Psa

[Bazile]

I was chatting to a friend who had his prostate removed = the PSA reading was 7 + if i remember rightly .
He is always advising people to have the test done

Another person i know had a reading of 4.34

It got me wondering about PSA readings .
Would a reading of 4.34 warrant further investigations ?

[Buenchico]

Start here:
https://www.nhs.uk/conditions/prostate-cancer/should-i-have-psa-test/

[1581960]

I believe a single PSA test is not at all reliable, repeated testing over a period of time showing increased readings would be more concerning.

[bhg481]

I've seen 3 different doctors in our practice over the years (1 man and 2 women) and all 3 have the opinion that they're so unreliable that they didn't think there was any point, although they would happily let me have one if I wished. I had one which was normal and have never bothered since but I do have the finger test.

[Sqad]

I agree with the posts of all three above.
No PSA of 4.34 would not warrant further investigations UNLESS.there were associated signs and symptoms of prostate problems....e.g urgency, dribbling, poor urinary stream.

[sunny-dave]

I agree with sqad - I looked closely into the research on PSA testing when I was working in the NHS - we were considering a local initiative - eventually binned because of lack of good evidence of efficacy/accuracy of the test.

I wouldn't have it done myself unless I had some fairly compelling physical symptoms - far too much chance of 'over-diagnosis' followed by ghastly angst and potentially unnecessary treatment.

[goodgoalie]

Notoriously unreliable test. You can have a raised PSA and not have cancer (three-quarters of men with a raised PSA do not have cancer), and a non-raised PSA and have cancer. It is advised that otherwise well men with no classic symptoms ( pain when peeing, having to get up often in the night to pee, or urgency to pee) should not get a PSA test.
I wouldn't - can lead to unnecessary unpleasant further investigations. Most men with prostate cancer will die with it, not of it.
Of course, if you do have any of symptoms above, see your GP immediately.

[Sqad]

goodgoalie.

"Most men with prostate cancer will die with it, not of it."

Are you MAD??....nonsensical statement.

[sunny-dave]

I think gg's statement is shorthand for

"you will find more cadavers with asymptomatic prostate cancer, than you will find cadavers where the prostate cancer was the cause of death".

[Arrods]

I had the PSA test under the 'old system'. I had a reading higher than hitherto (7 I think) - but it was taken immediately after I had been to the gym. Now understand that the advice was to refrain from undue physical activity before the test.

[goodgoalie]

Exactly, dave. Thanks

[goodgoalie]

This from the website of the American Cancer Society:
"Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today."

[Sqad]

goodgoalie/ dave.

You are quite correct and my response to goodgoalie was OTT and precipitous.

I thought that you meant the survival rate, without treatment.

My apologies goodgoalie.

[tinkerbell23]

I can help you! I give people their prostate biopsy results xx

[sunny-dave]

You keep that latex-clad finger to yourself, Tinks !!!

[tinkerbell23]

Agree with others that 4.3 isnt high.

We advise not to test a PSA when you have any sort of ongoing infection, and refrain from vigorous exercise, cycling & ejaculating a week before testing your PSA.

It may be different in England but your friend sounds as if he has had a higher grade/volume of disease and had a biopsy to warrant this removal.

PSA getting to 10 we investigate for sure.... over 20 we would be investigating & requesting a bone scan to rule out any spread. Xx

[tinkerbell23]

Dave i dont do the “dirty work” lol... i just deliver the “significant news” and counsel on treatment options & start the ball rolling!!!!

Xxxxxxx

[tinkerbell23]

One more thing , we recommend prostate cancer UK if you wish to read up x

[Peter Pedant]

// I thought that you meant the survival rate, without treatment. //

Prof Stansfeld taught us in the seventies that if you dissected any eighty old you would find an average of three tumours ( not benign) not doing an awful lot
so I can easily see that men die with ca pr and not from it

no one has mentioned PPV
positive predictive value
if the test is up - what is the chance of having ca pr ?

3 Mar 2012 - Overall, the positive predictive value for a PSA level >4.0 ng/mL is approximately 30%, meaning that slightly less than one in three men with an elevated PSA will have prostate cancer detected on biopsy [63–65].

as a screening test - pretty crap

[tinkerbell23]

As a general rule we advise that

60% of 60 year olds
70% of 70 year olds
80% of 80 year olds

Etc.... would have some form of prostate cancer...

Of those % ‘s only 3% would die from it x

[goodgoalie]

Thanks, Tinkerbell, reinforces my point, about which Sqad was so rude.