Download 635 prostate cancer survivors and their

MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
635 PROSTATE CANCER
SURVIVORS AND THEIR FAMILIES,
FROM ACROSS THE UNITED
STATES, SHARE THEIR THOUGHTS
ON THE PSA TEST.
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
TensofthousandsofmenthroughouttheUnitedStatesfeelconfusedaboutthe
prostatespecificantigenbloodtest.TheUnitedStatesPreventiveServicesTaskForce’s
May,2012recommendationagainsttheuseofthePSAtestforprostatecancerscreening
forallmenhascausedconcern,angerandfear.MenthroughouttheUnitedStatesnow
questionwhetherthePSAtestisrightforthem.
Weareconcernedthatmenwillnotlearnthattheyhaveprostatecanceruntilthey
aresymptomaticwithalatestagedisease.TheproblemwiththePSAtestisaroundthe
timingandextentoftreatmentwhenthereisapositivePSAtestorbiopsy.Those
problemsfromover‐treatmentcomefromdoctorsprovidinginadequateconsultations
whichcanfrightenmenintotreatmentsthatmaybetoosoonorinappropriate,and
patientsthatarewillingtosubjectthemselvestotreatmentswithoutdoingtheresearchto
fullyunderstandtheirsituation.
Thisbookisintwoparts:Onequitebriefandtheotherquitelong.
ThefirstpartcontainsseveralfactsaboutPSAtestingandprostatecancer
treatment. ThesecondpartcontainscommentsaboutthePSAtestfrom635prostatecancer
patients,wives,husbands,partners,sonsanddaughters.Readthroughthesepagesand
youwillfindsomeonelikeyou;someonewhooncewonderedifthePSAtestwasrightfor
them.
If you are a man with African genetic heritage, then you
should know that prostate cancer kills twice as many Black
men as it does other men in the United States. As of May, 2012,
we do not know why. But, this staggering disparity should give
you reason to be more concerned about prostate cancer if you
are Black. Some doctors also consider family history of
prostate cancer as presenting an elevated risk.
Factsyoumustknow:
 PSAstandsfor“prostatespecificantigen”test,not,“prostatecancerspecific
antigentest.”ThePSAtestsuggestspossibleproblemsbutdoesnotdefinethem.
 Alowor“normal”resultcangiveyouafalsesenseofsafety.ThePSAtestisnotat
allfoolproof.
 AnelevatedresultonyourPSAtestcanstartacascadeofbadchoicesandharmful
treatmentsthatmaydonothingtoextendyourlife.UseMalecareandother
prostatecancersupportgroupstohelpyounavigatethat.
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.

PSAtestsareonehalfofatwopartexamination…theotheristhedigitalrectal
exam,whereyourdoctoractuallyfeelsforlumpsandbumpsthatmaybe
suspicious.
 Beskepticalofstatistics.Fiveyearsurvivalratesforprostatecancerareexcellent
becauseprostatecancertendstogrowslowly.Aboutathirdofmenexperience
recurrenceandadvancedstagedisease5–10yearsaftertheirinitialtreatment.
 Beskepticalofanyonewhominimizessideeffectsfromtreatment.Noman
emergesentirelyunchangedafterprostatecancertreatment,andmanymen
experiencequalityoflifereducingimpotenceandincontinence.
 Donotrushintotreatment!Askyourdoctorabouttheprosandconsofactive
treatmentversusactivesurveillance.
According to the American Urological Association, not
all prostate cancers require active treatment and not all are
life threatening. The decision to proceed to active treatments
is one that men should discuss in detail with their urologists
to determine whether active treatment is necessary or
whether active surveillance is appropriate.
WhatisthePSAtest?
ThePSAtestisabloodtestthatmeasurestheamountofaprostatespecificantigen,
inyourbloodstream.Prostatespecificantigenisaproteinproducedbycellsofthe
prostategland.IfthequantityofPSAiselevated,thenthereispresumptionofsuspicious
activityinyourprostate.Yourdoctorwillprobablyreferyoutoaurologistforabiopsy.
Biopsieshaveasmallriskofinfectionandyoushoulddiscussthisriskwithyour
doctor.AskyourprimarydoctortodiscusswhatotherreasonyourPSAresultmightbe
elevated.Askaboutinflammationorprostatitis,enlargementoftheprostate,called
BenignProstaticHyperplasia(BPH).Sometimesprostateaffectingactivity,likesexor
bikeridingridethedaybeforeyourbloodtestcanraiseyourPSAtestresult.
Evenifyoudogoforabiopsyandthepathologyreportofyourbiopsydescribes
sampleswithprostatecancertissue,youstillarenotatdeathsdoor.Askyourdoctorto
reviewyourbiopsyreportwithyou,andalsoasktohaveasecondopiniononyourbiopsy
report.Moreinformationaboutgettingasecondopinioncanbefoundat
http://malecare.org/second‐opinion‐on‐biopsy‐slides/
Theguysthatweworryaboutmostaretheoneswhogettreatedbythefirstdoctor
theymeet,andthinkthattheyarenowcured.But,youarenotlikethat.Weknowthat
becauseyouarereadingthisbook.Youarealreadylightyearsaheadofmostcancer
patientswhoknuckleundertotheirdiagnosis.And,becauseyouareseekinginformation,
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
youhaveagreatchanceofgettingthebestpossibleoutcomeofanymandiagnosedwith
prostatecancerin2012intheUnitedStates.
Consider avoiding the PSA test if you feel that you might die in
ten years or less, either due to advanced age or pre-exiting
illness.
ProstateCancercanremainsmall,containedandreasonablystable.Inthis
situationitposesnohealthrisk.Mostprostatecancersgrowsoslowlythatyouwilldie
fromsomethingelsebeforeyouwillbeoldenoughforprostatecancertokillyou.But,for
approximately30,000menintheUnitedStates,everyyear,prostatecancergrowsrapidly
andissoaggressivethatitwillkillyouregardlessofwhenitisdiscovered.
Avoid public prostate cancer screenings if you are predisposed
to mood and anxiety disorders. Only have a PSA test after
speaking with your doctor.
First:Makenodecisionsuntilyouarecomfortablyinformedaboutyoursituation.
Readthepatientanddoctorwrittenarticlesaboutprostatecancersymptoms,
treatmentandcausesonmalecare.org.
Prostatecancertendstobeprogressslowly.Thereisusuallynoneedfor
urgency.Butmakenomistake…somemendodiefromcancer.Thereisnoworseside
effectthandeath.
Ifyourdiagnosisisgenuinelygrave,yourdoctorwilltellyou.Ifnot,thentaketime
tounderstandwhatyoucandotoextendyourlife,withoutdamagingyourqualityoflife.
Second:Askquestionsaboutyourcancerdiagnosisandcancertreatment.
Answersaboutcancerwon’tfindyou,youhavetoask.Pleasedon’tassumethat
yourdoctorwilltellyoueverythingthatyouneedtoknow.Therearelistsofquestionsfor
youtoaskaboutprostatecancertreatmentsontheMalecare.orgwebsite.
ProstateCancertreatmentmayextendyourlife,butmightalsocausecollateral
damageorsideeffects,suchasincontinenceorimpotence.Eventhebesttreatment
choicemayhaveconsequencesyouprobablywon’tlike.Andnocurrentlyavailable
treatmentisperfect.Aboutathirdofallmenseetheirprostatecancerreturntothreaten
theirlifeaftertheirinitialtreatment.
Learnaboutthedifferencebetween“cancercure”and“cancertreatment.”
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Third:Decideforyourselfifyoucanmanagetohaveahappylifeifyourdoctortells
youthatyouhaveacancerinsideyou,butthatitwon’tkillyou.
Howmightyoufeelwhenyouheartheword,“cancer,”inthecourseofyoureverydaylife,
knowingyouharboratumorandthatthereprobablyisn’tanythingthatyoushoulddo
aboutit.
Fourth:Speakwithotherguysatanonlineorin‐personprostatecancersupport
group.
Youarelucky.Ouronlinesupportgroups,withhundredsofguysparticipating
everyday,areonlyaclickaway.Hearourstories.Putyournaturalandperfectlyhuman
thoughtsandfearsintoamorehelpfulperspective.Cancertreatments,symptoms,
diagnosis,andcausescanbeconfusing…weareheretohelp.
Mostmenexpecttheirdoctortorecommendthepreciseprostatecancertreatment
thattheyneed.Theyaresurprisedandanxiouswhenthedoctordiscussesseveral
possibletreatmentsandsaysthepatienthastodecideforhimselfwhichonetochoose.
Mostallmenfindvalueinspeakingwiththethreedifferentspecialiststhattreat
prostatecancer:urologist,aradiationoncologistandamedicaloncologist.Get
consultationswithallthreebeforemakinganydecisionabouttreatment,togetabalanced
pictureofthebenefitsanddrawbacksofallthecancertreatmentoptionsavailabletoyou.
Instantlyquestionanydoctorwhosaysthatsheorhecan“cure”prostatecancer.
Whatdoes“cure”reallymeanforaprostatecancerpatient?Beskepticalofanydoctor
whodiscountsorminimizesthepossibilityofincontinenceorimpotencefromthevarious
prostatecancertreatments.
Askifactivesurveillance(monitoringyourcanceruntilatimewhentreatmentis
absolutelynecessary)isappropriateforyou.Trytobringasecondsetofears,afriend,
familymemberorvoicerecorderwithyouduringallconsults.Youarehuman,anditis
difficulttohearandlater,remember,everythingthatyourdoctormaytellyou.Readmore
aboutdoctorchoicemakingandgettingagoodconsultatMalecare.org.
Then,taketimetoletallofthisnewinformationrelaxintoyourthinking.
Experiencetellsusthatmenwhotaketimetogetanunderstandingoftherealitiesof
prostatecancerwillfindthemselvesmakingtreatmentchoicesthattheycanlivewith,
withoutregret,nomatterwhattheirlongtermoutcomes.Theguyswhosuffermostare
thosewhosuccumbedtotherushtotreatment.
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Now,continuereadingthroughthehundredsofpatientexperiencesaboutPSA
testing.Youarefreetoskim,orreadclosely,but,doaskyourselfwhilereading,ifPSA
testingisrightforyou.
Moreinformationaboutprostatecancer,andprostatecancersupport
groups,canbefoundatwww.malecare.org.Pleasefeelencouragedto
contactmeifyouhaveanyquestionsorcommentsaboutthisbook.
Note:Thephotosinthisbookarenotnecessarilythatoftheperson
whowrotetheadjacenttext.
DarrylMitteldorf,LCSW
ExecutiveDirector
Malecare,Inc.
Menfightingcancer,together.
[email protected]
Now,pleaseproceedtothenextpage.
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Richard
IamlivingproofofthevalueofthePSAtest.Iwasasymptomaticatage49andwas
diagnosedwithaPSAof58withmyfirstPSAtest.IwishIhadbeentestedearlier.
Gary
MyDoctorfoundmyPSAgoinguprapidly.Heorderedmetogetabiopsy,andit
wasfoundIhadahighcountthatshowedIhadprostateCancer,anditwasavery
aggressivetype.Ifeelthetesthassavedmylife,asearlydetectionallowedthemtotreat
mebeforeitspreadtootherareaofmybody.
Thomas
PSAtestprobablysavedmylife.HadIheededthewarningandmyprimary
physiciandonealsoImayhavehadmycancerremovedearlier.NowatthistimeIamwith
prostatecancerandPSArisingevenafterradicalprostatectomy.MysonalsohadPSAtest
asfirstindicationofhisprostatecancer.Ihavefivesonsandtheyareallatrisk.Atthis
momentwehavenobetterwarningsystem.
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Luke
IgotmyPSAtestedforthefirsttimewhenIwas51yearsold:averyhighand
dangerousscoreof38wastheresult.MybiopsyshowedcancerwithaGleasonscoreof
3+4=7.
IattendseveralgroupmeetingsoftheMalecaregroupinNYCanddecidedtogofor
thesurgery.IamnowwatchingmyPSAscoreaftersurgery,becausethatisthebestway
toknowwhentokillmycancerifitevercomesback.
IfmyGPdidnotrecommendaPSAtest,Iwouldstillbeunawareofadeveloping
cancer;nowIhaveafightingchance.
ItisnotthatthePSAscreeningtestthatistheissue,itiswhatthepatientand
doctorsdowiththeresult.PleasecontinuePSAscreeningforallhighriskmenandallmen
over45yearsold.
Michael
In2008Iwenttomydoctorforaroutinephysicalandfoundthatinthetwoyears
sincemypreviousexammyPSAhadincreasedfrom2to10.Adigitalexamrevealedan
anomaly.AsubsequentbiopsyreturnedadiagnosisofprostatecancerwithaGleason
scoreof7(4‐3).
AfterconsideringmyoptionsforacoupleofmonthsIchoseIMRTRadiation
therapyandnow,threeyearslater,IamcancerfreewithaPSAof0.4.Ihavenotsuffered
anysideeffectsfromthetherapyandmylifecontinuesasitdidpriortotreatment.
PSAtestsarenotanissue.Theissuesrevolvearoundsideeffectsfrombiopsiesand
therapiessuchassurgery.Weneedtorefinetherapiessothatmenexperiencefewerside
effects.Andwhenappropriate,themedicalcommunityneedstomoreconvincingwhen
theypromotewatchfulwaiting.
Eric
After25yearsofPSAtestingmyresultsstartedtoincreasedramatically.Aftera
positivebiopsyIelectedtohaveaRobotic‐assistedlaparoscopicprostatectomy.Ihave
hadacompleterecoverywithminimalsideeffects.
WithoutthePSAtestIwouldneverhaveknownaboutmycancer.Althoughthe
PSAtestisnotperfect,untilthereissomethingbetter,Ifeelmenshouldcontinuewiththe
testing.
Robert
MyfamilydoctorwatchedmyPSAnumbersoverafewyears.Whenthenumbers
begantorise,herecommendedabiopsyoftheprostate.Whentheresultscamebackas
positiveforcancer,Isoughtthebestsolution.BothdoctorsIconsultedrecommended
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
surgeryforamaleofmyage.IhadaradicalprostatectomyandmyPSAremainsazero,
threeandahalfyearslater.
WithoutthePSAtestsandthetreatment,Ilikelywouldhavehadcancerthat
spreadandperhapswouldhavekilledme.
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Paul
AcoupleofyearsagoduringaroutinephysicalthroughaPSAtestmyprimarycare
physicianfoundittobeveryhighat42andsentmeofftoanurologist.HediscoveredI
hadaninfectionandprescribedamedicationtobringthenumberdown.Itdidcome
downbutnowonlyto15somyurologistdidabiopsyandfoundcancerinmyprostate.I
electedforsurgery.Iamnowcancerfreeandfullyrecovered.HadInothadaPSAitwould
havebeenamuchdifferentstory.
Richard
Beingasurvivorofprostatecancer,Icanattesttotheimportanceofhavingablood
testforProstateSpecificAntigen(PSA).ItisfromaseriesofPSAtests,producingan
upwardtrend,thatfurtherinvestigationbecamewarrantedandrevealedanaggressive
cancerrequiringtreatment.FormeDigitalRectalExams(DRE)performedatthesame
timerevealednoevidenceofcancer.Itisimportanttonotethatsincethereisnohistoryof
prostatecancerinmyfamily;PSAtestingledtoearlycancerdetectionandsavedmylife.
William
WithoutPSAtestingmycancerwouldhaveremainedundetecteduntilatumorwas
largeenoughtobedetectedinaroutineDRE.WhenthePSAwasover4.0(nothingnoted
onDRE)IwasreferredtotheurologistwhodiddetectsomethingonaDRE.Asubsequent
biopsyconfirmedthecancer.ThebiopsyresultsalongwiththePSAhistorywhichshowed
therapidincreaseinPSAlevelresultedinmydecisionforprostateremoval.Inthe
absenceofroutinePSAtestingandtheresultinghistorymycancercouldhavegone
undetecteduntilitwastoolate.
Ken
Afterage50thePSAwaspartofmyannualcompanymanagementphysical.I
continuedtohavethePSAdoneafterretirementatage66.Atage68thePSAincrease
causedmydoctortosendmeforabiopsywhichwaspositiveandscary.Afterthe4
monthsofdailyradiationbothPSAandinternalexamshowednomoreprostatecancer.
WithoutthePSAtesting,IwouldneverhaveknownasIwasanotherwisehealthymale.I
nowexpecttoenjoytheLIVINGbenefitsofmyretirementyearsforalongtime.
Ted
ProstateCancerkilledmydad.Iwasdiagnosedatage47.Haditnotbeenforan
elevatedPSAIwouldnothaveinvestigateditfurtherandfoundit.Iamnowgoingon7
yearsasasurvivor.
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andadvocacynonprofitorganization.Learnmoreatwww.malecare.org
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Anonymous
ThePSAjustsavedmylife.I'm57anditdoubledinayear.Thatistheonlyflag‐
coupledwithtypicalurinaryissuesandfatigue‐thatpromptedthebiopsyanddiagnosisat
Stage1.Ihadmyprostateremovedlastweekandwilllikelyneverhavethatcanceragain‐
becauseitwasdetectedearlyandthereforeverytreatableorremovablewithlittlechance
ofspreading.Oh‐PSAtestingwillconfirmthatalso.It'sabsurdthatinsurancecompanies
wouldbothpromotepreventiveandwellnesscareandthennotpayforthePSA's.
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Raymond
PSAtestingallowedmetotracktheprogressofanenlargedprostatetothepoint
wherewatchingandwaitingseemedanunnecessaryrisk.Atthatpointabiopsywas
indicatedandperformedwhichresultedinastage3readingandtreatmentbyradiation.I
was79yearsold.Iamnow90andtheradiationtreatmentwascompletelysuccessful.PSA
testinginmycasewasanecessarypartofthediagnosisandtreatmentandavoidedundue
worryandindecision.Toavoiditseemedtometheheightofsilliness.
Phillip
PSAandDREtestssavelives.
Iamacommercialaviator–anairtransportpilot.Twenty‐twoyearsagoIwas
flyingcorporatejets,andIwasrequiredtoundergoamedicalexaminationeverysix
monthstodemonstratethatIwasfittofly.
Myaviationmedicalexaminer[AME],acardiologistcertifiedbytheFederal
AviationAdministration,wasrequiredbytheFAAtoofferallmalepilotsage40andolder
adigitalrectalexamination[DRE]forearlydetectionofprostatecancer–secondgreatest
killer‐cancerofmen,afterlungcancer,andcauseofdeathofmorethan34,000American
menannuallyinthemid‐to‐late1980s.
Atthattime,theFAA,likemanyfederalagencies,withoperationaltruckers,
railroadengineers,ship’sbridgecrews,militaryandcivilianflightpersonnel,andothers
wererequiredtocomplywithanedictfromtheCentersforDiseaseControlinAtlantato
offermalesaged40andolderdigital‐rectalandprostatespecificantigen[PSA]testingfor
prostatecancer.
InFebruary1989,myAMEfoundaninduration–alumpinthedistalportionofmy
prostate.HerecommendedIconsultwithanurologist.Ididsobuttheurologistthoughtit
wasmerelyanenlargedprostate,andtreatedmewithantibiotics.
Fouryearsandeightflightphysicalexaminationslater,myAMEwassoalarmed
overwhathedescribedasthehardestlumpheeverpalpitatedinapilot’sprostate,thathe
recommendedIseekasecondopinion.
WhenIadvisedmyurologistofmyAME’sconcern,heagreedtobeginaseriesof
six‐needlebiopsiesofmyenlargedprostate.Finally,inlate‐1993,afterthreebiopsiesand
18needletissuesamples,theurologistandhistechniciansfoundAdenocarcinomacells–
prostatecancer,judgedbyalocalpathologisttobeGleasonScore6.
Bylate1993,scansandvarioustestspromptedmyurologistandvarious
consultingspecialiststodeterminethatmytumorhadlefttheprostate,wasinmy
abdomen,andhadmetastasizedtomypelvis,ribs,andotherbonesinmybody.
Andsobeganmylongbattleagainstprostatecancer.
Nineteenyearslater,afterunsuccessfulexternalbeamradiation[70Grayover
sevenweeks],nearlysevenyearsofandrogendepletiontherapy[ADT],severalhormone
shots,65hoursofhyperbaricoxygentreatment,participationina28‐manphaseone
prostatecancervaccineclinicaltrial,IcontinuetoundergoregularchecksofmyPSA.
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Ihavediscontinuedmedications,mytumorgrowthapparentlyiscontrolledandI
amaveryactive,productivememberofsocietywho,atnearlyeighty‐oneyearsofage,
participatesasanexecutiveofficerofa39‐stateprostatecancercoalition,Iamacertified
flightinstructorforsingle‐andmulti‐engineaircraft,instrumentflightinstructor,witha
commercialseaandmanyotherflightratings.
IamafirmbelieverinDREandPSAtestingtodetectpotentiallylethalprostate
cancerasearlyaspossible,andtocontrolorcurecancer,ratherthandiefromit,liketoo
manyofmydeadfriends.
Anonymous
IammarriedtoamanwhodiscoveredhehadprostatecancerbecauseofaPSA
test. IbelievethathewouldnotbewithmetodayunlesshehadaPSAtest.
