Get tested or don’t. Next case.
Well, this certainly has been an interesting discussion. It demonstrates how controversial the PSA test is. I would just like to reiterate my original intent.
If you have an elevated PSA result it might be elevated because you road a unicycle before the test. So, before you let the medical professional sound the alarms, wait a couple weeks and have it checked again. This time stay off your unicycle and anything else that pounds on that area of your groin for a few days before the test.
It is known that trauma to the prostate will cause the release of PSA from the normal cells of the prostate into the blood stream and the serum PSA level will increase. Given the half-life of PSA 2-3 days, it might take a few days or more to come down to your normal baseline level.
Another false positive can happen if your MD draws a PSA level after a digital rectal exam (when they stick their fingers up you butt and push on the prostate). This will cause PSA to be released into the serum. So, never let them check your blood level after a digital rectal exam.
Anyway, enjoy riding your Uni everyday, except just before the PSA blood test
I thought most doctors are aware of the limitations of the PSA test as a screening tool. That’s why they talk about it until they bore themselves silly.
There are certain situations where it is useful (for instance to monitor treatment of prostate ca).
As you point out, it’s not the ideal screening test because it can’t differentiate aggressive from non-aggressive cancers, and leads to unnecessary tests and procedures that can cause harm, and ultimately, hasn’t shown a difference in survival.
The same logic applies to why we don’t screen for lung cancers with chest xrays. By the time they show up, it’s not going to change the outcome or survival. Or mammograms in young women, and the old FOB test for colon cancer. Every screening test has limitations.
The problem is, we don’t’ have a good test for prostate cancers yet.
We also classify cancer by organ or cell type, which is historical nonsense. They should be classified by the genetic defect, which they probably will be, eventually.
Medical treatments are calculated on a NNT (numbers needed to treat basis). eg, you need to thrombolyse about 15 people with a heart attack at 1hr to save one life.
An NNT of 48 doesn’t mean that 47 were necessarily misdiagnoses, it just means the treatment made no statistical benefit to them.
Speaking of NNTs, I found this website. Seems to be written by a team of savants who spend too much time doing systematic reviews for pleasure 
http://www.thennt.com/psa-test-to-screen-for-prostate-cancer/
In summary, it’s a crap test.
What is needed is to be able to test for aggressive cancers early enough to make a difference, which isn’t the PSA. For indolent prostate cancers- it’s something you die with, not die of.
You’ll never convince these guys with science.
But if elevated PSA levels can simply be seen as reason for further testing, is this no good in itself?
How else would an aggressive cancer present itself before it began metastasizing?
You may or may not get it before it metastasizes, but that’s no different to many types of cancer.
We don’t always have a screening test for cancer. A screening test needs to:
-be cheap and easily performed
-pick up early cancers or pre-cancerous lesions to make a difference in outcome
-cause minimal harm
With something that develops from known pre-cancerous lesions- like cervical cancer- screening is useful because it can pick up early changes which can lead to cancer, or pick up cancers early enough to make a difference.
Contrast that with ovarian cancer- by the time it presents, it’s usually too late to make much difference. There is no good screening test for ovarian cancer, so people don’t bother. They are picked up by diagnostic tests, not screening tests.
Depends how elevated. If it’s extremely elevated, I think that’s your diagnosis made already. Which makes it more of a diagnostic test although you’d still want the histology on the cancer.
If it’s slightly elevated, then it could lead to tests that can cause harm (biopsies etc). Which is fine if it was shown to make a difference to an outcome, but I don’t it has.
ahem! who are these guys? (I feel a bit cross there: you did’nt accustomed us with this kind of remark Billy … I respect highly your opinions -when I can understand your point of view :D- So I am going to make an acerbic reply about the fact that it is inelegant in a discussion to pose oneself as the sole defensor of science and thus tag other’s opinions as “unscientific”. GizmoDuck is a MD so I listen to his opinion as I listen to my MD’s opinion and I do not pretend to “know” on this topic, I just “listen” …so it is a good thing that you point to different links to inform us but please do not go as far as pretending there is only one side to science -happily I know this is not your position about science!-)
Hopefully, there is one scientific truth, even if we haven’t arrived at that truth yet.
however, my reading of the data and medical interpretations of it, from all the links reviewed here, is that science has decided the test is worse than useless. if you are not convinced by the science and the scientists opinions, so be it. We can only offer.
You can cite people who were helped by prayer or crystal ball readers or the PSA test, but that does not make prayer or crystal balls or the PSA test reliable.
IMHO.
By the way, MDs and PSA test labs have profited $billions on this fraudulent test, and will probably be reluctant to give it up despite all the scientific evidence to do so.
Actually I’m not 
It’s MBChB over here.
Cool!
More letters means you must be better than a simple MD. 
Scott
shrugs
Another view
Here is another view:
Scott
My PSA has been increasing these years, with it recently crossing the recommended threshold. At the specialist office, I asked if my daily unicycling could raise the PSA level. He immediately said no, that it would not impact the results. Later, I think I remembered reading this tread, and took a week off riding before the follow-up PSA test. Low and behold, my PSA dropped lower than it had been in the last few years of my riding a unicycle, now well below the threshold of interest. Same trend in results that PBOly had who started this topic. I’ll see if my general doctor can order another in another week of my non-riding just to see how the PSA reduction results hold up.
I do have particular odd way of riding my 36" uni. While riding straight, I like to zig-zag the wheel out to right and left, resulting in my banking right and left as I ride along, It is both challenging and fun for me. I’m sure this mode of riding grinds at the prostate which probably especially raises the PSA level.
Nope. Never going to ask my doctor to check my PSA-level, 'cause if my levels are rising she will threaten me to quit unicycling before I fall off and kill myself.
Well, here we are 10 years later. My PSA is still in the normal range every year for my annual labs. I always avoid riding for about 1 week before the lab test. My prostate has never been an area of concern since.
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That is great news PBOly, thank you for the update.