Aa
elevated psa in grey area
in 2001 had elevated psa 4---had dre it was normal had biopsy it was normal
2006 psa was 2.88 ---recent 11/2007 (I'm 64)had psa 8.77 and repeat psa a week later it was 6 dr wants to do a biopsy this thursday eventhough dre was normal----why not do a free psa and if a high number hold off on biopsy---has any other more reliable test been developed to mscreen for prostate ca? I dread the biopsy and the waiting for results is torture.
2006 psa was 2.88 ---recent 11/2007 (I'm 64)had psa 8.77 and repeat psa a week later it was 6 dr wants to do a biopsy this thursday eventhough dre was normal----why not do a free psa and if a high number hold off on biopsy---has any other more reliable test been developed to mscreen for prostate ca? I dread the biopsy and the waiting for results is torture.
Hi. You raise a valid issue with the free PSA determination. Reviews have shown that the need to do biopsies can be reduced indeed in the total PSA range of 4-10 (which is where your results lie). This advantage of doing the free PSA only works for those with a small prostate volume. If your DRE is normal, it is possible that the volume is low. However, the DRE largely evaluates part of the prostate only and cannot totally assess volume. I am guessing you have no problems voiding, this would increase the likelihood of having a normal prostate volume.
There will be some doctors who will be concerned however, with reducing the number of biopsies, because it may also mean a reduction of detecting cases. Perhaps this is your doctor’s philosophy.
Prostate cancer screening is actually controversial as it has not been shown to improve survival unlike the case for screening for Breast cancer. I am getting the impression that you are not prepared to undergo a biopsy. This attitude is understandable, however, once you have a PSA taken – you should be mentally prepared to go through with the more invasive steps in the screening should it arise.
Perhaps you should discuss these issues with your doctor. Prostate Cancer screening is best done with shared-decision making. This means you understand that the screening is not one blood test, but is actually a cascade of tests, one of which is the biopsy. You also understand, that while the screening itself may not save lives, those detected with early cancer have a good chance for cure (put another way, early cancer detection saves lives, but current screening methods do detect early cancer but this is at the expense of men without cancer being included in some invasive testing).
There are more variations/derivatives of PSA being developed. But it seems we’ll have to either accept what is here now, or choose to not undergo screening for the time being.
There will be some doctors who will be concerned however, with reducing the number of biopsies, because it may also mean a reduction of detecting cases. Perhaps this is your doctor’s philosophy.
Prostate cancer screening is actually controversial as it has not been shown to improve survival unlike the case for screening for Breast cancer. I am getting the impression that you are not prepared to undergo a biopsy. This attitude is understandable, however, once you have a PSA taken – you should be mentally prepared to go through with the more invasive steps in the screening should it arise.
Perhaps you should discuss these issues with your doctor. Prostate Cancer screening is best done with shared-decision making. This means you understand that the screening is not one blood test, but is actually a cascade of tests, one of which is the biopsy. You also understand, that while the screening itself may not save lives, those detected with early cancer have a good chance for cure (put another way, early cancer detection saves lives, but current screening methods do detect early cancer but this is at the expense of men without cancer being included in some invasive testing).
There are more variations/derivatives of PSA being developed. But it seems we’ll have to either accept what is here now, or choose to not undergo screening for the time being.
Hi,
Prostate biopsy is gold standard to see state of prostate.
Alternatively you can get your PSA done again with free value and decide further.
Discuss with your surgeon about your thoughts.
Prostate biopsy is gold standard to see state of prostate.
Alternatively you can get your PSA done again with free value and decide further.
Discuss with your surgeon about your thoughts.
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