Prostate Cancer PSA Testing

50 Hertz

Pedelecer
Mar 6, 2013
172
2
I guess that most, but not all, male Pedelec members are 50 years or older, so at some stage must have contemplated the pros and cons of PSA tests. For those that wonder what I am going on about PSA stands for Prostate-specific antigen and the level of this can be determined by a simple blood test.

The PSA level, can, but not always so, give an early indication of abnormalities with the prostate, in particular cancerous growths. This is useful because when symptoms of prostate cancer eventually present themselves, there is a moderate probability that it has spread to a secondary site which worsens the prognosis for recovery.

On the face of it, the decision to have your PSA level tested is an easy one and makes perfect sense, or does it?

If the PSA test reveals an abnormal level, then further investigation is required which usually entails scans and probably a biopsy. The difficult thing with prostate cancer is that you can have it and not know about it or indeed never know about it. You could be 50 or younger and have prostate cancer now and live to be 100 and it will never trouble you. On the other hand, it might spread to your bones or liver and cause serious life threatening problems.

So what happens if your PSA test shows positive and a biopsy reveals that cancerous cells are present? Do you submit to invasive surgery, which could be totally unnecessary and which is likely to have a negative impact on your quality of life? Do you do nothing and quite likely live a full life and die of something totally unrelated many years later? If you take the decosion to do nothing, what would it be like living with the knowledge that you have cancerous cells that may or may not spread?

So, the PSA test and whether to have it carried out is not an easy decision, and by asking yourself the question, the deliberations raise even more issues.

My reson for thinking about this is two fold. Firstly, I have just attained the age of 50 and thankfully have enjoyed good health thanks in part to regular exercise, good weight control and no alcohol (I just don't like alcohol, rather than denying it myself). I have checks for other health issues and am currently reviewing prostate cancer screening. I'm by no means a health fanatic, running scared of every ailment going, but I think that it makes sense to reduce ill health risks if the impact on leading a normal life is not adversely affected. The second reason is that I have recently read an article regarding 3 leading Urologists, all of who have prostate cancer, one is terminally ill. Interestingly, all 3 regularly tested their PSA level, which makes me think that there may be some benefit to having the test done.

Sorry this isn't bike related, although I understand that cycling can raise your PSA level, but I wondered if anyone else has had any thoughts regarding this subject and would like to share them. I suppose we are all likely to be of an age where this topic is relevant.
 
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flecc

Member
Oct 25, 2006
53,154
30,570
I've previously ruled out having any PSA test due to it's very unreliable indications, and my doctor has never recommended it. My prostate gland packed up production very early many years ago as I reached 50 years old and it soon became clear that I was at least suffering the effects of BPH (benign prostatic hyperplasia) or possibly a more serious aggressive prostate cancer. Since the former is so common and the latter so comparatively rare, I decided to take the chance without any test or other exploration since my lifestyle was a healthy one in both diet and exercise. That proved to be a good decision and now decades later at 77 years old I only suffer the effects of the BPH.

Almost two years ago I got my doctor's agreement to go onto daily Tamsulosin tablets to relieve a degree of the increasing ill effects on micturition ability and for the present that is adequate. However, I've no doubt that a point will be reached eventually when I need a prostate reduction or preferably removal, but I'm deferring that to as late as possible due to the known risk of post-operative urinary incontinence. This is said to be about a 10% risk which for me is too high for it to be lightly dismissed. I do have full blood and faecal tests about once a year on my doctor's recommendation.

Hopefully this experience will be some small help to you in reaching your decisions. Like you I don't drink alcohol because I simply don't enjoy it.
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50 Hertz

Pedelecer
Mar 6, 2013
172
2
I've previously ruled out having any PSA test due to it's very unreliable indications, and my doctor has never recommended it. My prostate gland packed up production very early many years ago as I reached 50 years old and it soon became clear that I was at least suffering the effects of BPH (benign prostatic hyperplasia) or possibly a more serious aggressive prostate cancer. Since the former is so common and the latter so comparatively rare, I decided to take the chance without any test or other exploration since my lifestyle was a healthy one in both diet and exercise. That proved to be a good decision and now decades later at 77 years old I only suffer the effects of the BPH.

Almost two years ago I got my doctor's agreement to go onto daily Tamsulosin tablets to relieve a degree of the increasing ill effects on micturition ability and for the present that is adequate. However, I've no doubt that a point will be reached eventually when I need a prostate reduction or preferably removal, but I'm deferring that to as late as possible due to the known risk of post-operative urinary incontinence. This is said to be about a 10% risk which for me is too high for it to be lightly dismissed. I do have full blood and faecal tests about once a year on my doctor's recommendation.

Hopefully this experience will be some small help to you in reaching your decisions. Like you I don't drink alcohol because I simply don't enjoy it.
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Thanks for giving me an insight into your thoughts on this subject flecc.

Like you, I consider the probabilities and the likely consequences of following the courses of action which are open to me.

With PSA testing, I am erring toward not having it done. I have not spoken to my GP about it, preferring to do my own research without his influence. The main deciding factors for me are the unacceptably high likelihood of this test leading me down a path of unnecessary treatment which can have a negative impact on quality of life. Plus there is also a high probability of the test results causing unnecessary anxiety. I'm not one for burying my head in the sand, but I think that the PSA test, for me, is not the right choice, but I will continue to review my decision periodically.

I wouldn't want to influence anyone else's decision, obviously you need to consider your own circumstances, family history, life style etc. Having said that, there are screening tests for other ailments which are worth looking into. Your GP may not always make you aware of them for cost reasons, but with the right approach, they are available.
 

flecc

Member
Oct 25, 2006
53,154
30,570
With PSA testing, I am erring toward not having it done. I have not spoken to my GP about it, preferring to do my own research without his influence. The main deciding factors for me are the unacceptably high likelihood of this test leading me down a path of unnecessary treatment which can have a negative impact on quality of life. Plus there is also a high probability of the test results causing unnecessary anxiety.
Those have been exactly my thoughts on the subject, and like you I haven't asked my doctor about the option but am influenced by his not mentioning it while knowing about my prostate condition. Clearly he doesn't think it a worthwhile option, since he's very ready to recommend other tests like the regular blood ones. My past online research and a BBC Radio 4 program on this subject long ago both indicate that there is little faith in the value of PSA tests, so I prefer to put my faith and effort into a healthy lifestyle and diet with good weight control, all reducing the possibilities of health problems.
 

johnc461165

Esteemed Pedelecer
Aug 19, 2011
546
22
WN6
I was treated for bladder cancer 7 years ago and now have an annual systoscopy (camera) check, about three years ago blood was detected in my urine sample and on the odd occasion it was clearly visible when I went for a pee. after tests nothing sinister was found other than an enlarged prostate clearly visible on screen, I now take a Combodart tablet daily which reduces the swelling and I have had no further problems, after 3 more annual checks I will be declared clear of the original cancer. Wish this snow would clear off as well so I can get out on my bike, first things first
 

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