PSA Level. How Often Do You Have It Checked?

Men's health
1

PSA Testing Guidelines and advice seem to be all over the place but the newer trend seems to be less is better for a number of reasons. 

Below are guidelines from Sloane Kettering. Other reputable organizations may have different guidelines. Your doctor may have his or her own.

According to Sloane, since my PSA at age 60 was less than  1 ng / mL, I should have had no further testing. And yet, my last urologist made it a point to test me every year even though my PSA remained less than 1 ng through my 60's. I am therefore considering not having any more PSA tests. 

Wondering how the rest of you deal with PSA testing, and what guidelines you follow.  Please give your age, PSA level and if you plan on having further PSA testing. 

Here are the guidelines from Sloane:

Men ages 45 to 49 should have a baseline PSA test.

If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.

If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.

If the PSA level is less than 1 ng / mL, men should see their doctor for another PSA test between the ages of 51 and 55.

Men ages 50 to 59 should have their PSA level checked.

If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.

If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.

If the PSA level is less than 1 ng / mL, men should see their doctor for another PSA test at age 60.

Men ages 60 to 70 should have their PSA level checked.

If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.

If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.

If the PSA level is less than 1 ng / mL, no further screening is recommended.

Men ages 71 to 75 should talk with their doctor about whether to have a PSA test.

This decision should be based on past PSA levels and the health of the man.

Men ages 76 and olderProstate cancer screening is not recommended for men ages 76 or older. A high PSA level does not generally mean that a man should have a prostate biopsy. A doctor will often repeat the PSA test after a few months to determine if the PSA level is still high and investigate whether there is a reason other than cancer that could explain the increase.

2

I'll start. 

Age:  70.

PSA as of a year ago: less than 1ng/ml

I am leaning toward no further PSA testing

Jim  

3

Age 66, PSA 2.7. Age 67, PSA 5.4. Had biopsy, no cancer, but prostate was much larger.

4

H Dalebf,

When does your doctor want you to have another PSA test? According to the Sloane guidelines, that would be in another 2-4 years. 

Jim

5

PCa is no respecter of age and could kick off at anytime if you have the right genes and something triggers it.

Would you really want to wait until you become symptomatic later in your 70s only to find you have a PSA into double or even treble figures.

You may argue that at say 75 at diagnosis you may get another 5 or 8 years of life with the right treatment but don't forget that the older you get some of those treatments will be inappropriate due to age or other conditions and only survive a couple of years.

An annual PSA test right up to 85 should be available to all who request it.

That's my take on the matter and as someone who may or may not have PCa still present following treatment I shall continue to have a PSA test as long as they can find a vein in my arm to stick the needle in.

Incidentally, my father devoloped PCa sometime in his 80s and remained symptom free until his mid 90s by which time the undiagnosed PCa had metastasised into his spine, bladder and pelvis and finally succumbed to the condition aged 98.

 As he had no other life threatening conditions and was extremely fit and active until 6 months before his death, who knows if an early diagnosis following a PSA test in his 80s may have led to a limited treatment regime that may have given him another few years of active life.

6

I was told once a year. If I am paying for it and it's not high, I think once every couple years will do. So many things affect the test results I don't feel it's a accurate test. Hoping they come up with something better.

7

Hi Rogcal,

My purpose of this thread was not to get into a debate on whether the guidelines posted, or my personal choice, is right or wrong. There are many reasons pro and con regarding testing with no rights and wrongs IMO,

I really just wanted to know how people here and their doctors were dealing with PSA testing.

That said, I guess this thread will open up that other discussion. 

Sorry about your father. The point you made iis a good one and suggests that longevity facors might be factored into the equation, 

as the guidelines I assume go by average life spans.

On the other hand, there is also the sometimes unecessary worry, stress and endless testing, biopies, to consider. 

Jim

8

Waffalobill,

What is your age and PSA level?

Jim

9

53. Had it checked last was over a year ago. Can't remember exactly. Was just over 1. Doc told me between 1 and 4 was good. Had it taken a couple times. Before and after being on finasteride. Was still low. Will probably have it taken again this fall. I read so many articles on it they have me a bit confused. Half say it's good to have it checked once a year, others say it's not it just causes panic cause so many things can effect the results.