Bruce
Iwasdiagnosedwithprostatecancerinlate2003becauseoftheearlywarningsof
thePSAtest.Theoriginaldiagnosiswassubsequentlyconfirmedbybiopsyandlaterin
May2004receivedasuccessfulradiationseedimplant.Ihavenodoubtthatwithoutthe
PSAtestdetectionoftherelativelyrapidriseinmyPSAthatIwouldhavefacedan
uncertainoutcome.
Greg
Aboutoneyearago,aftertheurgingofmywife,Iwentinforaroutinephysical,a
PSAscreeningwaspartoftheprocess.TheresultscamebackwithanevaluatedPSAlevel
withpromptedtheschedulingofavisitwithanurologist.HisPSAtestalongwitha
prostateexaminewarrantedaprostatebiopsy.Withthoseresultscamethephonecall
thatchangedmylifeforever,IwastoldIhascancer.
Iunderwentsurgerytoremovemyprostateandknockonwood,myfirstyearasa
cancersurvivorhasbeenanenlighteningone.WhenIreadanarticleabouttherecent
reportthatPSAtestsareunnecessaryandthattheyhaven’tsavedanyone’slifeIalmost
felloutofmychair.IamlivingproofthatthePSAtestcananddoessavelives,itdidmine.
Val
AfterIfinishedprotontreatment,IwastoldtogetPSAtestedevery3months.PSA
hadbeenaround0.3forayearandIalsocontinuedmyLuproninjections.ThenPSA
startedtodoubleevery3monthsandayearlateritwasover4.Myoncologistbecame
concernedbutneededtobesureitwasnotatestingerror,soaretestresults2weeklater
showedevenahigherPSA.Wealsoneededtomakesurewewerenotexperiencingan
Foundedin1998,MalecareCancerSupportisAmerica’sleadingprostatecancersurvivorsupport
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
infection.Wetriedoneantibioticfortwoweeks,itdidn’tworkPSAon12/04/2010was
9.3sowewenttoanotherfamilyofantibiotics–nohelpPSA17.8on1/24/2011. MyoncologistsuspectedcancersowestartedwithbonescanthenCTandMRI,no
cancerdetectedbutPSAroseto25.6by03/10/2011.Oncologistdidnotgiveup,he
obtainedpermissionforPETNaFF18(designedforboneinvestigation)–nothing
positive.HethenrequestedPETdfgF18–Bingo–almostallabdominalandsomechest
lymphnodeswerefilledwithcancercells.Myprostateontheotherhandwasclear
indicatingProtonCenterdidagoodjobbutunfortunatelycancerbecamemetastaticprior
totreatment.PSAbecametheguidethatletusdiscoverlocationofmycancerthrougha
rightinstrument.RadiationoncologistsuggestedIgotoamedicaloncologistfor
treatment.
AftermanytestsandscansmymedicaloncologiststartedmeonDocetaxel
chemotherapyon4/07/2011.PSAwasstillrisingandafter4infusionsMRIindicated
growthinlymphnodes.IwasswitchedtoCabazitaxel(Jevtana)chemotherapyandPSAat
30on07/12/2011.After4treatmentsPSAincreasedto48.35on09/16/2011soanother
MRIshowedfurthersmallincreaseinlymphnodesizes.On10/062011withPSArisingto
50.61itwasdecidedtodiscontinueCabazitaxelandtryZytiga.Aftermuchapprovalwork
IstartedZytigaon10/21/2011andplansaretomonitorPSAevery3weeksprobablyfor
next8months.
Asonecanseefrommyexperience,PSAwasavaluabletoolthatmyradiation
oncologistwasurgedtokeeplookingforcancertillitwasfound.Mymedicaloncologist
usedPSAtorequestMRIforconfirmationthatchemowasnotworkingandchangeshadto
bemade.
Anonymous
Iamasurvivorofprostatecancerforover4years.
IhavehadaseriesofPSAtestsovertimeandIskippedonePSAtest.Thefollowingyear,
whenIwas73,thetestprovedpositiveandwithaGleasonScaleof9,whichledto
radiationtreatment.IfIhadnothadthatPSAtest,IfeelcertainthatIwouldnotbethere
today.MycurrentPSAtestwas.02
Therewasnoprostatecancerinmyfamilyhistory,whichsomewouldsayisa
reasonnottohaveaPSAtest.Iwouldsaythattheyarewrong.
Craig
Ittookme14yearstofinallygoformyyearlycheck‐up.AndIgotthebadnews
thatIhadprostatecancerhadaPSAof59.9andwasoutsidetheprostategland.IfIwas
onethoseguysthatwentforannualphysicals,IwouldbewhereI’mnow.
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Stephen
Iwasdiagnosedwithprostatecanceratage53.Bythetimeitwasdiscoveredbya
digitalexam,ithadspreadbeyondtheprostate.HadIfollowedtheguidelineoftesting
PSAatage50,Imightnotstillbedealingwiththecancerbecausethetreatmentsmight
haveputitintoremission.
Joe
IhadanelevatedPSAnumberatage64.Mydoctorsuggestedanothertestafter
threeweeks–itwasalsoelevated.HesuggestedIvisitaspecialist.Hedidnormaltesting
andsaideverythinglookedOK.But,sinceyouareinherewhynottakea
biopsy,whichtheydid.
HeaskedmeaboutthesevennormalindicatorsforProstateCancer–Ihadnone.
TheresultscamebackandItestedpositivein3ofthe8tests.Afterdiscussingitwithmy
regulardoctorandfamily,Ischeduledtheproceduretoremovemyprostate.After
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operationtheyfoundthatIhadcancerontwooutersidesoftheProstategland.Further
follow‐upshaveproventhecancerdidnotmovebeyondthemargins.AFTER10YEARSI
AMHEALTYANDNOSIGNSOFRETURN.
IcautionedmythreesonsandmybrotherthattheyshouldrequestaPSAteston
theirnextannualphysical.Theydidthistogetabase‐line’oftheirPSAlevel.
Allturnedoutnormal.
LASTYEAR,THEPSAOFMYELDESTSON(age51)WASELEVATED,theydid
normalfollow‐upsandretesting.WithinsixmonthsHEWASALSODIAGNOSEDWITH
PROSTATECANCER.Now,sixmonthslater,hehashadRoboticsurgeryandhadthegland
removed.Followuptestinghassofarproventhatithasnotspread.
Ward
3yearsago(atage58)IhadnotevenheardtherewassomethingcalledProstate
Cancer(PC).IhadneverhadorheardofaPSAtest.Iwashavingsymptoms(Ididnottell
anyoneabout)thatIdidnotunderstand.So(2and1/2yearsagoatage59)Iwentfora
physical.AsaroutinemynewdoctorincludedaPSAtest.ADREdidnotindicateanything.
Theresultwas75.Heknewrightawaywhattheproblemwasandsentmetothe
Urologist(bythenthePSAhadrisento79).Afterbiopsies(all12sampleswereallPC)and
scansitwasdeterminedthatIhadStage4advancedmetastatic(Gleasonscore9)PC.It
hadalreadydamagedpartofmybladder.Ithadspreadthroughmanylymphnodes(more
biopsies)upmyback.OfcourseIstartedtreatment.
NowwhenIgetaphysicalmydoctorremindsme(accurately)thatIwouldbedead
todayifitwerenotfortheroutinePSAtest.MyfamilyandIallthankGodthatmydoctor
hadtheforesighttoincludethat“routine”PSAtest.
Anonymous
MyPSAwasdeceptivelylow,1.5,foramanof66years,butaroutinedigitalrectal
examtoldthestory.OnemightthinkthatIwouldbeopposedtothePSAtest.Onthe
contrary,Ihavetoomanyfriendswhofirstlearnedofapossibleproblemastheresultofa
highPSA.ThisledtoaDRE,biopsy,etc.resultinginthediscoveryofaggressiveprostate
cancer.Thetestisfarfromperfect,butitisoneofaveryfewtoolswehavetopointusin
therightdirection.Hopefullynotreatmentiseverperformedwithoututilizingallthe
toolswehave.
Therearenearly34,000reasonswehaveeachyearintheUnitedStatestoremind
usoftheimportanceofeverytool,nomatterhowimperfect.Wecannotlosesightofthe
livesthatarelost.
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Ed
ItstartedinNov2009.DuringmyregularphysicalIhadaPSAtest.Thenumbers
werealittlehighandIhadanotherone6monthslater.Itwentupagain.Iwasputon
antibioticsfor3weeksandthenanotherPSAtest.Itwasupagain.Thatledtoabiopsyand
inNov.2010,Iwasdiagnosedwithaveryaggressiveprostatecancer.Nofamilyhistory
andnosymptoms.IhadaradicalprostatectomyinDec.2010andamalivetodayand
recoveringnicely.TheonlyreasonIamaliveisbecauseofPSAtesting.
Harley
Inthesummerof2007asapartofaroutinephysical,mydoctororderedaPSA
test.AbloodtestrevealedanelevatedPSAcountandIwasreferredtoaUrologist.What
followedwasabiopsyresultinginaGleasonScoreof8.Furthertestingrevealedthe
cancerwasisolatedtotheprostateandIbegantoresearchthevarioustreatmentoptions
availabletome.Followingmuchresearch,asecondopinionandalongconsultationwith
myurologistIoptedforaradicalnervesparingsurgeryprostatectomy.
ThiswasnotadifficultdecisionasthiswasnotmyfirstcancerandatthetimeI
was57yearsold.OfcourseregularPSAscreeningfollowedthesurgery.Myscoreswere
wellwithinintheacceptablepostrangesurgeryuntilJuneof2011.Again,throughtheuse
ofPSAtestingIwasdiagnosedwitharecurrence.Nowtheprocessofresearch,securinga
secondopinionandmeetingswithmyurologistareassistingIamexaminingtreatment
optionstohandletherecurrence.MyfamilyandIfeelthatthePSAtestwasalifesaverand
I’mforevergratefulofitsavailability.
Linda
Mystoryisalittledifferent,asthePSAdidnotsavemyhusband.Hewasoneofthe
2.8%thathadtherareaggressivetypeofcancer.HisPSAcamebacknormal,asdidthe
physicalexam.
InJulyof2009,justafterwebothretired,hefellinourpoolbreakinghisback,
leavinghimparalyzedfromthechestdown.Hediedonceduringsurgery,andtheynever
expectedhimtomakeitoutofrehab.Hefought,andcamehomeafter5weeksinrehab,
notevenneedingsub‐acuterehab.Hecamehomewithpaininhisshouldersandchest.His
painwasignored,andblamedonthespinalcordinjury.Itwasbonemets.Beforehefellin
thepool,hehadbeenhavingproblemswithfrequenturination,slowstream;allthered
lights.Butduetohisinjury,thatallbecametransparent,ashehadtoselfcatharsize
himself.
Finallyafter8daysinbedandnohelpfromhisdoctorsItookhimtotheERwhere
theyfoundthebonemets.Fromthereonitwasadownwardspiral.Wedidlotsof
alternativemedicine,stoppedthechemoasthatjustaboutkilledhim.Ultimatelythe
cancerwonandIlostmybestfriendandsoulmate.Iamcrushedandlostwithouthim.
ThePSAisnotthebesttestintheworld,butit’sallmenhavetouseasabaselineand
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somewhatpredictorofaproblem.Amanandhisfamilyhavetherighttomaketheir
decisiononatreatmentcourse.NotdoingthePSAandnotpayingforitwillcostour
spouses,fathers,sons,brothers,andfriendstheirlives.
Rick
Turning50,Ihadnonoticeableissueswithmyprostate,butitwasrecommended
thatIhavemyfirstbaselinePSAscreeningforprostatecancer.Thetestcamebackhighat
6.2,threemonthslaterat8.1,andoverthenextfewmonthsitwentupto10.2.ThoughI
hadasmallprostateandnoothersymptoms,Ihadthebiopsy,whichunfortunately
showeda75%malignancy.
Aftersomeresearch,Ichosetohavea(robotic)radicalprostatectomy,wherethe
post‐operativebiopsyshowedanaggressivecancerveryclosetotheedge,butluckily
withinthemargins.Previousfinger(rectal)examsdidnotsuggestanyearlier(insurance
covered)PSAtest,soIamgratefulthatmy‘agefifty’insuranceguidelinewasineffect.
IwouldevensaythatassertivelyloweringtherecommendedPSAscreeningageto40,
couldgiveamanbetterpreventativeoptions,especiallyforthoseathigherriskof
prostatecancer.
IamawarethatthePSAtestisn’texacteither,ithasitslimitations,butitisoneof
thefewtoolswehavethatcanaidinearlyprostatecancerdetection.ThePSAscreening,a
simplebloodtest,wastheredflag(notaproblemcreator)thatsavedmylife.
Donna
Ihavelostonebrothertoprostatecancerattheageof57.Bythetimeitwasfound
ithadspreadtohisbones,lymphnodesandultimatelybraintumors.Ifthedoctorhad
onlydoneaPSAtestwhenhefirsthadsymptomsormoreimportantlyifithadjustbeena
routinetestforhimlikeamammogramisforme,wouldhestillbeherewithustoday?But
hehassavedhisyoungerbrother’slife.
Atage49,ouryoungerbrotherhadbeentestedforacoupleofyearsnowandwhen
therewassuddenlyarapidriseinhisPSAlevelwasimmediatelysenttourologist.Aftera
biopsythedreadednewscameonceagain.Butbecausetheyweretestinghim,itwas
caughtinveryearlystageandheoptedforradicalremovaloftheprostateandamonth
aftersurgerynowisdoingfinewithnocomplications.Hewillcontinuetobewatchedto
makesurethereisnorecurrence.
William
IwasdiagnosedwithprostatecancerinMayof2005.3of12coreswerepositive,
Gleason7andahighPSAof50.IhadroboticsurgeryinSeptemberof2005andmyPSA
hasbeen0.01orlowereversince.ThankGodtosometerrificsurgeonsandthePSATEST.
Thistestisthebestthatwehaveatthepresenttime.Whynotkeepusingit.Icouldsee
stoppingitsuseifyouhadsomethingbettertoreplaceit,butyoudon’t
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Mark
Myeldestbrotherwasdiagnosedwithprostatecancerthathadspreadbeyondthe
prostateover8yearsago.Sincethattime,IwastakingmyPSAtwiceayear.Andoncemy
PSAshowedsomeerraticreadings,Iwenttoaurologistandhadabiopsy.Inadditionto
twiceayearPSAreadings,biopsiesandaPC3test,acanceroussamplewasdiscoveredon
oneof16samplesextracted.Fromthat,Idecidedtohavemyprostateremoved.The
cancerwascontainedinsidetheprostate.I’vehadtwoPSAreadingssincesurgeryandthe
cancerisundetectable.IwillneedtotakePSAtestsfortherestofmylifetodetermineif
theantigenispresentordetectable.
Edwin
AttheyearlyphysicalinNovemberof2005IwastoldthatmyPSAhadjumpedtwo
pointsinthelastyearandwassenttoaurologist.HedidabiopsyandsaidthatIhadtwo
canceroussamples.ThereforeIhadtheprostateremovedinMarchof2006andthepost‐
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surgicalbiopsyonceagainconfirmedtwoareasofcancerwithGleasonscoresof3‐3and
3‐4,respectively.TheurologisthaskepttakingPSAreadingswhichwereessentially0
rightaftersurgeryandhaverisentoa0.2now5.5yearslater.IamthankfulthatthePSA
testhelpedusfindthecancerandthattheurologiststillhasthistooltofollowany
changes.
John
IwasdiagnosedwithprostatecancerinMarch2010.BecauseIhadestablisheda
baselinePSAat50yearsofage,myvelocityindictedaproblem.AbiopsyledtoaGleason
scoreof7(4+3)andacommentfrommyurologistthatmyintermediateaggressivecancer
undiagnosedwouldhaveledtomydeathin3‐5years.Aftermuchresearch,Ichosetouse
protonradiation.ThankstothePSAtestandmyoutstandingtreatment,myPSAisdown
to0.9andmylongtermprognosisisexcellent.Ihavenosideeffects15monthslaterandI
havemuchtobethankfulfor,especiallymyyearlyPSAtest.
Anonymous
Whenmyhusband’sprostatecancerwasdiscovered,hisPSAwasalreadyover100.
Hewas58.Hehadapaininhisbackandwelearnedthattumorswererampantupand
downhisspine.3yearsearlier,hisPSAwas“normal.”Afternumeroustreatmentsand
clinicaltrials,hediedatage59.
Hiswas,obviously,themoreaggressiveformofcancer.But,withannualPSAtests,
wemighthavecaughtthisandtreateditinsuchawaythathewouldstillbealivetodayto
enjoyhisgrandchildren,andcontinuetogivebacktotheworldthathadgivenhimso
much.I’drathererronthesideofcautionwhenitcomestoPSAtestingasIsowishwe
haddone.Imisshimterribly.
Rick
Iwilljusttellyouofmyexperience.Iwentforaphysicalafternothavinggoneto
theDr.’sforafewyears.HeorderedaPSAanditcamebackat4.5Ihadnosymptoms
exceptabitofurgencyandgettingupatnightafewtimes.CheckingbackonearlierPSAsI
foundthatIhadslowlybeenrising.MyurologistorderedabiopsyandIwasdiagnosedat
61andhadsurgeryjustbeforemy62ndBirthday.Ichosetheroboticradicalsurgery.
IwasstagedT3a,withaGleason6(3+3).Bonescanwasclear,aswerethelymph
nodesbutthecancerhadprogressedbeyondthecapsule.Ihavecontinuedwithtwice
yearlyPSAswhichhaveremainedundetectable.Ihaveelectednottohaveradiation
unlessthePSAbeginstoriseagain.IamverygladmyDr.orderedthatPSAasmyfather
KidneyCancerat50andmymotherhadBreastCancer.
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Anonymous
MyprostatecancerwasdiagnosedwhenIwas60yearsold.Iamnow73.ThePSA
testsindicatedthatmyPSAscorewasrisingovera24monthtimeperiod.Abiopsywas
performedandthecancerdiagnosiswasconfirmed.IwastreatedbyBrachytherapy
(radioactiveseedimplantation).ThiswasfollowedupbyExternalBeamRadiation
treatmentforsixtoeightweeks.
Sincethetreatment,IhavehadmyPSAtested,initiallysemiannuallyandthen
annually,andsofarmyPSAscorehasbeennegligible.Ihavehadnosideeffectsfromthe
treatmentsandsofarIamdoingwell.Iamstillsexuallyactivebutatareducedleveland
withthehelpofViagra.Idon’tknowifthereducedsexualactivityistheresultofthe
radiationorifthatiswhatnaturallyhappensatmyage.
Iamdistressedthatthereislittlemoreknowledgeabouttheappropriate
treatmentcoursenowthanwhenIwasdiagnosed13yearsago.Mentodayfacethesame
difficultandstressfuldilemmawhentryingtodecidewhatisbestforthem.Bottomline
formeisthatIampleasedthatthePSAtestinghelpedfindthecancerandthatmy
treatmentappearssuccessfulatthispoint.
Richard
ThePSAtestsavedmylife.Itestedpositive10yearsagoattheageof58andhad
surgerytoremovemyprostate.Myfatherdiedofprostatecancer.Iamthankfulthatmy
PCPinsistedthatIgetaPSA.
Robert
PSAtestingsavedmylife.Myusuallineis“Mywifesavedmylife.”Iwas59,had
shinglesandhatedgoingtothedoctor.Shemademeseeherinternist.Hecouldn’tcure
theshingles,but,sinceheansweredtomywife,hegavemealongoverduecomplete
physicalincludingaPSAtest.Afewdayslater,hecalledandsaidmyPSAwassomewhat
high.Itwasprobablynothing,buthethoughabiopsywouldbeagoodidea.
Iputoffgoingtotheurologistforafewmonthsbecauseofwork,holidays.Again
theurologistsaiditwasprobablynothing,butherecommendedwecheck.Iagreed.
Theprocedure,totakeadozensamplesfromdifferentareasofmyprostate,was
unpleasant,butnotawful.Thepre‐testanxietywasactuallyworsethanthebiopsy.Ileft
prettyconfidentthatweweredonewithmedicalstuff.
TheurologistcalledonaFridayafternoonandaskedmetocomerightover.My
wifemetmeattheoffice.Thedoctorseemedupsetashetoldusthatthetestwaspositive.
Infact,cancerwasfoundinalmostallsamplesandtheGleasonscore(aseverity
measurement)was7,moderatelyhigh.Atthatpoint,mycancerwasconsideredtobe
StageT2(onascaleofT1,leastsevere,toT4,mostsevere).
TheurologistbrieflyoutlinedtherangeofchoicesIhadtodealwiththisnews–
ongoingmonitoringwithoutactivetreatment,calledwatchfulwaiting;varioussurgical
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approachestoremovetheprostateand,ifnecessary,surroundingtissue;orradiation
treatments.Othertreatments,suchaschemoandhormones,probablywouldbe
consideredifoneofthefirstthreewerenotsuccessful.Hesuggestedthatwedosome
researchonourown,talkwithourinternistandthinkitover.
Aftermuchreading,talking,conferringwithotherdoctors,wedecidedonradical
prostatectomy,surgicalremovalofmyprostate.Duringtheprocedure,thesurgeonfound
thatmyseminalvesicles,outsidetheprostate,werealsocancerousandremovedthemas
well.Fortunatelynolymphnodesshowedcancer,reducingtheriskoffurtherspread.The
stageofmycasewaschangedtothemoresevereT3bN0becauseithadspreadjust
beyondtheprostate.
