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Medical Forum / Diseases and Disorders / Prostate BPH / January 2005PSA test
went to my urologist today for the yearly check-asked about the PSA test and what I read about it being not so good-he said for guys my age 55-true but for older guys it can save their life-he says it has pointed to cancer in some of his patients that they never would have discovered(and saved their lives)..he said at my age-he looks at the PSA number over a few years to see if it spiked-it has been about 2.5 for 4 years.. He said my prostate has been the same size for 4 years. 35 grams... Michael > went to my urologist today for the yearly check-asked about the PSA test > and > what I read about it being not so good-he said for guys my age 55-true but > for older guys it can save their life-he says it has pointed to cancer in I honestly dont know how he can make such a stupid comment. The test either works or it doesnt and the latest data says it doesnt. So why would the test care what age a person is? The fact that a person who went through a PSA was found to have cancer because he went for that test, according to what I have read, is because blind Freddy could have found it with a white cane. > > went to my urologist today for the yearly check-asked about the PSA test > > and [quoted text clipped - 8 lines] > because he went for that test, according to what I have read, is because > blind Freddy could have found it with a white cane. He said the high PSA reading-the jump from his last test numbers-alerted them to cancer.. >> > went to my urologist today for the yearly check-asked about the PSA >> > test [quoted text clipped - 16 lines] > He said the high PSA reading-the jump from his last test numbers-alerted > them to cancer.. ....which in no way invalidates what I posted. > > went to my urologist today for the yearly check-asked about the PSA test > > and [quoted text clipped - 8 lines] > because he went for that test, according to what I have read, is because > blind Freddy could have found it with a white cane. The test is still valid, not only for tracking the size of the prostate, which also be done by a DRE, but for giving an indication of the possibility of cancer by a sudden rise in the psa value. Also a DRE will not detect the medial lobe growth into the bladder. There is no question that as the prostate grows so does the psa value, but the rise is gradual in bph. A sudden jump in the value, of 50% or more is sufficient to cause concern, cancer being one, prostatitis is another. Age does play a role, since bph normally has its onset in males over 50. However, there are a number of males who have bph in their 40's. I would suggest that anyone with bph should have a psa test done anually. If the rise in the psa values is very gradual, then the indication is that the prostate is growing normally with age. Any sudden jump should be further examined, by biopsy, or at least milking the prostate to see if there are any abnormal fuilds in the prostate, which might indicate prostatitis. If prostatitis is ruled out then a biopsy should be done. Jack >> > went to my urologist today for the yearly check-asked about the PSA >> > test [quoted text clipped - 20 lines] > the > medial lobe growth into the bladder. Apparently, no to the cancer bit. It is being reported as being no more reliable than pointing a bone at you and seeing if it wobbles to prove you have cancer. There is no question that as the > prostate grows so does the psa value, but the rise is gradual in bph. A > sudden jump in the value, of 50% or more is sufficient to cause concern, > cancer being one, prostatitis is another. I have a friend also with prostate problems. The guy has had BLADDER cancer (they stick something up your dick and scoop out layers of the bladder from the inside until there is no cancer) and lung cancer. Each time the cancer was found, it was beaten thank goodness. His prostate got so bad he was up pissing maybe 6 or 7 times a night. He was constantly under "cancer watch" and at no time, as his prostate got larger and larger, did he ever even LOOK like he was getting cancer. So, as to your statement that as the bladder grows etc, it depends on each person. > Age does play a role, since bph normally has its onset in males over 50. > However, there are a number of males who have bph in their 40's. I would I have had prostatitis at the very least since my middle 30s. I am 49 now and a large prostate. No cancer though I peed blood and also had it all bloody after sex (coming from me) a few weeks back. I am not concerned that the peeing blood means I have cancer. I