To Take Or Not To Take .......... a PSA Test.

[thequietman]

Hi guys,

 

I am at that magical age of 50 where things begin to change regarding health and such. I had some flow issues beginning 4 years ago at 46 years young, and have had yearly DE examinations and utlra-sounds with my urologist. All appears fine, but the prostate is growing a little bigger each time.

 

Now is the time for a PSA test and I am unsure, if it is the right move for me. I have been reading that the NHS doesn't advise such a test due to the results being not terribly reliable. I have read the studies being done, and recently America has also been suggesting that the test creates more issues than it solves.

 

To be clear, I am one of those people who constantly worries and if I get a pain, I immediately think it's the worst thing possible. I hate myself for thinking like this. I have been taking blood tests for the past 4 years to check on the usual cholesterol, blood count, glucose, etc, and all are within range.

 

My enlarged prostate doesn't really give me issues apart from reduced flow and dripping after I urinate. I am hoping it is BHP and that medication can fix it for me. I haven't started taking drugs for it because it doesn't really affect my day to day life. However, I am caught up in the PSA test dilemma. 

 

My father was diagnosed with prostate cancer quite recently at the age of 69, but is now on the mend after treatment. This is when my worries began and have never gone away.

 

If I don't take it and get the enlargement treated, I will always be thinking that it's something more. If I do take the test and I get an elevated score, I am not sure if I can handle the situation. If I take the test and get a  'normal' range, then this doesn't guarantee me that everything is OK anyway. It's confusing and worrisome.

 

I know most people on here are quite senior and have gone through this test regularly. Were you apprehensive like me, is it something that you worry about, did you put it off until much older?  Thanks for any input.

Edited May 7, 2020 by thequietman

[stouricks]

The majority of men with prostate cancer die WITH it not BECAUSE of it. Stop worrying and have a beer.   PML

[Tropicalevo]

Personally, I believe that it is useful to take the test regularly just to have something to measure life by. However, if you are a worrier - maybe not. It does not really tell you much other than you probably have an enlarged prostrate and you already know that.

High PSA does not mean that you have prostate cancer.

I have had high PSA for the last 9 years. Gradually increasing with every test. (I am 69)

Doctors here kept saying - have a biopsy.

Doctor friend of mine said - only as a last resort. You are putting wounds into your prostate and that can cause problems! (He also recommended testing for 'free PSA'. More accurate.)

I had a number of MRI's (more accurate than the PSA test) and the docs in Bangkok eventually said that there was a worrying 'spot' on my prostate and it was getting larger. So I had a biopsy.

All clear except that the wounds bled on and off for two years! They did not warn me about that.

Now I have stopped all tests etc and I monitor myself by the timings inbetween nocternal bathroom visits. Recently up to once every hour, on the hour.

I have just started taking doxazosin. After one week - best night's sleep for years. 4 hours before the bathroom visit.

BUT everyone is diferent. The comment above by stouricks is very relevant.

The majority of men over 70 have prostate cancer. Most do not die because of it. Doctors call it 'the friendly cancer'.

[Aforek]

What do you call " PSA test " ? Blood test ? it's nothing  and gives informations ( over 10 or 11 of PSA you can be anxious, enlarged is from 4-5 , not dangerous at this stage ) 

I got an operation for enlarged prostate 11 years ago and this year my PSA is 5.1 which is normal for a man of my age ( 70 years old ) 

a rectal exam is a good test, an urologist is able to say if prostate is big and has cancer ( not same consistance ) ; I got also a biopsy  11 years ago because PSA of 8 ( but no cancer ) 

 

enlarged prostate doesn't lead to cancer, it's not the same problem 

from my opinion, you can't have an enlarged prostate and a cancer in the same time 

[stouricks]

30 minutes ago, Tropicalevo said:

I have just started taking doxazosin. After one week - best night's sleep for years

Strangely, I have just STOPPED taking doxadosin because one of the possible side effects is rhinitus ie stuffed up nose. I could not sleep because of that, after a couple of years taking it. My nocturnal visits have not come back yet, but my nose is fine.

[Sheryl]

Some elevatioon in PSA is to be expected with benign enlargement so may not be realistic to expect a totally normal score. The "normal" range does nto take age related BPH into account.

 

What is important is, if it is elevated, how much elevated and how fast does it rise over time.  Very high levels e.g. over 100  are unlikely to be due to BPH alone, and rises in BPH will not be rapid but rather very gradual.

 

It is a useful tool (especially for someone with family history of prostate cancer) but needs to be interpreted together with clinical signs and history i.,e. it is not a do-it-yourself thing that you can just compare to a chart. Skill and experience of your urologist and having a urologist you can talk things out with very important. Where do you live?

[Phil McCaverty]

4 minutes ago, Sheryl said:

Some elevatioon in PSA is to be expected with benign enlargement so may not be realistic to expect a totally normal score. The "normal" range does nto take age related BPH into account.

