PSA test and digital exam.

[datzenmike]

Gentlemen, yesterday was my semi annual physical which includes a PSA blood test and a digital exam. I urge anyone 50 and older to have this done at least every 5 years, possibly sooner as you age. This is about the only way to early detect prostate cancer and keep track of it. Most men develop this type of cancer sooner or later in life but it is so slow acting that we usually die of old age first... a comforting thought. In some cases cancer is more aggressive and this test can show a sudden increase in PSA which will alert a doctor to look into this more carefully. Obviously you need a base line reading to compare so get it done. I believe the test is now a ridiculously low $15. I remember when it was 10X that. The rectal exam takes about 4 seconds, or about the same time as sex with my first girlfriend, and from experience, there's not much difference between a man or woman doctor's finger. Go into this with a positive outlook. If you feel you should be embarrassed you can try that, but hell, by 50 you should have had enough life experience to find it underwhelming at best. I did, even with a woman doing it.

We all have one so get it checked.

[Byron510]

Good words to live by Mike. Our mutual friend Art diagnosed his prostate cancer early as well, gave him 15 more years with us that I was quite thankful for. Art passed on the importance to a much younger me how important it is to simply watch yourself, take note and act immediately when something is not right.
You're a wise man Mike, and will live long because of it.

Byron

[defdes]

I always thank my lucky stars for my Japanese doctors small, delicate fingers.

[StrutlessWonder]

Gentlemen, yesterday was my semi annual physical which includes a PSA blood test and a digital exam. I urge anyone 50 and older to have this done at least every 5 years, possibly sooner as you age. This is about the only way to early detect prostate cancer and keep track of it. Most men develop this type of cancer sooner or later in life but it is so slow acting that we usually die of old age first... a comforting thought. In some cases cancer is more aggressive and this test can show a sudden increase in PSA which will alert a doctor to look into this more carefully. Obviously you need a base line reading to compare so get it done. I believe the test is now a ridiculously low $15. I remember when it was 10X that. The rectal exam takes about 4 seconds, or about the same time as sex with my first girlfriend, and from experience, there's not much difference between a man or woman doctor's finger. Go into this with a positive outlook. If you feel you should be embarrassed you can try that, but hell, by 50 you should have had enough life experience to find it underwhelming at best. I did, even with a woman doing it.

We all have one so get it checked.

Hi Mike,

Glad your exam went well, but I disagree.
As a Primary Care Physician by day, I feel I need to add my 2 cents. I talk about this stuff with my patients every day.

Cancer screening tests (or any screening test) are designed to catch something early, before it is clinically detectable, to save lives without causing significant harm, and at a reasonable cost.
Think PAP smears to detect cervical cancer, Mammograms to detect breast cancer, colonoscopies to detect colon cancer, etc.

PSA testing and digital rectal exams have come under scrutiny as screening tools in patinets without symptoms and without and family history of prostate cancer.
The latest 2012 evidence-based recommendation from the US Preventative Services Task Force: Recommends AGAINST routine PSA screening at age 50.

http://www.uspreventiveservicestaskforc ... eening.htm
"Based on this work, the Task Force concludes that many men are harmed as a result of prostate cancer screening and few, if any, benefit."
"A better test and better treatment options are needed. Until these are available, the USPSTF has recommended against screening for prostate cancer. "

This is because the treatment for prostate cancer is often worse than the disease, the decision to have a digital rectal exam (DRE) and a PSA needs to be clearly explained and the consequences of a positive test clearly discussed. My grandfather (a physician) was diagnosed with prostate CA in his 80s. After treatment he was impotent, had to wear a diaper, and had chronic rectal pain. He lived to 96. If his prostate CA had been untreated he still might have lived to 96, and he would not have had the other problems or pain. His son (my uncle, also a physician) is 77, has prostate CA, and is doing nothing about it. He has no symptoms, feels great, and will likely die of something other than his prostate cancer. I don't know Art's history, symptoms, or exact diagnosis. Maybe it saved his life, or maybe he would have lived to the same age even if he hadn't been diagnosed and treated.

You are 100% right that most prostate cancer grows slowly, and most men die from old age before they succumb to their prostate cancer.
In fact, if you analyzed prostates from 95 y/o men, nearly every one would have prostate cancer in them.
The problem is that we cannot currently predict with great certainty how to better detect the "deadly" prostate cancers in men without symptoms. Maybe someday.
Now if you have any family history of prostate cancer, or symptoms suspicious for prostate cancer, that's a different story. Then you should get tested.
And if you have had prostate cancer, then routine follow-up DREs and PSAs may be indicated.

Now back to Datsuns.

[datzenmike]

Yeah I read that about the states. Yes there are false positives but haven't heard anything about false negatives. Here we screen and keep a watchful eye on future developments. Presumably only when several markers indicate a problem is a bi-opsy done to test for malignancy. Then it is up to patient and doctor to discuss if the situation is dire, or can you afford to run the clock out.

$15 for some peace of mind or worry year after year if you'll end up like Frank Zappa.

[butters68]

cost me $30 bucks 4 month ago