Prostate Cancer

[Bazile]

What is the current medical opinion as to when / what age should men have a test / or should men have a test for Prostate cancer ?

[Bazile]

Sorry to go on about this

Ok so a low PSA reading is unlikely but not impossible .

1. Would it be advisable to have further tests , e.g a biopsy , if for example you had a low PSA reading , but you also have the passing water symptoms , mentioned ? .

I have also read that pain in joints - back/hip/pelvic may also be a sign of prostate cancer - is that correct ?

[sunny-dave]

Sqad - with no family history and no physical symptoms I wouldn't even be thinking of having a PSA test, let alone worrying about what to do with the results.

Yes - there is a small chance that an asymptomatic tumour might be missed, but I'd rather risk that than potentially be frightened into undergoing unnecessary treatment (which as you know can be pretty 'quality of life destroying').

[Sqad]

Bazile.

\\\1. Would it be advisable to have further tests , e.g a biopsy , if for example you had a low PSA reading , but you also have the passing water symptoms , mentioned ? . \\\

In which case you need to consult a Urologist. If it were ME, I would ask for an MRI scan, but unfortunately that would be like getting water out of a stone (sorry about the pun) in the UK.

\\\\I have also read that pain in joints - back/hip/pelvic may also be a sign of prostate cancer - is that correct ?\\\

IF due to prostate cancer, then they would be a sign of advanced disease, a situation arisen because urinary symptoms had been ignored.

[Sqad]

sunny-dave...fine.

\\\\sqad is not reflecting current thinking.\\

I am reflecting MY current thinking which doesn't always agree with MODERN thinking. I answer questions as to what I would do in the circumstances.

[Bazile]

ok - thanks all for your contributions .

it's certainly not black or white as to what blokes should do , even though you see warnings about prostate cancer everywhere , nowadays

[Sqad]

Bazile.

\\\\\it's certainly not black or white as to what blokes should do \\\

Well it is to me.......I can't see the problem.

[sunny-dave]

Sqad - I do genuinely respect and value your opinions - you've helped me (and many others) in the past and I hope will continue to do so for many years to come.

We do disagree occasionally - but with the best of intent on both sides, I'm sure.

Dave

[Sqad]

sunny.......;-)

[Peter Pedant]

Bit of a confused thread here

Bazile you started off asking a screening question - when should men have a PSA ? - and slaney argued effectively that screening doesnt seem to work.

However - you then volunteered a symptom - urinary slowness etc.

so your real question is: screening aside - if I have urinary symptoms, and back ache should I see a wee doctor?
and I think we would all agree the answer is yes.


GIGO - wrong question wrong answer.

[Bazile]

sqad

//Well it is to me.......I can't see the problem. //

ok sqad - just to clarify then - it is your opinion that men 40+ should have a PSA test whether they have the symptoms or not .

Is that your opinion ?

[Sqad]

YES.

[Old_Geezer]

One often wants general information and having asked one question finds a supplementary one will give a better understanding on which to base a decision. I'd not call that garbage. Exceptional is the one who, trying to get an understanding of something, knows immediately the best final question.

[Bazile]

peter

As i said there are warnings everywhere now about prostate cancer .

I was trying to ascertain at my age whether or not it is advisable to have a test or not .

[Bazile]

indeed -Old_Geezer

[Clanad]

I'm a little surprised that there's been no discussion of a relatively new, alternate test for possible prostate cancer. Having had a n elevated PSA test (4.7) a few year ago, my urologist wanted to immedately do a biopsy. This isn't to be taken lightly... many men will report that the biopsy is one of the worst procedures they've endured.

At any rate, I had just read about the PSA blood ratio test and requested that before any other decisions. I think the urologist was somewhat chagrined, since the ratio value came back at over 25%. He didn't bother to call me with the news, but rather the Lab Tech that performed the test let me know the results.

It's described here:

There are some new PSA tests that may help you and your health care provider determine if you need a biopsy. You should know that doctors do not always agree on how to use or analyze the results of these additional tests.

•Percent-free PSA. PSA takes two major forms in the blood. One is attached, our bound, to blood proteins and the other circulates freely. The percent-free PSA test indicates how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not. Studies show that if your PSA results are in the borderline range (4 to 10), a low percent-free PSA (less than 10%) means that the likelihood of having prostate cancer is about 50% and that you should probably have a biopsy.
Many doctors recommend biopsies for men whose percent-free PSA is 20 or less.

[Sqad]

Clanad...you have mentioned this before and for reasons best known to the "scientists" it hasn't been adopted in the UK.

[slaney]

Clanad - not all American doctors believe in the usefulness of percent free PSA, or other PSA tests
"Numerous strategies have been proposed to improve the diagnostic performance of PSA when levels are less than 10.0 ng/mL. These strategies include measuring PSA velocity (change in PSA over time), PSA density (PSA per unit volume of prostate), free PSA, complexed PSA, and using age- and race-specific reference ranges. We suggest not routinely using any of these strategies in deciding which men to refer for biopsy."
Richard M Hoffman 2014.
http://themedicalroundtable.com/users/richard-hoffman

The American Cancer Society "recommends that that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening. Men should not be screened unless they have received this information".
The same site also mentions that "not all doctors agree on how to use these other PSA tests"
http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-detection

A complex subject, but Bazile should see his GP, as advice can only be given on an individual basis.
I hope it all turns out well for you Bazile.