have had a sporting accident when I was a kid that ruptured a kidney. It was bound to start playing up sooner or later. > > The test is still valid, not only for tracking the size of the prostate, > > which also be done by a DRE, but for giving an indication of the [quoted text clipped - 6 lines] > reliable than pointing a bone at you and seeing if it wobbles to prove you > have cancer If you have a psa value of 10 after having a value of 5 the year before, there is a 50/50 chance you have prostate cancer. The question is how aggressive is the cancer. A biopsy will give you that answer. > There is no question that as the > > prostate grows so does the psa value, but the rise is gradual in bph. A [quoted text clipped - 9 lines] > like he was getting cancer. So, as to your statement that as the bladder > grows etc, it depends on each person. I said as the prostate grows, not the bladder. Although I did mention that the medial lobe of the prostate can grow into the neck of the bladder. > > Age does play a role, since bph normally has its onset in males over 50. > > However, there are a number of males who have bph in their 40's. I would > > I have had prostatitis at the very least since my middle 30s. Prostatitis and bph are two entirely different conditions. Prostatits is inflamination of the prostate caused by an infection. BPH is caused by the benign growth of the tissue of the prostate, believed to be caused by excess dihydroxi-testosterone in the system. I am 49 now > and a large prostate. No cancer though I peed blood and also had it all > bloody after sex (coming from me) a few weeks back. I am not concerned that > the peeing blood means I have cancer. I have had a sporting accident when I > was a kid that ruptured a kidney. It was bound to start playing up sooner or > later. I would have that checked out. As you said it may be caused by the ruptured kidney, which should have been removed, if the rupture was servere enough to cause the kidney to quit functioning. The only cases of blood coming from the prostate that I know of is when the prostate has been cut. By a biopsy or any resection of the prostate, such as TURP, PVP, TUNA, TUMT or what have you.. However, if you had blood in your ejaculate during intercourse, without having had any of the above mentioned within three weeks of the sexual activity, I would see a urologist Jack: Actually, your comments are not quite correct. Blood in the semen is almost always (yes, there are exceptions) a very benign matter. I remember reading articles that said things like blood in the urine needs to be absolutely checked out. Ditto for blood in the stool or blood in the vomitus. However, blood in the semen is not a problem. Anyway, I read up on this because I suddenly started getting blood in the semen. My doctor was not too alarmed. However, it didn't go away quickly so he sent me to a urologist (one who is well-respected and has practiced for many years). He kind of chuckled and said: [paraphrasing]: "Look, it is no problem; it never is. You broke a blood vessel. The prostate is loaded with many small blood vessels. You probably bled once or twice. But the blood stays in the prostate and slowly gets expelled via ejaculations." In fact, my semen started as blood red (which quickly led me to my first doctor visit). As time went on the color turned lighter/rusty. As the urologist predicted, it went away. He said it could actually take 25 or so ejaculations before it is gone. But it was probably a single bleed. I'm glad the urologist didn't make a big thing out of it! Mel >> > The test is still valid, not only for tracking the size of the >> > prostate, [quoted text clipped - 75 lines] > without having had any of the above mentioned within three weeks of the > sexual activity, I would see a urologist Mel, Thanks for the info. Good to know if it ever happens to me, although now that I have retro, the doc will have to figure it out. If it only happens after an ejaculation, I guess I can assume it came from the prostate Thanks again. Jack > Jack: > [quoted text clipped - 19 lines] > > Mel > Jack: > [quoted text clipped - 3 lines] > absolutely checked out. Ditto for blood in the stool or blood in the > vomitus. However, blood in the semen is not a problem. I regularly have bloody stools and twice have had bloody semen in about 18 months. Neither are things to worry about for me and most people. Bloody stools can just mean that, like me, you suffer from bad gastric reflux and acid and that it has made things difficult and you bleed a lot in the bowels when going to the toilet and nothing else. Eg, there is no cancer or anything else, just