Duringfollow‐uptestingafewmonthslater(PSAagain),itwasdiscoveredthatI
stillhadcancerousprostatecellsactivesomewhereinmybody.Afterconferringwithmy
wife,surgeon,internist,andaradiologist,Ibeganradiationtreatment.Myoncologistalso
offeredmethechoiceofjoiningaclinicaltrialusingchemotherapyandhormone
treatments,thetheorybeingthatthiswouldpreemptivelykillanyremainingcancer
beforeithadachancetoreestablishandspread.Again,mywife,myinternistandI
discussedit,andwedecidedtoproceed.
Eachofthesetreatmentswasunpleasant,tosaytheleast.Thesurgeryleftme
frightened,miserableforweeks,andexhaustedformonths.Theradiationsappedmy
energy.Eachchemotreatmentmadememildlyillforafewdaysandtwitchyandirritable
constantly.Thehormonesinducedatruemalemenopause–weightgain,hotflashes,
moodiness,lostlibido,wreckedskin,fatigue,whichlastedthreeyears.Thecombinationof
treatmentsleftmewithmild,butlong‐termdigestivecomplicationsandaconcernabout
possiblefurthernegativeeffectsdowntheline,becauseoftheradiationexposure.
Iwouldn’tchangeathing.Ihatethetreatmentssideeffects.Buteverythingtellsme
that,givenmycondition,asdemonstratedduringsurgeryandfollow‐uptests,mycancer
wasseriousandaggressive.Ifithadn’tbeencaughtwhenIwas59,itishighlylikelythatit
wouldhavespread,mademeveryillandsubstantiallyshortenedmylife.
Iamnow64yearsold,andthismonthIgobackformyfiveyearfollow‐uptests.
Everyreportsofarhasbeenclean–undetectablePSA.Ihope,andexpect,thatthisone
willbethesame.Ifitis,wewillquietlycelebrate.IrelishthetimeIhavenow,andplanto
keeponhaving,withmywife,oursonsandmynewgrandchild.Ifthetestdoesindicatea
recurringcancer,wewilltalk,researchandthink,andthendecidewhatisbesttodo.
ApositivePSAtestdidnotmakemeundergoanyoftheseproceduresor
treatments.I,mywife,myfamily,mydoctorstalked,thoughtandmadedecisionsthat
seemedrightforme.Iweighedanddecidedtotaketherisksassociatedwitheachtestand
intervention.Icannotbesurethatmycancerwouldhavespread,justasIcannotbesure
thatitwillneverrecur.ButthefirstPSAresultgavemeinformationthatstartedmeonthe
decisiontrack.
ItappearsclearfromrecentresearchthatPSAdataisfarfromperfect.Itcannottell
whethertheelevatednumbersareanormalhighoratruesignofpathology.Itcannottell
whetheracanceritdoesreflectsisfastorslowgrowing,orjusthowaggressiveitmay
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become.Butwithoutthetest,Ineverwouldhavestarteddownthepaththatfoundmy
fairlydangerouscancerandgaveme,whatIbelieve,ismybestshotatalonger,healthier,
happierlife.
IknowthattherearenumerousfalsepositivesonPSA(andmaybefalsenegatives),
andthatevenafollow‐upbiopsycanresultincomplications.ButthePSAisjustanumber,
notamandate.Thetestgivesthepatient,hisfamily,hisdoctors,information,limited
thoughitmaybe,andthefreedomtomakeadecision.Lackofthatnumberjustleavesus
inthedark.
Weneedmuchbettertests,andbetterwaystousethePSAandotherteststhatwe
currentlyhave.Butuntilwedo,IwanttheopportunitytofindoutmyPSAandmakemy
owndecisionastowhatisnext.Iwantmysonstohavethatsamechoiceaswell.
David
Inlate2010,baseduponhigherthannormalPSAnumbers,myfamilyphysician
suggestedImeetwithaUrologist.FurthertestingbymyUrologistledtoabiopsyinearly
March…anon‐toopleasantexperiencewithagreatdealofpain,swelling,andavisittothe
emergencyroom,catheterplacementfortwodaysandbloodinmyurineforseveral
weeks.
OnApril1st,2011,IwasdiagnosedwithProstateCancer.
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Asarelativelyyoungmaninmyearly50’s,youcanimaginethatIwasquite
devastated.
MenofALLagesovertheageof49,untilabettermethodisfound,GETYOURPSA
TESTANNUALLY.Andifyouarediagnosed,doyourresearch.Meetwithmultiple
urologistsandradiationoncologiststodeterminethebestcourseoftreatmentforyou.
Kathie
IfullyagreethatthePSAtestisfarfromperfectbutrightnowit’sthebestearly
indicatoravailable.HadmyhusbandhadaPSAdonewewouldnodoubtstillhavehim
withusbutunfortunatelythatisnotthecase.IfIcouldhavehimbackwithimpotenceand
incontinenceIwouldbethrilled.Mynephewandmybrother‐in‐lawbothhadearly
detectionfollowedbysurgeryandIknowtheirfamiliesarebeyondgratefulfortesting.
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Paulie
Mydadsurvivedprostatecancerinthe1970's.Let’sjustsaythetreatmenthas
changedradicallysincethen.MymomsurvivedbreastcancertwicesoIknewmy“cancer
clock”wasticking.MyelevatedPSAin2010requiredabiopsy,whichfoundlocalized
cancer.Afteraradicalprostatectomy,follow‐upPSA’sshownoreoccurrence.
SoifIdidn’thavethePSAresults,Iwouldn’thavehadthebiopsyandIwouldn’t
havedetectedthecancerandI’dbewalkingaroundwithcancertoday,ignorantbut
hardlyblissful.
NowI’mahappygrandpaof3withonemorecominginDecember.ThankstoPSA
testing,Ihaveachancetowatchthemgrowup.
John
IhadmyroutinephysicalinSeptember2007.Aspartofthebloodworkup,aPSA
wasdoneandtheresultscamebackhigh.After30daysofantibioticstoruleoutinfection,
thelevelincreased.Iwasreferredtoaurologist.Onceestablishedattheurologist,a
biopsywasdone.9of2corescamebackpositivewithaGleasonscoreof(4+3)=7.Being
young,Ioptedforaprostatectomy.ThepostopresultsconfirmedtheGleasonscoreand
thetumorinvolved60%oftheprostate.Iamnearlyfullyrecoveredat7monthspostop.
ThePSA,inmyopinion,savedmylife,andjustonelifesavedisreasonenoughto
encouragetesting.
Everett
In2005attheageof52,IdecidedtoaskforaPSAtestasInoticedthatIwas
havingacoupleofthesymptomsthatJoewaswritingabout.ThePSAtestcamebackwith
aGleasonscoreof8.0andIimmediatelyhaveaBiopsywhichcamebackwith8of12
sampleswithapositivereading.IimmediatelyafterspeakingwithmyUrologisthad
SurgerytoremovetheProstateandhereIamCancerfreetoday.
IstillhavePSAtestsannuallytoendurethattheCancerhasnotreturned.Acouple
ofyearsagomy44yearoldbrotheralsowasdiagnosedwithProstateCancerafteraPSA
testandalsoisCancerFree.ItwouldbeashametodoawaywiththePSAtest.Iwould
highlyrecommendittoanymaleover50orearlieriftherehasbeenahistoryofitinyour
family.
Anonymous
Iwasdiagnosedwithprostatecancerattheageof46.Thediseasewasalreadyin
thelymphnodesbesidetheprostatewhenIwastohavesurgery.AnearlierPSAscreening
mighthavesavemefromstrugglingwithdiseaseforthelast20years.
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Paul
IwastotallyshockedwhenIfoundoutthatIhadbeendiagnosedwithprostate
[email protected],butthePSAwasincreasingatdouble
thenormalrate.Aninitialphysicalexamdidnotshowanyswellingorabnormalities.On
thebiopsies2/10showedcancer.Sincemycancerwasaggressive,Ihadaradical
prostatectomy.Thebiopsyoftheremovedprostatehadshownthecancertobeconfined
totheprostate.Surroundingtissueshadnotshownanycancer.
Over2yearslaterIamcancerfree.IhavehadnoincontinenceproblemsbutIstill
haveaproblemgettinganerection.MyurologistandIareworkingonthisproblemand
therearesolutionsforthisproblem.I’mgratefulthecancerwasremoved.Prostatecancer
issoprevalenttoday,thatscreeningisamust.
Paula
Myhusbandisactivedutymilitaryandhewasscheduledforhisannualphysical
whenaco‐workersuggestedheaskforaPSAtest.Myhusbandwas38yearsoldandhad
notexperiencedanysymptomsofprostatecancersoweknowitwasdivineintervention
becausemyhusbandlistenedtohisco‐worker’ssuggestion.HeaskedforaPSAtestnotat
allexpectingtheresultswouldhaveanymajorfindingssowhenthedoctortoldhimhis
PSAlevelwas4.6wewereshocked.Hewasreferredtoaurologistwhowithina3week
timeframeretestedhisPSAwhichwasnow4.8.Theurologistputhimonantibioticsto
ruleoutaninfection.
Afteranother3weeksandantibioticshisPSAwastakenagainwithnochange.The
urologistscheduledhimforabiopsies.Theresultsofthe14samplesshowedcancerin12
withaGleasonscoreof6.InMarch2011,myhusbandhadhisprostateremovedby
roboticsurgery.TwoPSAtestslaterandhisPSAisZERO!
John
Ineedtotellmystory.Iamahealthy50‐year‐oldguywithawonderfulwifeand
twokidsages6and8.IalsohaveagreatjobasabuilderinSouthDakota.Lifeisgood,
thingsaregoinggreat,orsoIthought.
IwasdiagnosedwithmetastaticprostatecancerinlateAugust2010.Mywholelife
changed!IfeelasthoughIhaveanewpurposeinlife,thatnewpurposeistoeducate
everyguyoutthereaboutprostatecancer,whatitis,whyit’simportanttobechecked
everycoupleofyearsuptoage45,theneveryyearafterthat,andhowtoavoidgetting
thiscancer.
Mywifesays,“Johnhascancer,butcancerdoesn’thavehim.”
ThePSAtesthelpeddiagnoseProstateCancerinme.Forthreeyearsmydoctorsdidnot
doaPSAtestsothecancergrewandspread.OnceaPSAtestwasfinallydoneitconfirmed
Ihadprostatecancer.APSAof1770thistestissoimportanttoallmen.
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Anonymous
Afterhitting50yearsoldIstartedgettingPSAtests.At53myPSAstartedto
rapidlyrise.DoctororderfurthertestsandProstateCancerwasconfirmed.Iwasoperated
onandhavebeenCancerfreeforover10years.ThetestshelpsavemylifeandIamvery
thankfultheywereavailable.
Althoughtherearesideeffects,theyarebetterthanbeingdeadinmy50’s.Ibelieve
PSAtestingistomenwhatbreastcancerscreeningsaretowomen.
Sandra
Menhavearighttoknowwhatishappeningwithintheirbodyandthentomake
informeddecisions.ItiscondescendingtosaythatyouwanttoeliminatePSAtesting
becauseoftheproblemofovertreatment.Itisourjobasadvocatestoseethatmenand
theirphysicianshavethebestinformationavailablesotheycandecideonthebestcourse
forthemselves.
MyhusbandelectedActiveSurveillance(thenknownaswatchfulwaiting)and
whenafterafewyearshisnumberssuddenlybegantorisehemadethedecisiontooptfor
surgery.Though73atthetimeofhistreatment,hisDadhadlivedto94andIthinkthat
sometimesweforgetthatmenlivelongerlivesthanwhatwasexpectedyearsagoand
havearighttoavoidthehorribledeathofprostatecancer.
Lee
AfriendofminewasdiagnosedwithProstatecancerafterchanginghisinternist.
Hispreviousonedidn’t“believe”inPSA’sbuthisnewoneinsistedonitandmyfriends
PSAwasquitehigh.
Meanwhilemywifeaskedme“what’syourPSA?”Myresponse(Iwas56yearsold,
itwas1997)was“what’saPSA—andfurthermorewhatistheprostrate”.Ididn’teven
knowhowtospellit(andIhadaPHDinbiomedicalengineering:–(.Anyhow,Iaskedmy
Dr.whatmyPSAwas,hesaiditwasfind,butIhadn’tbeentestedfortwoyearssoIwent
inandgotthePSAtest.Myinternistcalledme,sayingthatmyPSAhadrisenconsiderably
andIshouldgotoaurologist.TheurologistdidareturnPSAafewweekslateranditwas
stillabithigh(5.6ifIrecall).
Hecouldn’tfindanythingwithaDREbutsuggestedthatIgetabiopsy.Ireadabit
aboutprostatecancer,spoketoafewcolleaguesattheUniversitywhohadbeen
diagnosedwithProstatecancer,anddecidedthelikelihoodofcomplicationsfromthe
biopsy(whendonebyanexperiencedurologist)wasquitesmallandworththeriskof
findingoutmoreaboutthestateofmyprostate.TheDr.calledmeandmywifein(a
companionisamusttoheresomewhatcomplexandanxietyraisingreports)andtoldus
thattherewasconsiderablymalignancyinseveraloftheCores—Ithinkthescorewas7.
HesuggestedIconsiderthealternatives—surgery,radiation,watchfulwaiting
andgavemearticlestoread.TheurologisttoldmethatIhadacoupleofmonthstodecide
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whattodo,thattherewasnoreasontorushintoadecision.Ispentthenextcoupleof
month’sreadingallIcould,lookingontheweb(therewasagreatsite—Iforgetthe
name),speakingtopeople—thereweremoremenouttherethanIrealizedwhohad
beentreated).
Thatwas13yearsago,sofarsogood.Ihadarecuperationofafewmonths,my
sexualprowessisn’tthesame,andIgettoseemygrandchildreneveryfewmonths.I
RESENTthesestatisticianstwistingrealityandtellingusweshouldn’ttrytoknowwhat
wecanfromaPSAtest.Theyhaveneverclaimedithasnovalue,andtheyarerightthatit
canbe“misused”ifmenarefrightenedintoaprematuredecisionbasedonfear.ButI
decisiontogowithignoranceandnohaveregularPSAscreeningisatleastasbadas
jumpingintotreatmentwithoutcarefulconsideration.Wearenotnumberandwehavea
fundamentalrightandobligationtoseekknowledgeanduseit.
DoItrustallurologistsandtheirconclusions–NO—butonaverageItrusttheir
approachandexperiencefarmorefromthekindofnumbercrunchersmakingupthese
publichealthtaskforces.
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Donna
Myhusbandwasdiagnosedatage49withProstateCancer.Thecancerhadalready
spreadtohislymphnodesandseminalvesicles.MyhusbandwasaVietnamVeteranand
wasexposedtoAgentOrange.
IfwedecreasePSAtesting,thenotherVietnamVeteranswilldowithoutVeteransbenefits
forthemselvesandtheirfamilies.
Somanymenresisttestingbasedonfearofsideeffectsoftreatment.Wedon’t
needasystemthatwillincreasethatnumber.
Myhusbanddiedatage64ofProstateCancer.
Daniel
IfitwerenotforthePSAtestIwouldhavePCstilltothisday.Icountmyselfvery
luckyandblessedthatIcanbecalledasurvivor.Earlyin2011Ihadfinallydecidedtosee
myfamilyDr.aboutmyneedtourinateseveraltimesanight.Ifiguredthatitwasduetoa
strictureinmyurethra,somethingthatIhadbeendiagnosedwithmanyyearsago.Of
courseIwaswrong;insteadmyfamilyDr.saysIthinkyouprobablyhaveanenlarged
prostate.SohesetsmeupforaPSAtestandafollowupexam.SoIgogetmybloodtest
andjustfigureheyI’m49anenlargedprostateisnobigdealtheygotpillstofixthat.
AboutaweeklaterIseemyDr.andhetellsmemyPSAis3.7whicharenotcritical
andmostlikelynotabigdealbutrefersmetoaUrologist.SoIgotoseetheUrologistwe
talkaboutmysymptomsthenhedoesadigitalexamwhichhesayseverythingfeels
normal.HetellsmethathewouldlikemetogetafragmentedPSAtestandexplainstome
thatitismorein‐depthandwillgivehimabetterideaofwhatisgoingon.
AgainIgoalongmymerrywaythinkingallisgoodandwon’tbelongtillIgetsome
pillstoshrinkmyprostateandIwillbeabletosleepthroughthenight.Igobacktothe
UrologistandhesaysIhavesomebadnewsyouhavea50/50chanceofhavingPC.
NeedlesstosaythisshakesmeupalittlebutIstillthinkthingswillbefineheneverfelt
anyabnormalitiesonthedigitalexam.
SoIgetscheduledforthebiopsyandgobackforthefollowup.Againhetellsmehe
hassomebadnewsformeitisconfirmedIhavePC.Iatthispointaminshock,howcome
thedigitalexamneverindicatedaproblem.Iendeduphavingmyprostateremovedin
Juneofthisyearandmy3monthPSAcameback0.IamafirmbelieverinthePSAtest.I
hatetothinkhowlongwouldithavetakenandwhenitwasdiscoveredwouldithave
spread.IknowthatfromthetimemyurologisttoldmethatIhada50%chanceofPCtill
hetoldmeIwasPCfreewassomeofthemostagonizingmonthsofmineandmyfamily’s
life.
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Rudy
ArisingPSAnumber–from4.8to5.6–overthecourseofayearledtoabiopsyin
2005andafindingofprostatecancer.Ihadsurgery:Gleasonscorewas7(3+4),witha
cancercellonthemargin.ThePSAtestsavedmylife.Ihadnosymptoms.Thetestalso
savedthelifeofmyfatherandtwobrothers,alldiagnosedwithprostatecancerwithno
symptoms.Myfather,diagnosedin1981underwentradiationtreatmentandisstillalive
todayattheageof87.
Anonymous
TodayIamprostatecancerfree.ButonlybecauseaPSAtestrevealeditsattack
veryearly.AboyhoodfriendhadhisPSAtesttoolate;heisnowdead.Weare/wereinour
late70s.DidthestudygroupdeterminewhatpercentageofmenwhohadPSAtestingand
discoveredthediseaseearly,diedanyway?Whatpercentagelivedalongerlife?Thisisnot
thewaytoreducehealthcosts!!!IencouragealltoarguestronglyinfavorofPSAtesting
withtheirphysician
Bryan
IfnotforthefactthatIhadaPSAtestatage46,Iwouldbebeyondthepointofno
returnnowattheageof50.IhadnosymptomsorsignsofProstateCanceratthetime.As
aresultofthePSAtest.ItwasdeterminedthatIhadProstateCancer.Thecancerhad
leachedoutoftheprostate.AtthattimeIhadsurgerytoremovetheprostateandalsohad
hormoneandradiationinthe3yearsfollowingthat.WenttomydoctoronOct.,2011.As
ofrightnow,Iamcancerfree.IthinkthePSAisavitaltoolinearlydetectionofProstate
Cancer.
Paul
PSAtestingsavedmefromprostatecancerhurtingmyotherorgans.Ihadnoother
symptomsexceptforthisabnormalriseinmyannualPSAscore.Inturn,thePSAtesting
ledmetoprostatecoresamplingwhichdiagnosedthecancerandallowedmetobe
successfullytreated.
Ifyouwonder,wouldIhavesurgeryagainhavinghadtheexpectedreductionin
potency?Absolutely!Itcomesdowntohavingahealthynormalliferatherthandying
fromanundiagnosedcancer.
NowfeelinghealthyagainthePSAtestismyonesourcetolearnifthecancerisin‐
check.Anescalatedscoreformewithoutaprostatewouldindicatefloatingremainsof
prostatecells–perhapscellsthatareaffectingotherorgans.Inall,thePSAtestmeans
security—securityinknowingI‘dhaveotheroptionsifmynumbersspike.
ManyofthearticlesIhavereadagainstPSAtestingfailtoacknowledgethe
following:
a)ThePSAtestistheonlyprostatehealthindicatorwehaveatthisjunctureandtestingis
notinvasive.
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b)AnabnormalPSAscoredoesnotleadautomaticallytotreatment–abiopsyconfirmsor
refutesthepresenceofcancer.Inmycasethebiopsyshowedcancergrowths(andlater
thesurgeryshowedthecancertobeevenmorepervasivethantheinitialbiopsy).
c)ThePSAonlyprovidesthepatientwithaseriesofoptionstowhichheismedically
entitled;itdoesnotmandatesurgeryorradiation.Inmycase–aswellasthemajorityof
myprostatecancersurvivorpeers—theoptionswereclearlyexplainedforbothtreatment
andfornon‐treatment(activesurveillancebeingamongtheviableprotocolstoconsider).
NoonepathwasimposedinthecasesthatIknowpersonally.
d)AndPost‐surgery,PSAchecksaretheonlylitmustesttofindifthecancerisin‐checkor
metastasizing.Againifthecancercontinuestogrow,thephysiciangivesusoptions.
InsteadofeliminatingPSAtestingcoveragewhynotincreaseawarenessandeducation
regardingprostatecancer?