 

What is important is, if it is elevated, how much elevated and how fast does it rise over time.  Very high levels e.g. over 100  are unlikely to be due to BPH alone, and rises in BPH will not be rapid but rather very gradual.

 

It is a useful tool (especially for someone with family history of prostate cancer) but needs to be interpreted together with clinical signs and history i.,e. it is not a do-it-yourself thing that you can just compare to a chart. Skill and experience of your urologist and having a urologist you can talk things out with very important. Where do you live?

I tested at a level of 10 at age 55. I subsequently underwent 2 years of treatment for prostate cancer.

 

The NHS subsequently raised the trigger level to 10 but have now reduced it back to 4. More than 4 get a DRE by a specialist.

[bkk6060]

My father had P cancer also.

My experience is lifestyle is a big factor with the test results.  Are you fat, drink, sit on your butt all day no exercise?  Do you ejaculate frequently 3 to 4 times a week?

Again, from personal experience sitting around sexless can raise the PSA.

Also, drink lots of water before your test.

 

 

Edited May 7, 2020 by bkk6060

[Captain Monday]

wrong area

 

 

 

Edited May 7, 2020 by Captain Monday

[Phil McCaverty]

Just now, bkk6060 said:

My experience is lifestyle is a big factor with the test results.  Are you fat, drink, sit on your butt all day no exercise?  Do you ejaculate frequently 3 to 4 times a week?

Again, from personal experience sitting around sexless can raise the PSA.

Also, drink lots of water before your test.

 

 

Completely wrong. To get an accurate reading from a PSA test you must abstain from all forms of sexual activity for one week.

[Phil McCaverty]

1 minute ago, Captain Monday said:

Another illegal cargo flight from Singapore!

Thank you China Cargo, operated by China Airlines based in Taipei.

Did the pilot have prostate cancer?

[Lacessit]

I have BPH according to my urologist. I take saw palmetto capsules, which he says works for 50% of his patients. I must be in the right 50%.

My GP does not seem to be concerned about my PSA level, which apparently increases by 0.1 units each year. As Sheryl says, it's the rate of increase to watch out for, so the OP would need to first start the baseline.

Statistically, priests and other males who practice celibacy have higher levels of prostate cancer, so the OP might want to shift the odds in his favor.

 

[bodga]

6 hours ago, Tropicalevo said:

Personally, I believe that it is useful to take the test regularly just to have something to measure life by. However, if you are a worrier - maybe not. It does not really tell you much other than you probably have an enlarged prostrate and you already know that.

High PSA does not mean that you have prostate cancer.

I have had high PSA for the last 9 years. Gradually increasing with every test. (I am 69)

Doctors here kept saying - have a biopsy.

Doctor friend of mine said - only as a last resort. You are putting wounds into your prostate and that can cause problems! (He also recommended testing for 'free PSA'. More accurate.)

I had a number of MRI's (more accurate than the PSA test) and the docs in Bangkok eventually said that there was a worrying 'spot' on my prostate and it was getting larger. So I had a biopsy.

All clear except that the wounds bled on and off for two years! They did not warn me about that.

Now I have stopped all tests etc and I monitor myself by the timings inbetween nocternal bathroom visits. Recently up to once every hour, on the hour.

I have just started taking doxazosin. After one week - best night's sleep for years. 4 hours before the bathroom visit.

BUT everyone is diferent. The comment above by stouricks is very relevant.

The majority of men over 70 have prostate cancer. Most do not die because of it. Doctors call it 'the friendly cancer'.

That friendly  cancer is  not friendly at  all, my Father died in agony with it at 85, his last 12  months  were marked with bouts of screaming pain every 3-4  minutes, something I'll never forget. Pain relief did  nothing for him, I was very disappointed with that, all it did was made him  hallucinate.

He  got it at 69 years old, I  still shed a tear thinking about his last 12 months and worry for my own later years as his  Father too had the same although  I look and take  after my Mother it may give me a  miss.

[Sheryl]

1 hour ago, Phil McCaverty said:

I tested at a level of 10 at age 55. I subsequently underwent 2 years of treatment for prostate cancer.

 

The NHS subsequently raised the trigger level to 10 but have now reduced it back to 4. More than 4 get a DRE by a specialist.

 

Should get DREs routinely anyway.

[Sheryl]

1 hour ago, Phil McCaverty said:

Completely wrong. To get an accurate reading from a PSA test you must abstain from all forms of sexual activity for one week.

 

Not a week. 48 hours

 

https://www.nhs.uk/common-health-questions/mens-health/why-should-i-avoid-sexual-activity-before-a-psa-test/

 

Fortunately...if it were a week there would be a lot fewer men able to get it

 

Shouldn't do any bike riding before the test, either, and serious bikers might need to wait as much as a week

[rodknock]

yes get the blood test.

[rodknock]

is there a lab near soi. 50 where i can get a psa test?

