PSA testing, what are your feelings about it?
Here in the prostate cancer community, there are many thoughts, feelings, and experiences about PSA testing. This is a space to share about all things PSA testing.
PSA testing is basically a simple blood test and can easily be included as part of annual physical exam with or without the "dreaded" digital exam. I would tell any man to insist on a PSA test even if his MD says "you do not need one" because the test is not 100% accurate etc. While PSA testing is not a test for cancer it can offer some guidance for future action.
Additionally I suggest to always keep a written history of your psa tests. If you see an increase in numbers over a few tests it may be a good idea to connect with a urologist vs staying with a GP. I did that a few months ago and candidly that early warning paid off for me. Dennis (ProstateCancer.net TEAM)
thank you Been there. In 1999 I had an overdue physical. I was feeling great, no symptoms of anything, but health fair tests had revealed my cholesterol was high. I had recorded that my dad died of prostate cancer on my medical history form, but when the doctor told me I was fine except for the cholesterol, I asked shouldn't I get a PSA test? He replied, "You don't need one, but I'll write a scrip if you really want it." I thought it over for a few seconds, responding that I did want it, having my first ever PSA within the hour. That was on a Saturday.
Three days later, Tuesday, I was in the same place for an allergy shot, and the doctor, looking both glum and embarrassed, called me into his office after the shot. He invited me to sit down, and without another word slid a paper across his desk to me. I read it, realizing it was my PSA report, but could not find the number, which I expected would be between 1 and 10. I did see the figure 113.6, but considered it some kind of medical code. Suddenly I realized that WAS my PSA result! I then noticed the pathologist's scrawled note: "Get appt ASAP." I was stunned, shocked. My first thought was "It can't be as bad as it looks because I'm still breathing."
The biopsy confirmed aggressive prostate cancer, GS 4+3=7 (GG3), all cores positive, most 100% cancer, with doubling time evidence from intermittent ADT vacations showing a PSADT from PSA 5 to PSA 10 of three to four months. The stage was 3. An attempt at a cure with radiation in 2013 plus my fourth round of ADT was successful, as my PSA eventually fell to less than 0.006 and has stayed there for years. With that rapid doubling time and my baseline PSA over 100, I was at the hidden edge of a cliff but blind to it. I strongly support PSA testing!
PSA tests aren’t wrong/misleading (unless there’s a lab error). Many people have simply misunderstood its purpose.
For initial diagnosis, a PSA test isn’t a “cancer test.” The PSA number itself is similar to a “check engine” light in your car; it indicates that something may be wrong, and further checks should be made “under the hood.” Might be as simple as a UTI; might be BPH; might be more serious. (Or the man might have engaged in an activity causing a temporary rise in PSA. Many things can affect PSA, which is why it’s important to be sure that your PSA is as accurate as possible.)
Just need to have further checks. No need to panic, or rush to a quick treatment decision, or get overly concerned. With early and annual screening, if there is an elevated PSA, other tests and numbers should also play a role in deciding on additional treatment.
Yes, a PSA of 25 is highly survivable. There are many things that factor in determining prostate cancer diagnosis, treatments and outcomes. Don’t let fear distract you; let the numbers guide you step-by-step through this and you’ll be fine. (I know a guy who had a PSA of 11,700 on his very 1st PSA test. He attends an online support group that is held every Wednesday evening.)
I had my 1st PSA test at 45y (in 2000) — because I asked for it. That’s the way it often is with PSA testing; a guy simply has to ask for it.Yes, as others have noted, it is often survivable, and may not even be prostate cancer as an infection can boost PSA even into the hundreds with elevation also caused by some other causes, such as "infarction", though infection and cancer are probably the main causes of an elevation as high as 25. If it is cancer, a PSA that high likely rules out prostatectomy as an option, but these days modern radiation is just as good as surgery as wiping out cancer in the prostate and has the key added advantage of wiping it out in areas surgery can't reach.
I just posted about my own first PSA test result of 113.6, and it is virtually certain that I am now cured almost 26 years later. What follow-up have you had and how are you doing?
I had an 8.6 the prior year. At my wellness exam, the doctor told me "we do not do PSA at your age". I finally took myself to urology. PSA 16.3 and 21 of 23 biopsies bad. Radiation; chemical castration. Alive but no longer a 'man'.
You're still a man. Cancer creates a new me is my mantra. Sure, there are things I absolutely hate about such as radiation and ADT but I can still live most of my life with my new normal. Death ends it all. I hear you, brother
If it was up to me, I'd have PSA testing for men start at 40.
