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Old 02-02-2020, 06:51 AM   #21
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IMO, a few factors are in play here.

One, the PSA test is fully accurate. Too many false positives and false negatives. Two, doctors, especially specialists could be very tunneled vision. Three, there may be the fear of liability so ordering the needle test on the patient regardless of possible side effects and impact and inconvenience on patient.

I go to my GP every year for an annual physical. He used to check the old fashioned way (digital, rubber gloves ). For the past few times, he only ordered the PSA test. Each time, the result was normal.

I wonder if the old fashioned way wouldn't been a way for Midpack's GP to do a second check. Of course, that's probably something that maybe a patient may not request as who wants to get tested more that way than needed . Plus, I'm not sure which is more accurate. Old fashioned or PSA.

On the tunnel vision, here's an example. A few years back I brought a relative in to see a neurologist for some tests for a possible condition During the evaluation and testing, to doc and staff seemed to question why a visit was even necessary. After and MRI was concluded that she probably didn't have the condition. But then they wanted to do follow up some other tests anyhow and appointments. Follow up for what? Seemed like the doc wanted to test just to test despite already ruling out what we were evaluating in the first place. Kind of like you go in for pain in the knee, the docs treats you for a pain in the elbow which wasn't hurting in the first place.
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Old 02-02-2020, 06:54 AM   #22
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Originally Posted by audreyh1 View Post
I think that’s quite understandable given their attitude and that it could have been their error. But now you have to show them results from another lab?
That doesn’t bother me at all, I scanned and emailed the results yesterday. I assume they’ll see them Monday, and I’ll never hear from them. Who knows, they may surprise me.

My 2013 GP, who we liked a lot BTW, had his nurse acknowledge my normal retest, and they never mentioned it again.

In all fairness, I did not go to the urologist this time. He/she may have recommended a retest for all I know. But based on my first experience where the urologist, GP and nurse told me I was stupid to ask for a retest (“why, the results will be the same”), I chose to get a retest first on my own this time, right or wrong.

And the other thing that REALLY put me off the first urologist. He had very good marks online. He did a quick DRE and didn’t notice anything but told me to schedule a biopsy with his receptionist. I asked him ‘how much does a needle biopsy cost?’ He said ‘I have no idea, but what do you care, your insurance will pay for it!’ I didn’t show it, but I was furious. I wanted to say that’s why US healthcare costs twice as much as other developed countries without better outcomes but I didn’t - he was already angry at me. Dope...

That whole experience changed my views on doctors. Most are great, but the patient should educate themselves and know what’s going on where possible.
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Old 02-02-2020, 06:54 AM   #23
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As mentioned above, there are various causes of a high PSA reading.

The very first one I had, long ago, was a little over 9 and it scared the you-know-what out of me. Doc sent me to a urologist who guessed it was prostatitis, so he gave me some antibiotics and a few weeks later it was down to a normal level.
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Old 02-02-2020, 06:59 AM   #24
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Originally Posted by easysurfer View Post
IMO, a few factors are in play here.

One, the PSA test is fully accurate. Too many false positives and false negatives. Two, doctors, especially specialists could be very tunneled vision. Three, there may be the fear of liability so ordering the needle test on the patient regardless of possible side effects and impact and inconvenience on patient.

I go to my GP every year for an annual physical. He used to check the old fashioned way (digital, rubber gloves ). For the past few times, he only ordered the PSA test. Each time, the result was normal.

I wonder if the old fashioned way wouldn't been a way for Midpack's GP to do a second check. Of course, that's probably something that maybe a patient may not request as who wants to get tested more that way than needed . Plus, I'm not sure which is more accurate. Old fashioned or PSA.

On the tunnel vision, here's an example. A few years back I brought a relative in to see a neurologist for some tests for a possible condition During the evaluation and testing, to doc and staff seemed to question why a visit was even necessary. After and MRI was concluded that she probably didn't have the condition. But then they wanted to do follow up some other tests anyhow and appointments. Follow up for what? Seemed like the doc wanted to test just to test despite already ruling out what we were evaluating in the first place. Kind of like you go in for pain in the knee, the docs treats you for a pain in the elbow which wasn't hurting in the first place.
The test is accurate. It measures the amount of PSA that seeps into your blood from the prostate. The problem is that there's no number that says for sure you have prostate cancer or you don't. You can have cancer with a PSA of 1, and not have it with a PSA of 10. Although as the number increases the chance of you having cancer also increases. However it's the best cheap test available. It just tells you something is not normal.

DRE can find cancer if it's on the outside of the area being tested, but that leaves out that anterior of the prostate and the inside too.

