have you had a positive PSA test

[Thorn]

A consultant urologist once said to me that all too often men come to him too late for him to help them. Yet, despite this, some GPs are still opposed to automatically including a PSA test in the annual review, saying that it's not always accurate, and can give false positives and, more dangerously, false negatives, and can lead to unnecessary treatment.
But surely, until a better test is rolled out across the NHS, such a test is a starting point. Yes, some men will undoubtedly be missed by a false negative test, and it is for the consultant to weed out the false positives by further examination, so that unnecessary treatment is avoided.
The purpose of this post is to find out how many PFers have had their lives saved by a PSA test, and how may have suffered from a false result.

 

[canonman]

I had a couple in the past at local Lions events (once a year and incredibly popular, hundreds attending) that were considered 'borderline' and my typical man's reaction was to find the bucket and sand.
Last week I decided to ask for another. Similar result, slightly higher.
GP said, still only slightly high but referred me. Within 4 hours (yes HOURS) I had a phone call from urology. Booked in for MRI this week, consultant appointment immediately afterwards and if a biopsy is called for, that will be straight afterwards. It's called a One-stop Prostrate clinic!

 

[Vinny]

Presumably you have to be lying down for that one?

Work had a huge campaign about a year ago.
The one thing that anyone should bear in mind is that it is very strongly hereditary. A friend whose father had prostate cancer and was very unwell for some years as a consequence, ignored the peeing in the night for ages (around 50 years old). He has been diagnosed with quite advanced cancer. When he got the diagnosis, the consultant asked if he had a son. He does - tell him, get tested at 40, don't wait for 50.

 

[TheDecameron]

I had a couple in the past at local Lions events (once a year and incredibly popular, hundreds attending) that were considered 'borderline' and my typical man's reaction was to find the bucket and sand.
Last week I decided to ask for another. Similar result, slightly higher.
GP said, still only slightly high but referred me. Within 4 hours (yes HOURS) I had a phone call from urology. Booked in for MRI this week, consultant appointment immediately afterwards and if a biopsy is called for, that will be straight afterwards. It's called a One-stop Prostrate clinic!

Good luck with this Canonman and I hope you don’t end up prostrate. Sounds like you’ve got an excellent service there. My consultant told me ( different cancer) that the absolute level of a blood tumour marker wasn’t significant, it was the presence of a rising trend that indicated further investigation. Going back to the OP, I’d be inclined to look up reputable information sources like NICE here or NIH in the States and avoid any blogs in the subject.

 

[mjw]

I had a PSA over 30 years ago that suggested an issue. I had a policy at the time and work had me in to a specialist within days. He deemed me OK but slightly enlarged.
The coda to this is that it’s no longer an issue cos my prostate came out with a few other bits when I had a bladder cancer diagnosis two years ago. I’m now cancer clear and having a good time but would say that, unless me and my sig. other hadn’t had plenty in the past, at 65 I’d be forlorn. Fortunately we went at it like mink throughout our time together and I’d advocate anyone in a similar position to do the same. It’s good to look back at significant shags and laugh together but impossible if you never did it.

 

[canonman]

Good luck with this Canonman and I hope you don’t end up prostrate. Sounds like you’ve got an excellent service there. My consultant told me ( different cancer) that the absolute level of a blood tumour marker wasn’t significant, it was the presence of a rising trend that indicated further investigation. Going back to the OP, I’d be inclined to look up reputable information sources like NICE here or NIH in the States and avoid any blogs in the subject.

Thanks, appreciated.
I had private health cover since mid 80's and used it a couple of times but the incredible treatment that my wife has received on NHS (after BUPA found a get out) for a heart condition, we dumped it. They are certainly on the ball (sic) here!

 

[clifftaylor]

Had the blood test done last Wednesday, and haven't heard anything from the GP; hopefully that means there's nothing to report - either way, it is what it is.

 

[dweezil]

Had it done last year and got a low 0.7 plus a confirmatory finger up the bum.

Planning a repeat of the first bit this spring now I have a base reading.

Always consumed loads of tomatoes which is supposed to help if you believe that.

 

[Woodface]

A friend had a slightly elevated reading, pushed to get a referral, had quite advanced cancer, he has had op & clear so far.

 

[hifinutt]

brilliant thread to highlight this vexed subject . a public health consultant dr friend of mine calls this the prostate stress and anxiety test . needs a fair amount of thought . a number of meds can put it up . I have had one though and had a friend die fairly young of prostate cancer

the nhs states this


Routinely screening all men to check their prostate-specific antigen (PSA) levels is a controversial subject in the international medical community. There are several reasons for this.

PSA tests are unreliable and can suggest prostate cancer when no cancer exists (a false-positive result). Most men are now offered an MRI scan before a biopsy to help avoid unnecessary tests, but some men may have invasive, and sometimes painful, biopsies for no reason.

Furthermore, up to 15% of men with prostate cancer have normal PSA levels (a false-negative result), so many cases may be missed.

The PSA test can find aggressive prostate cancer that needs treatment, but it can also find slow-growing cancer that may never cause symptoms or shorten life. Some men may face difficult decisions about treatment, although this is less likely now that most men are offered an MRI scan before further tests and treatment

Treating prostate cancer in its early stages can be beneficial in some cases, but the side effects of the various treatments are potentially so serious that men may choose to delay treatment until it's absolutely necessary.

Although screening has been shown to reduce a man's chance of dying from prostate cancer, it would mean many men receive treatment unnecessarily.

