This forum is for the discussion of anything to do with Prostate Cancer. There are only four rules:
No fundraisers, no commercials (although it is OK to recommend choices of treatment or medical people based on your personal research; invitations to participate in third-party surveys are also acceptable, provided there is no compensation to YANA);
No harvesting e-mail addresses for Spam;
No insults or flaming - be polite and respectful at all times and understand that there may be a variety of points of view, all of which may have some validity;
Opinions are OK, but please provide as much factual evidence as possible for any assertions that you are making
Failure to abide by these simple rules will result in the immediate and permanent suspension of your posting privileges.
Since this is an International Forum, please specify your location in your post.
That sounded interesting to me too so I looked it up. Here's the question and answer.
Q: I am 55. My father died of prostate cancer at 71. I am surprised that my doctor relies exclusively on my PSA and does not also perform a digital exam of the prostate. Is a PSA alone proper medical procedure? — Jas
A: We increase the ability of screening to diagnose prostate cancer by using both. Men with low PSA levels may have aggressive cancer. In fact, the more aggressive the cancer, the less likely that the PSA level will be elevated. The cells are so undifferentiated that they don’t make a lot of PSA. Men with low testosterone also cannot make PSA well. The digital rectal exam helps us make a decision about whether men should be biopsied. The two tests together are better than either one alone.
There are three issues about PSA that are often not clearly stated:
1. PSA is NOT prostate cancer specific: a high PSA does not mean that the man definitely has cancer: a low PSA does not mean that he does not have cancer.
2. If we use the current ‘trip wire’ of 4.0 ng/ml that usually triggers a biopsy, often without any observation to see if such an ‘elevated’ reading is due to any other cause, then we know that there are at least as many men who would be diagnosed with PCa with a PSA lower than 4.0 ng/ml as there are men who have a PSA higher than this.
3. There is a form of very aggressive prostate cancer that generates very little PSA. There are many theories as to why this is so, none of which I find particularly convincing, but it is still a fact. It is one of the reasons that an annual DRE (Digital Rectal Examination) is so important because these types of tumours, aggressive as they are, grow very rapidly and can therefore be detected by manual examination.
Hope this helps a little to understand another aspect of this very complex subject. It has always seemed to me that one of the reasons that these items do not receive much publicity is because of the vested interests in PSA testing and screening which generates billions of dollars each year and prevents the development of a better, more precise, more PCa related test.
Interesting enough, my PSA of 4.8 yielded a Gleason of 9 however, if you arrange all YANA members by lowest to highest PSA, using 4 and below as a low PSA and 7 and above as a high Gleason, out of 115 individuals, 32 fell into this category or 28%. Not having a real benchmark (I don't think there is one) its noteworthy based on these small numbers, if projected out will hover around that same 28%. The percentages are based on "x" number of guys from Australia, England, Whales, U.S., etc. I think if you applied this approach to Japan, China, etc., it would not be close to the 28%.
