Doctors screen men for Prostate Cancer by doing a Blood Test called the PSA. If the PSA is elevated they will recommend closer montoring or further work-up for signs of Cancer. My PSA has been increasing over the last few years but stayed within the normal range. Last summer I had the first reading above the normal range, just slightly. Knowing that manual manipulation of the Prostate can raise the PSA Level and knowing that I have been riding my unicycle more in the last few years I asked my doctor about it the Unicycle factor. He said bicyclists sometime get elevated PSA results.
So, we waited a month and repeated the PSA test. I forced myself to stay off the Unicycle for 1 week prior to the test. The PSA came back at the low end of the normal range! Dramatically lower than I have tested for years!
What does this mean? Well, for sure don’t let a single high PSA level trigger extensive further testing until you do what I did. Next year, before my annual blood tests I think I will stay off my UNI for a few days prior.
I know you are joking about Unicycling gives you cancer. I just wanted to let people know it can cause a temporary false positive on a cancer screen. I don’t want people (or their wife in my case) to freak out when they get an abnormal PSA reading.
though I am regularly screened for PSA and though I had variations I am (statistically) sure those were not linked to my practice of unicycling. So I keep on riding!
that looks like a big overstatement: that the interpretation of PSA may be not clearer as it seems: yes! but pretending that it means nothing is a dangerous thing: a friend of mine had an alert because his PSA jumped, went to the doctor who double checked … and there is was : a good tumour was removed early and the specialist opinion was it was good thing because the evolution will have been bad AND relatively quick. For another friend they decided to do nothing and wait because other symptoms showed there was no cause for excessive alarm. So IMHO the conclusion is that PSA is a sign, not a sure sign, but a sign and that calling this a “fraud” is … well irresponsible. The cost of checking is minuscule and I do it every year.The real problem lies with the decisions of intervention : some are a bit hastily decided.
Nope. Pick a recent story. They advise men NOT to get the PSA test. PSA testing appears irresponsible.
Study Finds PSA Test Saves Few Lives - NYTimes.com www.nytimes.com/2009/03/19/health/19cancer.html
Mar 18, 2009 – The popular PSA test saves few lives and seems to expose men to unnecessary treatment, two new studies say.
U.S. Panel Advises Against Routine Prostate Test - NYTimes.com www.nytimes.com/2011/10/07/health/07prostate.html
Oct 6, 2011 – Giving healthy men P.S.A. blood tests for prostate cancer does not save lives and often leads to treatment that can cause needless pain and …
Answering Questions About the P.S.A. Test - NYTimes.com well.blogs.nytimes.com/.../answering-questions-about-the-p-s-a-test/
Oct 6, 2011 – News that an influential panel of experts is advising healthy men not to be screened for prostate cancer with a widely used test is certain to …
Op-Ed Contributor - P.S.A. prostate screening is … - New York Times www.nytimes.com/2010/03/10/opinion/10Ablin.html
Mar 9, 2010 – Americans waste an enormous amount of money on an inaccurate test for prostate cancer.
sorry I have read such stories but still stick to another advice : as stated " PSA is a sign, not a sure sign, but a sign … The cost of checking is minuscule …The real problem lies with the decisions of intervention : some are a bit hastily decided. "
questionning the validity of PSA is good practice (even for journalists :D) -for sure indiscriminately overreacting with high PSA level is wrong but hastily throwing out everything with the bath water is wrong too! (now I live in a different health system … where medicine is not so up to date … but cheaper)
if he had jumped a PSA test my friend will be dead right now …(but I agree this is not an argument with a statistical validity)
The problem with diagnosing and treating cancers that don’t actually exist is that the person rarely dies from cancer, which your friends (wrongly) experience as a wonderful thing which they (wrongly) attribute to the treatment.
Any problems leftover (they are often left with serious sexual side effects).
