PSA testing

Erectile disfunction, premature ejaculation, delayed orgasm, etc.
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be64
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Re: PSA testing

Postby be64 » Sat Sep 30, 2017 5:43 pm

The danger of testing PSA is that if it is elevated then the doctor might order biopsy. When this happens cancer might be found. The problem is that the cancer may have never gotten to the point of concern if it had never been found but once found, men often have their prostate removed with all the problems that accompany that. All unnecessarily. Incetwinlynwouldnt recommend jumping quickly to biopsy. I'd want to see several unexplained high PSAs before moving toward biopsy.

My doctor checks my PSA annually. In my early forties it was in the 0.4-0.6 range. Now in my early fifties it's in the 0.7-0.9 range. Only twice has it been over 1. It was 1.2 once and 2.5 once. Each attributable to recent bouts of prostatitis. This month it was 0.74
I know a low PSA does not guarantee there is no cancer but nevertheless it makes me feel good that in over seven years of TRT with my testosterone level kept in the very top of the range my PSA has not gone up.
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Re: PSA testing

Postby OldMarriedLady » Sat Sep 30, 2017 9:51 pm

"When you love them, they drive you crazy - because they know they can."
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Re: PSA testing

Postby PacNorWestGuy » Mon Oct 02, 2017 10:24 am

OldMarriedLady wrote: He said almost every couple in their 50's and older that he sees in his practice have stopped having sex except maybe as a birthday/anniversary thing.

Did he offer this useless piece of information as some kind of recommendation or maybe commiseration? smh. While I have a few 50-something male friends who have post-menopausal wives that believe sex isn't important anymore. None of my friends share that belief. It has unfortunately become a major area of conflict in their marriages. However, my pastor and his wife, who are both in their 60's, certainly do not adhere to this line of thinking. Both of them have stated that they will permanently stop having sex in this life just prior to entering the next (since God will have something much more glorious for us to share in eternity). While they admit that they don't make love as often as they did in the past, they still renew their marital intimacy at least once a week or so and highly advocate the same for their parishioners.

As far as the PSA score thing goes, it is now much more accepted that Velocity and not the absolute score is more indicative of potential issues. The emphasis is on "potential" issues. My father died from prostate cancer, which evidently makes me 3 times more likely to be diagnosed with the cancer. Since I turned 50 I have had my PSA evaluated every 6 - 12 months. My father's PSA score was 3.5 when he was diagnosed with cancer. The only reason he went in to get checked was that he (and my mom) were alarmed to notice blood in his ejaculate (that was an interesting conversation for a guy to have with his mom... :oops: ) . My scores have been consistently between 1.5 and 3.0 for the past five years. However, a few months ago my test came back at 6.1. That was very alarming and my primary doctor scheduled me for an immediate followup with an urologist. I was quite surprised to be greeted by a woman urologist (there are lots of men gynecologists, but...). At first I was a bit shaken by a woman urologist (blame it on my age), but she was awesome! She explained everything and was very attuned to how this high score may be affecting me emotionally. She noted my family history and did a digital rectal exam, or DRE (God bless a woman with small hands :oops: ). She found nothing of note and ordered a follow-up PSA and biopsy. The PSA came back at 2.6, well within my historical norms, so she cancelled the biopsy and placed me on a surveillance plan where my PSA will be monitored every three months. Of note is that a DRE can only find lumps on about 40% of the prostate. My father never showed any physical symptoms with his DREs. His cancer was on the urethra side (inside) of the prostate and it was very aggressive. People can cast aspersions on the PSA, but together with regular DRE screenings about 60% of prostate cancer can be detected. Yes, the PSA can give false positives. So can the airport metal detectors. Both trigger additional screenings, which although inconvenient and perhaps intrusive, lead to a much higher percentage of detection of "bad stuff".

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Re: PSA testing

Postby PacNorWestGuy » Mon Oct 02, 2017 10:49 am

be64 wrote:The problem is that the cancer may have never gotten to the point of concern if it had never been found but once found, men often have their prostate removed with all the problems that accompany that. All unnecessarily.