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Louise
MydadhadPSAtestreadinghighsosenthospital.Consultantperformedbiopsy
resultson12thOct2011cancer!Thistestcontributed2loudalarmbellsforourGP.Dad
iscurrentlywaitingfortheresultsofaMRI,then,possibletreatment.Allfamilyshocked
andnumbbutpositiveonoutlook.Prostatecancertestingisamust!
Anonymous
Duetoearlydetectioninmymidsixties’,followingannualPSAtests,myprostate
cancerwasdetectedatanearlystageand,usingbrachytherapy,thecancerwasdealtwith
beforerealharmcouldbedone.
MyannualPSA’sshowthat,after6years,therehasbeennorecurrenceofcancer.
Kelly
IwashavingmyPSAcheckedannually.Foryearsitremainedaround1.0,thenone
yearitjumpedto2.9.MyUrologistdidabiopsyanditcamebackpositiveforcancer.My
Gleasonscorewas6witha3+3.HadInotbeenreceivingregularPSAexamsmycancer
wouldhavebeenmissed.A2.9scoreisnotunusualfora55yearold.Havingahistoryof
myPSAscoresformydoctortouseasatooltodecidetobiopsyornotsavedmylife,
Steve
Iwas53whenIwasdiagnosedwithPC.IwaswithoutsymptomsandifthePSA
testwasn’tthereIwouldn’tbeheretoday.
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Kathy
Hi,mynameisKathyandmyfather,73yrs.youngnow,hasprostatecancer.He
wasdiagnosed3yrs.agow/metastaticprostatecancer.HisdoctordidaPSAtestandit
was4or6.Hisdoctorneverpushedtohaveitfurtherinvestigatedbecausehethoughtit
wasok,myfatherwasolderanddidn’tseemconcerned.
BUTitwasaconcern.Twoyrs.laterhewashavingproblemswithhisback,and
eventuallyfoundithadspreadtohisspine(vertebrae).Weallthoughtthathisbackwas
justactingupagain.Wewereallsowrong.HisPSAhadgoneto94.
Ifhisdoctorwould’vepushedandsaiditwasabigdealandstateditshouldbe
lower…..itwould’vebeenfoundearlyandneverwould’vemetastasizedtohisspine.PSA
testingisallwehavecurrentlytohelpdetectprostatecancerearly,ITISIMPORTANT!!!I
lookatnewresearchcontinuallytotryandfindnewtreatmentsthatmaycuremydad
beforeit’stoolate.Heisthemostwonderfulgivingandfair,honestmanIhaveevermet.
SomanyknowandlovehimandIsharehisnameDADbecausesomanydon’thave
adadlikehim.IwishIcouldcomehomefromworkforthenext10‐20yrs.tohaveabeer
withmyDadbutIamsureourtimewillbeshortenedbecausethisdoctordidn’tpushhis
PSAresults.
Charo
In1999,whenIwas54yearsold,IhadaPSAtestcompletelyonmy
owninitiativeatalabthatdidn’trequireadoctor’sorder.Hadthe
bloodtestdonebecauseaclosefriendhadjusthadaprostatectomy
forprostatecancer.
MyPSAwas13.Tookthetestresultstomyfamilydoctorwhodida
DREandreferredmetoalocalurologist.Hadapalpablenoduleon
theleftside.Firstbiopsywasnegative.Sixmonthslatersecond
biopsywasGleason3+4=7.
ImaginewhereIwouldbetodaywithouthavinghadthePSAtestdoneat
54yearsofagein1999withthecanceronthevergeofescapingthe
prostatecapsuleshell.
Alsoimagineifthecancerhadbeendiscoveredearlierhowmuchbetter
myerectilefunctionwouldbewithtwosetsofnervebundlesspared
insteadofonlyone.
Anonymous
NineyearsagoIwasdiagnosedwithprostatecancerandchoselaparoscopic
surgerytoremoveit.Imayhavechosenanothertreatment,asIlookback,giventheafter‐
effectsofsurgery,butIamfreeofcancerasaresult.WithoutthePSAtestandbiopsy,I
wouldnothaveknown.
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Myfather‐in‐lawdiedofprostatecancerduetothefactthathisdoctornevertested
forit.Howmanyothershavehadthesamefate?
Iamasurvivorbecauseofit.
Don
In2004,IhadsomeofPSAteststhatshowedthelevelrosefromabaselineof
about2.0to3.5to4.8inthespaceof8months.Ihadabiopsydonebyaurologistandthe
resultwasthatseveralcoreshadaGleasonscoreof3+4.Ielectedtobetreated.Without
thePSAtests,Iwouldnothaveknownofthepresenceoftumors.
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MEN DIAGNOSED WITH PROSTATE CANCER, FRIENDS AND MALECARE FAMILY TELL YOU WHAT THEY THINK ABOUT THE PSA TEST Men fighting cancer, together.
Bob
Ifeelveryfortunatethatmyfamilydoctor,uponseeingmyPSAresults,referred
metoanexcellenturologistforfurthertestingandconsultation.Afterlongdiscussions
doctors,friends,andfamilyIdecidedtohavearadicalprostatectomy.Iwas51yearsold
andIdidnotwanttoriskhavingthecancerspread.Mytestsinthefouryearssincehave
beenexcellent,andshouldthecancereverrecurIknowIstilldidtherightthing.
Roy
MyfatherdevelopedprostatecancerbeforetheinstitutionofPSAscreening.
Thereforehehadthediseaseanddidn’trealizeit.Itwasn’tuntilhehadafallandx‐raysof
hishipindicatedthathehaddevelopedprostatebonecancer.Irememberseeingthosex‐
raysandthepainthatIfelt.
Iwatchedmydadbeingconsumedbythediseaseforapprox.8months.I
remember,towardstheendofhislife,prayingthatthegoodLordwouldtakehimand
relievehimofhispain.InmyheartiffeelthatifPSAscreeninghadbeenavailable,the
diseasewouldhavebeendetectedandIwouldhavehadmydadwithmeafewmoreyears
andhewouldnothavehadtohavegonethroughthepainthathedid.
Ihaverecentlybeendiagnosedwithprostatecancerandaminmy4thweekof
beamedradiationtreatment.IfeelfortunatethatIhadthePSAscreeningavailable.
Withoutitmyurologistwouldnothavesuspectedcancer,Ididnotexhibitanysymptoms,
Ifeltgood.Historycouldhaverepeateditself.ThankyouPSAscreening.Itmayhavesaved
alotofheartache.
Leo
MyprostatecancerwasdetectedbyaPSAtestinAugust,2008.Ihavehadfour
biopsiessincethen,anditthankfullyhasnotprogressedsincethen.WhileIdobelievein
thetest,Ialsoknowthatsomanyoutsidefactorscaninfluencethenumbers(sexual
activity,bikeriding,andinfectionsfromabiopsy).Myadvicewouldbenottotakea
suddenriseinthePSAresultsasaclearindicationthatthecancerisspreading,butuntil
anothermoreaccuratetestcomesalong,thisiswhatwehave.
Jim
IhadaPSAcountof10.OneyearlaterIwas10.1.Ithendecidedtogetabiopsy
done.Ihadnosymptoms.Ifeltgreat.ButthedoctortoldmeIhadcancer.MyGleason
scorewas7.Afterspeakingwiththemandreviewingmybiopsy,theysaidifIdonothing,
mylifeexpectancywouldbe5to8years.Ichosetogetoperatedon.Ithasnowbeenover
10years.MyPSAisnow0.
Ifeelthetestsavedmylife.
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Anonymous
MyfatherwasdiagnosedwithprostatecancerusingaPSAtest.Hedidnothave
signsorsymptomsthatwouldhavepromptedtestingifitwasnotroutine.Tothebestof
myknowledgehehadneverheardofprostatecancer,hesimplyaskedthedoctortodo
“whateverisrecommendedforaguymyage.”(Late50satthetime).HisPSAwas
elevated.Subsequenttestsshowedthatwhenhewasdiagnosed,thecancerwas
aggressiveandhadalreadyadvanced.
Withcuttingedgecarehesurvivedthediseaseforanotherfiveandahalfyears.For
theseyears,IamforeverthankfulandIfirmlyassertthattheseyearsweremadepossible
byaPSAtestthatpromptedthediagnosisandallowedhimtoobtainthetreatmentsthat
prolongedhislife.
WhileIunderstandthatwehavealongwaytogoinunderstandingthis
disease,inimprovingdiagnosticprocedures,educatingprovidersandpatientsabouttheir
options,andultimatelyadvancingtreatmentandprevention,withoutPSAtestingthereis
noothermechanismforearlydetectionofprostatecancersaveaDREwhichcanalsobe
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subjecttoerror.Weneedbothtoolsofdetectionatthistimeuntilbettermeasures
becomeavailable.Weneedtodoeverythingwecantomakesurethatmenhaveachance
tofightthedisease.AccesstothePSAtestispartofthat.
IamthankfulthatmydadhadthePSAtest.Ibelieveitultimatelyenabledhimto
choosetreatmentsthatextendedhislife.Iwishthesameforothermenwhomayfacethis
disease.
James
InMarchof1994,myPSAreading,whilestillwithinthe“normal”range,continued
toshowariseinthreeconsecutivechecks,eachlessthan6monthsapart.Myurologist
suggestedabiopsy….notsomethingonewantstodo,butIagreed.Thesamplescameback
positiveforprostatecancer.
Also,aGleasonscoreof4‐5accompaniedtheresults.Conferringwiththeurologist
andgettingasecondopinion,Ihadchoices:surgery,orwatchfulwaiting.Itdidnottake
melongtorealizethatIwouldhavethesurgery.IhadthesurgeryinMayof1994.Side
effectswereminimalandofshortduration.
Watchingovermyhealthinsubsequentyears,myPSAonceagainshowedaslight
increase14yearsaftertheoriginalsurgery.“Activity’wasdetectedintheprostatebed.I
choseatthistimetodoconformalradiationtotheprostatebed.Again,Ihavenoside
effectsandamenjoyinglife.
InallofthiscontroversyoverPSAtesting,Iamofferingthisopinion:withoutPSA
testing,Iwouldnothavebeendiagnosednotonlywithprostatecancer,butonewitha
Gleasonscorethatindicatedamoreaggressivecancer.
David
ThePSAtestisthebestthingwehavetodaytofindcancerinitsearlystages.Ihave
threefriendsthathavebenefitedfromthistesttocatchitearly.Formeandmydoctorit
developsanearlybaselinesoaspikewillbedetectedandwecanaddresstheproblems
earlyandsavemylife.
John
Iwas64whenmyPSAcaughtmyattentionbybouncingupanddown(itwasn’t
highbutitmorethandoubledin7months).Ihadnosymptoms,andtherewasno
palpabletumor.BasedonthePSAresults,Idecidedtogetabiopsy,anditshowedcancer
in7ofthe12zones(Gleason7).Ichosetohavearadicalprostatectomy,andsofar(two
andahalfyearslater)there’snosignofthecancercomingback.
IfIhadn’toriginallyhadthePSAdata,thatcancerwouldstillbegrowinginsideme,
andI’dhavenoideaitwasthereuntilitgotmuchworse.AndifIweren’tmonitoringPSA
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now,I’dhavenoideaifthecancershowsupagain,alertingmetotheneedforfurther
treatment.
IknowthePSAtestisn’tasreliableaswe’dalllike,butit’sallwehave.It’sfoolish
toignorethevalueofthistest.
JamesB.
MyPSAwaselevatedandelectedtohaveabiopsyperformed.Mybiopsywas
positiveforadenocarcinoma,soIhadaprostatectomyperformed.Iwasfortunatetofind
thecanceratearlieststages,soitwascontainedwithintheprostate.
Idon’tknowhowtheycansaythatthistestisn’tusefulindetectingcancer.IfI
wasn’ttestedwithaPSA,Iwouldhavehadtowaituntilmycancergrewenoughwhere
theMDcouldfeelanabnormalityduringarectalexam.Ifthatweretohappen,then
there’sagreatpossibilityitcouldhavespreadtootherareasofthebody.Iftheytakethe
PSAtestaway…you’regoingtoseeariseinmorbidityandmortality.
Lawrence
Ihavehadprostatecancerfor12years.Ijustuseherbstoslowthegrowthofthe
cancer.PSAhasonlydoubledoncein12years.WhenIstoppedusingtheherbs,thePSA
goesuponepointamonth.IfIdidn’thaveaPSAtest,Ineverwouldhaveknown,untiltoo
late,andsurgeryorchemotherapywouldhavebeenmyonlydefenseanditwouldhave
beentoolate.MyPSAisnowat16.7.Iam65yearsold
Anonymous
PSAtestingsavedmylife.In1994,theinsurancecarrierIhaddidnotapproveof
prescreeningforcancer.NoPSAalthoughdigitalrectalweredone,andnomammograms.
WhenIchangedinsurancecarriers,Ialsochangeddoctors(PCP)andheindicatedmy
prostatewasenlarged,orderedaPSAtest,whichcamebackat20,sentmetoaurologist.
Afterthebiopsytheyfoundcancer,fairlyaggressiveatage50.17yearslater,and
radiation,clinicaltrialsetc.,I’mstillhere,butIstillhaveprostatecancer.PSAistheonly
definitivewayoftrackingmycancernowsinceIdon’thaveaprostate.IfPSA’sare
abnormal,severalneedtobedoneoveraperiodoftimetoseetheriseratebefore
consideringinitialtreatment.
Lotsoffactorscomeintoplay,includingageofpatient,historyofPCainfamily,
initialPSAresult;evenabaselineatage35wouldbegoodtorefertoetc.etc.
William
MydoctornoticedasteadyriseofmyPSAlevelsandorderedabiopsy.Ididnot
haveanyphysicalsymptomsthatindicatedanythingwaswrong.Atage46Iwas
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diagnosedwithprostatecancerandelectedtohaveradiationtreatments.IfIwasnot
testedthecancerwouldhavespreadbeyondtheprostatebeforesymptomsappearedand
mychancesforsurvivalwouldhavebeengreatlydiminished.AllIcansayisthatby
havingthePSAtestIhaveasecondchance.
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Robert
Iam55yearsoldmanthatwasdiagnosedwithprostatecancerinOct2009.Itwas
thruPSAscreeningstartingin2008thatshowedmyPSAlevelsrising.Mydoctorwas
alarmedenoughintheraisefrom1to4inoneyear’stime,thatherecommendedabiopsy.
AbiopsyrevealedthatIhadcancerinover30%ofmyprostate.Afterconsultationwith
myurologistIagreedthatanaggressiveapproachwasneeded.Ichosetoundergoa
prostateremovalsurgery.Afterthesurgeryitwasfoundthatactuallythecancerwasin
over70%ofmyprostateandatthemargins.
Itwasgettingreadytospreadwithoutanysymptoms.Ifitspreaditwould
probablyleadtobonecancer.AyearlateranotherroundofPSAtestsshowedatumorhad
developedinmyprostatebed.Radiationwasnecessary.Iamnowoneyearcancerfree
thankstoPSAtestsandmydoctors.
David
MycanceroftheprostatewasfoundasaslightelevationinmyPSA.Thedoctor
thendidabiopsyandfoundthatIwasintheveryearlystages.Iwasrightat50yearsold.
MydoctorandIelectedtototallyremovetheprostate.Ihavebeencancerfreeforthe
past10yearsthankstothePSAtest.
Yost
Iwas43yearsoldwhenahighPSAresulttippedmydoctortothepossibilityof
prostatecancer.AfterappropriateinvestigationIhadabiopsythatconfirmedadvanced
prostatecancer.ThePSAtestsetmeonacourseofsurvival.MypartnerandIarethankful
fortheearlyPSAtest.
Mike
IconsiderPSAtestingaveryimportanttoolinthefightagainstprostatecancer.
AlthoughIwouldagreethatabetterdiagnostictechniqueisneeded,untiloneis
developedtheuseofPSAtestingandbiopsywhencancerissuspectedisalifesaver.
Diligentapplicationofthistechniquebymyurologistdiscoveredmyprostatecancer
elevenyearsagoatage56.Choosingaradicalprostatectomy,despitethepotentialquality
ofliferisksitposed,isadecisionmywifeandIhaveneversecondguessedandamhappy
toreportIhavebeencancerfreeeversince.
Thebaddecisionwouldhavebeentoignoremyurologist’sadvicetohavePSA
testingdonebecauseIwouldnoweitherbedeadorfacingmuchmoreaggressiveand
qualityoflifelimitingtherapytotreatadvancedstageprostatecancer.Ihopeabetter
techniqueofdetectionandstagingwillsoonbedevelopedbutuntilthattimedon’tgive
mentheoptionofignoringtheirprostatehealth.
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David
IthoughtIwasjustgettingthe“oldman”syndrome.Iwouldwakeupinthemiddle
ofthenight,sometimesmorethanonce,togopee.Othertimes,theurgetopeewasso
strong;IthoughtImightnotmakeittothebathroomintime.WhenItoldmygeneral
practitionerdoctoraboutthis,hetoldmetogoseeaurologist.Iwasnotexcitedabout
seeinganotherdoctor.Icontemplatedputtingitoff.IamgladthatIfollowedthroughwith
theappointment.WhenItoldtheurologistthesamething,hetoldmetogetthebloodtest
forPSA.Ihadnothadonebefore,sothiswasthefirstone.Itcameinat5.Myurologist
thendidaDREandfeltsomefirmnessintheprostate.Hethensuggestedthebiopsy.Iwas
52atthetimeandagreedtothebiopsy.
Thebiopsywentwellwithnocomplications.Iwentbackaweeklaterforthe
verdict.HetoldmeIhadprostatecancerandthatmyGleasonscorewas7(3+4).Hethen
gavemesomehomeworktodobyhandingmealargepackageofinformation.Ielectedto
havemyprostateremovedusingR.A.L.P.Threemonthsaftermysurgery,myPSAiszero.
WhenitcomestothePSA,Ithinkitisessential.Itistooeasytorationalizeurinary
problemsaway.Inaddition,PSAisnotthewholestory.
TherearemanymenwhosePSAislow,yettheyhaveprostatecancer.Iknowa
manlikethatwhohasafamilyhistoryofprostatecancer.Also,takecontrolofyourown
destinybydoingtheresearchaboutallofthetreatmentsavailableandwhattheside
effectsare.Theyareprincipallyincontinenceandimpotence.Donotletyourdoctor
bulldozeyouintoaparticulartreatmentplan.Beyourownmanandmakeyourown
decisionsthatyoucanlivewith.Besurethatyoufindaurologistthatiswillingtotalk
aboutincontinenceandimpotenceandiswillingtoworkwithyoutogetbothofthose
functionsback.
Thelastthingyouwanttoexperienceisregretoveryourdecisionbecauseofalack
ofinformation.Everybodyreactstothediagnosisofprostatecancerdifferently.Ifyou
havebeenrecentlydiagnosedandhaveheardthedreadedword“cancer”,Iurgeyouto
joinaProstateCancerSupportGroupinyourarea.
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Guy
Ihadsurgeryover2yearsagoandneedtogetPSAtestsevery6monthstomonitor
thecancer.Recently,thetestsshowedanincreaseinPSAfrom0.0,meaningapossible
recurrence.It’stheonlynon‐intrusivemethodcurrentlyavailabletocheckonthecancer’s
progress.
Anonymous
IstartedgettingPSA’sinmylate30'sabout1timeayear.After45mydir.would
orderthemmoreoftenduetomyfamilyhistory.Ilostseveralunclestoprostatecancer.
FatheralsohadPC,buteventuallydiedfromColorectalCancer.
MyPSAwasnotveryhighusuallyunder3.0formanyyears,andthenwentto4.8.
MyinternalmedDir.sentmebacktoUrologist,Urologiststarteddoingbiopsies,butthere
wasnocancer,evenafter3subsequentbios’.Thenin2007,PSAspikedagain,another
biopsy,nosurecancer,butcellsthatlooked“worrisome,”accordingtomyUrologist.In
Europe,thecellswouldbeconsideredcancer,butnotintheStates.
Anyway,hewantedtodoanotherbio,hedid(9monthslater),andfoundcancer
cells.AllofthetestsweredrivenbythePSAtest.Ihadnopain,nosymptomsandno
apparentproblemsuntilthebiopsiesstarted.
EventhoughIamOKnow,IalwayswonderediftherepeatedBiopsiesmayhave
acceleratedwhatmayhavebeenaslowgrowingcancer.Ididhavearadical
prostatectomyandsofarrelativelyfewsideeffects4yearspost‐surgery.
NotsureIormyDr.’swouldhavecaughtthishaditnotbeenforthePSAtest.
Again,Ihadnosymptomsonlyafamilyhistory.Idofeellikethetestmayhavesavedmy
life,atleastfromPC.Iwatched3familymembersdiefromPCanditisaterriblewaytogo
justlikeanyothercancer.
Anonymous
Attheageof47IthoughtIwasaveryhealthyperson.Iwaswonderinghowmy
cholesterollevelsweresoIhadsomeblooddrawnandtested.Thedoctorcalledmeafew
dayslatertosaymyPSAhadgoneupfromaconstant1.0to4.25.
AfewmonthslateraftermuchtestingIhadmyprostateremoved,itwasfoundtohavea
tumorthatwasbranchingoutbothlobesandabouttobreachtheoutersurface.
