A psychologist told me that she analyzed men who have prostate cancer.
Long story short, she found out that men who simply go to the doctor every 4-5 months to make sure that everything's fine are happier than those who did an intervention. The reason lies in the fact that you lose self-confidence when you're impotent and incontinent.
Sounds plausible to me and the results had high statistical significance, therefore I agree to your skepticism.
3+3 is the lowest you can get and 3+4 (what I had) is considered very treatable. Age is important, though, I was in my early 40s when I got the 3+4 result and that was not really something the urologists wanted to just watch. I think the auther was mid 40s maybe, so still not such a great idea to wait until you get urinary tract problems and/or have the cancer metastasize.
'Myth #1 - Prostate cancer is common, but few men actually die from it.
In fact, prostate cancer is the second leading cause of cancer death among men in the United States and claims almost 30,000 lives in the United States each year.'
> Prostate cancer screening did not significantly decrease prostate cancer-specific mortality in a combined meta-analysis of five RCTs. Only one study (ERSPC) reported a 21% significant reduction of prostate cancer-specific mortality in a pre-specified subgroup of men aged 55 to 69 years. Pooled data currently demonstrates no significant reduction in prostate cancer-specific and overall mortality. Harms associated with PSA-based screening and subsequent diagnostic evaluations are frequent, and moderate in severity. Overdiagnosis and overtreatment are common and are associated with treatment-related harms. Men should be informed of this and the demonstrated adverse effects when they are deciding whether or not to undertake screening for prostate cancer. Any reduction in prostate cancer-specific mortality may take up to 10 years to accrue; therefore, men who have a life expectancy less than 10 to 15 years should be informed that screening for prostate cancer is unlikely to be beneficial. No studies examined the independent role of screening by DRE.
This is a hot-button topic, which generates much heat. Most men (>80%) will have prostate cancer by the time they reach age 80 (ie, would be detected if their entire prostate was examined histologically (which is, you may surmise, not generally done). About 13% of men will be diagnosed with prostate cancer during their lifetime. About 2.9% of men will die because of prostate cancer.
Does anybody see the problem? Most men who will have prostate cancer develop will not die because of prostate cancer, but from something else -- and many of these men (most, actually) will have no idea they have or had prostate cancer ---> unless somebody goes looking for it.
A randomized controlled trial of prostate cancer detection using PSA was done in the US (sponsored by the NIH). It did not find any difference in the survival curves in men who were randomly assigned to PSA screening compared to those who were not so assigned. The trial has been criticised.
Obviously any man who had prostate cancer found through PSA testing and was treated and does not die from prostate cancer will be very happy, and convinced that the screening saved their life. But the actual RCT data is more complex, and PSA screening may simply be generating more "business" for urologists and radiation therapists, without providing real medical benefit.
Note that there are similar questions about another hot-button cancer screening topic, mammograms. But that is another chapter!
I had a similar journey although my prostate cancer was detected at age 42 by my family doctor during a routine finger-in-the-butt test at my annual physical. He thought it was “diffusely enlarged”, then PSA test (high), then biopsy (ouch!) revealed a 4+3 Gleason.
Like the author I had a radical prostatectomy but not robotically assisted.
Like everyone in our situation I was scared of the two I’s — incontinence and impotence. Luckily no sign of either one, 8 years out the plumbing is working fine.
The annual follow PSA screening is a bit scary, so far it’s always come back 0 but if there’s any PSA it’s going to be bad news.
All in all I’d recommend PC as a starter cancer — pretty treatable if detected early on and if you have a skilled surgeon you can come out of it fully functional. Age is a big factor, if you’re in your seventies it’s probably best to just watch it, for us young outliers it’s good to get it out.
What can we take away from this if we don't fit into the demographics of typical PSA test subjects (40-70 years old or family history of prostate cancer)?
Does it make sense to request one out of the blue, or is this one of those things that will make your doctor give you funny looks and assume you're a hypochondriac?
I went, for example, because I felt a second or two hesitancy when needing to urinate. See my below comments, which, sadly, have been modded down for whatever reason...
I would say if you have any sort of feeling something isn't right, then talk to your doctor. A DRE alone would probably be enough if you are super worried.
Get the PSA test if your over 45. Just get it. I just went through it as well as a biopsy because the PSA looked fishy. I did the PSA as well as the Free PSA test. I then had a 12-needle core biopsy, which, while unpleasant, let me know I was OK. I need to, as do all men my age (almost 50), get tested yearly. It's not a joke. It's tough to get men into the doctor for anything unless they feel they're dying. Guys, get tested, especially if you have a wife and children. You owe it to them, if not yourself.
