just saw on TV - new guide lines for prostate cancer screening

that cannot be easily summarized in an NBC report.

I just read the article that ASAdvocate provided the link for. This revised guideline has many ifs and buts. 

Most of us on this forum are in favor of routine PSA testing followed by a discussion(s) with an appropriate specialist(s). I will also postulate, that many (but not all) of us do favor the 'active surveillance' approach for dealing with low-risk prostate cancer. Significantly, the American Urological Association does present that option in its guidelines for low-risk prostate cancer.

https://www.auanet.org/guidelines/clinically-localized-prostate-cancer-new-(aua/astro/suo-guideline-2017)

PS: another link for the same (revised) guideline: 

https://jamanetwork.com/journals/jama/fullarticle/2680553

Had I not had a PSA test and the subsequent biopsy,MRI, and bone scan I probably wouldn't be making this post. It's pretty simple.

These "statistical recommendations" agains PSA testing kill individuals.  Most are derived from insurance-backed research.  The same trend began among women, with a retreat on the frequency of recommended mamograms from annual to less often. Most agencies have since disavowed that recommendation, and the best gynocologists again suggest annual mamos for women with even the slightest indications of risk.

I have recommended annual PSA checks to numerous friends from age 50 and older. None of them had ever had a PSA before, and their average ages were around 57. Interestingly, they all said that their GPs had told them in effect that "PSA tests are a racket and waste of time."  Two have since been diagnosed with PCa, two others have suspicious vectors, but they do not have long vector histories, because they do not have a history of PSA results. Now, they all wish they did have those baselines established. Several say that their doctors automatically attributed their issues to BPH.

After getting a PSA result myself in 2014 that indicated an annual doubling rate, my GP told me to "ignore it." He had long expressed to me that he regarded PSA as overused and abused.  I instead ignored him, and went to a urologist. She recommended an immediate biopsy, which eventually proved Stage II disease.

PSA draws are cheap and medically harmless. Some say that they are "psychologically harmful." If  a man is that much of a snowflake, I don't know what to say about him. Life itself is frightening, dangerous, ultimately fatal. Wishing to remain ignorant rather than aware is bizarre to me.

If I had no insurance coverage to pay for an annual PSA draw, I would pay out of pocket, and that is what I recommend to ever man over 50 years of age. My son, who is just in his 20s now, I will recommend be PSA tested annually at age 45, although by then, very likely more sophisticated tests will have been developed.

max

I'm with Max and CG on this one.... My PSA would rise to 9 with every Prostatitis attack, then settle back down to 4 with antibiotics, since I also dealt with BPH. 

But it shot up to 18, and then a biopsy was scheduled. Gleason 6 3+3. HOWEVER, during all the DREs not once did any GP or urologist detect anything but a smooth prostatic surface. Why? because the infection and the BPH expanded the prostate like an inflated balloon, making any malformation imperceptible to a DRE.

So yes, there should be a baseline of PSA established to detect pathosis in the prostate.

During 2015-16, I had a conga line of five different GPs and urologists giving me DREs, all were negative for irregular prostatic surface, not counting the massive size.

All of my many DRE's were always 'normal'.  Following post-RP pathology it was found that I had a single large tumor consuming one fourth of my prostate, directly below the bladder.  It had spread into the surrounding areas and the seminal vesicles.  It wasn't until my second urologist did an MRI that a fusion biopsy identified the tumor.  Before that, "your PSA is sky high, but all your tests are negative" was all I heard from my first urologist.

The fact that my PSA kept rising, and I had constantly irritating burning in my urethra that kept me up at night, plus my maternal grandfather died of prostate cancer didn't seem to mean anything to him for nearly four years.  More Cipro and even more Cipro. Perhaps you can understand why I'm bitter and cynical, especially when guys who had a little G6 cancer whine about overtreatment, and government bureaucrats tell doctors to not test for PSA.

I am humbled by the hero worship (if I can call it that). Honestly, I just roll with the hand that was dealt to me. My wife and I had met nearly forty years ago shortly after we had each prayed, hundreds of miles apart and unknown to each other.  I'd just had two major surgeries. She had completed rehab following a lengthy hospitalization. We were both so lonely and felt lost. We bumped into each other (literally!) in a restaurant, and I proposed about a month later. 38 years ago, neither of us ever married before or even engaged. That proved to me that prayer works, but I try to not pester the big guy with day to day minutia. God helps those who help themselves. But if you feel you need a regular spiritual recharge, go for it!

Grinder said:

Dude

You are perfectly justified in your bitterness. I am surprised at the relaxed demeanor you have for all the crap you have dealt with. 

I do get a little bummed reading about your experiences, but I also have to express some admiration as well. I figure if RobLee can work wonders with such a crappy hand he was dealt then what I am dealing with is a piece of cake.

Anytime you get pissed and want to vent... go for it. 

And Cipro? Really? That is the most ineffective but most prescribed antibio... I got both side effects common to Cipro... Black Tongue and mild neuropathy. During one of my prostatitis bouts, I woke up one morning and freaked out when I looked in the mirror and my tongue had turned black!

Turns out it is just a harmless temporary side effect of Cipro. The neuropathy is permanent though, but not real serious. Cipro is on my allergy list now, because every time I used it the neuropathy got a little worse. I think maybe they prescribe it so much because pathogens dont develop resistance to it. I think that it doesnt actually kill the pathogens, but affects the way they protect themselves and reproduce, allowing your antibodies to kill them. Or something like that.

But it would be worthless against DNA mutated prostate cells on the run. Almost as worthless as your first urologist's advice.

Hang in there.

Maybe we should start a prostate cancer survivor prayer ring... would that be crazy? I dont expect Benny Hinn type healings... but who knows what it may accomplish.

A further irony is that most cases of prostatitis are non-bacterial and even non-viral.  It is usually an inflammation caused by neither.  Surely urologists know this, but act as if they do not. Cipro in such cases throws good money after bad.  I had prostatitis off and on for nearly 30 years.  When the pathologist studied my gland following the RP, he mentioned the "inflammatory tissue."

There is an analog of this in Lymphoma diagnosis. Many patients first present with lumps in the neck, and are first sent to ENTs.  What inevitably then follows is a long administration of antibiotics, to "cure the infection."  With many patients this drags on for many months at times, despite no reduction in tumor (node) size.  I tell these folks when they write to the Lymphoma Board: "Don't let an ENT antibiotic you to death."

Cipro is a urological equivalent.

I am not saying that these apparant UTIs are never bacterial, but the doctor ought to have positive lab results to indicate this, not just perscribe pills with no results to back up a  diagnosis.

max