skin that bursts somewhere in your bowels, bleeds for a time and heals over until the next time. Uh... Gut: I trust you had a colonoscopy to rule out any serious problem??? Bleeding in the bowels is MUCH more worrisome until proven otherwise. Usually, if you can see it as red blood, it is due to very benign causes (hemorr., fissures, etc.). I guess the black tarry bleeds are from higher up and a bit more of concern. But that should STILL be checked out (I've been there, too!). Mel >> Jack: >> [quoted text clipped - 11 lines] > or anything else, just skin that bursts somewhere in your bowels, bleeds > for a time and heals over until the next time. >Uh... Gut: > [quoted text clipped - 8 lines] > >Mel This is very true. Bloody stools are potentially the sign of something serious. Best, Bob Robert A. Fink, M. D. Neurological Surgery 2500 Milvia Street Suite 222 Berkeley, CA 94704-2636 USA 510-849-2555 ********************************** NOTE: The material above is not "medical advice". Medical advice can only be given after an in-person contact between doctor and patient. ********************************** >>Uh... Gut: >> [quoted text clipped - 12 lines] > This is very true. Bloody stools are potentially the sign of > something serious. Worse than that, going to the doctor over here is a sign that you are a hypochondriac. If you don't go to the doctor, you aren't one. Gut: Your response makes no sense. Going to the doctor with blood in the stools would NEVER be the sign of a hypochondriac. Not going would be a sign of stupidity. Mel >>>Uh... Gut: >>> [quoted text clipped - 16 lines] > Worse than that, going to the doctor over here is a sign that you are a > hypochondriac. If you don't go to the doctor, you aren't one. > Gut: > > Your response makes no sense. > Going to the doctor with blood in the stools would NEVER be the sign of a > hypochondriac. Are you an American? I dont mean that in any possible nasty way. I am just saying you dont understand the doctors here. You are a hypochondriac for going to a doctor over here, according to most doctors, unless something definitely turns up but in most cases, it only turns up because you land in hospital. > Not going would be a sign of stupidity. Actually the other way around. If you go, you get treated like a bludger and a hypochondriac but if you end up carted to hospital and get admitted on the spot then you will be treated like a patient. By the time that happens though.... Gut: Somehow, I doubt that. (Yes, I am an American). Suppose you went to the doctor with a suspicious mole. They biopsy or remove it and it turns out to be benign. Do you mean you would be considered stupid for having it looked at?? That makes no sense to me. Mel >> Gut: >> [quoted text clipped - 14 lines] > on the spot then you will be treated like a patient. By the time that > happens though.... > Uh... Gut: > > I trust you had a colonoscopy to rule out any serious problem??? Yep, back in Feb 1990. > Bleeding in the bowels is MUCH more worrisome until proven otherwise. Depends on what the problem is causing it. Mine was caused by too much acid basically stripping skin away to the point that when having a sh.t, I bleed. Simple as that. > Usually, if you can see it as red blood, it is due to very benign causes > (hemorr., fissures, etc.). I guess the black tarry bleeds are from higher > up and a bit more of concern. But that should STILL be checked out (I've > been there, too!). I get both all the time. Have been since the middle 80s. Still here. Gut: What you said just underscores my point: Bleeding in the bowels is MUCH more worrisome until proven otherwise I'm glad yours was proved otherwise!!! Mel >> Uh... Gut: >> [quoted text clipped - 14 lines] > > I get both all the time. Have been since the middle 80s. Still here. Gut: I don't know your age, but after 14 years you might be due for another colonosc. just as a routine screening procedure. Especially in your case, where you do consistently have bleeding, you would not recognize new bleeding due to cancer. Mel >> Uh... Gut: >> [quoted text clipped - 14 lines] > > I get both all the time. Have been since the middle 80s. Still here. > Gut: > [quoted text clipped - 3 lines] > Especially in your case, where you do consistently have bleeding, you > would not recognize new bleeding due to cancer. You wont be diagnosed with having bowel cancer here until you are so far gone you are just about dead. Case in point - a customer of mine told me he was selling his business due to bowel cancer and having 3 months to live but undergoing chemo and if it worked, maybe 18 months. He had been sick and badly off for