Itisnowover4yearslaterandstillcancerfree,IamsureifthePSAtestingdidnot
flagthedoctorsthattherewasaproblemmycancerwouldhavespentelsewhere,because
Ifeltwellandhadnoindicationsofanyproblems.NowIfollowwithmydoctorwithjusta
simplePSAtesttoseethatIamstillcancerfree,itseemslikeaverycosteffectivewayto
checkforareoccurrence.
Eugene
Whenprostatichyperplasiawasdiagnosedseveralyearsago,myurologistbegan
testingmyPSAonaregularbasis.Overtheyears,myPSAkeptrisingtothepointwherea
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biopsywasindicated.Fortunately,prostatecancerwasnotdetectedthen,butwas
sometimelateraftertwofollow‐upbiopsies.Atthepointofdetection,myPSAhadrisento
14,andGleasonscorewas4+5,indicatinganadvancedstageofcancer.I’mconvincedthat
ifIhadskippedannualPSAtesting,mycancerwouldhaveimplodedbeyondthepointof
containment.Asitwas,mytreatmentoptionswerenowlimitedtoradiology,whichalong
withADThaskeptthecancerincheck,sofar.
Myonlyregretisthatmyurologistwaitedtoolongtoreachaconfirmeddiagnosis.
Inretrospect,itwouldhavebeenwisertostartanaggressiveregimenunderdirectionof
anoncologistwithaspecializationinprostatecancer.Sadly,formeitwastoolate,too
smart.
William
IhavelostmanygoodfriendstoProstateCancerbecauseitwasfoundtoolate.The
PSAtestsavedmylifebyprovidingearlydetectionandallowingmetohaveProton
radiation.Forthepast7yearsmyPSAhasbeenabout0.2ng/ml.
IconsiderPSAagoodlowcostandsimplescreeningtoolforDoctorstoprovide
earlydetectionofapossibleProstateCancer.
Mary
Myhusband’sbrotherwasdiagnosedwithProstateCanceratage48;Mikewas45
atthetime.WetoldhisprimarydoctorandweaskedifhecouldpleasedoaPSAtest.The
insurancecompanywasnothappyaboutthePSA,eventhoughhehasotherbloodtests
everythreemonthsfordiabetesandheartdisease).
In2008,hewashospitalizedfordehydrationandhisurologistcameintheroom
andtoldusthatmyhusband’sPSAwas4.7,almostdoubledfrom2.4thepreviousyear.
Thedoctoremphasizedthattheremightnotbeanythingwrongbuthewantedhimtogo
totheofficethefollowingweektotalkaboutthis.TheDREwasnegativeandthedoctor
suggestedanotherPSA.ThenextPSAwas4.87,soabiopsywasscheduled.
AbiopsywasdoneinSeptember,thesamedayhisalmost81yearolddadhad
surgery.AtthatpointhisPSAwas5.5.Thisbiopsywasnegative.DecemberPSAwasalso
5.5,sowedecidedonretestingin3monthsandthen6months.NoBPH,noinfections,etc.
soreallynootherreasonfortheincreasingPSA.PSAwentto6.2andthenbackto5.5,May
27,2009;thedoctortoldushefelta“smallhardened”areaontheDRE.Hesuggested
anotherbiopsy.
ThesecondbiopsywasdoneonJune2009andtheurologistappointmentwasJune
17,2009.ThistimetwooftensitesshowedcancerwithaGleasonof6.Mikewantedto
havesurgeryifpossiblebecauseofhisage,atthatpoint58,almost59andothermedical
concerns(diabetes,angioplasty),sohewasscheduledforanMRIandbonescan.
AllthewheelsweresetinmotiononJuly;hiscardiologistgavepermissionforsurgery
tentativelyuntilafterastresstest.HewasthenscheduledforsurgeryonAugust2009.
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Thesurgerywentwellandthefinalpathreportshowedaggressivecancer,though
stillconfinedtotheprostate,butthroughouttheentireprostate.Gleasonof7.Hadwe
waitedandfollowedthis“newadvice”,weprobablywouldhavebeendealingwithcancer
outsidethecapsuleoftheprostateandaverydifferentstory.HadInotjoinedawoman’s
on‐linesupportgroup,IwouldnothavepushedashardasIdidforMiketofollow‐upwith
hisurologist.IhearstoriesofmanymenwhodidnothavePSAtestsandthenhad
advancedprostatecancer,menwho’sdoctorsignoreddoublingPSA’s,etc.IknowthePSA
testisnotperfectBUTitiswhatwehavefornow.
Janet
Myhusbandis52hehadaPSAof1.3lastyearandnowthisyearitwas3.4his
biopsywaspositiveandheishavingaroboticprostatectomythankgodforPSAtests
otherwisewewouldn’thaveknownandwouldn’thaveachancetofightit.
Philip
Iama19‐yearprostatecancersurvivorwhohadthreePSA‐based
biopsieswhichdiscoveredmyGS4+4=8cancerwhichhadmetastasizedtoseveralparts
ofmybody.Further,Iknowthetoxicsideeffectsfrommyvarioustreatmentsloweredthe
qualityofmylife.
Nonetheless,Irecommend:
1.Menshouldparticipateinindividualonlyifcounselingisoffered.
2.Menbetween40and75,haveadiscussionwithyourdoctortoseeifyouhavehighrisk
factorsassociatedwithhavingprostatecancer.
3.MakeachoiceaboutPSAtestingonlyafteralongtalkwithyourdoctor.
Oscar
In2006whenIwas60yearsoldIhadrecentlymovedtoArizonasofoundanew
primarycaredoctor.Ihadmyannualphysicalandthatdoctorfailedtochecktheboxfor
PSAaspartofmybloodworkup.Itwasn’tuntilthefollowingyearwhenIchangeddoctors
thatIdiscoveredthisbecausemyPSAcamebackat16.1Isaidthiscannotbepossible
becauseIhadanannualphysicalthepreviousyearandnothingwassaid.
LittledidIknowthatthePSAtestwasnevergiventome.Sonowitwas2007andI
wasalreadyayearbehindtryingtofightthisdisease.UnfortunatelymyGleasonscorewas
10andIwasnotacandidateforsurgery.FiveyearslaterIamstillfightingwithPSA
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scoresashighas988.ThankgoodnessmyseconddoctordidrunaPSAtestthefollowing
yearwhichiswhatyouwouldexpectona60or61yearoldmanasjuststandardofcare
practice.
John
ThankstoaPSATestinDecemberof2005whenmyPSAwas26.4,Iunderwent
radiationandhormonetreatments.Sincethen,myhealthhasimprovedtoanalmost
undetectablePSAof.02;andmylifehasbeenextended.
Anonymous
IamawidowofamanwhohadProstateCancer.Histestingwastoolate,butI
definitelyfeelPSAtestingregularlywillsavemen’slives.Don’tmakeitdifficultformento
getthistest.Itmaysavesomeoneelsefrombecomingawidow.
Larry
IhadaPSAtestlastyear.Itwaselevated.Ifollowedthroughwithabiopsywhich
confirmedthePSAfinding.I’msohappytoknowthatIamnowcancerfree!
Darrell
Iwasdiagnosedat48withaveryaggressivecancer.Ihadnofamilyhistoryandam
Caucasian,sowithoutearlytesting(myfirstPSA),Iwouldnothavecaughtmycancerfor
manymoreyears.ButthereisnosciencetoindicatethathadInotcaughtituntilIhad
identifiablesymptoms,itwouldhavechangedanything.Iamstillfightingadvanced
cancerelevenyearslater.
ButbecauseIhavebeenactiveinasupportgroup,Ihavemetdozensofmenwho
nevershouldhavebeentreated,eitherbecauseoftheiradvancedageandhealth,orjust
becausetheircancerwasindolent.Manyofthesehaveserioustreatmentsideeffects.I
alsoholdtheUrologistsaccountablewhotalkedthesemenintotreatmenttheydidnot
need.
Julian
At50yearsoldapaininmyhiptookmetotheDr.sothatIcouldbetoldthatthe
past10yearsofdigitalexamshadnotdetectedmyprostatecancer.Havingmetsonmy
hipputmeinthecategorythatitwastoolatetotreat.Iwasgiven2years.LuckilyI
respondedtoADTtreatmentandIamstillalive6yearslater.
Ican’thelpbutthinkWHATIFPSAscreeningwasusedwithdigitalscreeningwouldthe
outcomebeanydifferent?
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Donotexcuseawayouroptionstosurviveandlivewithdignity.Detectionallows
ustodecideourcourseoftreatment.Ourlives,ourchoices.
Tom
Iamaprostatecancersurvivorformorethannineyears.InAugust2002,Iwas
sufferingfromexhaustion,goingtomyfamilydoctorforaphysical.HeperformedaPSA
test,revealingthatprostatecancerwascausingmyproblems.Otherwise,Iwasafifty‐
eightyearoldinperfecthealth.Aftermanyexaminations,tests,anddiscussionswith
numerousdoctors,Idecideduponaradicalprostatectomy.Yes,thisterribledisease
changedmylife,causingmemuchfrustration,butIhavebeenalive.Inowhavesix
granddaughters(twobornaftermysurgery),threegrandsons(twobornaftermy
surgery),andonegreat‐grandson.ThebiopsyrevealedIhadtheveryaggressivecancer,
withathree‐yearsurvivalrate.ThankGodforthatPSAtest.
Harry
IdonotunderstandthefuroroverasimplePSAtestonanannualbasis.Mostofus
in“theagebracket”goforanannualphysicalexamonceayearanywayandgivebloodfor
cholesteroltestsaswellasdiabetes,etc.What’stheharminaddingonemorecheckmark
ontheformtotestthePSAlevels?
MyPrimaryCarePhysician(PCP)notedthatforthepasttwoyears,myPSAlevels
hadrisenand‘suggested’thatIseeaUrologistforadvice.Ididthiseventhoughtherewas
nopressurefrommyPCPtodoso.TheUrologistlookedatthehistoryandsuggestedI
waitforanotherPSAtest6monthsdowntheroad.Whenthisoneshowedevenmoreof
anincreaseincounts,he“suggested”abiopsyontheprostate.Thisresultedinalowlevel
ofcancercellsbeingpresentatwhichtimeheexplainedalloftheoptionsthatwere
availabletome.
Hedidnotpushmeintomakingadecisionforanyparticularoptionandafter
discussionswithmywife,Idecidedtowaitandseeratherthantakedrasticandcostly
measures.Ithasbeen8monthssincemydiagnosisandIhavehadaPSAtestagainafter4
months.Therewasnochangesomydoctorwillcontinuetomonitorme.AtleastIknow
whatIamdealingwithandthedecisionistotallymineastowhethertogofurtherwith
thetreatmenteventhoughbothmyUrologistandPCPhavebothagreedthatIhavemade
therightchoiceatthispoint.
Ithoughtthatthepurposeofproactivetestingwastopreventmoreserious
complicationsbynotbeingtestedregularly.Tonottestatalltomeseemsludicrous
especiallyintheover50group.
Margaret
WhilePSAisnotanendallindiagnosingprostatecancer,itisthebestmarkerwe
haveasyet.Iamanadvancedpracticeregisterednurseandthecoordinatorofaprostate
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cancersupportgroup.Wehavememberswhowereasymptomatic,hadascreening
includingaPSA,andwerediscoveredtohaveprostatecancer.
Charles
Ihadaradicalroboticprostatectomy.MyPSAnevergotabove3.2butbecauseit
hadfluctuatedbetween2.2and3.2thedoctorthoughtIneededtohaveabiopsythat
revealedcancer.AfterstudyingdifferentmethodsIdecidedonthecompleteremoval
becauseIfeltthatthiswouldgivemethebestassurancethatthecancerwouldbe
removedandithasbeen6yearsandpraisetheLordI’mstillcancerfree.Also,asaresult
ofmyexperience,2yearslaterwhenmybrotherhadasimilarreadinghegotabiopsyand
itrevealedcancer.Heelectedadifferentmethodbecauseofhisageandhealthandtoday
healsoiscancerfree.Bothofusarethankfulthecancerwasdetectedearlythroughthe
PSAtestsandappropriateactiontaken.
Don
PSAtestingprobablysavedmylife.Notonlywasitkeyinthedetectionofmy
prostatecancer,butitwasalsoinstrumentalindetectingthefailureofmyprimary
treatment.Tothebestofmyknowledgeitistheonlythingthatwillbeabletotellmeif
thereisareturnofthedisease.Iwasfirstdiagnosedin2000.
Lana
Althoughmylovedonelosthislifetothisdreadfuldisease,thePSAtestwasthe
bestmeasureofhowwellacancertreatmentprotocolwasworking.It’saneasytestto
take,andisnotinvasive.Beingasimplebloodtest,itisrelativelyinexpensive.
James
AyearlyPSAbloodtestistheonlywayofcatchingprostatecancerearlywhen
thereistimetostopitinitstracksorarrestitforaprolongedperiodoftime.Itistheonly
waytomonitoreffectivetreatment.Thecostoverthelongrunwillbemoretotreat
prostatecancerthatisinoperable,(believemeIknow!).Therewouldbenoknowncourse
ofactionforsuccessfulornon‐successfultreatment.Itwouldnotbesoundmedical
practicetosuspendPSAtestingwhenithasbeenproventhatitisa“benchmark”for
men’sprostatehealthandmen’sprostatecancerprogression.
Kenneth
RoutinePSAtestingalertedmydoctortomyprostatecancer(GleasonScore:7).
Evenmoreimportantinmycase,withoutPSAtestingfollowingmyprostatectomy,I
wouldnothaveknownthatsomeofthecancerremainedandthatIalsoneededradiation.
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Anonymous
Iamahealthy55yearoldandmylastPSAscoreincreasedsignificantlyandwas
beyondtheacceptablelevelsformyage.IwentforabiopsyandwedidfindthatIhad
prostatecancer.WithoutthePSAscoreImaynothavebeendiagnosedearlyandhavethe
abilitytotakecareofthisbeforeitwasmoresevere.
Johnny
Ihaveadvancedprostatecancer.Aftersurgery31/2years,IstillhadaPSA
reading.Later,testsrevealedithadspreadto5ofmybones.Thereisnocurebutitis
beingcontrolledbytreatmentatthistime.ThePSAtestisveryimportanttomeatthis
time.WhenIgetaPSAreadingagain,Iwillknowthatthetreatmentisnolongerworking.
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Lawrence
12yearsagomyPSAstartedtorisepromptingmydoctortobemoreconcerned
aboutthepossibilityofProstateCancer.In2001PSAwashighenoughtowarrantaBiopsy
whichcamebackpositiveforprostatecancer;IhadaGleasonscoreof8.Iwas59and
madethedecisiontohavetheprostateremoved.ThePSAstayedlowfor5yearsandthen
startedtorise.In2005Ihadanotherbiopsyperformedandconfirmedthatthecancerwas
intheprostatebed.Itookradiationtreatmentforthatandafter5yearsmyPSAhas
startedtoriseagain.Iamonawaitandseeschedule.AtsomepointIwillstarthormone
treatments.
IfithadnotbeenfortheinitialPSAtest,thecancerwouldhaveprobablyspread
andIwouldbeinworstshapetoday.IhadnoSymptomsandfeltgreat.Wouldneverhave
hadhadthebiopsyifithadnotbeenforthePSA.
Ed
Earlyinmyprostatestory,thePSAtestwasbeneficial.Asthelevelkeptrisingover
theyears,cancerwaseventuallydiagnosedthroughmysecondbiopsy,atage50.Thisis
nottosayI’mafanofthePSAtest–moreonthatlater.
Afterdiagnosis,Iwaited16monthsbeforeagreeingtosurgery–veryactively
tryingtofindalternativetherapiesthroughwhichIcouldavoidsurgery.Eventually,when
myPSAlevelclimbedto14.0Iagreedtothesurgeryandhadmyprostateremoved.
MyPSAstoryaftersurgeryhasanentirelydifferentflavortoit.Itbegantoriseslowly
eachtimeIwastested,toaneventuallevelof0.14.Notasignificantlyhighnumber,but
theconcern(mydoctor’smostly)wasthatitwasalwaysincreasing,notfluctuatingupand
down.
Here’sthemostnegativeaspectofmyPSAexperience.Atoneappointment,my
surgeontoldmyPSAlevelhadrisenfrom0.14just3monthsago,to0.24currently.Avery
fastrise,andcauseforpanic(again,onhispart,notmine).
Athisrecommendation,Ischeduledanappointmentwiththeradiologisttogoover
options.WhenIcameinhesaid“IseeyourPSAhasrisento0.18.”Longstoryshort,the
0.24wasincorrect–nooneknowswherethatcamefrom.Theactuallevelwas,indeed,
the0.18asquotedbytheradiologicaloncologist.Angrythattheycouldn’tgettheir
numbersstraight,Idemandedanotherblooddrawthatday,andthatlevelshowedupas
0.16–decreasingforthefirsttimesincesurgery2‐1/2yearsprior.Threemonthsafter
that,mynextandcurrentlevelisdownagainto0.14.
Mybiggestissuewithallthisisthefactthatbasedonthisincrediblyflawedblood
test,incombinationwiththeerrorinrecordingthelevel;Iwasstronglybeingurgedto
“signup”for38consecutivedaysofradiationtreatment.Andnoonecouldunderstand
whyIwassayingno!
ThereiscurrentlyalotofpressonwhetherornottogetaPSAtest.Thatshouldn’t
bethequestion.It’sallwemenhavetochoosefromrightnow,soofcourseweshouldget
tested.Themoreimportantquestioniswhyisn’ttheremorefundingtofindanaccurate
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testforprostatecancersowedon’thavetocontinuemutilatingourbodieswith
unnecessarybiopsies,surgeriesandradiation.
Daniel
Iwasdiagnosedwithstage2ProstateCancerin2002.TheevaluationofthePSA
enabledmyUrologisttodoabiopsywhichgotmea5/6Gleasonscoreandmadethe
decisiononwhattypeoftreatmentIwouldseek.Ifthedigittestwastheonlymethod
beingusedIwouldhavenotbeensolucky.MyUrologistandmysecondopinionUrologist
bothadvisedmetheglandwassoftandpliableshowingnosignsofnodules.Ifitwasnot
forthePSAtestmyoutcomewouldnothavebeensogood.Now,cominguponmy10year
birthday,IgetaPSAtesteachyeartostayinformedofanypossiblereoccurrence.I’mone
oftheluckyones.
Scott
IamadamantthatmenshouldreceivethePSAteststartingat40.InOctober,2010,
whenIwas47,Ihadsymptoms(slowerurinaryflow,painduringsex‐sorry,nodelicate
waytoputit)thattwodoctorsdiagnosedasadoublehernia.Thedoctorsdidnotconsider
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cancerasapossibilitybecauseIhavenofamilyhistoryandIam,otherwise,exceptionally
healthy.WhenIstillhadsymptomsthreemonthsaftertheherniasurgery,athirddoctor
finallyorderedaPSAscreening.18wasnotthenumberIwaslookingforfrommyfirst
PSAbutit’stheoneIgot.
Overa3monthperiod,Ihad2moresurgeries(includinganopenradical
prostatectomy)andcountlessMRIs,CTs,andPETscans(includinganendo‐rectalMRI
thatIwouldn’twishonmyworstenemy).Thecancerhadspreadtomyseminalvesicles,
nervebundles,andlymphnodes.Manylocaldoctorsviewedmeasalostcause.
Throughtirelessresearch,mywifeandIfoundtwodoctorswhowerewillingto
aggressivelytreatmycancerpost‐surgery.IamcurrentlyonmoremedicationsthanIcare
tocountandamalmostfinishedwith54sessionsofradiationtreatment.Theobviousside
effectoftheprostatectomyandhormonaltherapyistheendofanormalsexlife.To
remedythat,Imostlikelyhaveanothersurgerytolookforwardto.
Ibelievethisordealcouldhavebeengreatlyminimizedifmyinternistwouldhave
startedannualPSAtestsat40.Itislikelywewouldhavecaughtthiscancerwhenitwas
stillcontainedintheprostate.Thatwouldhavegreatlychangedmycourseofcareandhad
lessimpactonthequalityofmydailylife.
Steve
In2006attheageof52IhadmyfirstPSAtest;Ireallyshouldhavedoneitearlier
eventhoughmyDRE’spreviouslyindicatednothingofconcern.MyPSAwas14.8,ina
coupleofmonth’sithadgoneupto15.8andmyGleasonScorewas7.Withan
intermediatestageofcancermytreatmentoptionswerelimited;ifIhadgottentesteda
coupleyearsearlierIwouldhavehadmoreoptionsavailabletomeandahighersurvival
rate.Ifitwasn’tforthePSAtestIcouldhaveeasilydiedofthisdisease.
Anonymous
Ihadnosymptoms,nophysicalcomplaints,anactivesexlifeandnourinary
problems.Ihadadigitalrectalexam,andwaspronouncedfitasahorse.Mybloodwas
thentested,forthefirsttime,andIscoredaPSAof8atage53,followedbyaPSAof12
onemonthlater.Followinganultrasoundanda12corebiopsy,Iamnowdiagnosedwith
Stage1prostatecancer,witha90%chanceofrecovery.Iwillforeverbeindebtedtomy
wifeforinsistingonthePSAtest.