Again some urologists will go straight to biopsy. Others will perform other tests before those. Pick your urologist well.
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Old 02-02-2020, 07:06 AM   #25
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Seems like a PSA thread comes up here several times a year. As I've said several times before, every male on my dad's side of the family has had high (actually very high) PSA's. They all had various related tests and more invasive procedures to evaluate their conditions. None had any cancers and all died of something else in the late 80's/early 90's. However all had problems after those invasive procedures and "some" of those problems lasted the rest of their lives.

I just had my annual checkup and I told my "new" doctor the story above and said I didn't even want my PSA checked again. I already know it's high. He said, I fully understand and don't blame you at all. We moved on.
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Old 02-02-2020, 07:07 AM   #26
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Never had PSA test, no intention of ever getting it.
Prostate cancer has now overtaken breast cancer as the most prevalent cancer.
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Old 02-02-2020, 07:12 AM   #27
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Originally Posted by easysurfer View Post
I go to my GP every year for an annual physical. He used to check the old fashioned way (digital, rubber gloves ). For the past few times, he only ordered the PSA test. Each time, the result was normal.
I didn’t know it at the time, but my 2013 GP did a DRE at the end of the physical and then a nurse drew blood for a lipid panel and PSA. Turns out that’s a complete no-no, a DRE alone can temporarily elevate PSA...
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Old 02-02-2020, 07:15 AM   #28
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Originally Posted by Car-Guy View Post
Seems like a PSA thread comes up here several times a year. As I've said several times before, every male on my dad's side of the family has had high (actually very high) PSA's. They all had various related tests and more invasive procedures to evaluate their conditions. None had any cancers and all died of something else in the late 80's/early 90's. However all had problems after those invasive procedures and "some" of those problems lasted the rest of their lives.

I just had my annual checkup and I told my "new" doctor the story above and said I didn't even want my PSA checked again. I already know it's high. He said, I fully understand and don't blame you at all. We moved on.
I agree, maybe I shouldn’t have posted again. I just remember the first time in 2013 how terrified DW and I were to be told I might have prostate cancer, it was life altering for a couple months - unnecessarily. That happens often from what I read. My only hope was to spare others the terror we (mostly DW) felt.

And my 2013 GP, nurse and urologist didn’t do anything to allay our fears, I had to spend weeks educating myself and fighting all three of them...it was shocking. I asked questions respectfully, and they were impatient or worse with me every step of the way. It took over 2 months for them to allow me a $49 retest. The whole situation was avoidable.
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Old 02-02-2020, 07:22 AM   #29
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Originally Posted by Car-Guy View Post
every male on my dad's side of the family has had high (actually very high) PSA's. They all had various related tests and more invasive procedures to evaluate their conditions. None had any cancers and all died of something else in the late 80's/early 90's. However all had problems after those invasive procedures and "some" of those problems lasted the rest of their lives.
FWIW, there is probably some luck (good or bad) involved in these situations. I've had high PSA readings for decades (urologist says it's because my prostate is quite large). I had three biopsies in the early years (all ordered due to a noticeable rise in PSA from the previous reading), and all were negative. No bad effects from any of them, and they certainly went a long way toward easing my mind about the issue.
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Old 02-02-2020, 07:23 AM   #30
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Prostate cancer has now overtaken breast cancer as the most prevalent cancer.
My understanding is that in most cases it is benign and would do no harm if left untreated. The risks of developing it are mitigated by a healthy diet, exercise, and maintaining a healthy body weight.

It's my belief that it's now most prevalent specifically because of some of the points mentioned in this thread - that PSA testing gets pushed so heavily, and there are so many false positives which get acted on. Further, most folks do not eat healthy, exercise regularly, and as a country we are obese - these are known facts. Couple this with the auto-pilot type of response so many physicians and individuals have towards it and it's no surprise that it is now most prevalent.

Personally, I eat healthy, exercise daily, and maintain a good body weight. I am extremely low risk. I've gone to a physician only once in the past 15+ years and that was for a routine physical. Should I develop any of the symptoms of prostate cancer, then I'll have it checked out.

I have no issue with how anyone chooses to address PSA testing or act upon the results in their individual case.
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Old 02-02-2020, 08:15 AM   #31
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Yep, been there, done that. My story is here.........

http://www.early-retirement.org/foru...=freedomatlast

As it turned out, my elevated PSI was a result of an enlarged prostate which wasn't allowing my bladder to completely empty. This in turn was agitating the prostate, which resulted in a high PSA result. Tamsulosin was prescribed and subsequent PSA tests have been normal. One of the biggest lessons learned for me was to select a urologist who will utilize a 3T MRI instead of a biopsy if needed. Fortunately, after taking the Tamsulosin for six months, my PSA returned to normal and the scheduled MRI was cancelled.