10

My private health insurance via my employer gives a private "full" medical every 2 years and from age 50 that includes a PSA test (and from age 45 it includes a DRE).  I am interested in, for those who do rather unusually have P Ca at say age 50, how often would such an indolent disease manifest in sudden LUTS symptoms ?  I suspect not intuitively ... I mean, ignoring those who have acute prostatitis, for those who have P Ca (whether diagnosed yet or not) does it cause sudden onset (24 hours, one day not there completely normal the next day YIKES I AM PEEING EVERY 5 MINUTES AND NOTHING MUCH COMES OUT WHAT THE HECK IS GOING ON ?!?) acute marked LUTS or .. might (P Ca) cause a more gradual onset of LUTS symptoms ?  With sudden onset acute LUTS always (I theorise, and am seeking others' views on this) being prostatitis ? I wonder if my PSA test (17 at age 49 falling in 3 days to 9.6) and almost immediate associated 3T-MP-MRI and biopsy, were really worth it .... certainly the PSA and 3T-MP-MRI (4 out of 5 on the liebhart scale) scared the heck out of me as I assumed an MRI was accurate (I now know only a negative MRI is accurate, positive ones can be inflammation and are inaccurate).  Uro did say "don't worry" several times but not a lot more really, and didn't answer when I (all the engineer) said, "well can you put a probability on this being P Ca at my age with this reading, just rough given your experience", and .... of course you think the worst, and assume "don't worry" means you probably have P Ca.  He did say right at the start based on sudden onset LUTS, "unequivocally you need PSA test according to NICE guidelines" (I never checked those NICE guidelines), and had written in the Daily Mail newspaper arguing that doctors should always refer men for a PSA test in such circ's.  My GP (doctor) had said a few days before, "don't be ridiculous you don't need a PSA test for these symptoms at age 49, it is definitely not PCa" though she didn't prescribe antibiotics, just suggested an ultrasound in 2 weeks and meantime I suffer. In truth even tho' uro also didn't try any antibiotics, it did begin to get better over 2 weeks on its own; maybe my GP knew that would probably be so ?  (she is not that communicative).  I said to the GP I want to insist on a PSA test under the two week rule (a schoolfriend who is a doctor, who had tutored me to insist on the PSA test, said to say that) but she said no (hence I went to a privae uro).  At age 50 in Britain I could have insisted, at least in theory, on a PSA test from my NHS GP - but at age 49 you can't insist, even if symptomatic.

 

11

NB I had had mild LUTS (pee 2 to 3 times a night; sluggish flow at times) for years previous, and reported that also; that may have a comprised a more compelling reason for a PSA test, than the sudden acute marked LUTS which, with hindsight, was surely always going to be prostatitis.  I did not disambiguate with my uro at the time whether the PSA test was unequivocally necessary, because of the former or the lattter .... got the impression the latter.  Given that the HOLEP he gave me cured the former perfectly, with strong flow and a sleep for 7 hours as an outcome, maybe daft to waste time thinking about it now !  (but many friends as they age will get prostate issues, I might one day too, so attempting to become knowledgeable may have merit - and sharing here helps others - even more should do it then we'd have even more real case data to read about .... )

12

If it was free I would have it done as many times as they want to pay for it. Lol.

13

WaffBill,

I should give you the name of my former urologist. I think he'd be happy to test you every month and he has all the codes. Yes, screening has saved lives, but it has also unecessarily ruined lives with unecessary worry, stress and procedures sometimes leaving the patient incontinent or impotent.

Cancer screening and treatment is a multi billion dollar industry  for the drug companies, equiptment manufacturers and doctors. This doesn't mean you shouldn't be screened but it does mean you should research beyond what your doctor may tell you. 

Here are two articles about six years old I found thought provoking. I will post the links in my next post (probably won't come out of moderation for a day or two) but if you want to read them sooner you can google:

"Evidence-Based vs. Anecdotal Medicine: Putting the PSA Test in Its Place"   (Albert Einstein college of Medicine)

And

"Can Cancer Ever be Ignored" (NY Times Magazine)

Jim

 

 

14

Two thought provoking articles on PSA Testing:

http://blogs.einstein.yu.edu/evidence-based-vs-anecdotal-medicine-putting-the-psa-test-in-its-place/

http://www.nytimes.com/2011/10/09/magazine/can-cancer-ever-be-ignored.html

15

Don't know yet. I had Plasma Button Vaporization in April and I won't see him again until August.

16

My docs would test as often as I asked. My insurance probably wouldn't pay. I cant afford unnecessary testing. Figure after surgery the psa would be high any ways. Probably why doc hasn't asked for another one yet. He told me to get one before my next app in November. That makes a year since last op and since I stopped finasteride. Having problems with insurance paying for stuff now,. Denying meds for Gerd. Even after meeting there criteria. Endoscopy confirmed Barrett’s esophagus. Biopsies came back negative for cancer.

17

I have my PSA tested every 12 months on the advice of my urologist. Testing is done in my GP office. last test result less than 2ng/ml. but urologist has said that i am in a high risk group.

18

Last week or the week before the Times reported that 50,000 men are diagnosed with PC each year in the U.K. with a death rate of 10,000.  20% of men with this disease die.  Can cancer be ignored! I think not. Obviously we will all have our own opinion about testing but if you are at increased risk of developing PC it seems to be good sense to have regular testing.

19

Waff,

OT  Hard to believe they won't pay for GERD meds with a dx of Barrets. What kind of insurance do you have? 

Jim

20

Been fighting with them for months. Finally gp referred me to gastro. He faught and failed. Did gastroscopy to confirm Barrett's, which meets there criteria, and still was denied. It's only for 2 omeprazole a day. Cheap stuff. I had to drive over there and sign a authorization so doc could fight them some more. They can't believe the resistance we are getting for a simple pump inhibiter. Been taking it for 8 years or so. They just started to deny it in November. Insurance is blue Cross.