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gowrestle

PSA

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Prostate-specific antigen, or PSA. Guys, if yer over 50, Get It Checked! And don't forget the palpation, very important.

(sage advice from the Medicine_Man)

 

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PSA screening actually isn’t recommended these days just so everyone knows

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PSA screening actually isn’t recommended these days just so everyone knows

Oh really?  So what's the alternative to early detection of prostate cancer?

 

 From Mayo Clinic:  "Prostate cancer screening can help identify cancer early on, when treatment is most effective. And a normal PSA test, combined with a digital rectal exam, can help reassure you that it's unlikely you have prostate cancer.

But getting a PSA test for prostate cancer may not be necessary for some men, especially men 70 and older."

 

https://www.mayoclinic.org/diseases-conditions/prostate-cancer/in-depth/prostate-cancer/art-20048087

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Oh really? So what's the alternative to early detection of prostate cancer?

 

From Mayo Clinic: "Prostate cancer screening can help identify cancer early on, when treatment is most effective. And a normal PSA test, combined with a digital rectal exam, can help reassure you that it's unlikely you have prostate cancer.

But getting a PSA test for prostate cancer may not be necessary for some men, especially men 70 and older."

 

https://www.mayoclinic.org/diseases-conditions/prostate-cancer/in-depth/prostate-cancer/art-20048087

I think he’s suggesting that the blood test for PSA can be unreliable. Not the imaging/probing typically done in a prostrate exam. I imagine that PSA could give a lot of false negatives or positives. What’s the point of a blood test if it’s so unreliable that you should always couple it to imaging and a biopsy of anything that looks suspicious?

 

Now if during the exam you find a growth. That’s when I think you have trouble with a capital T that rhymes with P and that stands for ...

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Oh really?  So what's the alternative to early detection of prostate cancer?

 

 From Mayo Clinic:  "Prostate cancer screening can help identify cancer early on, when treatment is most effective. And a normal PSA test, combined with a digital rectal exam, can help reassure you that it's unlikely you have prostate cancer.

But getting a PSA test for prostate cancer may not be necessary for some men, especially men 70 and older."

 

https://www.mayoclinic.org/diseases-conditions/prostate-cancer/in-depth/prostate-cancer/art-20048087

 

PSA use for screening of prostate cancer has a grade D from the USPSTF, meaning that the service outweighs the benefit and that it's not a recommended test. Reasons for this could be unnecessary biopsy or a surgery like a radical prostatectomy for elevated PSA, which can lead to complications like incontinence, infertility, and impotence. Research has shown it's an ineffective way to screen. PSA is a tumor marker used to which is better used for follow up post resection to follow recurrence.

 

https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/prostate-cancer-screening

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PSA use for screening of prostate cancer has a grade D from the USPSTF, meaning that the service outweighs the benefit and that it's not a recommended test. Reasons for this could be unnecessary biopsy or a surgery like a radical prostatectomy for elevated PSA, which can lead to complications like incontinence, infertility, and impotence. Research has shown it's an ineffective way to screen. PSA is a tumor marker used to which is better used for follow up post resection to follow recurrence.

 

If you think they ever do biopsies based solely off of a psa test, you're very mistaken. It's a screening tool, meaning it helps to tell if you're at risk. And yes it's more reliable as a way to follow progress of the disease or the recovery, but it is still used often as a way to HELP tell if someone is at risk. If there's a false positive, they follow up with other methods of testing before any biopsy is done. Unless of course you have the worst doctor in the world.

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I think he’s suggesting that the blood test for PSA can be unreliable. Not the imaging/probing typically done in a prostrate exam. I imagine that PSA could give a lot of false negatives or positives. What’s the point of a blood test if it’s so unreliable that you should always couple it to imaging and a biopsy of anything that looks suspicious?

 

Now if during the exam you find a growth. That’s when I think you have trouble with a capital T that rhymes with P and that stands for ...

Depends on how old you are. If a male and you live long enough you will get prostrate cancer. Its a slow growing cancer, so if you get it at 75, 80 etc. you'll probably out live it and die from something else. Now if 40, you'd better take care of it, and there's plenty of success these days if spotted early. Edited by ionel

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PSA use for screening of prostate cancer has a grade D from the USPSTF, meaning that the service outweighs the benefit and that it's not a recommended test. Reasons for this could be unnecessary biopsy or a surgery like a radical prostatectomy for elevated PSA, which can lead to complications like incontinence, infertility, and impotence. Research has shown it's an ineffective way to screen. PSA is a tumor marker used to which is better used for follow up post resection to follow recurrence.

 

If you think they ever do biopsies based solely off of a psa test, you're very mistaken. It's a screening tool, meaning it helps to tell if you're at risk. And yes it's more reliable as a way to follow progress of the disease or the recovery, but it is still used often as a way to HELP tell if someone is at risk. If there's a false positive, they follow up with other methods of testing before any biopsy is done. Unless of course you have the worst doctor in the world.

 

I explained above why it's a grade D. It's not recommended as a screening tool and one of the reasons was elevations were helping lead to things like unnecessary biopsies, which lead to further complications. It's all in the research the USPSTF put together in order to make it a grade D recommendation. I did not say above that PSA was used to purely determine biopsy, but research has shown conclusively that the risks outweigh any benefit. Please go look further, but I'm pretty confident in what I'm laying out here seeing as that's what medical education teaches 

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I explained above why it's a grade D. It's not recommended as a screening tool and one of the reasons was elevations were helping lead to things like unnecessary biopsies, which lead to further complications. It's all in the research the USPSTF put together in order to make it a grade D recommendation. I did not say above that PSA was used to purely determine biopsy, but research has shown conclusively that the risks outweigh any benefit. Please go look further, but I'm pretty confident in what I'm laying out here seeing as that's what medical education teaches 

But you did not answer my second question

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But you did not answer my second question

Meaning what alternative is there for screening? There’s no current recommendation to screen for it because of what I’ve essentially outlined. PSA screening hasn’t been shown to improve mortality and puts people at a higher risk than having an assymptomatic elevation. Obviously if someone is having symptoms concerning for a mass or a prostatic growth, than your management may change, but that’s not an asymptomatic screening test at that point. Basically if you’re an older male it’s not required or recommended to get a PSA done. You can obviously talk to your doc about it and the grade D rec can be outlined, and you can still likely decide to do it, but it isn’t something your primary care provider should coerce you to do

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