Utterly OT: Prostate Treatment

[Bill Wright]

No look guys, this is important. Get a PSA test every year, even if you have to pay for it. I did, and it saved my life. Yes it really did.

Bill

[Tim+]

PSA is a pretty lousy test for cancer. Many men die *with* prostate cancer rather then *of* prostate cancer. The more men who have a PSA test, the more men who will undergo unnecessary investigation and treatment for a condition that might well not have killed them, but they?ll suffer all the stress and morbidity associated with the treatment and monitoring.

If you believe it saved you, I?m happy for you. If *every* man over 50 say had a PSA test, they?d be a huge amount of over-treatment and side effects for a disease that wouldn?t have killed most of them.

Screening for disease is much more complicated than most people realise. A lot of harm can be done by inappropriate screening and treatment.

Tim

[Steve Walker]

But they don't just start treatment based on the PSA result do they? They carry out further investigations and continue to monitor if treatment is not required.

SteveW

[Harry Bloomfield]

Steve Walker has brought this to us :

Yes, they use ultra sound scans, DRE and MRI scans..

[spuorgelgoog]

Yes, but as many men are reluctant about going to the doctor anyway it's an excuse for pulling them in.

"There's nothing wrong with your prostate but that stump where you cut your arm off with a chainsaw is looking a little infected."

Owain

[Tim Lamb]

I started having regular PSA tests (every 2 years or so) when I reached

1. My father died at 74 from aggressive prostate cancer.

Nothing untoward until I reached 75 when my GP booked me in for a check up at the urology clinic. They decided to do an ultrasound guided biopsy and found a small amount of cancer.

Currently they have me on a 12 month re-check pre-ceded by a PSA test.

[Tim Streater]

I'm told that a single PSA measurement tells you little. It's the pattern of increase over some period that's important.

[tim...]

The argument is that the further investigation are unnecessarily worrying and invasive

Though that was before MRIs became the standard next step

tim

[tim...]

and a biopsy

[Harry Bloomfield]

I was one of those until a few years ago, I just didn't like the idea of being fussed over, the embarrassment. I was also wary of being told I had a problem, so had the idea that I would rather not know. Its great when they tell you you don't have a problem.

[Bob Eager]

I had three biopsies at 18 month intervals. The last once resulted in sepsis.

[Andrew]

I assumed that 'up to speed' referred to another activity :-)

[Brian Reay]

A little research seems to support that. There is a nominal guide upper limit which is age dependent. It nearly doubles naturally between about

50/60 and 75 ( the 50 to 60 appears in various places). Plus there are perfectly normal activities which can cause short term increases, including exercise (especially cycling it seems), the normal prostate examination by a doctor, and, shall we say, life?s little pleasures;-)

I?m not suggesting people shouldn?t get the test, far from it.

[Maurice]

Beware also that the presence of a urinary infection is likely to raise the PSA reading. The general rule I saw was "in the presence of a urinary infection postpone the PSA test for around 6 weeks after the infection is shown to have gone". The severer the infection, the longer you postpone PSA test.

(In my case the PSA shot up by 3x, and took 3 months for the prostate to recover from a severe infection, so as to return to near the pre- infection readings.

[Adam Funk]

It's very nice of you to post this personal information to be helpful to others.

[Bill Wright]

You know nothing about this. It was a Grade Nine. There was localised spread. The surgeon said I'd had the op just in time. I believe him.

You have the figures?

Bill

[Bill Wright]

The PSA test leads to a biopsy or MRI. That gives a definite answer re cancer, and also tells how likely it is to spread. Quite often the biopsy leads to nothing more than periodic monitoring of the cancer.

Bill

[Bill Wright]

That's right. But the GP might say, "Well yes it is going up a bit fast, but you haven't quite reached the threshold. Let's wait another year." That was when I said I wanted a biopsy NOW. I made the right decision. I'm still here. The surgeon said it was 'a nasty one, caught it just in time.'

Bill

[Bill Wright]

Not if the alternative is death.

Bill

[Bill Wright]

So what operation did you have that left the prostate in place?

Bill