Ask for friends if they are satisfied with their sexual performance.
as I have said the malignant tumour was there so the cancer did exist!
for another friend they decided to do nothing…
my conclusion: we are not qualified to issue general statements!
what I have not said was : no side effect whatsoever! (that’s what my friend tells me: he was afraid of that, but the doctor choose a far bigger scar as an after effect :o )
I agree with Billy on this one. The PSA test has been demonstrated to be useless for reducing death from prostate cancer. There is uncertainty in the study cited below, but if any positive effect is small. There is a large negative effect from overtreatment.
“Conclusions After 20 years of follow-up the rate of death from prostate cancer did not differ significantly between men in the screening group and those in the control group.”
Wobbling bear, you are in your 60’s, so your chance of having undiagnosed prostate cancer is likely around 60%.
Of course, your chance of dying from prostate cancer in the next few years is very small. Your lifetime risk is probably about 3%:
Most prostate cancer is relatively harmless. Your chances of dying with prostate cancer (but not of prostate cancer) is well above 50% and growing all the time.
The vast majority of men treated for prostate cancer (due to PSA screening and subsequent studies) would not have died of the slow-growing cancer that was detected. They may die of the surgery. The have a significant chance of impotency and incontinence due to the surgery.
The PSA test has a high false positive rate, the treatments are risky and have very negative side effects, and the death rate of the disease is the same for tested and untested populations. How do you define useless?
This may be the case, but this statement can and will be misconstrued. Malignant prostate cancer can metastasize and lead to a myriad of other problems that are far, far worse.
Hence, it is essential to check PSA, get exams, etc. It isn’t essential, however, to treat the prostate immediately and radically. This is what you should be saying. To say otherwise is reckless.
It’s like saying “it’s okay to bleed, 99% of cuts are non-fatal”… and then someone nicks a femoral artery…
Prostate cancer kills about 30,000 men in the US every year. Yes, it is a deadly disease.
Estimates from a European study suggest that you need to treat (biopsy and surgery?) 48 men to prevent one prostate cancer death. The surgery has lots of major negative effects, occasionally including death.
A 20 year study of men in Sweden found that the death from prostate cancer was the same for men tested for PSA and men not tested for PSA.
Most doctors are very poor at evaluating statistics. Doctors want to save lives, and they sincerely believe they are doing good through their work. (In many cases they are correct.) When a urologist sees studies like the one cited above, they say to themselves that it does not apply to their practice because they have better insight than the average physician, or that they are using the latest (unproven) version of the PSA test. However, statistics don’t lie, contrary to the common saying. If 50% of the urologist are really doing better then 50% are doing worse. Hmmm.
Doctors will count a treated patient who survives as a win. However, if statistical studies show that you need to treat 48 patients to save one life, then 47 of those patients should be considered as misdiagnoses, often with very negative outcomes and only one should count as a success. How do you tell which patient is which? Doctors are like the rest of us–they lie to themselves all the time.
Prostate cancer is deadly and should be treated. The diagnosis for aggressive prostate cancer is not well worked out. The PSA test is not it. Show me a real reduction in cancer deaths and I will start to believe we have a valid diagnostic tool. Until then I would watch for symptoms.
What else can you do? In my view exercise is almost always good–so get out on that unicycle!
What if the first symptom you notice is a metastatic tumor? Then you’ve let the cancer grow to stage IV and your prognosis is much worse than if you’d been a bit more diligent with testing / examination.
No one died from being too cautious. Again, I’m not advocating for immediate treatment, but I am advocating for testing early and testing often.
Testing is great if the test predicts something. Do you know of a good test from prostate cancer? The best I am familiar with is the check for an enlarged prostate.
You can always have that pesky prostate removed, just to be safe. Removing prostates will become the tonsillectomy for the geriatric set.
A high PSA reading means you should be visiting your doctor more often, and getting annual CT and/or MRI scans to ensure the prostate is the only organ affected by the cancer.
The alternative is what, waiting until you discover a tumor in your spine has left you paralyzed from the waist down? Or you find a tumor in your skull that has left you with brain damage?
Are you really against testing? I’ve seen what happens to people who never test… it’s not pretty. I have plenty of stories if you’re interested.
