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Psa not recommended after 70?

User
Posted 08 Aug 2023 at 01:14

I was told that psa test after age 70 was not recommended. I am 75 and still having psa labs every year. What are your thoughts? Thanks…

User
Posted 09 Aug 2023 at 10:14

I do wish that the medical profession would recognise PSA tests for what they are, which is an EARLY indicator that something MAY be going wrong with a patient's Prostate.

It is a simple and cheap blood test, which, if positive, indicates that further medical tests, such as biopsies or a CT scan, would  benefit the patient, and comply with the NHS obligations under "Duty of Care."

I am a white male, with no history of Cancer in my family, Father, Mother, 3 Brothers and a Sister.  I have had the occasional Kidney Stone - every 20 years or so, but other than that I have never had any problems passing urine, no pain, and I can start and stop the flow at will.

I was 63 years old and at my GP's surgery having blood taken for my annual blood checks - Cholestoleral, LDL, Liver Function Test, when the Phlebotomist asked my "Have you had a PSA test?"

"What's that?" I asked her.

"Its an early indicator for Prostate Cancer." she replied.

"No" I said.

"At your age you should have." she replied

"Well, you're in there!" I replied, looking at the needle in my arm, "Help yourself"

Two days later I was telephoned by my GP's surgery, and asked to come and see my GP.  He informed me that my PSA was 146, and told me that for a man of my age a PSA of 4 was normal. It might NOT be anything to worry about, but there are further tests we need to carry out.

So the process started - DRE from my GP, Biopsies - 12 out of 15 positive, CT Scan, NM Bone Whole Body Scan.

The result was Metastatic Prostate Cancer T3 N1 M1. 

My treatment since then has been Androgen Deprivation (Hormone Therapy). I get a quarterly injection of Leuprorelin, which is now supplemented by a daily 50mg of Bicalutamide in tablet form.

I have my PSA recorded every 3 months before my injection, and my GP and my Oncologist monitor my PSA levels and act accordingly. My PSA has risen in the past year from 3.65 to 4.82.

I had a CT Scan last week, and I am having a MN Bone scan today.

Prostate Cancer does not stop at 70 nor 75 nor 80, and the Medics should know that, and act accordingly

 

User
Posted 09 Aug 2023 at 17:38

We have a bizarre situation with PSA testing.

We have people like Bill Turnbull and now Nick Owen announce that they have Prostate Cancer, and this promotes a rush of white males over 50 (like Messrs Turnbull and Owen) to ask their GP for a PSA test.

Sadly, this is often refused as the Patient does not "meet the Profile" i.e. they are not Asian nor Afro-Caribbean; there is no history of cancer in the male line of the patients family. The fact that they are over 50 is not enough to sway the decision not to allow a PSA test.

On the other side of the coin it would appear that those who are vulnerable - in the Asian and Afro-Caribbean communities - are rather reluctant to volunteer for PSA testing.

Both these scenarios can lead to unnecessary loss of life.

During my 11 years of living with prostate cancer, I have met numerous Urology Consultants, and a few Oncologists. 

4 years ago the Head of Urology in a large hospital in the North West informed me, after reading my notes, that he would never have authorised a PSA test for me. I said "then I would be dead".  

He replied "Perhaps." 

When the "top of the tree" has that attitude, GP's will be reluctant, or even afraid to authorise a PSA test for their patients who do not "tick all the boxes."

18 months after my ProstateCancer was diagnosed, I was diagnosed with Bowel Cancer, following a self-administered Bowel Cancer Screening Test. My Colorectal surgeon said that it was unfortunate that I had 2 different forms of Cancer which occurred one inch apart from each other.

Ten years later I think that I am VERY FORTUNATE to have had both my cancers discovered at an early stage, which allowed Medical Staff to intervene when it mattered. My Bowel cancer had not metastasised through the wall of the bowel, and I had a ten hour operation (Lower Anterior Resection with Ileostomy and stoma) where eight inches of bowel were removed. 8 months later the ileostomy was reversed, and I resumed my full life again. My Bowel Cancer has been removed. I have changed my diet and exercise regularly, and I still complete an annual Bowel Cancer Screening Test. I had a colonoscopy last year, and every inch was clear.