The people on this site were of great help with encouragement and advice.
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Old 02-02-2020, 08:50 AM   #32
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Timely post for me. I just had my physical and PSA went up to 2.61 from 2.20. I do show an upward trend for the last 4 years. I did have one year where it jumped from 1.60 to 2.41, then dropped back to 1.71. So my GP sends me to a urologist. They say 2.50 is expected at my age (62) and to come back for a retest in 6 months. Hopefully it will go down or stay the same. That office does the biopsy rectally so not in any rush to do that. It's nice to hear other stories.
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Old 02-02-2020, 08:55 AM   #33
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The test is accurate. It measures the amount of PSA that seeps into your blood from the prostate. The problem is that there's no number that says for sure you have prostate cancer or you don't. You can have cancer with a PSA of 1, and not have it with a PSA of 10. Although as the number increases the chance of you having cancer also increases. However it's the best cheap test available. It just tells you something is not normal.

DRE can find cancer if it's on the outside of the area being tested, but that leaves out that anterior of the prostate and the inside too.

Again some urologists will go straight to biopsy. Others will perform other tests before those. Pick your urologist well.
Thanks for the clarification. In my case, since I get my blood glucose tested each physical anyhow, the PSA test is sort of killing two birds with one stone.
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Old 02-02-2020, 08:55 AM   #34
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I didn’t know it at the time, but my 2013 GP did a DRE at the end of the physical and then a nurse drew blood for a lipid panel and PSA. Turns out that’s a complete no-no, a DRE alone can temporarily elevate PSA...
Interesting fact. I didn't know til just now seeing your post.
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Old 02-02-2020, 09:05 AM   #35
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Yep, been there, done that. Mt story is here.........

http://www.early-retirement.org/foru...=freedomatlast

The people on this site were of great help with encouragement and advice.
In 10/2017 by PSA was 1.2 and that has been my number for years. Slipped up in 2018 and didn't have it done as I had a few other issues going on. The dr did do a urine test that year and discovered I had a minor UTI infection and prescribed antibiotics. In 10/2019 I changed doctors and he ran a PSA test which came in at 3.4. When the nurse called with the lab results she indicated all my lab work was normal but I specifically asked for the PSA count. I told her of the increase over a 2 year period but she said it was nothing to be concerned about. I have a follow up in April so will discuss further and will ask for another PSA and urine test as well. Didn't have a urine test last time so it's possible I may have another minor uti infection as I didn't know I had one 2 years ago. Who knows.....my increase in PSA could be from that. Or it could be just from the aging process.
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Old 02-02-2020, 09:11 AM   #36
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Here is another story... After falling while sking and then throwing around logs while cutting firewood the next day my hip got sore. It didn't go away like a sore muscle. I then got a notice from Humana telling me that prostrate cancer sometimes only shows up as pain in the hip. I see my doctor who tells me a PSA test may be appropriate but that Humana will only pay for one every two years and it had not been two years.
I did get a PSA and it was normal. She also had me get some xrays to see if I have arthritis. Still waiting on those results.
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Old 02-02-2020, 09:12 AM   #37
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Doctors in the US almost always recommend full tests and when anything suspicious or out of the ordinary pops up, they recommend new tests and procedures. We are a litigious society where everyone seems to sue somebody else on the slightest whim. Doctors are terrified of malpractice and thus over prescribe tests, procedures, and drugs to cover themselves in case something is there and the patient comes back and sues them for not ordering the extra tests. Fortunately, I am in good health and my doctors tend to take a more reasonable approach. But it is what it is.
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Old 02-02-2020, 10:12 AM   #38
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It makes sense to wait and repeat the test before evasive procedures. When my husband’s blood test went from no diabetes to diabetes in one year the doctor repeated it 7 weeks later before prescribing medication. He unfortunately did have it. At 49 he went to a urologist due to impotence even using medication. Turns out he had prostrate cancer. You just never know.
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Old 02-02-2020, 10:34 AM   #39
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A urologist is not 'required' to perform a needle biopsy. There are other methods that can be used to determine if you have cancer.

My PSA went up to 22 before I got a biopsy.
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Old 02-02-2020, 10:40 AM   #40
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Prostate cancer has now overtaken breast cancer as the most prevalent cancer.

Because people live longer than ever. PC is overwhelmingly a disease of aging. You might say it's an indication of our ongoing success. It's not like it's contagious or we're all doing something to cause it like lung cancer rates going up from smoking cigarettes.



Just because people eat better get exercise and all those good things doesn't mean The Natural World has ceased to be a factor.
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