Local PSA screening
- Thread starter michael_w
- Start date
AntarcticPilot
Well-Known Member
I simply ask my GP to include it whenever I have a blood test for anything. As I've had prostate trouble (benign, I'm pleased to say) they do it without it being an issue. But it's worth noting that PSA testing simply tells them that your prostate is getting enlarged, and it's very likely that you'll know about it before being tested. It's not a test for prostate cancer, though prostate cancer is a likely cause of prostate enlargement. I can see where your GP is coming from if you're otherwise asymptomatic. Believe me, an enlarged prostate is something you know about, often in embarrassing and painful ways!
Medic
Member
As a Medic with an interest in this area, I might chip in:
PSA is greyscale with a large overlap between benign (normal) and the levels at which cancer is likely. Tony Blair when PM promised any man who wanted a PSA could have it....
It is but one aspect of checking for prostate disease and, taken in isolation, can either give false reassurance or unjustified apprehension. The evidence base for benefit from screening asymptomatic men without particular risk factors using just PSA is, at best, flimsy; at worst, it may do harm.
The utility of PSA is enhanced when it is coupled with a rectal examination, but even that is not foolproof.
A marginally or modestly raised PSA level (as opposed to something really high) is more likely to be due to benign disease than malignancy, but may well result in invasive tests (prostate biopsy) which carry substantial and real risks of complications including sepsis and chronic prostate inflammation/infection. Some centres are able to do pre-biopsy MRI scans or fusion MRI/ultrasound scans for those with raised PSAs to reduce both the need for biopsy and to improve diagnostic accuracy.
And, to make matters even more complicated, it can be hard to distinguish between those men with prostate cancer for whom no treatment is the best option and those who benefit from aggressive treatment.
Overall, PSA screening is a complicated area - and random PSA tests may well do more harm than good. However, when considered fully and in conjunction with an assessment of symptoms, risk factors (including brothers or father with early onset prostate cancer) it can be really useful tool. It is certainly useful in measuring the response to treatment for those with prostate cancer.
PSA is greyscale with a large overlap between benign (normal) and the levels at which cancer is likely. Tony Blair when PM promised any man who wanted a PSA could have it....
It is but one aspect of checking for prostate disease and, taken in isolation, can either give false reassurance or unjustified apprehension. The evidence base for benefit from screening asymptomatic men without particular risk factors using just PSA is, at best, flimsy; at worst, it may do harm.
The utility of PSA is enhanced when it is coupled with a rectal examination, but even that is not foolproof.
A marginally or modestly raised PSA level (as opposed to something really high) is more likely to be due to benign disease than malignancy, but may well result in invasive tests (prostate biopsy) which carry substantial and real risks of complications including sepsis and chronic prostate inflammation/infection. Some centres are able to do pre-biopsy MRI scans or fusion MRI/ultrasound scans for those with raised PSAs to reduce both the need for biopsy and to improve diagnostic accuracy.
And, to make matters even more complicated, it can be hard to distinguish between those men with prostate cancer for whom no treatment is the best option and those who benefit from aggressive treatment.
Overall, PSA screening is a complicated area - and random PSA tests may well do more harm than good. However, when considered fully and in conjunction with an assessment of symptoms, risk factors (including brothers or father with early onset prostate cancer) it can be really useful tool. It is certainly useful in measuring the response to treatment for those with prostate cancer.
Koeketiene
Well-Known Member
+1
I have an annual blood test (had stroke/cardiac issues in the past) and since I turned 55 my GP includes PSA screening as a matter of course.
AntarcticPilot
Well-Known Member
Thank you. My experience is from the other end, and I can certainly empathize with your statements about needle biopsies! Not something I'd wish on anyone. And rectal examinations aren't pleasant for anyone.
MoodySabre
Well-Known Member
About 6 years ago I had all the tests to be a kidney donor (which in the end didn't happen). Amongst these was an MRI of my prostate. This showed it to be large. They quoted weight compared to a normal one. I had a long consultation with the senior urologist at St Thomas'. As I had no symptoms of it being "enlarged" - no difficulty peeing, no getting caught short, no getting up more once a night etc - he discussed it with a colleague and then signed me off as all clear.
I don't think that anything has changed (I'm now 75) and I don't ask for a PSA test. The consultant did tell me that if I ever got sent for a biopsy that I should ensure that it is not one carried out up the rectum as this carries too higher risk of infection and complications.
I don't think that anything has changed (I'm now 75) and I don't ask for a PSA test. The consultant did tell me that if I ever got sent for a biopsy that I should ensure that it is not one carried out up the rectum as this carries too higher risk of infection and complications.
scottie
Well-Known Member
Is this evidence of police and Masonic links in a good way of course?
