Prostate Cancer Screenings Essentially Useless

dopplerjockey said:

PSA Maybe not the Best Indicator
In my case folks, my PSA's have always been low. Two years ago my PSA was 0.18, and I had a normal digital rectal exam by my family physician, (I chose her because she had small hands.) LOL. The next year, my PSA was 0.24, and that rectal exam revealed "nodules". She referred me to a urologist in Boise, ID, who also palpated a single nodule. The initial biopsy revealed HPIN cells. A follow-up biospy 11 months later revealed adenocarcinoma in the left lobe of the prostate, and again, my PSA was low at 0.34. After undergoing robotic radical prostatectomy in Boise, ID, the pathologist who reviewed the entire prostate specimen isolated cancer in the right and left lobes, leading to a Gleason score bumped up to 7.
So, I'm not sure that the PSA levels I had without the digital rectal exam would have given us the true diagnosis. Fortunately, the surgical margins of my prostate where clear, which gives my surgeon hope that I might beat this thing, but only time and frequent PSA levels will tell. So, the moral of the story, "get the digital rectal palpation exam" when you get the PSA drawn. The digital exam is only uncomfortable for a short time.

Peter51 said:

PSA 13.6 at age 50 indicated need for biopsy!
Yes it is true that many men "die WITH prostate cancer and not FROM it". I have often heard it referred to as an "old man's disease". Well some of us may develop it at a young enough age that we could possibly live longer as a result of early detection! So let's say that someone develops prostate cancer and is age 70 years old. He may be better left alone and live on to succumb for other reasons. Now how about a person in his mid-forties that developes prostate cancer. Isn't it likely that his life will be shortened from the disease and could have been prolonged from early detection and treatment? Now apply this to a cross section of men of different ages and each in differect levels of health. Maybe we have a 70 year old who is as fit as a 40 year old and would live quite long if detected and treated at that age.

I was in excellent physical condition when at age 49 I had a PSA of 8.4. A year later it had increased to 13.6. I then was diagnosed and treated with RP. I believe that since I am now five years out with no detectable PSA reading that my life has been saved and prolonged. I humbly thank our medical industry for the testing of my PSA and pursuing further investigation which ultimately led to my Radical Prostectomy. I am convinced that PSA tests can save lives.

Peter

shubbysr said:

Can't look back . . .
Well, we can look back and wonder but, not for long because it does not matter. We may never know why some docs treat differently that others, especially with preventative or early detection.
I relocated to the South 5 years ago and I get puzzled looks from docs when I expect certain exams during my annual physical. I remember one doc who would not do a DRE. Another did not recommend colonoscopy, even though I have STRONG family history af male colon cancer. One can only wonder . . .

shubbysr