More research is needed to determine whether the possible benefits of a screening programme would outweigh the harms of:

• overdiagnosis – people being diagnosed with a cancer that would never cause symptoms or shorten life expectancy
• overtreatment – people being treated unnecessarily for tumours that would unlikely be harmful

https://www.nhs.uk/conditions/prostate-cancer/psa-testing/

 

[Thorn]

I've had the NHS line quoted to me by, I believe, he who posts on this forum as doctorf. Indeed, a biopsy is unpleasant, and, in many cases, unnecessary. But as hifinutt's post shows, there is the alternative of a scan. Whichever form of follow up exploration is offered, there must be some routine test which flags up the need for it, given mens' noted reluctance to go to their GP about this problem. This is why routine PSA testing is, to my way of thinking, necessary.

 

[wow&flutter]

I got as far as the biopsy stage, uncomfortable and a little scary but certainly not painful. It was quite a few years back but if I remember correctly they took around 12 samples but may have been more.

No cancer found with that biopsy but obviously they only take samples and there could be something brewing in an untouched area!

Again this was based on a second slightly elevated psa test, all appears fine these days touch wood!

 

[doctorf]

I've had the NHS line quoted to me by, I believe, he who posts on this forum as doctorf. Indeed, a biopsy is unpleasant, and, in many cases, unnecessary. But as hifinutt's post shows, there is the alternative of a scan. Whichever form of follow up exploration is offered, there must be some routine test which flags up the need for it, given mens' noted reluctance to go to their GP about this problem. This is why routine PSA testing is, to my way of thinking, necessary.

Thanks for the reference.
I wrote a paper on PSA screening last year, at the request of a charity I have a connection with.
The recommendations are still the same now as then.
General population PSA screening is not recommended. It does not saves lives and has ruined more than a few with unnecessary procedures.
Neither the NHS, Prostate Cancer UK, or Cancer Research UK recommend population screening.
There is good reason for that and it is not to save money.

 

[alan967tiger]

My dad died from prostate cancer; he was diagnosed at 60 and died at 73. As a cancer nurse in a previous life, I'm well aware of the strong hereditary link, so my PSA levels and a PR (or finger up the bum if you prefer) are done annually; indeed I'm having bloods taken tomorrow.

I'm 52 and do have symptoms such as frequency, which I've had on and off for a couple of years. PSA levels have been within the 'normal' range and haven't increased; PR has revealed some inflammation but no hard mass. I've convinced myself that at some point, I'll develop prostate cancer (and this allied to a nurse's dark SoH!), I just hope that its caught early.

 

[doctorf]

My dad died from prostate cancer; he was diagnosed at 60 and died at 73. As a cancer nurse in a previous life, I'm well aware of the strong hereditary link, so my PSA levels and a PR (or finger up the bum if you prefer) are done annually; indeed I'm having bloods taken tomorrow.

I'm 52 and do have symptoms such as frequency, which I've had on and off for a couple of years. PSA levels have been within the 'normal' range and haven't increased; PR has revealed some inflammation but no hard mass. I've convinced myself that at some point, I'll develop prostate cancer (and this allied to a nurse's dark SoH!), I just hope that its caught early.

If you do develop it, I have little doubt you will catch it early because you will be having regular screening.

 

[Thorn]

Thanks for the reference.
I wrote a paper on PSA screening last year, at the request of a charity I have a connection with.
The recommendations are still the same now as then.
General population PSA screening is not recommended. It does not saves lives and has ruined more than a few with unnecessary procedures.
Neither the NHS, Prostate Cancer UK, or Cancer Research UK recommend population screening.
There is good reason for that and it is not to save money.

Do you see the genome scanner as the way forward? If so, is not a PSA test the best way to see who might should be scanned? You and I have a number of friends who would not be with us now but for the rest.

 

[doctorf]

PSA is too non specific.

 

[seagull]

An old school friend of mrs s died of prostate cancer a few years ago, he was in his early 50s.

At the time I was exhibiting some of the symptoms but they could also have caused by my heart condition (I have Atrial fibrillation). I went to see my GP who also put it down to my AF but I insisted on having a PSA test. I was 55 at the time.

It was positive. I had the rectal examination which backed up the result. MRI scan and biopsy followed. I had a Gleason score of 7. I was given the choice of surgery or two years of hormone therapy followed by radiotherapy.

I chose surgery. My surgeon is rated as one of the best in the country. A few months after the operation he told me that my PSA was low but rising so he hadn't got it all out. It was monitored for a few more months then when it reached 2 I had more scans and was offered radiotherapy.

I had 33 sessions. I hoped that would be the end. My PSA was monitored, again it was low but rising. More scans showed that the cancer had spread to my hip.

I am now on hormone therapy, my PSA has dropped to negligible levels (<0.1) so I am currently stable.

I have struggled with the side effects of the treatment; fatigue, incontinence, impotence, weight gain, hot flushes etc. etc.

I'm still here though. It's my birthday next month, I'll be 60.

 

[clifftaylor]

PSA is too non specific.

What do you see as being the best way for a bloke (in my case 65) to keep an eye on the state of his prostate?

 

[Tony Lockhart]

Blimey. All the best to you, @seagull

I had a list of symptoms that made me borderline a few years ago, but nothing nasty came of it all, and symptoms have disappeared.

The thing I found scary was that when I told the guys at work, a fair few said they’d never bother going to the doctor about any symptoms. I made it my mission to just get the subject de-tabooed. I hope I’ve made a difference.