Primary No Longer Orders PSA Labs For Those Over 70 (blood, hormone, biopsy)

[Calvert Hall '62]

Unless their dads had prostate cancer.

Reason, according to primary: too many false positives resulting in unnecessary surgeries.

I wonder if it's actually insurers' protests. Are other providers following this practice?

At any rate, mine has never exceeded .25 and the disease is slowly progressive so I won't fuss.

[fortunatus]

Got a similar pitch from my PCP. "So your PSA is positive, now what?" His main idea was that it's really hard to know if/when to operate even with the test result in hand.

Moot point for me since mine was negative.

[Submariner]

My PCP did not want to get a PSA test on my blood sample. I insisted and I had a PSA of 25.

My urologist did a biopsy and 8 out of 12 core samples had cancer. The pathology report on the samples showed that my cancer had a Gleason score of 9 [which means that it was an extremely aggressive fast-growing variety of cancer].

I had my prostate removed, and I was cancer-free for four years before my cancer returned. The downside for me was that the surgeon had to remove my 'nerve-bundle' in his attempt to remove the cancer.

Last summer I went through radiation treatment and I started hormone therapy, to attempt to kill the last remaining cells of my cancer.



They say that if you live to be 100, you will have a 90% chance of having prostate cancer, and at that point, most of those cancers will be slow-growing.

I had prostate cancer in my 50s. I have never had any symptoms of cancer. But if we had not caught it when we did, it would likely have metastasized into bone cancer by now.

I am thankful for PSA testing. It clearly saved my life.

[genesiss23]

PSA has not been recommended for use for years. You can artificially increase someone's PSA by moving around the prostate. The results don't mean much. Also, if you are older, something else is going to kill you before prostate cancer.

[Submariner]

Originally Posted by genesiss23

... You can artificially increase someone's PSA by moving around the prostate. The results don't mean much. Also, if you are older, something else is going to kill you before prostate cancer.

A prostate can not move much, it is generally located in a specific location.

Also assuming that prostate cancer will be slow growing, is a bad idea. No body knows how aggressive prostate cancer is until after you have taken a biopsy and determined the Gleason score.

[genesiss23]

Originally Posted by Submariner

A prostate can not move much, it is generally located in a specific location.

Also assuming that prostate cancer will be slow growing, is a bad idea. No body knows how aggressive prostate cancer is until after you have taken a biopsy and determined the Gleason score.

Rectal digital exams is what I was trying to refer to. They do increase PSA.

[Submariner]

Originally Posted by genesiss23

Rectal digital exams is what I was trying to refer to. They do increase PSA.

So too sex.