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Age They No Longer Check PSA

ClaCla
Posts: 137
Joined: Jul 2017

My husband has had high PSA levels for close to 10 years.  He is turning a young 76 in a couple of months.  Today his Primary Care Doctor told him they no longer needed to check his PSA levels at his age.  Does that sound correct?  I don't like the idea of no longer monitoring it.  Thank you.

VascodaGama's picture
VascodaGama
Posts: 3050
Joined: Nov 2010

You did not share his PSA histology, but I think that it is wiser to find what is causing  the high levels of the serum.

I wonder if his doctor stops monitoring the PSA in patients older than 75 which is the age when surgery is no  more recommended.

Clevelandguy
Posts: 473
Joined: Jun 2015

Hi Cla,

Depending on the circumstances of the case, a lot of times if you have a low level non agressive slow growing cancer there is a chance you will die from something else other than the prostate cancer.  My Dad had prostate cancer in his mid 70s and they told him if it "flaired" up they would just knock it down with radiation and be done with it.      If it was me I would still want it monitored just to know what is going on.      Just my 2c worth.

Dave 3+4

Old Salt
Posts: 720
Joined: Aug 2014

'A young 76' may have many more years of good quality life ahead of him. Hence, I would also recommend to continue monitoring. 

If insurance won't pay for the test, I have read that it isn't expensive to pay for it out of pocket.

ASAdvocate
Posts: 117
Joined: Apr 2017

Has he had MRI's and biopsies? PHI or PCA3 tests?  Just psa tests? Not even free psa?

What is his psa history? Does he know the size of his prostate and what his psa density is?

If he/you don't have this information, then he absolutely should not stop being tested, and using the PHI test rather than just psa.

 

ClaCla
Posts: 137
Joined: Jul 2017

Thank you all very much.  After receiving everyone's response, we have e-mailed my husband's doctor and per ASAdvocate's suggestion have requested PHI and PSA tests.  It's so great to have a community to confer with.  Thanks again. 

ASAdvocate
Posts: 117
Joined: Apr 2017

ClaCla, the PHI test will provide psa and free psa results, as well as another cancer biomarker and a score of cancer likihood. All-in-one.

ClaCla
Posts: 137
Joined: Jul 2017

Thanks for the clarification, ASAdvocate.  Best success to you.

Chuckect's picture
Chuckect
Posts: 45
Joined: Jan 2018

I heard that to , but when i got weak, my joints hurt, and my leg became swollen, and i went to a real doctor my psa was 550 and i had metastatic stage 4 prostate cancer...  so don't listen to tha doctor....

Swingshiftworker
Posts: 1013
Joined: Mar 2010

There is a trend towards reducing PSA screening screening in general and for older men in particular because of the belief that the higher deterction of PSA has resulted in unncessary treatment and seriously adverse side effects w/relatively little benefit in terms of mortality. 

See: https://www.cnbc.com/2017/04/10/new-guidelines-for-prostate-cancer-screening.html

However, ever case is diffferent and if you and your husband think he is "at risk" for prostate cancer that would be life threatening, you certainly can still ask the the procedure be done or go elsewhere to get it done.

Good  luck!

ASAdvocate
Posts: 117
Joined: Apr 2017

SSW, As I am sure you realize, overtreatment is the result of bad advice following the finding of prostate cancer, not the finding itself. I was diagnosed almost nine years ago, and, because I did not have greedy or outdated doctors, I have never suffered overtreatment. So, I see nothing wrong, and useful knowledge to gain from being tested, even at older ages.

A few men have bad initial findings, and it would be a shame to miss them. Others, with ethical urologists, can benefit from the awareness and follow-up that findings of low risk cancer require.

 

hopeful and opt...
Posts: 2226
Joined: Apr 2009

I was diagnosed about the same time as AS Advocate, and was also fortunate to be monitored in a active surveillance program. One of my doctors, a surgeon recommeded active surveillance as well. I was grateful to have this choice, espeically when the doctor(a radiologist ) that I saw previously recommended a combiation of two different radiation treatments, brahy and IMRT, and told me that there was a 50 percent chance the cancer was outside the prostate and I had 8 weeks to make a decision, or else.

Following an active surveillance protocol, I have lived a "normal" life for the last nine years.

 When the new guidelines were being formulated and  issued, I, other survivors,  and many, many doctors wrote letters to these decision makers asking them to not institute this policy, and indicated that  men will die resulting from this policy. many men will be diagnosed with more advanced disease, that cannot be treated locally. There will be more deaths among this population that would be diagnosed when there are symptoms, and cure is not possible. 

I believe that the reason that these guidelines were instituted was mainly to limit short term expense and also  to stop overtreating when men are candidates for simply monitoring. Eventhough there are doctors that will not treat men with indolent disease, many men are terrified at the word "cancer" and seek a doctor who will treat. Over treatments includes surgery, all forms of radiation, HIFU, etc, etc.

 

Chuckect's picture
Chuckect
Posts: 45
Joined: Jan 2018

I said it earlier in this post,,  do not listen to any body that says to old to be checked...  i had a bad doc tell me that and wheni got sick i had metastatic stage 4 prostate cancer...  no cure you just die off it not with it...  wish i couldline up all stupid doctors...  sorry don't mean to rant

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