I need to make an appointment with the doctor about another matter, but while I’m there should I ask about prostate cancer? The documents I’ve read indicate that it’s really for those who are 50+, but, being a virgin, I’m in a higher risk group. I’m loath to waste time they could be spending treating those in real need if all they’re going to do is reassure me.
IIRC, men should start having a prostate check after 35.
Ask? Sure. But be aware of the American Cancer Society recommendations ahead of time.
You should also be aware that The U.S. Preventative Services Task Force advises against the blood test screening at any age. They have concluded the harms outweigh the benefits.
I don’t think asking a doctor or getting screened is a waste of time. Their job is to answer your questions and prevention/early detection of illnesses is as much of their job as actually treating them.
I don’t want to hijack this thread with personal questions, but why would being a virgin put you at a higher risk?
More sex = lower risk.
Doesn’t hurt to have a screening now - simply because they can use this as a baseline for future testing. If they know the levels have increased by a certain percentage, that can indicate aggressive (potentially) cancerous growth. If you simply have a high(er) number later, without the baseline earlier test, it is harder to determine if things are changing.
That said, I think my doctor(s) rushed me into having radiation treatment a bit too soon - they sort of scared me into it - and I wish I had waited another year or two to verify their results/suggestion that I go through the process sooner than later. I have since read that this is/was common to err on the safe side and send guys like me for the full treatment, when in fact, it was probably not yet necessary.
BTW, they were able to easily scare me as I had a friend in Germany who waited far, far too long and he died of prostate cancer - but he was in denial and refused to even see a doctor until it was too late. Still, thinking of him made me more nervous and more easily swayed into having the radiation treatments the minute they suggested it.
According to my doctor, I needed to start at 40 because my father had prostate cancer and my brother had pre-cancerous polyps.
That being said, according to my cousin, who is a doctor in Canada, both my father and brother were treated way more aggressively than they would be in Canada. In fact my father, even though he had confirmed cancerous growths at age 71 would not have been treated at all, because the cancer was growing so slow that he would likely die of something else before the cancer started impacting him. Otherwise he is in very good health, and his life expectancy before the cancer diagnosis (based on the actuarial tables) was 87. So he couldn’t see the logic of waiting and then potentially having to deal with much more serious, painful and debilitating treatment options. His treatment (surgery and radiation) wasn’t too bad, according to him, and he is a big baby when it comes to tolerating pain.
But if he masturbates regularly, it should also reduce the risk, since ejaculation of any kind will lower the risk:
On the other hand, I also see articles that claim that frequent ejaculation *increases *the risk of prostate cancer, so it seems that the science isn’t settled.
Screening tests are hard, and explaining to patients why they might not be appropriate for them is one of the more difficult things that I do. It’s much harder than cancer vs. not-cancer.
The problems with prostate cancer screening:
–A lot of the cancerous lesions detected with the PSA/DRE would take years to decades to even become clinically apparent, much less to cause problems or death. This wouldn’t be a problem if the treatment were relatively benign, but most of the time it’s really not. The nature of screening tests means that slow-growing cancers are far more likely to be detected by screening than more aggressive ones. (Google “length-time bias”.)
–Even in cancers that should be treated, it’s not always clear that treating them in that window between a positive PSA and the onset of clinical symptoms leads to better outcomes.
–The confirmatory test for a positive screen (a TRUS biopsy) is done by a urologist. To be blunt about it, urologists don’t get paid to NOT treat prostate cancer, so in my experience they tend to push aggressive treatment of every little lesion regardless of the circumstances.
That’s not to say it’s never useful, but there’s increasing evidence that treating all comers isn’t beneficial. It’s always worth discussing with your doctor, and I hope he’s good enough to actually discuss it and come to a reasoned decision based on your risk factors instead of just doing the test (which is always easier).
Your doctor will likely do a digital prostate exam, and have your PSA levels checked via a blood test. No sweat.
You really should read the post immediately above yours and the links I provided.
The doctor may indeed do just that, especially if (s)he is lazy or very time constrained, but doing just that may not be the best decision and is specifically advised against by the expert task force.
Heh. This is one of the reasons I post less and less about medical topics.
(Another reason is that I’m tired of getting accused of HIPAA violations every time I discuss a case.)
I rarely order screening PSAs on patients anymore unless they’re in a high risk group. And just being a male over 50 does not in and of itself count as a high risk group.
Okay. Thanks guys. I’ll ask.
Yah, I always give them a brief rundown on the risk/benefit of doing prostate cancer screening. I think the USPSTF needs a better PR department though; while most women know about the recent screening mammography and self breast exam changes (and the controversy that ensued), most men have no idea about the difficulty of screening for prostate cancer.
For the record, I’m in the U.K., not America. Anyway, I’ve made the appointment, but the receptionist really wasn’t interested in why I wanted an appointment. Most odd.
IANOD. My experience: Starting age 40, 10 years of digital exams by my doctor = no indication. First PSA at 51: 22 (concern threshold is 4). Biopsy showed cancer cells throughout the organ.
I am now 6 months past my surgery, and am prostate- (and so far cancer-) free.
That said, PSA is not a confirmation, but it does suggest further examination. Don’t automatically agree to treatment (surgery, radiation) until you’ve gotten a second opinion and done some research yourself. Even with a high PSA and biopsy results like mine, I think you can take some time to work out what’s best without adding to your risk.
I’m two weeks past having my prostate removed, doing great thank you. I had a high PSA result. Out of 15 biopsies one was suspect and one was cancer. When the prostate was removed the doctor was surprised that 40% of the prostate was cancerous. I’m 59 years old and I’m very happy I did the surgery. Because there was that much cancer I will have radiation treatment later on down the road. It’s a load off my mind that the cancer is gone.
I asked my doctor (I’m in my early 30s) and my doctor said, it’s a waste of money and time at my age. He said, after 40 they can do the “Finger” test and after 50 the blood test. Anything else he said, would be a time waster unless you have a history or symptoms.