Ben
PSAtestinghasbenefitsfornon‐PCpatientsaswell.MyPSAjumped750%in6
months.Thatfact,plushavingafamilialgeneticpredispositionforPC,mademyurologist
retakeaPSAreading6weekslater.Thesecondreadingshowedamuchlowerlevel.With
thisnewestresult,alongwithanormalDREandnootherdiscerniblecancer
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characteristics,myurologistwasabletotellmethatthetemporaryPSAspikewasmost
likelyattributabletoothercausesinspiteofmygenetics.Whatarelief!
Hugh
WhilemyPSAwasn’thighlyelevated,itwasawarningsign.Adigitalexamthen
revealedthetumor.
AsubsequentriseinPSAafteraradicalprostatectomyindicatedarecurrence.
MyGleasonscorewasa4+3=7,somycancerwasmoderatelyaggressivewithapositive
margin.Ifmycancerhadnotbeendetectedearly,IamconvincedIwouldbeintrouble
now.
IfeelverystronglythatthePSAtestsshouldbecontinued.Earlydetectionis
critical.Iamgratefulthatthesetestshaveledtomydiagnosisandtreatment.
Frank
IunderstandthatsomebelievePSAtestingresultsinunnecessaryworryand
biopsies.
Theproblemwithnotbeingtested,inatimelymanner,isthattheCancermay
escapeintothebloodstream.Thatwastrueinmycasesoevenaftersurgeryandradiation
Inowhavecancerinmybones.Withearlydetectionacureisavailableanditis
irresponsibletosuggestthatPSAtestingshouldnotbeencouragedandcontinuedasa
firstlineofdefense.
Ed
Iwillbe50inMay,2012.InlateDecemberof2006,IwenttoanUrologistafter
seeingbloodcertainmorningsafterintercoursethepreviousnight.Heperformeda
cystoscopyandfound“calciumstones”beforetheurethra.Itwasarelief;howeverthe
bloodnevercompletelydisappeared.InJanuaryof2008,myprimarycareMDwantedto
sendmeforanotherscope,butchosetoincludeaPSAinmyannualbloodworkupdueto
myindifferencetothepainthatthatprocedurecaused.
Thenumbercameback(3.0)andwewaitedtodoanotherPSAtestin3months.
Becausethatnewnumberwasover(5.0),myresultsweresenttoanurologistandIwas
instructedtoscheduleanappointment.Foolishly,IwaiteduntilOctobertocallthe
urologist,tenmonthsaftertheinitial(3.0)PSA.Whileonthephone,theofficecollected
thefileandtoldmeto“getinthere”immediately.
A“finger”examresultedinafollowupappointmentforabiopsy.Withinaweek,I
wasbackintheurologist’soffice,withmywife,hearingthat2tumorswereclosetothe
insidewallofmyprostate.Ilistenedcarefullytomyoptions:1)Donothing,2)Radiation,
3)Prostatectomy,and4)Computer‐assistedlaparoscopicradicalprostatectomy(CALP).I
choseCALPonDecember,8of2008.
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Post‐surgery,Iworeabagfor2weeks,followedbyKegelexercisesusingBiofeedbackand
electricalstimulationfor8weeks.Sexualfunctioncamebackalmostimmediatelyto100%
andPSAhasbeen(0.0)to(0.1)eversince.Earlytesting=earlydetection!
Claude
MyPSAtestresultedinabiopsy.Theresultofthatrevealedprostatecancer.Iwas
treatedforit.Thatwasin2006.Todatethingsarenormal.DoIbelieveinPSAtests…you
betIdo.
Anonymous
MyPSAhastoremainat0.01.Igettestedeverysixmonths,duetoastage3atumor
backinJune2006.Mycancerhadpositivemarginsbutafteraradicalplusfortydaysof
IMRTradiationandfourteenmonthsofhormoneswehavecancerfreeresultsno
problemswithotherfunctions.mydocwasverysteady!IknowthePSAtestplusthe
digitalsavemylife!Weknowthatthedoublingtimemostimportant.MyPSAtestthetest
thattellsmeifsomethingisbrewing.
Bill
IamsixyearsurvivorduetothePSAandroboticsurgery.Sincethesurgerymy
PSAhasbeen0.1.IfitwerenotforaPSA,I’msurethediseasewouldhaveadvancedtoan
untreatablestate.IrealizethePSAmaynotbetotallyaccuratebutitisbyfarthebesttest
wehaveatthispoint
Robert
MycancerwasdiagnosedbyDREbecausemyproviderdidnotdoPSAs.Myfirst
was11.8whichputmeatriskforspread.AfterradiationtreatmentmyPSAswerelowfor
10.5years.Icouldmeasureatrendlineandwhenthedoublingtimegotto6monthseven
thoughthePSAwaslowIhadanevaluationandfoundmicro‐metsonthesurfaceofmy
lungs.
CurrenttreatmentkeepsthePSAlowbutwithoutit,Iwouldhavenowaytoknow
whenthistreatmentfailsandwhenIwouldneedfurthertherapy.Iam14+yearsoutfrom
diagnosisandatage70ingoodhealthIstillhavealifeexpectancyof5‐10years.Iwould
liketoavoidthepainfuldeaththatmenexperiencewhenprostatecancerisnottreated.
James
WhenmyPSAcounthaddoubledwithin6months,mydoctororderedabiopsy,
whichshowedamalignancywithaGleesonscoreofsix.Ihadittreatedwithcry‐surgery,
andamcancerfreeafter5years!
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Anonymous
Myhusbandwasdiagnosedwithprostatecanceratanannualphysical.Hehad
absolutelynosymptoms.OnlytheriseinhisPSAalertedmyinternist.HisPSAwasonly
3.2(withinnormallimits,accordingtothelab),butourinternistwasconcernedaboutthe
velocityoftherisewithinjustoneyear.Hiscancerwasaggressive,andbrokethroughthe
capsule.HehadNOSYMPTOMS!!
Therewasnodoubtinourmindsregardingourchoice.Hewas57,andwedecided
onsurgery.Thesideeffectswerenotevenaconsideration….tous,thechoiceoflifewas
moreimportant!Myhusband,hisfather,andhisgrandfatherallhadprostate
cancer…..whataboutour2sons?Arewetotakeawayouronlyoptionofearlydetection
forthesetwoyoungmen?
Itisanarchaicmyththatprostatecanceris“slow‐growing”.
Intheyear2011,arewetobelievethatthereisonlyONEtypeofprostatecancer??With
thelevelofmedicalresearchandtechnologytoday,togetherwiththegeneticanalysisof
prostatetumors…..howcanaglobalstatementbemadethat“Prostatecancerisslow‐
growing,andmostlikelyisnotfatal”?Untilanotherdiagnostictestisavailable,thePSA
mustbegiventoallmenyearly…..especiallymenwithafamilyhistory.
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Jorge
PSAistheONLYtestwehaveregardlesshowflaweditis.ThankstoPSAIwasable
todiscovercancerinmyprostrateandhaveitremovedwhilethecancerwascontained.
OtherwiseIwouldbeacandidateforearlydeathduetoprostatecancer….
Pinky
Prostatecancerhaschangedmylifeforever.Havinghormoneresistantprostate
canceristhepits.Veryfewoptionsforme.Ifmydoctorshadfounditearlieritwouldbea
muchdifferentscenariothanIamnowfacing.GETTESTEDEARY!!Itmaysaveyourlife!!!!
Anonymous
Wentinforavasectomyat47yearsold.Nohistoryofprostatecancerinthefamily.
TheurologistsuggestedaPSAtestaspartofthisnormaltreatmentplan.Resultwas2.5,
biopsyfollowedwhichconfirmedcancer.GiventhefactthatIwasunder50withsmall
childrenandagoodprognosis,prostatectomywastherecommendedprocedure.Fully
“recovered”2yearspost‐op,butsexlifesucks.Don’tknowifIwouldhavebeenbetteroff
justwaitingandseeinggivingthehighratesofindolentprostatecancer.
Jerry
PSATESTINGPROBABLYSAVEDMYLIFE!At55,myPSAnearlydoubled(6.5);I
wentinforabiopsyandonlyonecorewascancerous.Gleasononitwasshown@3+4!
(REMEMBERTHAT)
Ihadsurgerywithinamonth.FULLBIOPSYSAMEBACKAT5+3!LUCKILYALLMARGINS
&NODESWERECLEAR!I’mcomingupon3yearssincesurgeryandPSAisundetectable!I
havea24yearoldsonandInowshouldhavemanyyearstoenjoyhistalentthankstoPSA
testing!
Anonymous
Late1992,IgotundercareofanewGP.HadbeenonMedicareabout3years.Was
toldthatIcouldhaveageneralcheckupannually.MynewDr.,whohadjustbegun
practice,andwasamemberofmychurch,askedifIhadeverhadaPSAtest.Ididnot
knowwhatitwas.Heexplainedittome.Isaid,ok.Camebackelevated,sentmetoa
urologist,anddigitalexamindicatedpossiblemalignancy.Wentinforabiopsy,PSAwas
elevatedfromabout10daysbefore.
Optedforasurgery.Gavemyownbloodforaboutamonth,andhadsurgery.PSA
hadgoneto18.SaidHedidnotgetitall.Hadradiation,allthiswasafterJan93.PSAnow
is.1.HadInothadthefirstPSA,whichasIseeit,iswhatthebrainsaresayingtheywon’t
payfor,Imostcertainlywouldhavebeenterminal.Itwasinthelymphnodes,butnot
beyondthem.
Thisisonlythebeginning.Inmycasetheyhavebeenalmost0before.19yearsis
prettygood.
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David
Iagreethatthisistheonlytestwenowhave,andshouldcontinuetobecoveredby
healthinsurancecompaniestoallowmentheopportunitytobeaswellinformedabout
theirhealthaspossible.Atanyrate,itsavestheinsurancecompaniesinthelongrun,by
oftendetectingcancerearly,sothatpossiblylessdrastictreatmentoptionsmaybe
administered,andwithamorepositiveoutcome.
AbettertestWILLbediscovered,anditwillbecomeincumbentupontheinsurance
companiestocoverthatoneanyway,andforthesamereasons.
David
Myfatherdiedahorrible,painfuldeathfrommetastaticCaPintheerawhenitwas
a“quietdisease”.Consideredjustadiseaseofoldmenwhodidn’ttalkaboutit.Being
forewarned,IgotearlyPSAtestinginthemid‐90andsurvivedthedisease.
Itwillbecriminaltonowbegindiscouragingmenfrombeingtested.
Whathappenedtothemantra“EarlyDiagnosis,BestChanceforCure”?Asmuchas
PSAhasshortcomings,itisSTILLthecanaryinthemineforCaPdetection.
WhatisneededisMORERESEARCHtoallowdiagnosisbetterthanPSAandDRE.
Butinstead,wegetanti‐screeningmessagestheresultsofwhichwillbeMOREDEATHS
fromprostatecancer.
John
In2004myprimarycarephysicianreferredmetoaurologistforminorpaininthe
prostatearea.TheurologistprescribedthreeweeksofantibioticsandwhenIstillwas
havingsymptoms,heblameditonmybicyclingactivity.Hewantedmetoschedule
anotherappointment,butdidn’texplainwhy.Icancelledtheappointmentandaccepted
hisbicycleexplanation.
TwoyearslaterIwenttoanewprimarycarephysicianforaroutinecomplete
physical.Imayormaynothavementionedinmyfamilyhistorythatmyfatherandmy
maternalgrandfatherbothhadprostatecancer.MynewdoctorincludedPSAinmyblood
work.MyPSAwas32.Thedoctortreatedmewithantibiotics(sameasIhadtwoyears
earlier)toseeifitwasaninfection,thenretestedthePSA–theresultwasthesame–32.
MydoctorthenreferredmetoTHESAMEurologistthatIwenttotwoyearsbefore.
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Thistimeherecommendedabiopsy–resultwasrelativelyaggressivecancer
(Gleasonindex6‐7.)Ineverchallengedthisurologistforhispoorcommunicationorfor
notcheckingmyPSAtwoyearsearlier,butIswitchedtoayounger,moreproactive
urologistformyradicalprostatectomyandsubsequentmonitoring.CATscansdidnotfind
anyevidenceofcancerbeyondwhatthedoctorremovedduringsurgery.However,three
yearslatermyPSAbeganrisinganddoublingfairlyquickly.
TheONLYconclusionthatmadeanysenseisthattherewerestillprostatecancer
cellsinmybody.Iwentthrougheightweeksofradiationtherapyonmypelvisinspringof
2010.IamnowfacingthestrongpossibilitythatIwilldevelopsystemicprostatecancer.
Nofurthersurgeryorradiationwillstopit.Thereisnoeffectivechemotherapyfor
prostatecancer,somybesthopewillbetoslowcancergrowththroughhormonetherapy
–withsideeffectsprobablyworsethanIhaveexperiencedfromsurgeryandradiation.
Mypointinthisdetailedstory:IfmyPSAhadbeencheckedin2004(whenImost
certainlyalreadyhadprostatecancer)thenIwouldhavebeentreatedtwoyearsearlier–
andwouldhavedefinitelyhaveimprovedmychancesofavoidingsystemiccancer.
COMMUNICATIONisthekeyonthissubject.
Menneedabetterunderstandingofwhattheirprostatedoes;thedifference
betweenaggressiveandnon‐aggressivecancers;andtounderstandtheirtreatment
optionsandlong‐termsideeffects.Ifyourdoctorisapoorcommunicator,findanother
doctor.
ThePSAmaynotbeperfect,butitiscurrentlytheONLYearlydetectionscreening
tool.TheresultsofaPSAscreeningaresimplythestartingpointformedicalinvestigation
–nottheconclusion.AndsincethereisNOCUREforsystemicprostatecancer,wouldn’t
yourathertakethechanceonincontinenceandimpotenceoverDYINGthehorribledeath
thatsystemiccancerultimatelyposes?IknowthatIwishIhadaskedmorequestionsin
2004.ItiscriticalthateachmanunderstandsindetailhowthePSAworksandthevaried
directionsthatfurtheranalysismightgo.
Aprostatebiopsyisnowalkinthepark,butitistheONLYwaytofindoutforsure
ifyouhavecancer.AndwithoutthePSA,howwouldyouevenknowthatyoumighthavea
problem?
Paul
Iwas46whendiagnosedwithPCa.Hadmydoctorfollowedtheusualprotocol?I’d
bedeadbynow.Iwashealthy.NofamilyhistorythatIknewof.Fastvelocity–allthebad
stuff.
ThePSAtestsavedmylife.
Vale
Ifitweren’tforPSAtesting,I’dlikelybedeadordyingnow.Iwaseventually
diagnosedwithprostatecancer–afteraPSAtest,thenbiopsy–attheageof49.Bythetime
mysurgerycamearound,thecancerhadalreadybeguntospreadbeyondtheprostate.
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HadthatinitialPSAtestnotbeendone,thecancerwouldhavespreadunchecked.ThePSA
testhelpedsavemylife.
James
MyPSAwasonaregularcheckgiventheswollenprostate.Suddenlythecount
jumpedfroma2toa3ina6monthperiod.Theonepointspikewasofconcerntobothme
andmydoctor.Itstayedatthe3whencheckedagainin3months,Biopsyreveledcancer
inonecoreoutof12.Gleasonof6.MyDad’sbrotherhadprostatecancer13yearsearlier
andithadescapedtohisbladder.
Mydecisionwaseasy;takeitoutnow–a.s.a.p.Idonotneedtowaitandfindouta
fewyearslaterthatacellortwohadescapedandthecancerisnowinanotherorgan.
Anonymous
IcouldnotgetmyprimarycarephysiciantolistentomewhenItoldhimthatIhad
repeatedprostateinfections.Hejustkeptgivingmeprescriptionsagainandagain.The
infectionwouldclearupandthenitwouldreturn.Iaskedforhimtosendmetoa
urologistbuttheurologistwasonlyinterestedindiagnosingmeashavingBPH.Ididnot
havethesymptomsofBPH,butthediagnosiswaskept.
So,Iaskedforasecondopinion.Iwassenttoafriendoftheurologistwhowasalso
theChairmanoftheDept.ofUrologistataveryfamousmedicalschool.Thisurologistdid
notbelieveinusingthePSAandhediagnosedmeashavingabladderproblem.Heputme
onmedicationthatdidnotdoanythingtohelpwiththepersistentprostateinfections.
So,IwenttotheVAHospitalandaskedthemforaPSA.ThePSAwas9.6andIhada
previousPSA(attheprimarycarephysician’soffice)6monthsearlierthatwas2.4So,I
handcarriedthePSAreporttotheChairmanofUrologyandaskedhimwhatitmeant.He
ignoredthePSAof9.6andthesixmonthearlierPSAof2.4andtoldmethatIhada
bladderproblem.IpersistedandaskedforabiopsybytheChairmanoftheUrologist
Departmentandhe(seemedtobeangry)agreed.ThebiopsyshowedthatIhadstage3tb
prostatecancer.
Ireferredmyselftoacancercenterandtheystartedmeonhormonetherapy,then
3monthslaterIhadaradicalprostatectomyfollowedby42daysofradiation.The
prostatecancerhadspreadintothesurroundingmusclestissueandlowerabdomen
tissue.Theyremoved11lymphnodesontheleftsideoftheabdomenand12lymphnodes
ontherightsidebeforethefoundcancerfreelymphnodes.Ihavebeencancerfreefor5
yearsandamstillupsetaboutthewayIwastreated.Ihopeothermenwillpersistwhen
theyfeeltheyhaveaprostateproblemandgettheappropriatehealthservices.
Carl
Inearly2008attheageof62IhadPSAtestthatwashigh.UltimatelyIwas
diagnosedwithprostatecancerinAprilandhadaroboticprostatectomyinAugustofthe
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sameyear.Idon’tknowifIwouldbealivetodayifthattesthadnotbeenpartofaroutine
physical.Asmuchasthattestcreatedconfusion,uncertainty,anxietyandevenangerin
me,IamverygratefulthatIhaditandthatitsetinmotionaseriesofeventsthatledto
mybeingcancer‐freetoday.
Inaddition,IbecameawareofmyexposuretoAgentOrangeinVietnamin1967,
somethingIhadnoconsciousawarenessof.Thisstartedanotherchainofeventsleading
metoconfrontsymptomsofPTSDfrommyexperiencesinVietnam,resultingindiagnosis,
therapyandultimatelyanewacceptanceandsenseofpeaceinmylife.Iconnectedwith
theVeteransAdministrationandnowreceivemostofmymedicalcarefromtheVA,which
doesanamazingjobofcaringforveterans.
Meditationisnowanimportantpartofmylifethatkeepsmecalm,appreciative
andopentolove.Iwillforeverbegratefulforthisnewchapterinmylifeandthe
appreciationIhavenowforthewondersinmylife,thedeeploveIsharewithmywife,
friendsandfamily.ItallbeganwithasimplePSAtest.Itsavedmylifeinsomanyways
thatIwillalwaysbegrateful.
Steven
IwouldbeinaworldofhurttodayifnotforthePSAtest.Mycancerwasdiagnosed
aftersurgeryasbeingconfinedtothegland.However,mysurgeoninformedmethatifI
wouldhavewaited12to15monthstoaddressthisissue,theoutcomewouldhavebeen
differentandthecancerwouldnothavebeenlocalized.Withoutthescreening,Iwould
haveneverknown.
ThePSAtestisallwehaverightnowandIwouldrecommendthatmencontinueto
gettestedinordertomakeaninformedchoice.Wellover30,000mendieayearbecause
ofthishideousdisease.IfeelIhavebeengivenadditionaltimeonthisearthanditisdue
toaskilledsurgeonandaPSAtest.
Nathaniel
AroutinePSAtest6yearsagoledtoabiopsywhichshowedIhadaGleasonscore
of8.0.ThebiopsyclearlyshowedIhavecancerandIwastreatedandmyPSA’shave
consistentlybeen0.1.IamafraidifinsurancecompaniesstoppayingforPSAtestingthat
manyneedlessdeathswilloccur,especiallywithhighriskgroupslikeAfricanAmericans.
Douglas
PSAtestingsavedmylife.Ishowednoothersymptomsofprostatedisease.Itwas
normalsizewithnopalpablenodesandIhadnotroubleurinating.However,therewasan
increaseofmyPSA.Asaresultofthatalone,Iwasbiopsiedandcancerwasfoundinearly
stages.ThePSAtestclearlyalertedmethattherewasaproblem.Itsavedmylife.
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Terry
In2003ItookaphysicalexamwhichincludedaPSAtest.Theresultsindicateda
possibilityofprostatecancer.Thedoctororderedabiopsy.Theytooksixcoresamples
fromdifferentsitesontheprostate.Threeofthesecamebackasonehundredpercent
cancerous.Ielectedtohavemyprostateremoved.
IgetafollowupPSAeverysixmonths.Thereisnoindicationofcancernow.Iama
cancersurvivorthat’sheretosayIamalivebecauseIgotaPSAtest.
Michael
IamaPCasurvivorsince2001(presentage61)TenyearsagoIhadno
symptomsofprostatecancer.IwenttoaPSAscreeningeventatworkfortesting.
Thedigitalexam(DRE)was“questionable”,inthedoctor’swords,butthePSAwashigher
thannormal(5.7)AfteranotherPSAwasdone(6.0)abiopsyconfirmedthepresenceof
cancer.Ihadanopenprostatectomydone(4‐2‐01)toremovetheprostateanda1.5cm
tumorwaspresentwithaGleasonof3+3=6.Thetumorwascontainedwithintheprostate
itselfbutattheveryedge.Iwaslucky.
