PSA
in [Prostate Cancer]
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From: Gut-Buster on 13 Feb 2005 15:34 "George Conklin" <georgeconklin1(a)earthlink.net> wrote in message news:KkIPd.509$W%5.228(a)newsread3.news.pas.earthlink.net... > > "Gut-Buster" <D-D-D-DONT.stare(a)me.privates> wrote in message > news:mCHPd.506$t27.21346(a)nnrp1.ozemail.com.au... >> News over the last year has basically said that a PSA is about as >> accurate >> as a finger up the bum in order to test for prostate cancer. Eg, with a >> finger, you cant tell if cancer is on the opposite side, not yet large. >> >> Anyone got any comments on PSA? I know they pick up cancer but the word I >> have heard is that it only does so when blind Freddie would have also >> done >> so. >> >> I only ask not to upset people but because though I haven't been >> diagnosed >> with it, I am a prime candidate who is unlikely to find out prior to >> being >> hospitalised. >> >> Thanks. >> >> > What you probably read is one expert's finding that the type of tumors > which need to be treated are those which can be felt. > > Not really. It was actually logical to me. If there is a small cancer growing on the opposite side of the prostate to where the finger feels, the doctor wont feel it yet that cancer may be terribly aggressive and within 6 months be unfortunate news. Been a little more on my mind of late. A good friend died of bowel cancer that looks like it started on the prostate. He was on chemo for 5 months on some drug that was fairly new and doing well. He would have the treatment on a Friday so have the whole day off, be sick that day and over the weekend and good to go on Monday. Never lost any hair at all. They had to change his chemicals, though, because apparently 5 months is all you can take or it starts to kill you. So, they put him on other stuff but gave him a month's break in which time he had developed a minor infection he didn't know about inside him. When they put him on the new stuff, the infection took off like a wildfire and that was that. He died New Year's Eve but thankfully was able to spend his last Xmas Day with his family.
From: Gut-Buster on 13 Feb 2005 15:52 "Leonard Evens" <len(a)math.northwestern.edu> wrote in message news:4fydnSdGLtxtwJLfRVn-rA(a)comcast.com... > Gut-Buster wrote: >> News over the last year has basically said that a PSA is about as >> accurate as a finger up the bum in order to test for prostate cancer. Eg, >> with a finger, you cant tell if cancer is on the opposite side, not yet >> large. >> >> Anyone got any comments on PSA? I know they pick up cancer but the word I >> have heard is that it only does so when blind Freddie would have also >> done so. > > That is definitely wrong. Indeed the great majority of men treated for > prostate cancer these days have had their cancers detected by PSA testing > rather than digital rectal examination. PSA testing can detect prostate > cancer earlier than a digital rectal examination would. It can do so > either because the PSA level is higher than some agreed upon threshhold or > because the PSA has been rising too quickly over a two year period. But > PSA can rise because of other reasons. Prostatitis, i.e., imflammation of > the prostate, can be one cause. Also, as men age, their prostates are > likely to enlarge, and that can increase PSA levels. That is probably the > main reason for increased PSA in older men. > Thanks for that info. The stuff I had read said that PSAs did a hell of a lot of false positives and not a small amount of negative results when there should have been positives. > Not all men with prostate cancer will have an elevated PSA. So urologists > recommend both PSA testing and digital rectal examination--the "finger". > Each would catch prostate cancers which the other will miss, but in the > great majority of cases, the PSA test will find it earlier. > I find it more than logical that a cancer on the opposite side of the prostate to where the finger feels would not be found by a finger probe and that worries me a bit. Like most people I hate the finger test but put up with it until I was treated like a hypochondriac for going for them, at which point I stopped going. I had 3 tests in 3 years. Two tests were within 6 months but were not my idea and totally unavoidable as I was bleeding and there was really some worry about what was causing that (nothing to do with prostate or cancer as it turned out and healed of it's own accord thank goodness). When you get told by a doctor that "maybe it is about time for you to grow up" you tend not to go back to a doctor. Strange thing is that he was the same guy who told me I was especially at risk for prostate cancer due to my chronic bacterial prostatitis. In any case, this was the same doctor who ended up in hospital with prostate and bowel cancer himself. > If you are at special risk for prostate cancer, then it would be wise to > have regular PSA tests in addition to digital rectal examinations (but Never had a PSA test in my life but from what you have posted, I would assume my PSA results would be unusually high anyway with my condition or likely not found as I take a large dose of Saw Palmetto to help with the problem and that is apparently able to mask PSA if I have that right. > see below). If you wait until a doctor can feel something, you run the > risk that the cancer will be more advanced by the time it has been found. That is why I am unlikely to be found out until in hospital. I have changed doctors since that guy suffered this himself not due to that fact but due to his pronouncement of me as a hypochondriac even though it had been near 2 years since I last saw him. > For example, in my case, the cancer was found by PSA testing using the > rapid rise criterion. The risk before surgery that my cancer would be > found to have spread beyond the prostate was about 42 percent and the more > serious risk that it would be found to have spread to the seminal vesicles > or lymph nodes was about 5 percent. Had I waited for the cancer to be > felt by the doctor's finger, these risks would have been elevated, > depending on the specifics, to 64-87 percent and 9-18 percent. > > There is some controversy about the value of PSA testing, but I believe > that most of those who are skeptical about its value