. If something seemed wrong, and GP didn't respond to my satisfaction, I found a specialist with more knowledge and experience.
 
The video seems to have a summary at the top (including but not limited to prostate care, diagnostic tests, medications, procedures and treatment) - and time stamped topics at the bottom. It is possible that different topics might be of interest to different individuals, but I understand why the video was recommended.
 
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