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Anonymous
IunderstandthatthePSAtestisn’talwaysaccurateinregardtoforecasting.But,I
cantestifythatdigitalrectalexamsaredefinitelynotagoodpredictor.Myexamsalways
foundmyprostatesmoothwithnoabnormalitiestothetouchandthatwasevenafterI
hadapositivebiopsyforcancer.IbelievetheTaskForceiscomingdownonthesideof
toomanymengettingsurgerywhentheircancerlevelislow(unfortunatelynotmycase).
WithoutPSAscreening,IwouldnothaveknownIhadadvancedprostatecancer.
Iunderstandputtingmoneyandeffortintoanewtest,butwhatdopeopledonow,before
thenewtestisdeveloped.
TheanswerappearstobesomekindofutilitarianRussianroulette.Apparentlyfor
themajority,whodonothaveadvanced,highriskcancer,bestnottoknowyouevenhave
it,sothere’snoworryorunnecessaryprocedures.JohnStuartMillandMr.Spockwould
undoubtedlyapprove.Ifyouareintheminorityandhaveamoreadvancedtype,well,
bettertobeintheblissofignoranceonyourtracktodeath.Atwhatpointdoyoueven
verifyifsomeonehasadvancedprostatecancer?
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Anonymous
Iamnowa66yearoldmale,thankstoarandomPSAscreeningadvertisedinthe
localnewspaper.
Mystorybeginsin1999,afterhearingofafriendscancer(notknowinganything
morethanthathehadbeendiagnosedwithprostatecancer–andnotknowingathing
abouttheprostate)Icalledmyfriendoutofconcernforhishealth.
MyfriendsharedwithmehisproblemandsuggestedthatIgetaPSAtest.ItoldhimthatI
hadbeenintothelocalHMOformyregularphysicaljustacoupleofmonthsbeforeand
wastoldthatIdidn’thaveanyproblemswithmyhealth.Hesaidthatheknowsthatthe
HMO,bypolicy,didn’tscreenforprostatecancerandthataPSAbloodtestwasan
importantscreeningtool.IsaidokanddismisseditthinkingthatImightrememberformy
nextphysical.
AmonthpassedwhenInoticedafullpageadvertisementforafreeProstateCancer
screening,andthought“thisseemstoberathertimely”SoIcalledthenumberand
scheduledanappointmenttobescreened.
ThedayofthescreeningIwasinstructedtofilloutahealthquestionnaireandthat
Iwouldgivepermissionforablooddrawandaninterviewwiththeurologistwherehe
wouldperformanexamcalledaDRE(digitalrectalexam).OKwithme,aftertheblood
drawIwasexaminedbythedoctorandwhileperformingtheDREthedoctorletslipan
‘oh–oh’ratheraudibly.Iaskedwhytheoh–oh,andhesaidsomethingtothefactthathe
mighthavefeltsomething,butthatthebloodtestwouldprovidemoreinformation.
Acoupleofweekslater(actuallyApril1st)Ireceivedaphonemessagefromthe
medicalassistantinstructingmeofmyPSAreadingof29.8andthatIshouldconsultwith
myownurologistattheHMO.
FollowingmyvisitwithmyHMOurologist,andtheresultsofmyprostatebiopsy
andadditionaltests,IwaspresentedwithmyowndisturbinginformationthatInotonly
hadprostatecancerbutafairlyproblematicchallenge.ThediagnosiswasthatIhada
Gleason9disease,andfurthertestshadshownthatithadescapedthecapsule(spread
beyondtheprostateorgan).Additionally,myprognosiswasn’tallthatrosy.TheDoctor
toldmethatbasedontheoutcomeofthetreatmentthattheycouldonlyguessthatI
wouldhaveabout8monthstotwoyearsbeforeIwouldfalltothedisease.
ThegoodnewsisthatI(afteracoupleofrealemotionalmonths)Iwasabletoput
athoughtfulprocesstoworkonlearningmoreaboutwhatmy‘competition’tolifewas
about,andalsolearningmoreaboutfindingthe“A‐Team”totreatmydisease.
IknowthatthegoalofthisreportwastopresenttheimportanceofPSAscreenings,buta
secondarylevelofimportanceisWHATTODOwiththeinformation.First,don’tbe
satisfiedwiththestatusquo.Learnmoreaboutyourpersonalsituation,andactonyour
owninstinctsbygetting‘seconds’opinion.Ipersonallyinterviewed6differentdoctors,
withvaryingspecialties.
Iwasn’toriginallyacandidateforradicalprostatectomy,andactuallywasaboutto
undergoexternalbeamradiation.However,duetoextenuatingcircumstancesandan
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excruciatingSIMexperience.Iwasofferedanoptionofundergoingtheradical
prostatectomy,leavingtheexternalbeamradiationasatrumpcardtofuturetreatment
options.
Tammy
Myonlybrother,now55yrs.old,haddoneasbestosremovalinthe70's.Many
yearslater,hecontractedMesotheliomaandhadtoquitaverygoodjobasaSystems
EngineerforamajorcompanyinNYC.Thisalsoledtohisdivorce.Ithadgoneinto
remission,Iguess,formanyyears.Inthattimewehadlostcontactofeachotheruntil
recently.HeisnowdyingfromProstateCancerStageIVandcouldn’tgetaPSAtestuntilit
wastoolate.Nothingmorecanbedoneformybrotheratthisstageinhislifeashehas
about16monthstolive.
Joseph
MyPSAreadingwas5.1takenduringaroutinephysicaltorenewmyother
prescriptionsat59yearsold.IthenhadabiopsywhichfoundthatIhad8outof10core
samplespositiveandGleasonscoreof7(3+4).Ihadopensurgerytoremovemyprostate
andnow18monthslaterPSAisundetectable.Ihavehadnoincontinenceissuesfrom
about3monthsoutbutstillhaveEDissuesthatIcanlivewith.
Anonymous
WithoutmyPSAtestsIwouldnothavefoundcancerwithinmyprostate.Without
thetestsovertheyearsthecancerwouldhavespreadoutsidetheprostateandImightnot
beheretodaytowritethismessageofimportance.
IhadradiationseedtreatmentandmyPSAtodayisat1.Ihopethatitcontinuestodrop
below1.Veryimportantforallinsurancecompaniestorecognizethatwhilethisisthe
onlytestthatwehavetoday,it’sagoodone.
Anonymous
IbelievethatthePSAtestsavedmylife.Youcannottellmethatthetesthas
limitationsaswellasbenefits.ThesuddenrisesinmyPSAleadthedoctorstodetermine
thattheyshouldlookdeeperintotheproblem.
Edward
IwasdiagnosedwithprostatecancerinJulyof1993.Ihadaroutinephysicalin
whichmyPSAwasmeasuredandcamebackwithavalueof13.6ng/ml.Abiopsyproved
thatIhadprostatecancer.Ichoosesurgerywhichhada50%successrateforthatlevelof
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PSA.ThesurgeryfailedtoremoveallthecancersothatIwentonintermittentandrogen
deprivationtherapy.Ifoundthistherapyverycaustictotolerateand,changedtoa
Mediterraneandiet,loweredmybodyweightaccordingtomybodyMassIndex(BMI),
tooksupplementsthatalsoaidedmyimmunesystemtokeeptheprostatecancerincheck.
TodaymyPSAhasstayedbetween2‐3ng/mlthepast6years.
Felicia
WithoutPSAtestingmyhusband’scancerwouldnothavebeendetected.Even
thoughhewasinthenormalrangehislevelshavedoubledfromlastyear.OurDr.sentus
toaspecialistwhodidmoretestingandwefoundhehadcancer.Oncehehadthesurgery
noteven3monthslateritwasfoundtobemildlyaggressiveandnearthebladder.Thank
GodforPSAtesting.
Anonymous
Attheageof44,Iwenttoaurologistbecauseofsomecystsonmytesticles,which
werenothingmorethanepididymiscystswhichwerenothingtobeconcernedabout
unlesstheygotlarger.Theurologistaskedmeiftherewasanyhistoryofprostatecancer
inmyfamily,andIsaid“yes,myfatherandbothgrandfatherswerediagnosedwith
prostatecancerintheir70'sand80's”.Asaresult,herecommendedaPSAtest.The
resultsofthePSAtestwererelativelyhigh(especiallyformyage),whichledtoadigital
rectalexamwherehefeltahardspotonmyprostate.Thisledtoabiopsy,whichledtoa
diagnosisofveryaggressiveprostatecancer.
Ihadaradicalprostatectomyattheageof44!Withmyfamilyhistory,Ialways
figuredIwouldendupwithprostatecancerinmy60'sor70's,butcertainlynotatage44!
Afterthesurgery,thesurgeontoldmethepathologyresultsofmyprostateindicatedthat
therewasevenmorecancerthantheyoriginallyexpected,andhaditnotbeenremoved;I
WOULDHAVEBEENDEADWITHINTWOYEARS!IwasVERYfortunatethatthiswas
caughtearly(becauseofthePSAtest),andIdidnotexperienceANYofthetypicalside
effectsofthesurgery(impotenceand/orincontinence).PSATESTINGSAVEDMYLIFE!
HadInothadthatPSAtestdone,Iwouldn’tbewritingthistoday.NeedIsaymore?
Neil
HavinghadseveralDRE’sdoneandalwaysbeingtoldeverythingfelt‘normal’I
insistedthataPSAbedone.Thatinitialtestcamebackwithoutclarity,soIhadanother
doneacouplemonthslater.Ithadgoneup.Another6weekslateranotherwasdoneandit
hadgoneupsignificantly.Duetothisabiopsywasdoneanditcamebackwith4outof10
samplesshowingcancerouscells.IthenhadaRadicalProstatectomydoneandafter
receivingtheresultsofthetestdoneonthecapsuleitwasdeterminedtohavebeena
moderatelyaggressivecancer.
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I’mconvincedthathadInothadaPSAdoneIwouldbebattlingacancerthatmay
havebecomemuchworseormayhaveevenkilledme.Thatwas3yearsagoatage53.
Don’tletPSA’sbepushedasideasiftheyarenothelpingdiagnosesuchadevastating
disease.
John
Ourhealthdepartmentconductedahealthfair.APSAwaspartoftheblood
screening.MyPSAcameback4.3.IfoundoutIhadprostatecancerandthistestcaughtit.I
wouldbedeadnowwithoutthePSAtest.Anybodynotgettingscreenedatagefortyis
playingisgamblingwiththeirlife.
Bruce
Atage50Iwenttomydoctorforaroutinecheck‐up.HesuggestedgettingaPSA
test,Iagreed.AtthetimeIdidn’tevenknowwhataPSAtestwas.Thetestcameback4.00
andwastestedagainwhichcameback4.80.IwassenttoaUrologistwhereabiopsy
confirmedthatIhadProstateCancer.IfIhadnothadthisPSATestIwouldnothave
gottentheneededtreatment.MyPCisaggressiveandneededtotreataccordingly.
Michael
Atage57,IsoughtPSAtestingagainsttheadviceofmyprimarycarephysician.His
digitalprostateexamhadfoundnoevidenceofalumpornodule.WithaPSAthathad
increasedfrom3to5.5overthepastyear,Ihadabiopsythatshowedamoderately
aggressiveprostatecancer.TherecommendationfromtheUrology/OncologyCenterwas
forsurgery.Myprostatectomyrevealeda2cmtumorthatwasdescribedasverylarge.
(2cmseemssmallbutisapparentlylargeforaprostatecancer.)
Almostsixyearslater,Ihavehadnorecurrence.Icontinuetocheckregularlywith
PSAtesting.PSAtesting,againsttherecommendationofmyprimarycarephysiciansaved
mylife.
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George
I’maProstateCancersurvivor.
IwassuremyhighPSAmeantnothingasnooneinmyfamilyhaseverhad
ProstateCancer,butturnedoutwithaGleason6&Roboticsurgery.Atage66I’mtotally
Cancerfree,butwouldhaveotherwiseneverknown.Iprettymuchowemyhealthylifeto
thePSAtest.
Lifeisgood.
Anonymous
Mybrother’slifewassavedbecauseofthistest.Hewasdiagnosedwithprostate
cancerandbecausehehadbeengettingthePSAtestyearlyhiscancerwasfoundinits
earlystageandsuccessfullytreated.Todayheiscancerfree.
Anonymous
IlostmyDadtoprostatecancer31/2yearsago.AlthoughhehadroutinePSA
testing,theprostatecancerhecontractedwasaveryaggressiveone.Hefoughthardand
boughtusanotheryeartogether.IfithadnotbeenforPSAtesting,Iwouldn’thavehad
thatextratimewithmyDadthatIwillcherishfortherestofmylife.
Anonymous
Iwasdiagnosedwithmoderategrowthcanceratage65.Myprimarycaredoctor
wasconcernedaboutmyPSAlevelandsentmetoaurologist.Thedigitalrectalexam
showedaproblemwithmyprostate.Thebiopsyshowedcancerin9outof14samples
andgettingclosetotheseminalvessels.
Radiationwaseffectivewithminorsideeffects.IfIhadnothadthePSAandDREI
wouldhaveproblemsnow5yearslater.Ihavenotpersonallyknownanywomanthat
diedwithbreastcancer,butIhaveknown3menthatdiedwithprostatecancer.Twoof
themenneverhadtheirPSAdoneuntilthecancerhadspread.Theymightbealivetoday
iftheyhadhadthePSAandDREtestsdoneearlier.Theonewhohaditdone;sawalarge
increaseinPSAfromoneyeartothenext.Hewasabletogettreatmentthataddedapain
freeyeartohislife.
Anonymous
WithoutPSAtestingmyhusbandwouldhavediedalotsoonerthanhedid.It’snot
thePSAtestingthatyouhavetoworryaboutit’ssomeofthedoctorsoutthere.Whatdo
youwantlittleproblemsorLIFE?
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Donald
IhaveadearfriendwhoselifewassavedbyaroutinePSAtestthatledtoa
diagnosisatage50ofafast‐growingcancer.Hehadnosymptomsofanykind,soabsent
thePSAhewouldnothaveknownuntilprobablytoolateforthesurgerythatcamebefore
metastasis,surgerythatsavedhislife.
Mywife’sbestfriend’sbrotherhasessentiallythesamestory.
Al
AfterseveralincreasingPSAtests,Ihadabiopsythatdiagnosedmewithprostate
canceratage54.Ihadalaparoscopicroboticprostatectomyandamnowsixyearscancer
free.WithoutthePSAtestIwouldneverhaveknownIhadprostatecanceruntilitwasfar
advancedandwouldprobablydieatanearlyage.ItisunconscionablethattheUSPTFis
consideringrecommendingagainstPSAtestingwithoutanyalternativescreening
recommendation.
Louis
PSAtestingsavedmylife!Iinitiallywastestedin1993,withfollow‐upin1994.My
physicianaskedmewhetherornotIwantedtobe“proactive”andIsaidyes;Ihadno
symptomsbutmyPSAwasintheabnormalrange.BiopsyconfirmedthatIhadprostate
cancer.MywifeandIdecideduponsurgery.Ihavehadundetectable
PSAscoressince(exceptforonefalse‐positivethatwasalaboratoryerror),andam
18yearspost‐surgery.MyGleasonscorewas8.WhatIhavesubsequentlydeterminedis
thattherehasbeenaprostatecancergenetic“relationship”inourfamily;myfatherand
myfather’sbrotherhasdiedfromprostatecancer.Ihadanexceptionalprimarycare
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physicianandurologistwhoworkedtogetherwithme,explainedalltheissues,andletme
goforasecondopinion…andIwentwithmyurologist’srecommendationforaradical.I
haveNEVERregrettedmy/ourdecision;mypost‐surgicalsymptomshavebeenminimal.
TorecommendagainstPSAtestingisunprofessional.Forthosephysicianswhoare
arguingagainsttesting—justwaituntiltheyexpresssymptoms—andthenitmaybetoo
late!IamaUniversityscientist.HavingPSAtestingavailabletomesavedmylife!
Peter
WithoutPSAtesting,mycancerwouldhavenotbeencaught.Whiletherearereal
riskstoPSAtesting,biopsy,andtreatment…inmyopinion,testingisknowledgeand
shouldcontinuetoberecommendedandpaidforbyinsurance.Thisisparticularly
importantforyoungermenwhowilllikelynotoutlivePCa.
Whenabetter,moreaccuratePCatestisavailable,thanswitch.FornowPSAisthe
bestindicatorandshouldbecontinued.
Anonymous
Attheageof46Ihadaphysical,andforthebloodwork,mydoctorchecked“PSA”.
ThiswasmyfirstPSAtest,becausetypicallytestingstartsat50.MyPSAwashigh,
remainedsoinasecondtest1monthlater,thenafollowupbiopsydetectedProstate
Cancer.I’mnowapproaching5yearscancerfree.IfnotforthePSAtest,Iwouldhavenot
knownuntilmuchlater,riskingdiseaseprogressionbeyondmyprostate.
Jeff
PSAtestingsavedmylife.Fiveyearsago,Iwasahealthy46year‐oldguywho
exercisedregularlyandwenttoregularcheck‐ups.MyDRE’swerealwaysunremarkable
andIhadnosymptomssuggestingtherewasanythingwrongwithme.OnedayinAprilI
visitedalocalhealthfairsponsoredbyaDenvernewschannel.
Beingapsychologist,IthoughtIcouldpickupsomeinterestinginformationformy
clients.Idon’texactlylikeneedles,sowhatpromptedmetodecidetogetmyblood
checkedIwillneverknow,howeverIhavetoadmitIwasabitrelieved,whenIwas
turnedawaybecauseIhadnotfasted12hoursfortheglucosetest.
WhatmakesmystoryevenstrangeristhatIwenthomeandresearchedwherethe
healthfairwasgoingtobethenextday.Ifastedtherequired12hoursandtraveledto
anothercitywhereIagainstoodinlineandhadmyblooddrawn.
Afewdayslater,Ireceivedacallfromaseeminglydistressednursewhoinformed
methatmyPSAwas23.4andthatIneededtoseemydoctorimmediately.Ididn’teven
knowwhataPSAwas,atthattime,butIeventuallylearned.Boy,didIlearn.Furthertests
andabiopsyconfirmedprostatecancerwhichhadspreadtoaseminalvesicle.Ihad
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surgery,radiation,andtwoyearsofhormonetherapyandthissummerIcelebratedfive
yearsofbeingcancerfree.IamalivebecauseofaPSAtest.
Doug
In2004,IhadaPSAtest.Theresultswere10Nanograms/ML,higherthanlast
year’sresult.IsawaUrologistwhoscheduledaprostatebiopsyforthefollowingMonday.
ThePSAdoneagainattheUrologist’soffice,andwasevenhigher.
BiopsyresultswereconsistentwithaDXofProstateCancer.GleasonScore=6.The
urologistsaid,“AGleasonScoreof6isagoodscoretohave.”ThePSAsavedmylife;
otherwise,Imightbefightingcanceratthistime.Ihavehighbloodpressure.Idon’tneed
prostatecancertoo.
George
MyfatherdiedofprostatecancerbeforePSAtestingwasavailable.Duetohis
cancerthechancesofmycontactingthisdiseasearedoublethatofthegeneralpopulation.
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SoforpeaceofmindifnothingelseIgetannualPSAtestingwhichIhavestartedplotting
duetomyrisingPSAnumbers.
Anonymous
PSAsavedmylife.Ihadnosymptomsofprostatecancer.EvenafterthePSAresults
itwasnoteasytodetectthecancerthroughothertests.Giventhatthecancerwasnot
totallyencapsulatedandhadtraversedtheprostateliningIwouldnotbealiveifithadnot
beenforthePSAwarning.
Andrew
Imagineat46yearsoldhowshockedIwastofindIhadprostatecancer.Itwas
onlythroughmyworkphysicalthatincludedaPSAtestthatindicatedtherewasa
potentialproblem.Thedigitalrectalexamprovedtobeunremarkable,sothePSAwasthe
onlyindicator.Ihadnoprevioussymptoms.Iwasjustthereformymandatoryannual
physical.Well,afteratriptotheurologistandanotherPSAtestIwasscheduledfora
biopsywhichultimatelyshowedcancer.
Ihavenofamilyhistoryofprostatecancer,soifitwasn’tformyworkphysical,I
wouldn’thavegottenaPSAtestuntilIwas50andwhoknowshowfarthecancerwould
havegottenatthatpoint.AsItypemystoryIamhappytosaythatIamcancerfree.Ifit
wasn’tforthePSAtestIwouldbewalkingaroundwithprostatecancerrightnow.I,my
wifeandmythreechildrenareallconvincedthatthePSAtestsavedmylife.
Donna
I’mwritingformyhusband.HepassedawayfromprostatecancerlastDecember.
Hewasahealthyoung48yeardoctor.Hedidhislabeveryyearandhadacomplete
physicalexam.Onhis47thbirthdayhisPSAwasunder4.Byhis48thbirthday,hisPSA
was33.YesmendoneedtohavetheirPSAdoneandthescreeningshouldstartat40.
Wehavethreegrownchildren.Twoaremenintheirearly20's.Theywillstartat
30havingaPSAtest.
