OK Guys... let's talk PSA

Q

QuickSilver

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Location
Midwest
Hubby's doc just called and hubby's PSA has gone up from 5.1 last year to 5.4 last week. He wants him to see a Urologist. I have heard that PSA is not a particularly reliable indicator of prostate cancer and that it results in millions of unnecessary invasive procedures.. So I'm really at a loss as to what to do.. I'd hate for him to go through a prostate biopsy for nothing... YET.......... I'd hate for him to have prostate cancer and not catch it early. Anyone else have anything to share on this topic.. ?
 

I've had an abnormally high PSA for years. My prostate has been biopsied a total of five times. Every time the result is negative. Now they no longer even check my PSA, just a digital examine twice a year and now they'll probably stop that because of my age. A prostate biopsy isn't really that much of an ordeal.
 
Was sent to a urologist because, during a routine phys exam, my doc found an increase in PSA count.
The Urologist did a digital exam then took 3 or 4 biopsies. (He told me that this was going to sting a little.)
The results showed a 'moderate' cancer. I asked, "What now?". He said he'd remove the entire prostate and that would be the end of it.
Then I asked if there would be any "side effects". He said that I would be incontinent and impotent. So I said feggeddabout!
He called it the wish and wait theory; hope for the best. Which I have been doing. I haven't experienced EITHER one of those side effects.
I may add that this all happened about circa 15 years ago. (Well, having turned 91 a few days ago, I have to confess that the impotentcy
has kicked in, but I still pee a strong stream. Remember, Every case is different. Don't go by MY case; make your OWN decisions.
 

To clarify a possible terminology confusion between my comment and Falcon's. I was biopsied on five separate occasions and in each of these procedures four or five samples from different parts of the gland are extracted.
 
Question about the biopsies... are they done in the doctor's office or do you go to same day surgery at the hospital for a cystoscopy under general anesthesia?
 
Mine were in the Drs office which is well equipped.

The procedure is done via the anus with guidance by the Dr. As I mentioned before; each "snip" stung a little but not al that bad.

Just make sure your doctor didn't get his MD degree from an osteopathic school. (It's your a$$ we're talking about.) Well, I mean your husbands'.

(Please don't mention cystoscope to me; scares the $**t outa me! Hope I never hafta have one.)
 
Falcon said:
Mine were in the Drs office which is well equipped.

The procedure is done via the anus with guidance by the Dr. As I mentioned before; each "snip" stung a little but not al that bad.

Just make sure your doctor didn't get his MD degree from an osteopathic school. (It's your a$$ we're talking about.) Well, I mean your husbands'.

(Please don't mention cystoscope to me; scares the $**t outa me! Hope I never hafta have one.)
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I've been cystoscoped probably half a dozen times (the VA really looks after your plumbing) and I'd rather be scoped than biopsied any day. They numb the end of your ***** before inserting the cystoscope.
 
I've been scoped several times. Even had the microwave procedure done. What a waste of time and money. Didn't solve a thing. PSA okay but very large prostate. Two doses of Flomax daily help most of the time. Yes, Jim. The phrase bend over and spread your cheeks is not my favorite saying. :mad:
 
Josiah said:
They numb the end of your ***** before inserting the cystoscope.
Click to expand...

They numb....they numb what??? Ooooh noooo!

So much for that procedure, I'll be asking for plan B....

Edit: I have been catheterized exactly once in my life, somebody's gonna get hurt if they try that again.
 
I had to catheterize DH three times a day the last two years he lived. He never complained about discomfort. The doctor prescribed the right size catheter and we used a lubricant.
 
Josiah said:
If you guys are squeamish about this stuff. Consider some men because of medical problems with their urethra have to catheterized themselves every time they have to urinate. Now there's a heavy trip to handle.
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Absolutely, I see those ads on TV for catheters and marvel at the trials that some must endure...
 
Dr Ablin, the man who discovered PSA, has gone to great lengths to explain that PSA was never meant to be a diagnostic test for postrate cancer. He has expresseed his extreme displeasure that, having made his point, the pharmaceutical industry proceeded to make million$ from PSA testing and that thousands of men had received unnecessary treatment.

When I asked my GP about it, she said that it was too unreliable to use as a screening procedure and it was not performed unless there was very strong evidence of postrate problems.
 
Capt Lightning said:
Dr Ablin, the man who discovered PSA, has gone to great lengths to explain that PSA was never meant to be a diagnostic test for postrate cancer. He has expresseed his extreme displeasure that, having made his point, the pharmaceutical industry proceeded to make million$ from PSA testing and that thousands of men had received unnecessary treatment.

When I asked my GP about it, she said that it was too unreliable to use as a screening procedure and it was not performed unless there was very strong evidence of postrate problems.
Click to expand...

This is what I had been led to believe.. however, when you have your doctor saying that you MUST see a Urologist for a PSA of 5.4... because the high normal is 4.0.. do you say no? That's the problem.. SO... hubby has an appointment with a urologist next Monday.. Next step I am certain is a biopsy...
 
My doctor included PSA as one item in a routine blood test. At the laboratory, I was told this test is not covered by Medicare. I saw in the Medicare Manual where all men over 50 are entitled to PSA blood testing. The outcome was that I filed an appeal because of the wording in the Medicare Manual. Before it was over, my Congressman was involved and talked with the insurance company about why this was not covered. The end result was that my appeal was absolutely denied and that was the end of the matter. So now when I go for my routine blood test, I tell the laboratory people to cross off the PSA test.
 
John C. IMO you really should include the PSA count in your blood test as it does tell you the SIZE of your prostate but doesn't mean you have cancer.....But it COULD !
What's a few $$ when it comes to your health. ?!
 
25 years ago my PC was concerned about the rate of increase in my PSA not just the score, in addition, he felt what he called, a nail when performing a rectal digital exam an suggested I see a Urologist who also felt the nail. A biopsy revealed a highly agressive cancer with a Gleason Score of 9.5. After obtaining a Second Opinion at Stanford University I talked over the available options with the Urologist at Stanford. I opted for a Radical Prostatectomy because radio active seed implantation or radiation could literally fry the prostate and make any future surgery if required, extremely difficult. I was aware that impotence and incontinence might result from having a Radical Prostatectomy. The Surgeon told me he could do a Nerve Sparing Procedure that might take care of the impotence, but no guarantees. My cancer was serious enough that I did not want to mess around with watch & wait and getting that gland out was the best option for me. I was 100% continent one month after surgery and still am.I had successful sexual intercourse six months after surgery. I am a fan of PSA exams, because I am alive today because of one smart PC doctor picking up the rate of increase in my PSA scores, plus the rectal digital exam and finally the biopsy and lastly, a great surgeon which nailed down the problem. Many men have died I think, because they were hung up on the impotency/incontinence thing and delayed or did nothing. My life is more important than either of those two potential problems.
 
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