My Prostate Cancer has been managed for 11 years by quarterly injection and a daily tablet, and BY REGULAR PSA TESTING. I have never had to endure any Chemotherapy nor any Radiotherapy for either of my cancers.

I play golf three times a week, cycle to the golf course, and have visited Australia, Thailand, South Africa, Turkey, Spain, Portugal and Morocco.

I am alive, and well and annoying people all over the planet because both my cancers were diagnosed early, through simple (though perhaps messy) tests. 

EARLY DIAGNOSIS SAVES LIVES. 

DENYING PSA TESTS TO MEN OVER 50 CAN RESULT IN DEATHS.

Please, PROSTATE CANCER UK, will you spend some of the money we raise for you in re-educating the Medical Profession that ALL MEN OVER 50 IRRESPECTIVE OF RACE OR COLOUR DESERVE TO HAVE A PSA TEST IF THEY WANT ONE.

Lots of men have are wary of Prostate Cancer testing because of the dreaded DRE. They must be assured that DRE's are a thing of the past.

Perhaps it would be an idea to show men how easy it is to have a PSA test, by recording and then broadcasting someone having a PSA test, and then showing what happens in the Pathology Lab when the blood is analysed.  Both Sky Sports and the BBC are supporters of Prostate Cancer UK. What about showing the recording during a break in a Premier League Soccer match, or an International Rugby match or a Cricket match?

 

User
Posted 09 Aug 2023 at 23:51

I asked my local GP for a PSA test when I was around 52, and they refused, as there were no symptoms. I only asked because my wife was pressing for me to get tested. She does worry a lot about possibilities bless her. GP used the argument, well do you really want to progress to invasive tests if the PSA is raised. Sort of put me off, but surely the objective is to save lives. Anyway he also said if we did everyone that asked, the NHS would be swamped. He stood his ground. To some extent I agree with his point, we all know the NHS is stretched to the limit, and resources are getting more scarce. 

Anyway more recently she started pressing again (I'm now 58). GP again was not keen to allow the test (different GP same practice). It was only after I raised the point I know 2 friends recently of similar age that found they had cancer (no symptoms) by starting at the PSA test. It felt like I had to convince him or pressure him for a test. Eventually he caved.

My first result was PSA 5.1. Had examination at hospital, it wasn't enlarged, but consultant felt it was partly hard. So the process begins.
2nd test 2 weeks later 5.6.
MRI showed 2 lesions, 1 on each side.
After a transperineal, I had the call it was positive and I have stage 2 cancer. There is zero family history of cancer.
To be honest it floored me so much, I didnt really digest much more of the information from the call.
Now awaiting the face to face to discuss with consultant.

Kudos to my wife for being on my case.

 

 

Edited by member 10 Aug 2023 at 00:11  | Reason: Not specified

User
Posted 08 Aug 2023 at 23:23

Just to add my data to the general thrust of the post:

I was diagnosed at 72 [G9, high risk], thanks to psa results that had indicated a trend over several years, sharply rising just before treatment. I had no symptoms, so without the psa results I would now be in deep s***. A DRE showed nothing.

[Current psa <.01]

Jules

Edited by member 09 Aug 2023 at 00:52  | Reason: Not specified

User
Posted 09 Aug 2023 at 01:01
How do you arrive at 'life expectancy for an individual? Is it largely on average projected forward for current age, inherited genes, heart lungs and other life limiting criteria or what, or to get a more realistic assessment, a combination of all these things? Furthermore, is this expectancy span subject to increase with each passing year? Glad I had my first PSA test leading to diagnosis around 70 years of age and feel that by now the locally advanced stage identified then, (beyond the point where the surgeon wanted to operate), would have meant I would not have lived to my current late 86th year. But this means still a long way to go to equal my father's near 100 and mother's 101 life spans. So for a considerable number of men, 70 in my view is too early an age not to be tested.

Barry
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User
Posted 08 Aug 2023 at 07:06

In my opinion, keep having your annual psa tests for life. Prostate cancer is a plague at your age but can be caught early this way. 

User
Posted 08 Aug 2023 at 08:17
You don't say if you have had prostate cancer? If yes the test cut off is irrelevant.

If no, continuing the tests is really dependant on your life expectancy. If it's 20 years then PSA tests are a good idea. If it's 2 years then probably a waste of time.