about 3 years. Each time he went he was told it was all in his head. So, he goes to the hospital with gut pains that wont go away. He was admitted, tested and found to have inoperable bowel cancer and asked why he didn't get it looked into years ago when it wouldn't have been inoperable. He said to me "I just looked at them with my mouth hanging open and told them, eventually, that I had been many times. They didn't have anything to say after that". I told him to sue the doctor but he said he was told he would have 3 months and now that he is undergoing chemo, he is too weak. That's life over here. Gut: Where is "over here." Where are you located? (Also, if what you say is even remotely correct, remind me never to move there!) Mel >> Gut: >> [quoted text clipped - 19 lines] > > That's life over here. I believe 4 or greater is the number that starts ringing bells of concern. Some doctors use a bit lower number. It is a potential screening tool, not a direct indicator. 2.5 sounds good, (in my non-medical opinion). 2.5 plus digital examine and if digital does not locate any cysts, then likely the doctor considers you to be OK. And that does make sense, in my non-medical opinion. Best of luck to you. "Michael Balarama" <mbalar@ev1.net> wrote in message PSA number over a few years to see > if it spiked-it has been about 2.5 for 4 years.. > He said my prostate has been the same size for 4 years. 35 grams... > Michael Michael, most of the data suggest that there is a relationship between age and PSA level. The older one gets, the higher it goes. Seems to be related to increase in prostate size (BPH) as one grows older.The PSA now appears to be strongly related to the degree of inflammation in the prostate. More recent research indicates that it may not be a good marker for cancer in a large majority of males, especially those over 50. It is sad that many practitioners don't keep up-to-date on the research. > went to my urologist today for the yearly check-asked about the PSA test and > what I read about it being not so good-he said for guys my age 55-true but [quoted text clipped - 4 lines] > He said my prostate has been the same size for 4 years. 35 grams... > Michael i wanted to address both of the posts because they are related. please seee comments between. ~ curtis ========= Re: prostate cancer biopsy From: drberry@cox.net (drberry) Most biopsies are not pleasant and the morbidity rate is somewhat high....post bleeding, prostatitis, and pain. One practitioner told me that he had a patient with PSAs in the 20's; he had multiple biopsies, and no cancer was discovered. For a while so-called "doubling time" was considered important, but now most researchers are warning that the PSA is not an accurate measure to diagnose cancer. In any event, about 10% of prostate cancer patients die soon regardless of any treatment (life can be prolonged some months though...but the quality of life may be low). Most, around 90%, who have cancer cells in their prostates live a normal life span and die with cancer, not from cancer. I have a colleague/friend, who was diagnosed a decade ago with PC (with a high Gleason score) who decided to do watchful waiting, and he is still alive with no problems (except for a high PSA). I, myself, have always run a PSA varying between 5 and 7, and plan to do nothing -- other than not measuring the PSA anymore. Michael Balarama wrote: What is a prostate cancer biopsy..They want to do one on me because my PSA was elevated..Dr said it is unpleasant and they go in through the but. PSA was 3.4 up from 2.5 the last 5 years. Michael Re: PSA test ===============> the PSA test is a very strong test if used as for what it is intended for. most people only understand part of what the PSA test does and that is MEASURE psa in the blood stream. they don't understand the purpose of those numbers. yes, prostate infections can drive psa up fast and quickly. but knowing how the psa level and prostate work can make the difference between life and death of the individual. if you have a psa velocity rise of .75 in one year, that should trigger a need for a biopsy. this is after a round of antibiotics is given and confirmed that the psa rise is valid. a .75 indicates that it COULD be an aggressive prostate cancer. sure, there may be some negative biopsies, but for the ones that the prostate cancer was detected, it just saved their life. the comment PSA was 3.4 up from 2.5 the last 5 years is not a fast velocity rise, but it is indicating that something is going inside the body and medical staffs are using the 4.0 as an absolute cutoff number. it is a fact that 15 to 20% of the men at age 50 have prostate cancer inside the prostate. they don't know why some pca will take off while others, the pca doesn't develop, but if the person was to die and they opened his prostate up, he would have pca cells inside the prostate. so, what causes pca to go active - i don't know. the only tool that can detect this change is the psa test. now to the next post........ From: drberry@cox.net (drberry) Michael, most of the data suggest that there is a relationship between age and PSA level. The older one gets, the higher it goes. Seems to be related to increase in prostate size (BPH) as one grows older.The PSA now appears to be strongly related to the degree of inflammation in the prostate. More recent research indicates that it may not be a good marker for cancer in a large majority of males, especially those over 50. It is sad that many practitioners don't keep up-to-date on the research. Michael Balarama wrote: went to my urologist today for the yearly check-asked about the PSA test and what I read about it being not so good-he said for guys my age 55-true but for older guys it can save their life-he says it has pointed to cancer in some of his patients that they never would have discovered(and saved their lives)..he said at my age-he looks at the PSA number over a few years to see if it spiked-it has been about 2.5 for 4 years.. He said my prostate has been the same size for 4 years. 35 grams... Michael ===========> first, a biopsy is mildly uncomfortable, but they are not painful. they can use a numbing agent before hand or in my case, they didn't. most people don't want something the size of a small broom handle stuck up them and that is the uncomfortable part is, but it certainly not miserable. it is an ultra-sound device that shows the doctor where the areas of prostate cancer may be. the biopsy is the gold standard as far as knowing if you have prostate cancer or not. the worse pain i had was when they fired the needles and it felt like having a rubber band on your wrist and snapping it lightly. that was it. as far as the morbidity rate is somewhat high....post bleeding, prostatitis, - nothing is further from the truth. it is VERY RARE if someone was to die from a biopsy. yes, there is some post bleeding, but it goes away as the prostate heals, and the biopsy does not caused prostatitis. the comment - I have a colleague/friend, who was diagnosed a decade ago with PC (with a high Gleason score) who decided to do watchful waiting, and he is still alive with no problems (except for a high PSA). I, myself, have always run a PSA varying between 5 and 7, and plan to do nothing -- other than not measuring the PSA anymore. ============> reminded me of a person who used alt. meds to treat his pca. he refused the conventional treatments. he did keep his psa around 300 to 400 and was going in to see the doctor in that november. i died within a few weeks after that. here's the cold hard facts. it takes approx. 8 years from prostate cancer to develop and spread into the body. it takes approx 5 years from that point before the pca spreads into one of the vital organs for life and the person dies, so you are looking at an approx. 13 year window depending on what a person's gleason score is. so the person who has pca for 10 years and done watchful waiting is still alive except for the high psa, can you guess how much longer he has? and the high psa number? this is the amount of hormone that is available to feed the prostate cancer, so it will develop even faster and shorten up his doubling rate. what i did not cover is that how pca spreads - it usually goes into the nearby bones - the lower back and hips. the bones gets very thin and collapse which accounts for the pain. it is a pain like you can not imagine and there are three different level management level in the final stages of life. i should know. i have walked this path to the very end with my own father who did the watchful waiting and i was dx'ed 30 years before the age he developed it. so it has affected my life too. as to the comment - I, myself, have always run a PSA varying between 5 and 7, and plan to do nothing -- other than not measuring the PSA anymore. ========> i will say "good luck" and wish no harm and a very good life for what lies ahead. ------------- i posted this because i want to put out the correct information on the psa test. it is what saved my life and triggered the biopsy, which showed i have prostate cancer in BOTH lobes. i was only 56 at that time. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." http://community.webtv.net/PALMER_ENT/doc |
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