[4MyEgo]

8 hours ago, thequietman said:

Now is the time for a PSA test and I am unsure, if it is the right move for me. I have been reading that the NHS doesn't advise such a test due to the results being not terribly reliable. I have read the studies being done, and recently America has also been suggesting that the test creates more issues than it solves.

I don't know if anything I am writing down is going to help, or any of my symptoms are similar to your, I too am a worrier when it comes to health.

 

When I was 50, I visited my doctor and told him that I was peeing too frequently, he asked me to write down every time I peed over the next 24 hours and then go back and see him, I was surprised to see that I wrote down 15 times in the 24 hour window. He put me onto a drug called Flomaxtra and I was on it for 3 years, was still peeing a lot and a mate of mine noticed me going to the toilet a lot when we were out, and I told him what was going on and he said, mate, just tell the Dr you want to see a Urologist as the drug isn't working, and I did, now this seems the opposite to what you are experiencing, e.g. your peeing less.

 

The above said I saw a Urologist soon after and he wrote the below letters to my GP which I copied and pasted, the first one was in:

 

March 2014.

 

Thank you for referring this 53 year old gentleman with a several year history of lower urinary
tract symptoms, consisting of frequency and nocturia.

 

His prostate symptom score is relatively
low at 8, but his nocturia is particularly irritating to him. He denies any urinary tract symptoms
and has no family history of prostatic malignancy.

 

He has been on Flomaxtra for nearly 3 years without significant benefit.

 

His rectal examination today demonstrated a small benign feeling prostate gland.

 

I agree further evaluation of his urinary symptoms is warranted. I have organised to check a
urine culture and PSA today and will obtain a flow rate and perform a flexible cystoscopy next
week.

 

The following week I went back and he performed the flexible cystoscopy, which if you not up to speed with it, its a camera put through the eye of your tiger, not a nice feeling, but goes in a long way and you get to see where it goes on the TV, a kind of surreal feeling.

 

From memory I think he said I had an enlarged prostate and recommended a UroLift procedure as opposed to tablets, stating that the tablets would work but I would probably be dead in 10 years which was alarming, however he said, if you were 70, I would recommend them but as your young and fit, the procedure is the way to go, so I booked myself in.

 

May 2014 

 

I reviewed the patient in the rooms today. He has had an excellent result following the recent
placement of the UroLift device. He has a great flow without any hesitancy. He does have some
urinary frequency but I am sure this will improve over time.

I don’t think there is need for any anticholinergic medication just yet.

 

I will review him again in 6 months time though I would be happy to see him sooner should the need arise.

 

November 2014 

 

The patient maintains an excellent result following his Urolift procedure. He has an excellent
flow rate with complete bladder emptying.

 

His formal flow rate today was measured at
23cc with no significant post void residual.

 

I have reassured him accordingly.

 

I have suggested reviewing him again in 6 months time.

 

June 2015

 

I reviewed the patient in the rooms today. He maintains an excellent response following the
Urolift procedure last year.

 

He has an excellent flow rate and complete bladder emptying.

 

His urine culture was acellular and sterile and his serum PSA remains very low at 0.32. His
post void residual today was excellent at just 30cc.

 

I have suggested reviewing him again in 12 months time.

 

May 2017

 

I reviewed the patient in the rooms today. It is now 3 years since his Urolift procedure.
Pleasingly he maintains an excellent result with good flow and complete bladder
emptying. His rectal examination today demonstrated a small benign prostate gland
and his serum PSA remains very low at 0.31. I have reassured the patient accordingly.

 

He now lives overseas as you are aware and returns about every 2 years. I have suggested
seeing him again in 2 years time for a further prostate check.

 

October 2019 

 

I did see the Urologist last year and don't have the letter to my GP, but know he was pleased as usual.

 

I go to the toilet for a pee once in the early hours of the morning and then again when I wake up, major improvement to before as I used to go at least half a dozen times, and my sleep was always disturbed.

 

The above said I always get a PSA test down as the Urologist stated that that is the first sign of any problems.

 

It may well be that you need a UroLift procedure like I had ?

 

Hope the above helps, also I don't think enlarged prostates necessarily mean you end up with cancer. 

 

Google:

 

Benign prostatic hyperplasia—also called BPH—is a condition in men in which the prostate gland is enlarged and not cancerous. ... Benign prostatic hyperplasia often occurs with the second growth phase. As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker.

 

 

[moe666]

Take the test no big deal, a few years ago things didn't feel right took the test, damn scored a 10. Started some research 10 or over 50 percent chance you have cancer. Started on double dose of finisteride and prostate support a NOW company product doybled the dose of this. One month later retook the test down to 1.5 cut back on all supplaments. No problem since stay on finisteride and the prostate support

[Sheryl]

2 hours ago, rodknock said:

is there a lab near soi. 50 where i can get a psa test?

 

If you mean Soi 50 Sukhumvit in Bangkok, RSU

 

https://rsuhealth.com/en/home-en/

 

While website lists only packages it is possibel to walk in and get individual tests, I have done it