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Prostate - PSA and Cancer

Discussion in 'The New Monster Thread' started by Huck, Nov 18, 2012.

  1. Huck

    Huck Silver

    I'm one of those guys whose age and family history makes me a likely candidate to get prostate cancer. I had a biopsy at age 53 that was negative, but have had some additional spikes in PSA the last few years, plus BPH with resulting urinary problems. In all cases, treatment with antibiotics relieved BPH symptoms and lowered PSA.

    But I need a better alternative to antibiotics because when I take them, they kill off gut flora and I start having cravings again and weight loss stops. I tried colloidal silver instead of antibiotics and have been gaining weight.

    I have listened to Jack's Prostate Webinar which was very informative. I was already taking at least half of the recommended supplements and ordered several additional ones mentioned in the webinar. Maybe that will be enough, maybe not.

    I do still have reservations about not getting a PSA exam. I don't trust a government sponsored committee (USPSTF) to make medical decisions for me. As I understand the argument, even if an older man has prostate cancer, something else will most likely kill him before the cancer does. At 63, I probably have about 20 years still left in me. If cancer is detected when I'm 65, I don't want the government telling me that they no longer pay for treatment, which is what I think this recommendation by USPSTF is leading up to.

    The American Urological Association (AUA) has rejected the USPSTF recommendation against PSA testing. Here's the statement from AUA Presdent Suhil S. Lacy, MD.

    The AUA (American Urological Association) is outraged at the USPSTF’s failure to amend its recommendations on prostate cancer testing to more adequately reflect the benefits of the prostate- specific antigen (PSA) test in the diagnosis of prostate cancer.

    It is inappropriate and irresponsible to issue a blanket statement against PSA testing, particularly for at-risk

    populations, such as African American men. Men who are in good health and have more than a 10-15 year life expectancy should have the choice to be tested and not discouraged from doing so.

    There is strong evidence that PSA testing saves lives. The randomized trials used by the USPSTF do, in fact, show a benefit to patients. The PLCO Trial, imperfect by the pre-screening contamination of the control arm, nonetheless showed that, in a group of young men with no comorbidities, there was a significant reduction of prostate cancer death rates after a median follow- up of seven years (JCO 2011;29:355-361).

    Additionally, the Göteborg Trial also showed a substantial 44 percent relative risk reduction in prostate cancer mortality occurring in men 50-64 years of age after a median of 14 years.

    Importantly, the risk reduction occurred in a setting where many of the patients were not aggressively treated for prostate cancer, indicating that the harms of PSA-based screening can, in fact, be minimized by good clinical practice (Lancet Oncol 2010;11:725-732).

    Furthermore, we have seen a 40 percent reduction in prostate cancer- specific mortality in the United States over the most recent 20 years of PSA-based screening. This has occurred without substantial change in how men with prostate cancer were treated (primarily with surgery and radiation therapy).

    Models have suggested that more than 50 percent of this reduction is due to early detection (Cancer Cases Control 2008;19:175-181). Additionally, updated data from the European Randomized Study for the Screening of Prostate Cancer (ERSPC) has demonstrated that there is a 21 percent risk reduction in prostate cancer related death associated with screening (up to 29 percent after accounting for non-compliance). The number of cancers that would need to be detected to prevent one death has now dropped to 37.

    Rather than instruct primary care physicians to discourage men from having a PSA test, the Task Force should instead focus on how best to educate primary care physicians regarding targeted screening and how to counsel patients about their prostate cancer risk.

    The PSA test has allowed us to move beyond a time when men presented with high-grade, metastatic disease for which there were little or no treatment options other than palliative care.

    In its earliest stages, most prostate cancers cause no symptoms; to say that only men with symptoms of prostate cancer should be tested will potentially result in a return to such a time.

    Disparaging the PSA test when newer tests and diagnostics are not yet widely available does a great disservice to American men.http://epubs.democratprinting.com/publication/?i=116007

    The majority of the (Summer/Fall, 2012) QUEST, published by Dr William J Catalona and the Urological Research Foundation, addresses the problems with the USPSTF recommendation. The article on p 8 discusses the use of PSA, % free PSA, and Phi score for detecting prostate cancer. According to this article, the diagnostic accuracy of Total PSA is 55%, % Free PSA is 65% and Phi is about 75%. Phi hasn't been approved by FDA in US, but is approved in Europe.

    I found the % Free PSA lab earlier this year when I was looking for the best price for a PSA lab. It wasn't that much more expensive so I bought it and was glad I did. My PSA was elevated, but my % Free PSA indicated I had less than a 10% chance of cancer and the high PSA was most likely from inflammation.

    So I'm questioning everything. The AUA makes a good case for dismissing the findings of the USPSTF. On the other hand, I guess the income of some members of the AUA would be effected if the PSA test is not used as a diagnostic tool.

    For me, I will continue to have a yearly PSA including %Free and Phi when it becomes available. Even a biopsy, although not a fun day at the beach, is not that bad. When I had mine done, the doc used Novocain to dull the pain. He did it in his office and I drove home about a half hour after it was over. So PSA and biopsy if necessary.