would agree with > others that it makes sense for men who are at special risk for the > disease, either because a close male relative had it before age 65-70 or > because of ethnic background. > Ethnic background makes a difference? That is something I didnt know. Which race? I know a lot of men around my age who also have chronic prostatitis, have had prostate cancer or are going to see if they have it soon. I am 50 this year. The people I know, like me, are all Caucasian. > However, it should be noted that prostate cancer usually grows slowly, and > for many older men, it is not likely to be a problem. If your life > expectancy is less than 10 years, even if you have prostate cancer, it > may not be advisable to treat it aggressively, since you will probably die > of something else before it gets to be a real problem. Some of the Thanks for that info. I also have multiple auto immune problems (not AIDS but about 6 others anyway) and the worst problem I have is severe untreated sleep apnea (been through it all since 94 and no help) which is likely to be the cause of my death due to causing a heart attack before 10 years are out. At 10 years old, I thought I would live forever. 40 years later, I wonder if I will live 10 years. Such is life. There are worse ways to die! > prostate cancers detected by PSA testing may not become a serious problem > for 10-15 years. Indeed, some of them may never be a problem no matter > how long the patient lives. So it is possible PSA testing may not be > worth the effort in your case. However, the catch-22 is that you wont ever know it wasnt worth having PSA until you have it. Correct? > > One reason you may be confused about this is that news media recently > publicized a study by one physician with a background in prostate cancer > claiming something along these lines. He recommended not testing for PSA > and waiting until something showed up on digital rectal examination. This > is decidedly a minority opinion which few other experts agree with. > Indeed, urologists have noted that after the advent of routine PSA > testing, the percentage of more aggressive relatively advanced prostate > cancers has decreased greatly. Implicit in this man's conclusion is the > belief that the great majority of the cancers discovered by PSA testing > don't need to be treated at all, so there is nothing to lose by waiting > for something to be felt. But the success rate at curing prostate cancer > is definitely lower if you wait for that, so this "expert" is being rather > fatalistic about the disease, and assuming that those which "really need > to be treated", as he sees it, are often incurable anyway. I suppose his conclusions may be a result of his job. I think my slef employment of sticking my fingers inside computers to fix their problems is one that is more desirable to most men. :) > > However, all this is generality, and you are one man. You would be best > advised to find a physician you trust and discuss the whole matter with > him/her. The physician can take your particular situation into account > and advise you about the risks and benefits for you either way. I am not totally sure I could find a doctor I trust any longer. Having been told to grow up by one, you tend to get a bad opinion of the whole lot of them.
From: Gut-Buster on 13 Feb 2005 16:03 "MisterSkippy" <MisterSkippy(a)optonline.net> wrote in message news:2onu01594allo0rldnpo17nihli1p7v7op(a)4ax.com... > On Sun, 13 Feb 2005 23:20:35 +1100, "Gut-Buster" > <D-D-D-DONT.stare(a)me.privates> wrote: > >>News over the last year has basically said that a PSA is about as accurate >>as a finger up the bum in order to test for prostate cancer. Eg, with a >>finger, you cant tell if cancer is on the opposite side, not yet large. >> >>Anyone got any comments on PSA? I know they pick up cancer but the word I >>have heard is that it only does so when blind Freddie would have also done >>so. >> >>I only ask not to upset people but because though I haven't been diagnosed >>with it, I am a prime candidate who is unlikely to find out prior to being >>hospitalised. >> >>Thanks. >> > I think it is one more tool, the advantage being non-invasive. It is > most certainly not 100%. For most people the odds of regular PSA and > DRE exams detecting possible PCa early enough to allow for long term > survival after treatment are pretty good. Some people are going to > slip through the diagnostic cracks. These things happen. You do what > you can and then you live your life. > May I ask why you describe yourself as a prime candidate for PCa? I'm > at higher risk than some due to high grade PIN, but I'm taking some > steps in an attempt to reduce that. > I'm only going by what the doctor who called me a hypochondriac said to me. He said I was that because of my other medically proven health problems added to my chronic prostatitis. Due to my oxygen level going down to less than 60% every night while asleep, my body is not as good at fighting off problems as the average 50 year old apparently. Add all that to my chronic prostatitis which is bacterial and he says that is me. Seems logical. As an example, if I cut myself and that gets a minor infection then it can take about 6 months before it is gone. When I was in my 20s IF I got an infection (which wasn't likely as I have a slight keloid problem which strangely helped the healing process), a little ointment on it and a day or two later it was gone. Don't take all this the wrong way. I honestly don't go through life worrying if a meteor is about to hit me on the head. I realise I am unemployable as I have to sleep every afternoon and even on my best days am not as good as a 20 year old physically but in spite of all that and 7 years of my life where I was unable to do much more than get out of bed, I got myself back to the position of being able to make a small income. I cant live off it but it helps. I just don't give in but while saying that, I want to be prepared. If I were to be told I had prostate cancer and my chances of survival were less than favourable, I would likely not have much time to get things together. If I knew I had it and treatment could give me another 6 months then I WOULD have time to tidy things up. I just want to be prepared for anything so my wife wont have extra stuff on her plate.