Totally agree! The simple fact of the matter is that a majority of men over the age of 60 (I have heard as much as 66%) have some form of prostate cancer. If diagnosed with some form of prostate cancer at 60+ I would definitely evaluate if patience or treatment was the best option. Treatment may be more destructive than a slow growing cancer. However, if like my father, an aggressive cancer is found, treatment may add several years to your life.

On a completely non-random side note, modern research has found that men who ejaculate more are about 30% less likely to be diagnosed with prostate cancer. Scientists at Harvard medical center found that men who ejaculated 21 or more times a month enjoyed a 33% lower risk of prostate cancer compared with men who reported four to seven ejaculations a month throughout their lifetimes... So if your DW is really interested in keeping you around... :D :lol:

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be64
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Re: PSA testing

Postby be64 » Mon Oct 02, 2017 10:51 am

The part about your doctor saying that couples in their fifties not having sex anymore reminds me that my sister had a complete hysterectomy at about age forty for medical necessity. Afterword she lost her sex drive because of no testosterone production. Her doctor, an older man, told her that at her age she didn't need to have sex anymore. Needless to say she found a new doctor.

I've been in my fifties for almost three years now and my wife and I have had sex hundreds of times in those three years so I see no reason to just giving up sex because of age or medical issues. Sex is important enough to find issues and solve problems in order to keep it coming.

As far as blood in semen, that in itself should not cause too much alarm. Most of the time it's just due to a broken capillary somewhere in the prostate or seminal vesicles. I've had this happen a few times.
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Re: PSA testing

Postby OldBear » Mon Oct 02, 2017 11:14 am

be64 wrote:On a completely non-random side note, modern research has found that men who ejaculate more are about 30% less likely to be diagnosed with prostate cancer. Scientists at Harvard medical center found that men who ejaculated 21 or more times a month enjoyed a 33% lower risk of prostate cancer compared with men who reported four to seven ejaculations a month throughout their lifetimes... So if your DW is really interested in keeping you around... :D :lol:


My urologist - a well regarded Christian doc - told me that I needed to ejaculate 2 to 3 times per week for prostate health reasons. Mrs. Oldbear has wonderfully embraced (pun intended) this fact and need - she is very generous and willing to make it happen for US.

OML, hooray for you and your DH. ::clap

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be64
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Re: PSA testing

Postby be64 » Mon Oct 02, 2017 11:40 am

I'm hoping 16 ejaculations per month will be sufficient.

Something else which is supposed to be good for prostate health is prostate massage and self prostate massage with a device like the Aneros. Prostate massage helps to eliminate prostate congestion and increases blood circulation to the prostate.
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Re: PSA testing

Postby Oklahoma » Mon Oct 02, 2017 12:19 pm

OldBear wrote:My urologist - a well regarded Christian doc - told me that I needed to ejaculate 2 to 3 times per week for prostate health reasons.

My Doc told me the same thing!
I thought my DW was going to wear my thing down to a nub! Still do! I never know where she may 'assault' me! :)
(Not that I was complaining!)

Cheers to OML!

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Re: PSA testing

Postby be64 » Mon Oct 02, 2017 12:30 pm

Many years ago I was having a lot of problems with prostatitis. My wife was with me when the urologist said more sex would help. My wife listened and obliged.
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Re: PSA testing

Postby beekeeper » Tue Apr 24, 2018 1:43 pm

My cancer was high Gleason [meaning it was agressive], I am glad that we had my prostate removed. Unfortunately, the surgeon also had to remove the nerve bundle.

For four years my PSA tests have had scores of <0.04

But now the cancer has returned. It seems to be in the pelvic region lymphs. To treat this I am going through radiation treatments. But before they could start the radiation, they had to put me on a Testosterone inhibitor [Lupron]. My oncologist wants to keep me on Lupron for 2 years following the radiation treatments.

We want to kill the cancer before it spreads to my bones, but it sucks that I can not have any Testosterone.

