PSA – To test, or not to test for Prostate Cancer?

Coffin Cartoon
* See note below on Cartoon

There is an ongoing debate amongst some academics, politicians and doctors as to whether routine screening for prostate cancer using the simple PSA blood test is necessary. Their argument is based on numerous clinical studies (some inconclusive or contradictory) that supposedly show that there is no significant statistical survival benefit for men getting regular prostate cancer screening with a PSA compared to those men who did not have a PSA screening.

I remember when I first requested a PSA test in a health checkup from my general practitioner (that ultimately diagnosed my cancer), that he tried to talk me out of it.  “If you have prostate cancer do you really want to know?” he ask me.  “Why wouldn’t I want to know?” I asked?

“Well”, my doctor said, “People usually die with prostate cancer and not from it, and knowing you have prostate cancer causes undue worry and unnecessary treatments”. “Well I think I would want to know”, I persisted.  Fortunately I had that PSA test.

Maybe the clinical studies show statistically that no screening is better for the 5 out of 6 men who are likely to never get prostate cancer. And of the 1 in 6 who will get prostate cancer some will have a slow growing type and will not need immediate treatment.

But what about those guys (like me) who have or will have an aggressive fast growing (life threatening) tumor in their prostate? Although statistically not significant, determining risk and getting treatment early is necessary for longer term survival.

I am still here today because of that initial PSA test at age 51.  If I had had it sooner I may be cancer free today.

So I tell all my friends and those who ask who are over 45 years old to have a regular PSA blood test every year, and if there is any cancer in the family, that testing should commence at 40 years old.

And ignore the statisticians!

STOP PRESS! 25 July 2016
There is a very good article here:
about the latest PSA testing recommendations of the Memorial Sloan-Kettering Cancer Center in America.  It’s a very good article and all guys over 45 should read it.  They also recommend to start testing at 45 years old.  They recommend what action to take depending on your age and PSA result.  The only thing I would add is that instead of testing every 2 years for some age groups that is increased to every year.  (In Australia if you are over 50 yrs old 1 test a year is free on the Health system).



*Note – I hope you like the cartoon introducing this post.  It is based on one by ‘Axeman’, his website is in Links.  It is a joke and no way am I suggesting there is a conscious person i.e. you, me, hanging out in a corpse. We, the living entity, exit pretty fast and, as Socrates put it, it really becomes a matter of “Catch me if you can”! 

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