From: Leonard Evens on 13 Feb 2005 16:57 George Conklin wrote: > "Leonard Evens" <len(a)math.northwestern.edu> wrote in message > news:4fydnSdGLtxtwJLfRVn-rA(a)comcast.com... > > >>One reason you may be confused about this is that news media recently >>publicized a study by one physician with a background in prostate cancer >>claiming something along these lines. He recommended not testing for >>PSA and waiting until something showed up on digital rectal examination. >> This is decidedly a minority opinion which few other experts agree >>with. Indeed, urologists have noted that after the advent of routine >>PSA testing, the percentage of more aggressive relatively advanced >>prostate cancers has decreased greatly. Implicit in this man's >>conclusion is the belief that the great majority of the cancers >>discovered by PSA testing don't need to be treated at all, so there is >>nothing to lose by waiting for something to be felt. But the success >>rate at curing prostate cancer is definitely lower > > > Unproven statement Len and you know it. The science has never been > done,. as you well know. > > Actually your argument also applies to diagnosing prostate cancer by digital rectal examination. No double blind or otherwise suitably randomized study has ever been done to show that life span is increased---your criterion---by doing such examinations. Indeed there are those who would argue not only against PSA testing but also against regular DREs. They would leave all prostate cancer to be discovered through symptoms of advanced prostate cancer. In any event, the statments I made are supported by lots of evidence. For example, the Partin Table studies I referred to show that after surgery, cancers are generally more advanced in T2 or higher stages. Also, the significant decline in advanced prostate cancer diagnosis after the advent of PSA testing. As usual you conflate different issues and always come up with the same simple minded response.
From: Leonard Evens on 13 Feb 2005 17:16
Gut-Buster wrote: > "George Conklin" <georgeconklin1(a)earthlink.net> wrote in message > news:KkIPd.509$W%5.228(a)newsread3.news.pas.earthlink.net... > >>"Gut-Buster" <D-D-D-DONT.stare(a)me.privates> wrote in message >>news:mCHPd.506$t27.21346(a)nnrp1.ozemail.com.au... >> >>>News over the last year has basically said that a PSA is about as >>>accurate >>>as a finger up the bum in order to test for prostate cancer. Eg, with a >>>finger, you cant tell if cancer is on the opposite side, not yet large. >>> >>>Anyone got any comments on PSA? I know they pick up cancer but the word I >>>have heard is that it only does so when blind Freddie would have also >>>done >>>so. >>> >>>I only ask not to upset people but because though I haven't been >>>diagnosed >>>with it, I am a prime candidate who is unlikely to find out prior to >>>being >>>hospitalised. >>> >>>Thanks. >>> >>> >> >> What you probably read is one expert's finding that the type of tumors >>which need to be treated are those which can be felt. >> >> > > > Not really. It was actually logical to me. If there is a small cancer > growing on the opposite side of the prostate to where the finger feels, the > doctor wont feel it yet that cancer may be terribly aggressive and within 6 > months be unfortunate news. You have to try to avoid trying to think these things out ourselves. We all have models in our head about what is going on, but the biology doesn't care what we are thinking. A lot about disease, including prostate cancer, is not well understood and even the models which experts develop from years of study sometimes turn out to be misleading. What you describe can happen, but I have no idea how often it happens and whether it materially affects the statistics. > > Been a little more on my mind of late. A good friend died of bowel cancer > that looks like it started on the prostate. He was on chemo for 5 months on > some drug that was fairly new and doing well. He would have the treatment on > a Friday so have the whole day off, be sick that day and over the weekend > and good to go on Monday. Never lost any hair at all. They had to change his > chemicals, though, because apparently 5 months is all you can take or it > starts to kill you. So, they put him on other stuff but gave him a month's > break in which time he had developed a minor infection he didn't know about > inside him. When they put him on the new stuff, the infection took off like > a wildfire and that was that. He died New Year's Eve but thankfully was able > to spend his last Xmas Day with his family. Bowel cancer doesn't usually start in the prostate. It can metastsize to different organs, but I thought the usual place it goes to first is the bone. Also, they don't treat prostate cancer, even that which has metastzsized with chemotherapy like the kind you describe. But of course this could be some unusual form of prostate cancer. > > |