Should men get a P S A test

What are your plans?
I started with a PSA of 4.0 and a Gleason score of 7 (3+4). That was in 1991. I have experienced RP, RT, and HT over the years. My cancer went away after surgery, then returned after 13 years. Because of HT, it has been in remission for three and one-half years. I have felt good physically, and still do. Am I glad I was diagnosed and then had surgery? Yes. But I do not know for sure whether it saved my life. But I believe it did and I am happy to be alive. I am 85.

What is the outlook for you? How old are you.

I am not qualified to offer advice, other than suggest that you get expert opinions from more than one expert and study treatment options. Consider family members wishes and your own feelings.

I wish you luck.

Jerry

PSA TEST AND THE TASK FORCE
Matt,

I think you're referring to the recommendations of a task force that recommended eliminating PSA testing for men who were otherwise healthy and without symptoms. The task force did recommend continued PSA testing for men who have a prostate cancer diagnosis or who have had treatment as a rising PSA for men who have had a RP or radiation is an indication of recurrence.

There was a very lively discussion about this on this forum a few months ago and you can review it here: http://csn.cancer.org/node/227836

Essentially, the PSA is a lousy indicator of prostate cancer for undiagnosed men and statistically, you have as much chance as detecting PCa with the PSA test as you do with flipping a coin.

Men over fifty have about a 25% chance of having some prostate cancer show up in a standard biopsy whether or not they have had a PSA test. For most men the biopsy is detecting indolent cancer that is never going to migrate or pose a threat to the man but given our societal norms today and our aversion to anything associated with CANCER thousands of men each year undergo unnecessary treatment of this indolent cancer and end up in a worse state from the side effects of treatment than anything they would have had to deal with from the cancer.

In my opinion, the problem is not with the test itself (it's just one of many data points) but with the doctors who use this test as a means to force expensive treatments on scared and uninformed men and the men themselves who choose not to seek alternate opinions.

There are many pros and cons and many men are passionate in believing that the PSA test saved their life.

Over the years there has been much controversy about the PSA test, the rather arbitrary numbers that were used to signal a biopsy (a PSA > 4.0 ng/ml), and the urological community in general seizing upon this test to grow their business through increased numbers of biopsies and treatments (mostly surgery).

The best thing IMO is to be well informed, understand the statistical bias behind PSA testing, understand that for the overwhelming majority of men a PSA between 4 and 10 is most likely caused by BPH not PCa, and know those things that can cause PSA scores to spike by things like sex before the blood draw, exercise that presses the prostate (bicycle riding), some OTC medications like Advil, and even a hard stool. Knowledge is power.

K

psa test
If it was not for the psa test I would not be alive today. There are a few dr's out there that just say the absolute reverse. Don't take any notice of psa tests and instead make your Testosterone stronger!!!!!!!!!!!!!!!!!!!! by taking pills to enhance it. That's a turnaround if ever there was one. If I had taken notice of this I undoubtedly be dead today. A well known doctor from USA that has a blog on the internet and sends out emails is a firm believer on this subject. I, of course never took any notice of my psa levels (although I recorded them all that time) until they rose above 10 (took 11 years from 4 to 10). Back then the limit before investigation was 4.2; now it's 6.5). Barry