A PSA test takes 5 minutes. It's a simple blood draw and you learn the results in two days. Like ovarian cancer for women, prostate cancer is the "whispering death". It's often too late if it's metastasized after it's detected, then your chances are even less. Get the test, doubly so if you are a family man.
My understanding is that the current thought on the utility of a PSA test is mixed at best, because prostate cancer takes a long time to actually threaten your health, so above a certain age, even if you have prostate cancer you're likely to die of something else before the prostate cancer kills you. It's definitely not as simple as "seriously, just get it."
Public health "consensus" is driven often by cost considerations and in this case it might as well be damned. Unlike things like "vaccine refusal", here there is no enormous cost to the society, if more people decide to get tested. If one wants to get a PSA test, he should without worrying about recommendations.
[+] [-] bryanlarsen|9 years ago|reply
It's certainly possible that the intervention saved your life, but I'm highly skeptical. I think it just caused you unnecessary stress and trauma.
"Every old man dies with prostate cancer. Nobody dies from it." is the saying I've heard. Obviously it's hyperbole, but the core is valid.
[+] [-] throwmenow_0139|9 years ago|reply
Long story short, she found out that men who simply go to the doctor every 4-5 months to make sure that everything's fine are happier than those who did an intervention. The reason lies in the fact that you lose self-confidence when you're impotent and incontinent.
Sounds plausible to me and the results had high statistical significance, therefore I agree to your skepticism.
[+] [-] surfmike|9 years ago|reply
[+] [-] zwieback|9 years ago|reply
[+] [-] tadufre|9 years ago|reply
https://www.verywell.com/the-top-ten-prostate-cancer-myths-2...
[+] [-] douche|9 years ago|reply
[+] [-] maxerickson|9 years ago|reply
[+] [-] hadley|9 years ago|reply
— http://www.cochrane.org/CD004720/PROSTATE_screening-for-pros...
[+] [-] bill_from_tampa|9 years ago|reply
Does anybody see the problem? Most men who will have prostate cancer develop will not die because of prostate cancer, but from something else -- and many of these men (most, actually) will have no idea they have or had prostate cancer ---> unless somebody goes looking for it.
A randomized controlled trial of prostate cancer detection using PSA was done in the US (sponsored by the NIH). It did not find any difference in the survival curves in men who were randomly assigned to PSA screening compared to those who were not so assigned. The trial has been criticised.
Obviously any man who had prostate cancer found through PSA testing and was treated and does not die from prostate cancer will be very happy, and convinced that the screening saved their life. But the actual RCT data is more complex, and PSA screening may simply be generating more "business" for urologists and radiation therapists, without providing real medical benefit.
Note that there are similar questions about another hot-button cancer screening topic, mammograms. But that is another chapter!
[+] [-] nathan_f77|9 years ago|reply
Here's a video where he talks about it: https://www.howardstern.com/show/2016/10/4/ben-stiller-goes-...
[+] [-] zwieback|9 years ago|reply
Like the author I had a radical prostatectomy but not robotically assisted.
Like everyone in our situation I was scared of the two I’s — incontinence and impotence. Luckily no sign of either one, 8 years out the plumbing is working fine. The annual follow PSA screening is a bit scary, so far it’s always come back 0 but if there’s any PSA it’s going to be bad news.
All in all I’d recommend PC as a starter cancer — pretty treatable if detected early on and if you have a skilled surgeon you can come out of it fully functional. Age is a big factor, if you’re in your seventies it’s probably best to just watch it, for us young outliers it’s good to get it out.
[+] [-] nop_slide|9 years ago|reply
That is basically how it feels when I recommend Angular to people wanting to try a JS framework.
Happy to hear you are doing okay.
[+] [-] gthtjtkt|9 years ago|reply
Does it make sense to request one out of the blue, or is this one of those things that will make your doctor give you funny looks and assume you're a hypochondriac?
[+] [-] deepwave|9 years ago|reply
[+] [-] ogsharkman|9 years ago|reply
[+] [-] deepwave|9 years ago|reply
A PSA test takes 5 minutes. It's a simple blood draw and you learn the results in two days. Like ovarian cancer for women, prostate cancer is the "whispering death". It's often too late if it's metastasized after it's detected, then your chances are even less. Get the test, doubly so if you are a family man.
[+] [-] x1798DE|9 years ago|reply
[+] [-] aub3bhat|9 years ago|reply
Public health "consensus" is driven often by cost considerations and in this case it might as well be damned. Unlike things like "vaccine refusal", here there is no enormous cost to the society, if more people decide to get tested. If one wants to get a PSA test, he should without worrying about recommendations.
[+] [-] deepwave|9 years ago|reply
[+] [-] lawless123|9 years ago|reply
[+] [-] ogsharkman|9 years ago|reply