P.S.A . test

[HumbleJim]

I've requested this from my GP, I have discussed it with them, they don't think there is much point unless I'm showing any symptoms of prostate cancer.

To me this is the point, I'd like to know early before any problems develop. So I think I'll have it anyway or an I just paranoid?

[ducgas]

Just had the results from my test, which were okay, but was warned that the test wasn't the most accurate and could lead to further tests which might be un-necessary. I'm happy that I went for it.

[HumbleJim]

My Doc said they would also like to carry out in internal examination did you do this?

[ducgas]

No, they said they would do that if the results were high or had any symptoms, which I don't. I would have still gone for it though.

[Revisitph]

Personally, unless I had symptoms (though Ca prostate usually is asymptomatic until late) or a bad family history of the disease I wouldn't have a PSA measurement - it is fine if the PSA is low or very high (likely to be benign and malignant respectively). However there is a large grey area, and then you go into the slightly-high-PSA-investigation cycle.. scans, possibly transrectal "octant" biopsies (usually 5 needle cores each side via a dildo/ultrasound probe in the back passage - ouch), if they are benign but the PSA remains up or if there is a pre-malignant change (PIN) on one or more of the biopsies, follow-up, possibly more octant biopsies, possibly saturation biopsies (larger numbers of biopsies, or template biopsies - up to 50 needle cores through the skin between the scrotum and anus...), then if a low grade carcinoma is found there is the option of watchful waiting (PSA levels, scanning and more needle biopsies) or the potential for a radical prostatectomy which may or may not leave you with sexual function and continence and may or may not prolong your life. However this is a very personal decision and needs careful discussion with someone who is an expert in the field - of course the first decision is whether to have a PSA blood test, realising that an equivocal result may lead to you being advised to go into the investigation cycle.

There is no prostate cancer screening programme in the UK (we have cervical, breast and now bowel cancer screening) because the tests are not sensitive and specific enough to outweigh the cost, morbidity (harm caused by screening) and (very small) mortality from screening and treatment which flows from it, -vs- the value of picking up the cancers early.

It's a big and complex subject! Before deciding whether you really want to get your PSA tested, look at reputable sites like http://www.cancerresearchuk.org/cancer-help/type/p...

The cancer research uk site (above) has a very sensible account. You'll be able to find others as well, but make sure that they are independent, like CRUK - NICE probably has something as well but I've not looked at their site.

Edited by Revisitph on Friday 1st August 21:03

Edited by Revisitph on Friday 1st August 21:06

Edited by Revisitph on Saturday 2nd August 08:40

[HumbleJim]

Hmmmmmmmmmmmmm............Food for thought.

[Wacky Racer]

I have a history of PC in my family, Dad, his brother, his son, all died....I had a PSA test seven or eight years ago which was clear and fine.

However, I have since read the test can be unreliable, so I am not going to bother in future, unless I develop symptoms....but obviously if you catch it early enough you stand a better chance....

[Revisitph]

Wacky Racer said:

I have a history of PC in my family, Dad, his brother, his son, all died....I had a PSA test seven or eight years ago which was clear and fine.

However, I have since read the test can be unreliable, so I am not going to bother in future, unless I develop symptoms....but obviously if you catch it early enough you stand a better chance....

Look at the CRUK site - and see if you can decide from other sites (NICE may well have guidance to GPs as to who to refer) into how high your risk is felt to be (if the closeness, ages and number of relatives who had it, is sufficient to warrant PSA screening). If so, in that specific instance it might be worth having regular testing.

[TwigtheWonderkid]

If I get a blood test for anything, I always ask for PSA to be included. It varies though. Highest it's been is 0.7, last test was 0.1. I think 4.0 is alarm bells.

No idea of family history as no paternal infomation.

[Pugsey]

Don't do it. It's not very reliable, plus what may be 'normal' for some may be (say) 0.5 and as high as anything up to 10 for others. If yours is anything over 4ish you'll then be into a world of worry and tests, all of which may be totally unnecessary. **DO go for tests at the first sign of symptoms though.

• From someone who did the 'man thing' and ignored the symptoms for too long and now has advanced prostate cancer including the bxggxr having crept into my bones.

[NDT]

Interesting to read the views on here.
A close family friend was asymptomatic and asked for a PSA test while at the Dr for something else.
Very high PSA result identified his prostate cancer and has led to treatment which hopefully should seriously extend his life.

[55palfers]

http://www.spirehealthcare.com/parkway/

I have had three friends who had Prostate cancer and early diagnosis is a massive help for a full recovery.

This place runs a free PSA test clinic every year around Feb / Mar time. Keep an eye on their web-site.

I've been going there for years. Friendly place and they post the results to your home.

[Wacky Racer]

Pugsey said:

Don't do it. It's not very reliable, plus what may be 'normal' for some may be (say) 0.5 and as high as anything up to 10 for others. If yours is anything over 4ish you'll then be into a world of worry and tests, all of which may be totally unnecessary. **DO go for tests at the first sign of symptoms though.

• From someone who did the 'man thing' and ignored the symptoms for too long and now has advanced prostate cancer including the bxggxr having crept into my bones.

Very sorry to hear this, how are you feeling in yourself at the moment, or is it a daft question?

From what I can gather, one of the usually signs is getting up in the night a few times to pee, and my dad said he noticed lower back pain.

[Dogwatch]

I think I've been lucky. I mentioned to my GP that I had occasional rectal bleeding (turned out to be a large polyp) and while the GP was poking around he felt something on my prostate. A biopsy confirmed cancer and I spent last summer attending 37 sessions in close company with a linear accelerator aimed at my poor prostate which had been working perfectly normally until then.
(A later Endoscopy following up the polyp showed dozens of little burns on the gut wall by the Prostate, quite painless though).

The Consultant was happy with the PSA result in March so if I can repeat it next month I'll be officially in remission.

Last weekend someone handed me a flyer from the local Lions Club who are organising a free PSA testing session in September, but had they done it two years ago would I have gone along? Probably not.

[Revisitph]

As well as the UK CRC site http://www.cancerresearchuk.org/cancer-help/type/p...

This independent USA national cancer institute site http://www.cancer.gov/cancertopics/factsheet/detec... and other sections of that site relating to prostate cancer also has a high quality discussion and addresses the issue of PSA testing and screening.

Personally, with no symptoms and no known family history of prostate cancer I wouldn't, but it's a decision only you can make, preferably a decision informed by the facts and advice from your GP or others.

Edited by Revisitph on Friday 8th August 20:26