I got my first fingering from my doctor at 35. He hasn’t mentioned a PSA yet.
Dr. H. Gilbert Welch at Dartmouth is doing a lot of work on the costs and benefits of screenings, and refers to the PSA test as the “poster child for overdiagnosis”. Sample interview here
General medical advice here in Australia is that you should start being checked (or at least discuss it with your GP) at age 40.
Two years to go until I get far more intimate with my Doctor than I’d prefer 
I have mixed feelings about the campaign (for want of a better word) to de-emphasize PSA testing. On the one hand, I can certainly see where a knee-jerk reaction to an elevated PSA can lead to unnecessary diagnostic procedures and/or surgeries. There’s also the low-but-not-zero of a prostate biopsy leading to peritonitis.
On the other hand, there’s my experience. The urologist ran me through two courses of antibiotics and one of BPH medication to rule out other causes, only resorting to a biopsy when the reading continued to climb significantly. The biopsy showed that 3/4 of my prostate was involved, and a post-op biopsy identified a “high grade” tumor in one lobe. Left untreated, it would have killed me within ten years, and according to my PCP the initial symptom would have been intense and intractable back pain. So the PSA allowed me to dodge a serious bullet.
I guess my take on the subject is that it’s a potentially valuable — but also potentially abusable — diagnostic tool that should be used when conditions such as age and family history warrant. I just don’t like the torch-and-pitchfork approach taken by some who see it only as another sign that the medical profession is out for enrichment at patients’ expense.
I understand that there is some talk around medical circles about a new urine test for prostate cancer that would be more accurate than PSA.
I had PSA numbers that were rising a point or two over a couple of years, so that they were between 5 and 6, so my PCP recommended I go to urologist, and eventually he recommended a biopsy, which I agreed to (never again, if I can possibly avoid it). Fortunately, the biopsy was 100% clean, and my PSA stabilized.
It’s hard to know what to do about PSA testing. It can certainly lead to unnecessary concerns, and to procedures (like my biopsy) that will prove to be unnecessary as well. But it is just about the only diagnostic tool they have, unless this new urine test works out. The finger test really will only show enlargement and/or change over time, both of which might (or might not) indicate a potential problem. The PSA, bad as it is, is still better than that.
Here’s hoping the new test works out.
Roddy
I was post #18. I never did need the radiation treatment. It’s been 4 years now and my PSA has been ZERO since the operation. Everything still works except me being able to make babies. I see the doctor in Jan. of 2017. If the PSA is ZERO he said he’ll cut me free and to go live my life. Loving life. 
I can run off with this topic, but will limit myself.
First, the PSA (blood) test. Find out what the inventor of the test has to say about its current use.
Hint: he is appalled. He thought he was developing a tool to monitor those already diagnosed.
My former PCP (oncologist/internist) insisted on a digital (no, it does NOT mean a computer is used) test at 55.
My current PCP is content that my decision to forgo any further routine screening (at age 65) was valid.
Please read up. Just as the “Every woman must have mammograms every other week!” noise has been revised, so has the “OMG! You’ll die of prostate cancer unless!” noise is being revised.
False positives cause more problems than false negatives - ESP. the damned PSA* screen.
-
- the only way to diagnose prostate trouble is the digital exam - having a finger stuck up your butt. We Boomers demanded a more dignified test. The poor little PSA test was widely hailed as a NEW! Dignified! Prostate Test! No more fingers in butts! Nobody need ever again die of Prostate Cancer!
(just a quick Q: exactly how many die OF prostate cancer?)
My conclusion: If male = true AND age > 99 THEN prostate cancer = true.
Note “prostate cancer = true” is NOT “massive treatment = indicated”
OR - What the good Doc said way back when
I agree with you to a point – prostate cancer generally is a slow-moving old man’s disease and success is considered having the man die of something else before dying of the cancer. But there are cases where the man is younger and the cancer faster-growing. My father was mid-60s and his had grown a lot more quickly. For a man with no other health issues, he was expected to live a lot longer so it made sense to have the prostate removed.
And let’s face it, the reaction to “you have cancer” is often “get it out of me” regardless of any other factors.
I’d never even considered getting a check for prostate cancer. I gotta say, it’d have to be a really big check before I’d even think about it.
The OP was 4 years ago. Since he’s still posting recently whatever happened with his prostate has not (yet) proven fatal.
I hope he’ll stop by and fill us in on the last 4 years of hopefully-unexciting prostate action.
I wanted to talk just about the excerpt above. It boggles my (American) mind anyone would think that way. I’m buying a service. A service that’s very important to me. I’m entitled to all the service I’m willing to pay for. If the doc wants to take an extra 10 minutes to discuss the pros & cons of screening or to perform a DRE or a whatever, well that’s what I’m paying for. Not to have half my issues dealt with and the other half ignored because I was too timid to speak up.
Note I’m not suggesting one should push for screening willy-nilly or ignore medical advice. I’m questioning the attitude of leaving the doc’s office with questions unasked because one is more concerned that somebody else in line behind them *might *have a greater concern.
Hypochondriacs obviously carry my attitude to harmful extreme. But it smells to me like the OP carries his opposite attitude to potentially harmful extreme as well.
I get a PSA twice a year, but my doc has never done a finger exam on me. The reason I get tested twice a year is that I take testosterone replacement therapy. Apparently that increases my risk.
Your doc should finger you. It’s the combination of PSA and digital exams for higher risk folks that results in better outcomes. NOT PSA alone.
Or so say the urologic experts, and I believe them.
I read that taking Vitamin E supplements also increases your risk of developing prostate cancer.
Every year(for the last 10 or so) I’ve participated in a prostate cancer screening program at a hospital(part of a local medical university) History is taken, blood drawn for a PSA(cholesterol too) and a “finger wave” is included. I feel I get valuable information to give to my PCP, and TPTB can ponder the jillions of numbers to aid us in the future. My concern, as an up-threader mentioned, is the quicker-acting form of prostate cancer. I know, I know, percentages, but I want them in MY favor. You DO have to do your research, as there’s a lot of conflicting info out there. Does anyone feel that the pooh-poohing of screening and further tests might be JUST a bit mercenary, and is a ploy to save money, by trying to allay our fears? Death panels! OMG!!! :eek:
It’s not too young. And cancer isn’t the only concern. There’s also enlarged prostate.
Get the PSA. In five years, have another PSA. Observe the rate of change.
But that’s not going to give useful information for the vast majority of older men. It’s NOT a reliable test for most patients. That fact, stated quite eloquently by DSeid earlier in the thread and years ago, has NOT changed.
No. We primary care docs would love a reliable test that helps us help our patients, and we embrace other screening tools when they’ve been shown to do more good than harm.
I will continue to oppose tests that do more harm than good, or that do not give truly useful information.
Again:
Find out for yourself what the PSA test is and how us works.
What all can trigger a “positive”?
Does a “negative” really mean “nothing to worry about”?
Relying on ONLY the PSA sounds like “worst of all possible worlds” to me.
Your mileage may or may not vary, but your evaluation of available data might.
The OP is 45 years old.
I dunno. I had an appointment with a urologist and he proactively told me I don’t need a prostate screening yet. I would suppose your doctor (urologist or GP or whatever he may be) would be happy to give you a recommendation based on your medical history and their experience which carries more weight than internet speculation.