User
Posted 08 Aug 2023 at 08:56

Well this guy was diagnosed and treated at 75 so keep it going!

Nick Owen reveals prostate cancer diagnosis at 75

User
Posted 08 Aug 2023 at 10:33

Whoever gave you that information is completely wrong. Prostate Cancer is a silent disease. Many men die because of other reasons with undetected cancer than those who die because of it.   

Edited by member 08 Aug 2023 at 13:01  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 08 Aug 2023 at 10:34

As francij says, depends on life expectancy, and as you're from the USA also depends on cost of treatment. Nearly all men get prostate cancer but usually it is so slow growing that it isn't worth treating. If you are 75, living a comfortable life and treatment would bankrupt you and having a cancer inside you would worry you then don't have a PSA test.

Dave

User
Posted 08 Aug 2023 at 19:13

Hi. My psa is elevated at 4.3 and I have bph. I haven’t been diagnosed. By the way I feel I think I may have 10 yrs. I felt the same way when I was 70. There are 2 schools of thought. I opted to continue. 

User
Posted 08 Aug 2023 at 19:32

I agree with all of the posts, thank you. If one is 70 with a life expectancy to 80, and diagnosed at 71 with pca that is not slow growing but aggressive, one could be in a bad situation. I really don’t understand the reasoning. Insurance covers the cost here but even if it didn’t, you may have to go back to work.

 

American Urological Association (AUA) age guidelines: The AUA does not recommend routine PSA screening for men 70 or older or with a life expectancy of less than 10 to 15 years. Screening may be considered in men ages 55 to 69 with the knowledge that it will prevent about one cancer death for every 1,000 men screened.

benefits.

American Urological Association (AUA) age guidelines: The AUA does not recommend routine PSA screening for men 70 or older or with a life expectancy of less than 10 to 15 years. Screening may be considered in men ages 55 to 69 with the knowledge that it will prevent about one cancer death for every 1,000 men screened.

Expert guidelines don't recommend PSA screening in men 70 and older. Because of their more limited lifespan, these men are less likely to benefit from early detection of low-risk cancer. One reason is that there may be simply less time for the condition to become life threatening in most men. "You're facing other competing causes of death, and the likely benefit from treating the prostate cancer—which itself could cause medical problems or even death—is going to be offset by the risk of dying from a medical illnesses such as heart attack, stroke, diabetes, or even another cancer," Dr. Garnick says.

User
Posted 08 Aug 2023 at 19:43

I have never heard so much rubbish in my life, Prostate cancer does not go away at 70 as many a member will tell you .My prostate cancer was diagnosed at 70 after a private medical to renew my 7.5 ton driving licence and was the best thing my doctor done for me. 

I had Brachytherapy at 70 and in remission  at the moment .Maybe ask the doctor or medic that told you this if they will give up life saving treatment once they reach 70. I am 7 years on from prostate cancer treatment  and still have a life to live.

John .

User
Posted 08 Aug 2023 at 19:59

Indeed!

User
Posted 08 Aug 2023 at 21:01

I tend to agree with your opinion. In the UK the cost of treatment is not a factor as it is in the States. I was diagnosed at 71. At 70 my PSA was normal. I am now 84 and cancer free as far as my PSA (<0.003) is concerned. When I was diagnosed my cancer was well contained with very clear margins, I have no other health conditions. A recent health assessment shows that my life expectancy is estimated to be 90+. Had I not been tested would I be writing this? Who can tell? I am pleased I was diagnosed and had prostatectomy. I am lucky I guess to be enjoying life with my wife in all its aspects and three grand children. I think it would be foolhardy to stop testing at 70+ because you can always have an option not to treat.

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 08 Aug 2023 at 21:34

Need to practice copying and pasting.

User
Posted 08 Aug 2023 at 21:38

Mr. Mehta,

You’re spot on. You probably won’t stop at 90. Cheers!

User
Posted 08 Aug 2023 at 23:23

Just to add my data to the general thrust of the post:

I was diagnosed at 72 [G9, high risk], thanks to psa results that had indicated a trend over several years, sharply rising just before treatment. I had no symptoms, so without the psa results I would now be in deep s***. A DRE showed nothing.