    The problem for me is choosing what to do if biopsy shows cancer. My preferred treatment, if it should become necessary, is proton beam treatment, something rarely presented as an option. Quite expensive, but it is painless and seems to have the smallest incidence of side effects. More info on proton beam can be found here.

    Thoughts? Any other "older" guys going through this? If so, what is your plan? If you already met the robot, what were the side effects?
  2. DarleenMB

    DarleenMB Silver

    You should have watched the November webinar on prostate cancer. It was excellent. And no, I don't have prostate issues but DH does.
  3. Huck

    Huck Silver

    I did, that's the point. The American Urological Association (AUA) disagrees with several of Jack's conclusions.

    So what does one do when 2 opposite opinions are presented by 2 respected sources? I'm here looking for more information and experiences.
  4. Thor

    Thor Banned


    The PSA TEST is a joke - it never tests for cancer ! If you get a biopsy it causes the cancer to spread 100% of the time. Sad that doctors push this bs... :(

    The PSA is a 33-kDalton serine protease inhibitor made by the Ascomycete fungi, Aspergillus flavus, Aspergillus fumigatus, Aspergillus oryzae, Ophiostoma piceae, and Scedosporium apiospermum. An elevated PSA is seen not only in men with prostatic disease, but also in women with breast, ovarian, pancreatic, and colon cancer; and even in women during pregnancy.

    The antifungal drug, Nizoral® (ketoconazole) lowered PSA levels in men with prostate cancer

    high PSA signals a fungal infection gone awry, then the antifungal effect of ketoconazole should be the obvious reason for the lowering of the PSA.

    Arena, Jay; Drew, R. Poisoning: Toxicology, Symptoms, Treatments. 5th ed. Charles C Thomas. Springfield, Ill. 1986.

    Just shows how clueless doctors really are
  5. Huck

    Huck Silver

    Did you read any of the info I referenced?
  6. Thor

    Thor Banned

    why? I posted the facts about the psa - it's not for cancer
  7. colleencoble

    colleencoble New Member

    A routine PSA caught the huge spike in my husband's PSA (from 1.5 to 9) and a biopsy showed VERY aggressive prostate cancer. By the time he had surgery it had moved from the prostate to the seminal vesicles. Right now he's cancer free but there is a 30% chance it could come back. I tell every guy I know to make sure they have a baseline and get tested. It could save their life. Yes, it can go up for something other than cancer just like the CA-125 can go up for things other than ovarian cancer. But it's the best screening tool we have right now. At least you can get tested further to find out what is the cause. And please, the biopsy is not that bad. I was with Dave in the room when he got his and he didn't even wince. We girls get poked, prodded and squashed every year.

    I will never ever quit urging guys to get checked. I lost a dear friend to prostate cancer the same year Dave was diagnosed. When it strikes younger men, it is deadly.
  8. Thor

    Thor Banned


    Colleencoble - did you read my post above? PSA test has nothing to do with cancer. ugh :( sad that doctors brain wash people.....

    Even if you have cancer there is only a 25% or less chance the biopsy will find it and if the needle does catch cancer cells...there is something you should ask your urologist about:


    It will be a VERY uncomfortable subject for the doc...since there is a considerable chance the biopsy needle will drag cancer cells out of the prostatic capsule and "seed" them into the rest of your body. Consider the information that follows:

    "In The New England Journal of medicine Dr. Fritz Schroder and Dr. Ries Krause from the Erasmus Medical Center in Rotterdam, Netherlands were asked if prostate biopsies really save lives. Their answer was, "No."

    Only 1 out 4 of these biopsies was able to even detect cancer. The reason for this is: The way a prostate biospy is performed is a needle is inserted into the prostate gland. Then, very small sections of prostate tissue are extracted from 6 - 45 different areas within the prostate gland.

    But, the needle may not even go where a cancer exists. Some call it the "needle in a haystack search".
  9. Thor

    Thor Banned


    we girls get poked - oh please.

    Try getting Circumcised - suffering a life time of penile truama. Nearly no feeling left, Frenelum (same nerve tissue of the clit) is chopped off, hard dried out glans, unable to ejaculate, impotence, erectile dysfunction and more... sure child birth might last 24 hours but try a lifetime of pain.

    I would die if my Foreskin was chopped off - ouch....

    Men suffer far more than any woman ever will.
  10. LinD

    LinD New Member

    Is this pain DH has never mentioned to me?
  11. Huck

    Huck Silver

    Did his doctors mention proton beam as a treatment option? My guess is no since they don't get to do surgery.
  12. colleencoble

    colleencoble New Member

    Dave's biopsy showed cancer in ALL quadrants. And we never would have known it was there if not for the PSA.

    Yes we discussed proton beam. We have one of those here in Indiana. But Dave's cancer was very aggressive. We just wanted it OUT and gone.
  13. Thor

    Thor Banned


    Removal of the prostate gland (prostatectomy) means you're impotent and will never have sex again - thats a bit extreme for treatment

    if it moved into the testicles then he must have needed to be castrated too? That's really a sex change operation in the end.

    that's scary

  14. colleencoble

    colleencoble New Member

    It wasn't nearly as scary as him dying! And the shots work as he's regaining some of that. So the no sex thing is not true.

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