How to decrease the yearly psa anxieties?

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Dick Smith - 05 May 2008 23:19 GMT

Every year I get my PSA checked, and every year I get anxious awaiting
the results...It's maddening because I don't have PCa, although my
father died of it, so I know what it can bring. Is it worthwhile to
get it checked yearly if it causes me a month of anxiety? I had it
checked in January but didn't call the doctor to find out what it was
until today! Last year I had them mail me the results and got all
anxious opening up the letter. I figured I'd get checked yearly out of
respect for my dad, but now I'm always afraid it'll jump big.

I'm 40 years old and got first checked when I was 37 after seeing what
PCa did to my dad, he had an aggressive form of it. Every year I since
then I get nervous when getting the results. I would imagine it's
worse for those that are post treatment, but what the hell should I
do?

Also, does PSA fluctuate? When I first got checked it was 0.8, then,
0.7 then 0.7 again and now 0.6. So it's going down, but I know next
year if it's .7 or .8 I'll be shittin' thinking it's the start of a
uptrend.

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I.P. Freely - 06 May 2008 00:14 GMT

> Every year I get my PSA checked, and every year I get anxious awaiting
> the results...It's maddening because I don't have PCa, although my
> father died of it, so I know what it can bring. Is it worthwhile to
> get it checked yearly if it causes me a month of anxiety?

Only if it saves your life.

But why not get the best of both worlds: check your PSAs and fix the
anxiety problem (e.g., books, Google, psychologist, drugs)? Win/Win.

I.P.

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Dave Head - 06 May 2008 00:35 GMT

>Every year I get my PSA checked, and every year I get anxious awaiting
>the results...It's maddening because I don't have PCa, although my
[quoted text clipped - 15 lines]
>year if it's .7 or .8 I'll be shittin' thinking it's the start of a
>uptrend.

How's your cholesterol?

Get put on a cholesterol lowering drug like lipitor and you'll get your blood
done every 3 months, with availability of results the next day after 3:00 PM
(if you go to my doctor, anyway.) Results include a lotta stuff, like PSA. No
waiting to speak of.

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I.P. Freely - 06 May 2008 01:10 GMT

> Get put on a cholesterol lowering drug like lipitor and you'll get your blood
> done every 3 months, with availability of results the next day after 3:00 PM
> (if you go to my doctor, anyway.) Results include a lotta stuff, like PSA. No
> waiting to speak of.

Oh, boy ... now he'll be a nervous wreck for three months every quarter.
;-)

I.P.

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He'sDeadJim - 06 May 2008 00:46 GMT

Yes it flucuates and what means more than the number it's the jump
between psa tests. Mine was 2.3 then 2.1 a few months later
18 months earlier it was 1.3. All those are below the normal 4.0
where many guys start to wory. I have a friend who was in the 4.0 to
5.5 range but his biopsies habve been negative. Mine was found by DRE
in a physical. Don't only rely on psa

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Steve Jordan - 06 May 2008 00:58 GMT

Without a doubt, yes.

> .......if it causes me a month of anxiety?

Anxiety is not productive, especially when it is also unnecessary.

The Prostate Specific Antigen (PSA) test is not, not, *NOT* specific for
PCa.

If high, all it does is to alert the patient to the fact that further
testing is necessary. I understand that by far the most "high" PSAs
(normally >2.5 ng/mL to those medics who are familiar with it) are NOT
the result of PCa. Rather, they could be caused by

infection
prostatitis
a DRE within 48 hours of the blood draw
ejaculation within 48 hours of the blood draw
even bicycle riding
or anything else that stresses the gland

The only marker that is everywhere accepted as specific to PCa is the
Gleason score, which is based upon a pathologist's judgment after
microscopic examination of specimens from a biopsy.

And lastly, a diagnosis (dx) of PCa is very far from a death sentence.

Having a yearly PSA (plus a DRE, digital rectal examination, AFTER the
blood draw), is simply prudent in light of Dad's history.

(snip)

> Also, does PSA fluctuate?

Yes.

There are documented fluctuations within a 24-hour period.

What is important is a steady rise over time. Much time; months.

Relax. Enjoy life.

Regards,

Steve J

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Nom.de.Plume - 06 May 2008 22:56 GMT

> Every year I get my PSA checked, and every year I get anxious awaiting
> the results...It's maddening because I don't have PCa, although my
[quoted text clipped - 15 lines]
> year if it's .7 or .8 I'll be shittin' thinking it's the start of a
> uptrend.

I can't answer your question, Dick, but I don't think anticipation anxiety
is unusual. I begin to "sweat it" a week or so prior to my blood test and
for about seven years now -- and I've had prostate cancer -- everything's
lookin' good.

Ken Bland

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Leonard Evens - 06 May 2008 23:34 GMT

> Every year I get my PSA checked, and every year I get anxious awaiting
> the results...It's maddening because I don't have PCa, although my
[quoted text clipped - 10 lines]
> worse for those that are post treatment, but what the hell should I
> do?