[Current psa <.01]

Jules

Edited by member 09 Aug 2023 at 00:52  | Reason: Not specified

User
Posted 09 Aug 2023 at 01:01
How do you arrive at 'life expectancy for an individual? Is it largely on average projected forward for current age, inherited genes, heart lungs and other life limiting criteria or what, or to get a more realistic assessment, a combination of all these things? Furthermore, is this expectancy span subject to increase with each passing year? Glad I had my first PSA test leading to diagnosis around 70 years of age and feel that by now the locally advanced stage identified then, (beyond the point where the surgeon wanted to operate), would have meant I would not have lived to my current late 86th year. But this means still a long way to go to equal my father's near 100 and mother's 101 life spans. So for a considerable number of men, 70 in my view is too early an age not to be tested.

Barry
User
Posted 09 Aug 2023 at 01:22

Old Barry,

16 yrs. is worth annual psa labs. Inspiring stories by you gentlemen well into your 80s, more than likely due to a psa test. All the best.

User
Posted 09 Aug 2023 at 10:14

I do wish that the medical profession would recognise PSA tests for what they are, which is an EARLY indicator that something MAY be going wrong with a patient's Prostate.

It is a simple and cheap blood test, which, if positive, indicates that further medical tests, such as biopsies or a CT scan, would  benefit the patient, and comply with the NHS obligations under "Duty of Care."

I am a white male, with no history of Cancer in my family, Father, Mother, 3 Brothers and a Sister.  I have had the occasional Kidney Stone - every 20 years or so, but other than that I have never had any problems passing urine, no pain, and I can start and stop the flow at will.

I was 63 years old and at my GP's surgery having blood taken for my annual blood checks - Cholestoleral, LDL, Liver Function Test, when the Phlebotomist asked my "Have you had a PSA test?"

"What's that?" I asked her.

"Its an early indicator for Prostate Cancer." she replied.

"No" I said.

"At your age you should have." she replied

"Well, you're in there!" I replied, looking at the needle in my arm, "Help yourself"

Two days later I was telephoned by my GP's surgery, and asked to come and see my GP.  He informed me that my PSA was 146, and told me that for a man of my age a PSA of 4 was normal. It might NOT be anything to worry about, but there are further tests we need to carry out.

So the process started - DRE from my GP, Biopsies - 12 out of 15 positive, CT Scan, NM Bone Whole Body Scan.

The result was Metastatic Prostate Cancer T3 N1 M1. 

My treatment since then has been Androgen Deprivation (Hormone Therapy). I get a quarterly injection of Leuprorelin, which is now supplemented by a daily 50mg of Bicalutamide in tablet form.

I have my PSA recorded every 3 months before my injection, and my GP and my Oncologist monitor my PSA levels and act accordingly. My PSA has risen in the past year from 3.65 to 4.82.

I had a CT Scan last week, and I am having a MN Bone scan today.

Prostate Cancer does not stop at 70 nor 75 nor 80, and the Medics should know that, and act accordingly

 

User
Posted 09 Aug 2023 at 15:06
So to sum up:

If you are happy with the consequences of undergoing life changing treatment for a disease (even advanced PCA) that may not give you any symptoms for many years then have the PSA test.

If you like your life as it is and have no symptoms don't have the PSA test.

User
Posted 09 Aug 2023 at 17:38

We have a bizarre situation with PSA testing.

We have people like Bill Turnbull and now Nick Owen announce that they have Prostate Cancer, and this promotes a rush of white males over 50 (like Messrs Turnbull and Owen) to ask their GP for a PSA test.

Sadly, this is often refused as the Patient does not "meet the Profile" i.e. they are not Asian nor Afro-Caribbean; there is no history of cancer in the male line of the patients family. The fact that they are over 50 is not enough to sway the decision not to allow a PSA test.

On the other side of the coin it would appear that those who are vulnerable - in the Asian and Afro-Caribbean communities - are rather reluctant to volunteer for PSA testing.

Both these scenarios can lead to unnecessary loss of life.

During my 11 years of living with prostate cancer, I have met numerous Urology Consultants, and a few Oncologists. 

4 years ago the Head of Urology in a large hospital in the North West informed me, after reading my notes, that he would never have authorised a PSA test for me. I said "then I would be dead".  

He replied "Perhaps." 

