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Old 01-12-2012, 04:19 PM   #1
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steady rising psa

Husband at dr yesterday, psa reading of 1.5, he is 67 years old

the dr said there may be a concern because it has been a steady increase over the last 5 years.

scared us, but as I'm looking on different message boards I don't know what to think

his readings are. 2007 1.54
2008 1.0
2009 1.1
2010 1.3
and his last reading was 1.5
this looks to me to be well within his normal readings for his age, and wonder why the dr says this is a steady increase???

any thoughts from anyone

tia

 
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Old 01-12-2012, 04:55 PM   #2
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Re: steady rising psa

Hi Tia,
You are right not to worry, especially assuming his DRE was normal? Your husband's PSA is well under any number that should cause concern, and it's quite normal for the PSA to fluctuate a bit. Unless there are other risk factors like a member of his immediate family dying of prostate cancer, there is really no need for him to have an annual reading. You may have read about the recent controversy about PSA screening: your husband's annual (normal) readings and your doctor's and your concern help make their argument against routine screening. I hope you can put it out of your mind.

- Allen

 
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Old 01-12-2012, 05:10 PM   #3
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Re: steady rising psa

thank you for your quick reply. Yes, I did read about the controversy over psa testing and the dr himself said it's an "unreliable" test. this was at the VA center in Tampa and he said the VA requires him to do psa testing. thanks again

 
Old 01-13-2012, 08:22 PM   #4
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Re: steady rising psa

Hi tia,

I'm chiming in to join Allen in reassuring you that that PSA pattern and level look fine, especially for a 67 year old.

I'm thinking the doctor is doing his best to do the right thing but does not have a good grasp of prostate cancer and PSA testing. He is not alone in that, including some of the researchers behind the recent reports who have cast doubt on the value of PSA testing.

Just so you know, the three major trials that have asserted "no benefit found" for PSA testing have had numerous major flaws, with inadequate follow-up time being the critical flaw that utterly prevents any sound assessment whether screening with PSA is making a difference. In short, these trials need about another ten years of follow-up before they may be able to shed light on the key question, assuming the other existing flaws do not invalidate the information. It is sad that so many doctors and medical reporters do not understand this.

The doctor does not appear to appreciate the PSA test for what it is: a general purpose sentry that indicates whether something of concern is going on in the prostate. Most often, when the PSA is rising or elevated, that "something" is BPH - benign growth that so often happens with aging, or an infection/inflammation. Much less often it is cancer. Insisting that PSA be just a test for cancer is like trying to pound a square peg into a round hole. If we understand that values do fluctate somewhat, and if we understand that it does not reflect just prostate cancer, then we can see that it is not an "unreliable" test. Appreciating PSA for what it is enables us to use these results as excellent clues.

One of the key clues is the pattern of increase over time. The pattern for your husband does not look like the "exponential" increase that is the mark of cancer, though sometimes masked at the low levels that your husband has had. Even if it were cancer, which is quite unlikely, it would probably be a very mild kind that would not need treatment, just active surveillance, benefiting from research insights over the past decade. Moreover, your husband's small increases from year to year, including the last increase, are below the increases that guidelines suggest warrant further investigation for cancer, if other things (such as symptoms, DRE) don't raise concern. In my book, the doctor should have pointed out these facts.

All this said, it's a very good thing that the doctor is regularly giving your husband a PSA test, even if it is at the VA's insistence. Good for them!

Take care,

Jim

 
Old 01-14-2012, 01:15 PM   #5
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Re: steady rising psa

thank you too. His DRE was normal too. soft , nothng hard

i appreciate the replies

 
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