PSA
in [Prostate Cancer]
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From: Gut-Buster on 13 Feb 2005 07:20 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.
From: George Conklin on 13 Feb 2005 08:10 "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.
From: Leonard Evens on 13 Feb 2005 09:02 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. 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. 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 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. 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. 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 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. 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. 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 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. See above. > > Thanks. > >
From: MisterSkippy on 13 Feb 2005 09:23 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. "When a legislature undertakes to proscribe the exercise of a citizen's constitutional rights it acts lawlessly and the citizen can take matters into his own hands and proceed on the basis that such a law is no law at all." - Justice William O. Douglas
From: George Conklin on 13 Feb 2005 11:44
"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. |