At What Age Do You Stop Checking Your PSA?
My primary care physician stopped checking my PSA when I was 70 yrs old and recently (80 years old) it was taken & after a biopsy, etc. have been diagnosed with prostate cancer. Is this appropriate medical care to stop checking PSA at age 70?
Hi Balboa. This is a great question and one that strikes at the heart of perhaps the biggest controversy related to prostate cancer - the reliability of PSA, potential for over-treatment vs. not treating those in need, and life-expectancy. As noted in this article from Harvard Med, "American Urological Association (AUA) age guidelines: The AUA does not recommend routine PSA screening for men 70 or older or with a life expectancy of less than 10 to 15 years:" https://www.health.harvard.edu/mens-health/when-is-it-time-to-stop-being-checked-for-prostate-cancer#:~:text=American%20Urological%20Association%20(AUA)%20age,for%20every%201%2C000%20men%20screened. Note what it says about age and life expectancy. One of the problems for this rule is that life expectancy is increasing. I'm sure the average 70 year old today is hoping to make it past 80 and the mere fact that things such as prostate cancer are not being treated in older men is holding life expectancy from increasing further. Hopefully new tests for not only PCa, but also grade, such as the urinary ones, will be able to lead to better decision options on moving forward with treatment of PCa. Best, Richard (ProstateCancer.net Team)
Hi Balboa. I was diagnosed at age 70 with an aggressive form of prostate cancer.
Fortunately it was confined to the prostate and I was able to have surgery. I am now 77 and suspect my outlook might not be the same had I not been tested at 70. Following surgery my PSA began to rise again - the cancer was back and treated again this time with radiation at age 75.
Personally I believe when it comes to averages on being tested or not it is good to remember we are all individuals with different bodies, family histories and life experiences. In the end the choice is up to you.
Dennis(ProstateCancer.net Team)I'm responding to the comment, "prostate cancer are not being treated in older men is holding life expectancy from increasing further." ....having just turned 79 my treatments are ongoing and showing progress, ie: my PSA was once 285 2 months ago and is now 26 and shows signs of further declining.
Unfortunately, these decisions are often made per guidelines based on actuarial tables rather than an individual's needs. The guidelines do not consider the patient's right to determine which outcomes are acceptable.
Dr. Patrick Walsh has commented that the guidelines are not suitable for real world use. I do not have the figures at hand, but Dr. Walsh made the comment that half the prostate cancer deaths are in men diagnosed after age 75.
I am a peer support volunteer and in contact with men in their 80s with stage 4 cancer. My latest contact was a gentleman age 82 who had been diagnosed just 4 months earlier with prostate cancer in his bones.
Failing to screen men after age 70 ignores the fact that the individual may not have been screened before that time and already carrying cancer as well as aggressiveness of the cancer and genetic factors. I feel it is obvious that the choice on screening should be based on an informed decision by the individual.