When the "top of the tree" has that attitude, GP's will be reluctant, or even afraid to authorise a PSA test for their patients who do not "tick all the boxes."

18 months after my ProstateCancer was diagnosed, I was diagnosed with Bowel Cancer, following a self-administered Bowel Cancer Screening Test. My Colorectal surgeon said that it was unfortunate that I had 2 different forms of Cancer which occurred one inch apart from each other.

Ten years later I think that I am VERY FORTUNATE to have had both my cancers discovered at an early stage, which allowed Medical Staff to intervene when it mattered. My Bowel cancer had not metastasised through the wall of the bowel, and I had a ten hour operation (Lower Anterior Resection with Ileostomy and stoma) where eight inches of bowel were removed. 8 months later the ileostomy was reversed, and I resumed my full life again. My Bowel Cancer has been removed. I have changed my diet and exercise regularly, and I still complete an annual Bowel Cancer Screening Test. I had a colonoscopy last year, and every inch was clear.

My Prostate Cancer has been managed for 11 years by quarterly injection and a daily tablet, and BY REGULAR PSA TESTING. I have never had to endure any Chemotherapy nor any Radiotherapy for either of my cancers.

I play golf three times a week, cycle to the golf course, and have visited Australia, Thailand, South Africa, Turkey, Spain, Portugal and Morocco.

I am alive, and well and annoying people all over the planet because both my cancers were diagnosed early, through simple (though perhaps messy) tests. 

EARLY DIAGNOSIS SAVES LIVES. 

DENYING PSA TESTS TO MEN OVER 50 CAN RESULT IN DEATHS.

Please, PROSTATE CANCER UK, will you spend some of the money we raise for you in re-educating the Medical Profession that ALL MEN OVER 50 IRRESPECTIVE OF RACE OR COLOUR DESERVE TO HAVE A PSA TEST IF THEY WANT ONE.

Lots of men have are wary of Prostate Cancer testing because of the dreaded DRE. They must be assured that DRE's are a thing of the past.

Perhaps it would be an idea to show men how easy it is to have a PSA test, by recording and then broadcasting someone having a PSA test, and then showing what happens in the Pathology Lab when the blood is analysed.  Both Sky Sports and the BBC are supporters of Prostate Cancer UK. What about showing the recording during a break in a Premier League Soccer match, or an International Rugby match or a Cricket match?

 

User
Posted 09 Aug 2023 at 22:52

Alfabertie,

I’ve read about the 70 y.o. cutoff but are you saying there are medical Drs. who actually discourage some 50 y.o. not to have a spa test? Insanity.

 

User
Posted 09 Aug 2023 at 22:52

Psa, not spa obviously.

User
Posted 09 Aug 2023 at 23:51

I asked my local GP for a PSA test when I was around 52, and they refused, as there were no symptoms. I only asked because my wife was pressing for me to get tested. She does worry a lot about possibilities bless her. GP used the argument, well do you really want to progress to invasive tests if the PSA is raised. Sort of put me off, but surely the objective is to save lives. Anyway he also said if we did everyone that asked, the NHS would be swamped. He stood his ground. To some extent I agree with his point, we all know the NHS is stretched to the limit, and resources are getting more scarce. 

Anyway more recently she started pressing again (I'm now 58). GP again was not keen to allow the test (different GP same practice). It was only after I raised the point I know 2 friends recently of similar age that found they had cancer (no symptoms) by starting at the PSA test. It felt like I had to convince him or pressure him for a test. Eventually he caved.

My first result was PSA 5.1. Had examination at hospital, it wasn't enlarged, but consultant felt it was partly hard. So the process begins.
2nd test 2 weeks later 5.6.
MRI showed 2 lesions, 1 on each side.
After a transperineal, I had the call it was positive and I have stage 2 cancer. There is zero family history of cancer.
To be honest it floored me so much, I didnt really digest much more of the information from the call.
Now awaiting the face to face to discuss with consultant.

Kudos to my wife for being on my case.

 

 

Edited by member 10 Aug 2023 at 00:11  | Reason: Not specified

User
Posted 10 Aug 2023 at 02:22

I’ve not heard of any reports of anyone below the age of 70 being discouraged or denied a psa test. Not to say there isn’t. I’ve been getting an annual psa since I was in my 40’s. 

 
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