My father died of leukemia at age 46, and I spent many years thinkining
I or someone close to me had leukemia, so I understand how you feel.
Here I am, almost 75, and no leukemia. So looking back, all that worry
was a total waste of time.

Even though your risk of getting prostate cancer is higher than normal,
yourrisk of being diagnosed in any given year is pretty small. And
the odds wouldn't start going up until you are a bit older.

Keep in mind that great progress has been made in diagnosing and
treating prostate cancer. My guess is that the odds are at least 3 to 1
that you will never get it and probably even higher than that. But even
if you do get it, you are unlikely to die of it.

> Also, does PSA fluctuate? When I first got checked it was 0.8, then,
> 0.7 then 0.7 again and now 0.6. So it's going down, but I know next
> year if it's .7 or .8 I'll be shittin' thinking it's the start of a
> uptrend.

Right now your PSA is just about where it ought to be and there is
nothing unusual about the kind of variation you report. If it
suddenly jumps to 1.5 or thereabouts in a single year, that might be
reason for a biopsy, but it is pretty far from that to metastatic
prostate ancer.

If a cancer is discovered early in a man your age, there is an excellent
chance of a cure, and with a good doctor, an excellent chance of
avoiding side effects such as incontinence and impotence.

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Danger Mouse - 10 May 2008 11:13 GMT

>> Every year I get my PSA checked, and every year I get anxious awaiting
>> the results...It's maddening because I don't have PCa, although my
[quoted text clipped - 39 lines]
>chance of a cure, and with a good doctor, an excellent chance of
>avoiding side effects such as incontinence and impotence.

And, you also have to realize that if you do find that you have cancer, if its
in an early stage, you probably have 5 - 10 years before it starts getting
really threatening. That's 5 - 10 years of medical progress to come - 60
minutes had a piece on a new approach to cancer treatment with _no_ side
effects that involves nanotechnology, where carbon or gold nanostructures
(nanotubes? I forget) are vectored to individual cancer cells by an agent of
some sort, and than they are stimulated by an electromagnetic field of high
power radio waves at 13.56 megahertz. That heats and kills the individual
cancer cells. So far, in tests, it works 100%, and there's also a 100% lack of
side effects. Its going to clinical trials probably in about 3 years.
Hopefully, the clinical trials will be over and the whole thing approved for
use about the time your PC would be starting to get serious. Walk into your
Dr's office, be injected with nano-tech agents, come back in a couple days,
stand in front of a radio antenna... cured. Get out of the Dr's office and go
back to work, you lazy goof-off... <G>

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Steve Kramer - 07 May 2008 00:17 GMT

I wish I was in your position to decide, but I never made it that long.
Howver, if I had, I would have it tested annualy for at least 5 years before
I started messing around with the frequency. Especially if I got it
initially at 37.

> I'm 40 years old and got first checked when I was 37

Did you used to use the handle "USC Gamecock?" If not, you are tied for the
record for the youngest patient on this NG.

If you have accurately stated these numbers, then I am confused. If you
were 37, you almost certainly had surgery. Your PSA looks, however, like
post radiation numbers.

Please let us know of your history.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1 2/12/08
Non Illegitimi Carborundum

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Steven L. - 23 May 2008 03:46 GMT

> Every year I get my PSA checked, and every year I get anxious awaiting
> the results...It's maddening because I don't have PCa, although my
[quoted text clipped - 4 lines]
> anxious opening up the letter. I figured I'd get checked yearly out of
> respect for my dad, but now I'm always afraid it'll jump big.

Take some advice from a fellow neurotic, who also worries about his
yearly PSA (and I had a prostate biopsy too!):

In my experience, I have found that if you find something else to worry
about, your mind will focus on that, and you'll stop worrying about the psa.

For example: Suppose you go and have unprotected anal sex with a
prostitute. You'll be so terrified that you caught an STD or even HIV,
that you will forget all about your psa. :-)

But don't try this at home. :-)

Signature

Steven L.
Email: sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

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Joe Price - 23 May 2008 06:00 GMT

> In my experience, I have found that if you find something else to worry
> about, your mind will focus on that, and you'll stop worrying about the
[quoted text clipped - 3 lines]
> prostitute. You'll be so terrified that you caught an STD or even HIV,
> that you will forget all about your psa. :-)

This lines up well with a theory I claim to be my own. I think each of us
has our own "Worry Budget" with a fixed amount of worry we each are
compelled to expend.

The total monthly allotment of worry is unique to each of us. My amount of
worry is not necessarily equal to yours but mine is pretty much always about
the same - volume?, mass? area? - whatever.

The point is that we will "spend" that worry on our concerns whether those
concerns happen to be critical or trivial so long as they are the most
important concerns in our lives at the time.

If there is a lot of terrible stuff going on, things we would normally fret
about are "not worth worrying about". Conversely, if everything is
generally fine in our lives we will get worked up about crap that doesn't
matter at all.

There. That is my theory. I cannot prove it but it feels right. It is
also pretty much what you said above. But it is still MY theory. Mine.

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