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Re: PSA testing

Postby ledgemoor » Tue Apr 24, 2018 3:02 pm

So sorry man. You are in my prayers.
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Re: PSA testing

Postby SeekingChange » Tue Apr 24, 2018 4:06 pm

Beekeeper, my heart aches for you. I am praying for you as well.
God can change what people do, behavioral patterns that have been in play for decades. He can change what we do to cope, find comfort, survive conflict, to count. Rahab had done a same old thing for years...then she did something new.

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Re: PSA testing

Postby seeking perspective » Tue Apr 24, 2018 5:22 pm

I'm sorry the cancer has returned. I will be in prayer for you.
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Re: PSA testing

Postby beekeeper » Tue Apr 24, 2018 6:14 pm

PSA testing is not perfect.

But if you are going to have your blood tested for a dozen other things, adding this one test into the batch does not hurt.

If your PSA levels stay low, fine, one less thing to think about.

If your PSA goes high, go see a urologist.

In my case, with stage 3 cancer, I was fortunate to have caught it before it metastisized to bone cancer through-out my body.

I am thankful for the PSA testing.

I feel badly for guys who have PSA levels that yo-yo up and down for many years. I do hope that a better test comes along soon.

Given what tests are available to us in 2018, I recommend that all men over 50 should have their PSA tested every second year. It just might save your life.

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Re: PSA testing

Postby Graypoet » Wed Apr 25, 2018 3:09 am

I will be praying for you Beekeeper. Stay positive and focus on God's Word. I wholeheartedly agree with PSA testing. PSA testing is a must for those of us 50 and older.
Proverbs 5:18-19 Let thy fountain be blessed: and rejoice with the wife of thy youth. Let her be as the loving hind and pleasant roe; let her breasts satisfy thee at all times; and be thou ravished always with her love.

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Re: PSA testing

Postby hotrod » Wed Apr 25, 2018 8:09 am

I too will be praying for you beekeeper


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Re: PSA testing

Postby be64 » Wed Apr 25, 2018 9:15 am

You are one of the lucky ones. The problem with PSA screening and prostate screening in general is that more men have their lives ruined with needless treatment than those who’s lives are saved. Such as detailed in this article.

https://www.wddty.com/magazine/2017/apr ... tment.html


“Yet another 2009 study found that, between 1986 and 2005, more than a million additional men were diagnosed with prostate cancer and needlessly treated by surgery or radiation11—and most likely lost their sexual function or bladder control as a result.

Put another way by Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center, men who undergo biopsy and treatment have about a one in 50 chance of being spared cancer that would otherwise have killed them within 10 years. And a 49 in 50 chance of being treated unnecessarily for a cancer that was never a threat.”
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Re: PSA testing

Postby beekeeper » Wed Apr 25, 2018 9:36 am

PSA testing is not used to diagnose cancer. They do a bone scan and a MRI, to see if there is enough evidence to justify doing a biopsy. Even if they did a biopsy and found nothing, you would still have your prostate and full function.

After my biopsy we met with the urologist to discuss the best path forward. For many men if they have a low Gleason cancer it will be slow growing and not present a probem for another 30+ years. For something like that, they prefer to do 'Active Surveilance' of the cancer. Just to track how much of the prostate has converted to cancer, each year.

Our urologist said that for a 70 year old man with low Gleason, they would never operate on the prostate. If they do nothing, the cancer is growing so slowly that surely the man will die from other causes before he turns 100 and needs to be concerned about his prostate.

Our medical science is advancing very rapidly. Maybe back in the 1980s a high PSA was seen as an indication of cancer. But that is not the case today.

I remember that in the 1970s doctors were in a mad rush to do hysterectomys to cure female 'hysteria'. A lot of females had their reproductive organs removed needlessly. It is a shame that had to happen. However it is decades later now, and doctors today know a lot more about how our bodies work.

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Re: PSA testing

Postby be64 » Wed Apr 25, 2018 11:53 am

The problem is however that in many cases a high PSA leads directly to biopsy. A biopsy is cheaper than a bone scan or MRI.

There are studies which suggest that there would be fewer men with unfavorable outcomes if no prostate cancer screening was done.
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