William
PSAtesting,Ibelieve,savedmylife.IwastestedandfoundmyPSAlevelwas6.6.I
alsohadabiopsyandwasscheduledforsurgerybuthadaheartattackfromwhichI
nearlydied.Idecidedonwatchfulwaitingconcerningthecancer.PSAwasstablefor3
yearsuponwhichtimeitsuddenlywentfrom6.6to10.4.Ihadnervesparingsurgery6
weekslater(1998)andhaveshownnofurthersigns.Ihaveexcellenturinecontrol,no
incontinencebutcannotattainanerection.MyPSAisnowundetectableforwhichIam
mostgrateful.
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Phillip
Thischeaptesthassavedthelifeofmybothmybrotherandmyselfandlackof
testingtookmyoldestbrother’slife.
BothmybrothersliveinEnglandwhereroutinetestingisnotdone.Becauseofthismy
oldestbrother’sprostatecancerwasdetectedwaytoolatetotreateffectivelyandhedied
withinafewyearsofdiagnosis.Afterthisexperiencemyotherbrothergottestedandwas
foundtohavePCalsoandisdoingwellafter7years.IFHEHADNOTINSISTEDONBEING
TESTEDHEMIGHTHAVEENDEDUPLIKEOUROLDERBROTHER!
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James
Iwouldbedead,ifIfollowedthe“watchfulwaiting”advice.MyPSAwasonly
slightlyelevated,butthebiopsyshowedintermediatecancer,7outof10ontheGleason
Scale.ThePSAwascertainlynot“falsepositive”inmycase,andlikelysavedmylife.Isn’tit
bettertoerronthesideofcaution?
George
Iama15yearsurvivorwithoutinvasivetherapyuntilCryo2.5yearsago.Iamnow
65yearsofageandwithoutPSAteststohelpmemonitormycondition;IdonotfeelI
wouldhavehadthesameoutcomeorsuccessfightingthisdiseaseasI’vehad.Iamstill
monitoringmyPSAonaregularbasisandpayingforthetestsmyselfonthemajorityof
times.ObviouslyIfeelitisaninvaluableresourceinthebattleagainstPC.
Alfonso
Ibelievemystatementputsprostatecancerintherightperspective:NFL
viewershipis67%maleand33%female,however,thismonthNFLplayersareladenin
pinkuniformapparelandaccessoriestopromotetheawarenessofBreastCancer.
Statistically,individualswithprostatecanceranddeathscausedbyprostatecancerare
rightinlinewiththenumbersforbreastcancer.Evenmorecrucialisthebehaviorof
maleswhenitcomestogettingcheck‐ups.Mostmendon’tgotothedoctorforroutine
check‐upsevenwhentheyhaveailmentsofanyvariety.
Anonymous
IhadneverheardofaPSAtestwhenanursesuggestedthatIgetone.Itested
positiveforprostatecancer.Iamstillalive18&1/2yearslater(October2011)becauseof
earlydetectionandthegraceofGod.Iknowthatearlydetectionsaveslives.Ialsobelieve
thattheefforttoreducetestingisaMedicaldoctor’sschemetotreatmoreadvanced
patients(makemoremoney).Ialsobelievethatthemedicalcommunityisnotactively
searchingforcures(intendingtomakemoremoney),causingmanymaleswithprostate
cancertodiebeforetheirtime.
Judith
I’mthewidowofafinehusband,fatherandgrandfather–greatlymissed.Because
ofanincreaseinhisPSA,hehadabiopsywhichshowedcancerandaprostatectomyin
August2004.Thedoctorwasconfidentthathe’dgottenitallandrecommendedno
furthertreatment,otherthanmonitoringthePSA.Threeyearslater,itincreasedto1from
negligible,andnoonesoundedanalarm.Threemonthslater,itwas123.Severaltests,
includingaprostascintdidn’tshowanycancercells,andanappointmentwassetupfor
THREEMONTHSLATER.Thatappointment,hisPSAwasover1200andthecancer
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hadspreadtobonesandliver.Obviously,Iregretlettinghimleavethatday,threemonths
earlier,withoutaddressingtheissueofaPSAof123.Iquestionedthedoctoraboutit:
“shouldn’thebetreatedevenifnocancercellsareevident?”“Didn’taPSAthathigh
indicatethatsomethingiswrong?”Hewasreassuringandhowwewantedtobelievethat
everythingwouldbeokay!!WhenBob’sPSAincreasedfrom.00‐toover1.00,ifwehad
paidattentionandinsistedonclosermonitoring–nevermindifinsurancewillpayfor
morefrequenttests!–MaybeBobwouldstillbewithusoratleasthavehadmoretime–
toseenewgrandchildrenandgreatgrandchildren.
Thebestdoctorsintheworldinstateofthearthospitals–stillmakemistakes;
they’reonlyhuman.Patientsandfamilymembersneedtobeinformedandtheirownbest
advocates,seekingsecond,thirdandfourthopinions,ifnecessary
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Maria
My49yearoldhusbandwentinforhis“WellnessExam”inJune,2011andhisPSA
camebackat57.OnemonthlaterhewasdiagnosedwithStage4ProstateCancer.His
cancerhasalreadyspreadtohislymphnodes,bladder,nervebundles,andseminal
vesicles.
HadhisdoctorfolloweduponhisPSAtestof4.8in2006,myhusbandwouldnot
belosinghisbladderandhisprognosiswouldbemuchbetter.
TheproblemisNOTwiththePSAtest!Theproblemsarewithdoctorsnot
educatingtheirpatientsandpatientsnotbuildinguponthateducation.
Myhusbandhadnosymptomsotherthanamildlyweakenedurinestream!
IfhehadnothadthePSAtest,hiscancerwouldstillbegrowingoutofcontrolwithoutus
evenknowing.
ProstateCancerisNOTanoldman’sdisease!Nooneinmyhusband’sfamilyhas
hadProstateCancer,sotherewasnoreasonforhimtothinkhewasathighrisk.
ThePSAtestpossiblysavedmyhusband’slife.Anincompetentdoctorin2006
allowedfurtherharmtocomemyhusband’sway,notthePSAtest!
Anonymous
MyfatherlosthislifeasaresultoffailingtohaveregularPSAtest.Mygrandfather
diedbeforeavailable.Nomatterwhatissaid,annualPSAandexamsaveslives.
Gary
Myfatherdiedfromprostatecanceratage65.IstartedcheckingmyPSAlevelsat
age40.In2006mylevelsjumped3pts.andabiopsyconfirmedtheworst.Twomonths
laterIhadaradicalprostatectomyandI’veneverlookedback.ThisyearIraninthree
triathlons.I’mconvincedthatthePSAtestingidentifiedmycancerintimetosavemylife.
Robert
Iwas49yearsofage.MyPSAwas4.0(buthaddoubledinlessthan2years).The
biopsyindicatedaGleasonScoreof6andcancercellsneartheperipheryoftheprostate.
ShouldIhavetriedwatchfulwaiting?Whoonthepanelmakingtherecommendations
wouldhaveoptedwatchfulwaiting?
Ioptedforsurgeryandhavebeencancerfree(PSAtestsnotindicatingany
activity).
Bob
Uponbeingdiagnosedwithprostatecancer,Iwassenttoaurologicalpracticewho
immediatelyrecommendedabiopsy.Followinga9.0PSAandadmonitionsfromthe
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doctorsafterthebiopsy,Iwentthroughalmostayearofseeingallsortsofphysicians,all
ofwhomrecommendedsurgeryorradiation.
Thesedidn’tfeelrighttomeand,asIbegantoresearch,Ifoundpeoplewhohad
achievedagoodresultfromsupplementsandothernon‐surgical,non‐invasivetreatment.
Onlymonthsafterconsultingaphysicianwhoputmeonanumberofsupplementsand
onlytwoprescriptiondrugs,changedmydietandseveralothercommonsensethings,my
PSAregistered3.8.SincethenthePSAreadinghasvariedbetweenthatat5.6.Iam
convincedthatImaywellhavebeenmuchworseoffasawholepersonifI’dhadthe
surgery.
Seemstomethatthere’snothingwrongwiththePSAitself.It’sonlyabloodtest.
It’swhatmanyonthemedicalcommunitydowithitthatiswrong.Havingbeenthrough
myfouryearexperiencenow,I’mgladtohavethePSA.Asmydoctorhassaid,“Thereare
manyreasonsforyourPSAtogoup,manyofthenegative,butonlyonereasonforitto
comedown.Something’sgettingbetter.”
It’snotthetest;it’sthekneejerk(moneyearning)reactionsofmanydoctorsthat
causethenegativeconsequences.
Lee
Mydadwasdiagnosedatage50.Iwasdiagnosedat46.BecausemyPSAwas3.9,
myGPreferredmetoaurologistforabiopsy,whichconfirmedcancer.
Ifitwasn’tforthePSAtest,Iwouldhavebeeninbigtrouble.BythetimeIstartedproton
therapy4monthsaftertheoriginalPSAtest,myPSAtestedat5.3.Mycancerwas
aggressive.
Yes,thereareanumbervariableswithaPSAtest,butwithagooddoctor,proactive
patient,andaccuratetesting,THISTESTSAVESLIVES.
Tony
Iwas44in2006whenmyprimarycarephysicianprescribedaPSAtestinmyfirst
physicalsinceIhadturned40yearsold.MYPSAindicatedaveryhighreadingat19.8.
Afteraseriesoftestsandsurgeryitwasdeterminedmycasewasadvancedprostate
cancerbutstilltreatable.Ihavebeeninremissionfornearlyfiveyears.Ifirmlybelieve
thathadmycancerremaineduncheckedbythePCPonthatdaythatIwouldbeeither
deadordealingwithincurablemetastaticprostatecancertoday.Ithinkthatthisis
indisputableevidencethatscreeningsaveslivesand/oratveryleastextendslives.
Elliot
Duetofamilyhistory,IhadseveralyearsofPSAtestingeveryotheryearstartingat
age39.MyPSAjumpedto4.0atage45,andwasclimbing20%peryearatage46.A
biopsyshowedGleason7cancer.Iamnow14monthspostroboticsurgerywithaPSAof
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0.01!Myurologistwasveryrealisticabouttherisksofincontinenceandimpotence
associatedwitheachtreatmentoption.Hewasveryclearthaterectilefunctionwouldnot
improve,andwouldlikelydecline.Ihavenoincontinenceproblems,butIdohave
impotenceissuesrequiringinjectionsforintercourse.Giventhefranknessofmydoctor,I
amoverallverysatisfiedwithmytestingandtreatmentexperience.Iwatchedmyuncle
dieofPC,anditwashorrible.
Tometheerectileissues,thoughfrustratingattimes,areanacceptablepriceto
payfortheopportunitytoavoidthatdeath.IfirmlybelievethatthePSAtestingsavedmy
life.
Bill
MyPSAwentup2.5butbecauseitdidnotpassthecomputertestof4.0myregular
doctorsdidnothing.Theyonlywentthroughthemotionsofthedigitalrectalexam.Bythe
timeIgottoacertifiedUrologistitwastoolate.Ihadthesurgeryandtheradiationbutit
wastoolate.Myregulardoctorsthanbackdatedmymedicalrecordsandnowclaimthat
theytoldmethatIhadcancer3yearsearlieranddidnothing.
Thisiswithoutanybiopsyorpathologyreport.
Kenneth
Iwasgoingtothebathroomfrequently.Had“start/stop”issues.OnawhimI
mentionedthistomyMD.PSAat21.6.Then,yPSAroseto27.IfIhadwaitedalittle
longer,Imightnotbeherenow.I’mnotasurvivor,yet.I’mundertreatmentforstage4
prostatecancer.Mysonhastobetestedatage42.ThePSAtestMUSTbekeptformen.
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Terry
WehaveafamilyhistoryofcancersoIfeltthePSAtestswereimportantforme.I
hadanannualPSAtestsincemyearly50saspartofmyannualphysical.Theresultwas
alwaysinthenormalrangebutincreasingslowly.
Atage59myPSAincreasedabout50%.MyurologistorderedanotherPSAthree
monthslater.MyPSAwasupanother30%butstillinanormalrangeat3.9.
TherisingPSAconcernedmyurologistandhesuggestedabiopsy.Aftersomediscussion
andconsideration,Iagreedtohavethebiopsy.12coresweretakeninapainfulbutshort
procedure.Onlyonecorecontainedcancer.TheGleasonscoreforthecancerwas4+3.
Thisearlystagecancerwaslocatedonlyintherightprostatelobe.
Myurologistrecommendedradicalprostatectomy(RP).HesaidthatIwasinno
riskofdyingsoon.Heexplainedthatprostatecancerisusuallyslowgrowingbutthe
Gleasonscoreof4+3indicatedmycancerwasaggressiveandwouldbelikelytospread
outsideoftheprostateifnottreated.Theprostatectomywasrecommendedtoimprove
myoutlooktenyearsandmoreinthefuture.HadIbeen10or15yearsolder,thedoctor’s
treatmentrecommendationmayhavebeendifferent.Theremayhavebeennotreatment
atall.
Istartedresearchingoptions.Theavailableliteraturewasallovertheplace
regardingappropriatetreatment.Imetwithtwootherurologists,radiationandmedical
oncologists,andothermembersofamulti‐disciplinarycancerteam.Allofthem
recommendedRP.IeventuallydecidedtohaveRPbutwaitedforsevenmonthsdueto
otherhealthconcerns.
IhadsurgeryinJuly2011.Thepost‐operationpathologyreportindicatedthe
cancerwascontainedintheprostate.Nonewasfoundinthelymphglandsorsurrounding
tissue.However,thecancertumorhadspreadtotheleftprostatelobe.10%ofmy
prostatewascancerous.Thisindicatedanaggressivecancergrowth.
Ihaveeveryreasontobegratefulforearlydetectionandtreatmentofmyprostate
cancer.
Nooneknowshowlongwouldithavetakenforthecancertospread
outsideofmyprostate.Ifithadspreadoutsidetheprostate,treatmentwouldhavebeen
muchmoredifficultandprolonged.IfIhadn’thadPSAtesting,thecancermayhavegone
undetecteduntilitwastoolatetoeffectivelytreatit.
I’mstillrecoveringfromsurgery.Ihaveslighturinaryincontinenceandwearapad
forprotection.Ialsohaveerectiledysfunction(ED).Hopefullybothofthesesideeffectsof
RPwillclearupovertime.Eveniftheydon’t,IhavenoregretsaboutchoosingRPtotreat
mycancer.
Judy
Myhusband’sPSAhadbeensteadilyrisingbuttheresultsweresimplyfiledinhis
chartsinthedoctor’sofficeandignoreduntilhebeganexperiencingsymptomsthatcould
notbeignored.The“fingertest”atthedoctor’sofficeleftlittleneedforanotherPSAtest;
thedoctorsenthimdirectlytotheurologistwhoimmediatelyscheduledabiopsythat
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revealed“advancedaggressiveprostatecancer.”Wesoonlearnedthatthereisalong
historyofaggressiveprostatecancerinhisfather’sfamily:atleasttwo,perhaps3uncles
andhisgrandfatherhadhadit.(HisownfatherdiedofHodgkin’sattheageof50,“too
young”togetprostatecancer.)
HisGleesonscorewastoohighforradiationseeds,andattemptedsurgeryproved
unsuccessfulasthetumorshadalreadyspreadoutsidetheprostateandwere
compromisingbloodvesselsandnervesinhislegs.ResortingtoPlanB,heoptedto
provideasmuchhelpaspossibletothemedicalfieldbyparticipatinginexperimental
treatment.Foreightyearsheunderwentradiationandninedifferenttypesof
chemotherapy,bothon‐andoff‐study.Hispositiveattitudeandlovingdisposition
disguisedhispainanddiscomfortasthediseasegraduallydiminishedhisphysical
abilities.
Webothbecameavid(ifprivate)advocatesofPSAtesting,encouragingmento“get
tested,learntheirnumbers,andknowwhattheymean.”Iamoutragedthatthemedical
professioncanevenconsiderlimitingordoingawaywiththistesting.Iknowthatitisnot
alwaysapreciseindicator,butitisacrucialindicatoranditneedstobedoneregularly.
Iwillneverknowifmyhusbandwouldhavelivedlongerifwehadlearnedofhiscancer
sooner,butIcertainlywantmysonsandgrandsonstobetestedregularly.Earlydetection
providesagreateropportunityforcrucialpreventivemeasures.
Theeightyearswehad(afterhisdiagnosis)werepreciousbeyondmeasure.His
attitudeattheoutsetwasthathedidnotwanttospendhisremainingtimefocusedon
whatcouldorshouldhavebeendone–itwouldnotchangethecircumstanceswefaced.
Buttherewillalwaysbethatquestioninthebackofourminds:“Whatifwehadknown
earlier?”
Tony
Onaroutinephysicalexamin1997,atage56,Iwasdiagnosedwithprostate
cancerfollowingaroutinePSAtest.Fourteenyearslater,Iamstillbattlingthedisease,but
becauseofanearlydiagnosisandtreatment,Ihavesurvived14yearsandmyqualityof
lifehasbeengood.Atthetimeofthediagnosis,theurologisttoldme–”donothing,andyou
willbedeadin5years”.Ihadnothadanysymptomsandwouldnothaveknowntohave
anytreatmenthaditnotbeenfortheroutinePSAtest.Thetestmostlikelysavedmylife.
Manny
Inanannualcheck‐upmyPSAlevelwasa9anditcontinuedtorisetoa14beforeI
hadmysurgery.Ihadanaggressivecancerwhichspreadtooneofmylymphnodes.Prior
tomytesting,Ihadnosymptomsandfeltfine.Myprostratewasthreetimesthenormal
size.AftermysurgerymyPSAwasat4andcontinuedtorise.Mydoctorrecommended
Hormonetherapy.TodaymycurrentPSAis0.36.WithoutaPSAtest,Iwouldnothave
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beenconcernedaboutProstatecancerespeciallysinceIhadnosymptomsordiscomfort.I
believethistestinghelpedidentifythecancerbeforeitwastoolate.
Thomas
In2008,Ihadmybiopsy,whichconfirmedPCa,andIhadadaVinciprostatectomy
on10/10/2008.MyprimarycareproviderhadbeenmonitoringmyPSAonaregular
basis,andthefactthatitincreased,eventhoughitwasnotveryhighinabsoluteterms,
signaledtheneedforabiopsy.Inaperiodofaround18months,ithadgonefrom2.3to
3.7,anincreaseof1.4.Hehadtoldmethatanincreaseof.75in1yearwouldbe
noteworthy.
Ihadnosymptoms,andithadnotbeendetectablebyDRE,soPSAscreeningisthe
onlywayitwasdetectedasearlyasitwas.
Jon
ThePSAtestisaninexpensivewayofprovideusefulinformationindetermining
thelikelihoodofhavingprostatecancer.AfterlearningthatmyPSAlevelwaselevated,I
hadabiopsy,whichindicatedIhadprostatecancer.Aftermuchconsideration,Ichose
radiationandseedimplant,asawayoftreatingit,whichwassuccessfulinmycasewith
relativelyfewsideeffects.InowusePSAtestingasayearlypost‐treatmentmonitor.
ThemainargumentagainstPSAtestingisthatitcanleadtounnecessarytreatment
thatcancausemoreharmthangood.TheanswerisnotlessPSAtesting,butmore
educationabouttreatmentoptionsandpotentialbenefitsandsideeffectssothateach
mancanmakeamoreinformedchoice.
Jim
PSAtestingmayhavesavedmylifeandgivenmedecadesofmoretimetospend
withmyfamily.IhadveryhighPSAreadingswhichpromptedaseriesofbiopsiesthat
foundGleasonscore7.5cancercells.Nowthebigdecision:takecareofitortakethe
chancethatthecancerIhadwasnotoneoftheaggressivetypes.PlayingRussianroulette
withmylifewasnotagoodchoice,soIhadthesurgery.Ihadsomepost‐surgeryissues,
butthetrade‐offwasworthit.
WithoutPSAtesting,Iwouldhaveneverknownaboutthepotentialforaggressive
cancerwithinmeuntilithadreachedthepointofkillingme.If5outof20prostate
cancersareaggressive,thenitmighthavebeena20%chanceofitkillingme.I’mgladI
knewthatIhadachoicetomake.
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Mike
Asaprostatecancersurvivorwhohadaradicalprostatectomythenhadarising
PSAaftersurgeryandwentontohavesavageradiation,howwouldIhavebeenableto
tellmycancerwasgrowingagainifnotforfrequentPSAtesting.Andnow71/2years
aftermysurgeryIstillneedtomonitormycancerthroughPSAtestingevery3months,
andthisseemstometobethemostcosteffectivemeansofdoingthat.
Asimplebloodtest.
TheproblemseemstobePSAtestingleadstoovertreatment.That’snotduetothe
PSAtestitself,that’sduetothemedicaldecisionmakingprocessafterwards.PSAtestingis
agreatwarningtool,andabsolutelynecessaryafterprostatecancertreatmenttomonitor
recurrence.Whenthetreatornottreatdecisioncanbeaccuratelyassessedandonly
aggressivecancerstreated,perhapsPSAtestingwillbevindicatedandregainitsplaceas
thebestmostcosteffectivesimplestearlywarningmonitorforprostatecancer.
Linda
Myhusbandatage62wasdiagnosedwithprostatecancerwithaPSAtestthat
showedahigherreadingthantheyearbefore.Itwascaughtbeforeitwasoutofthe
prostate,andafteraRadicalProstatectomy,itisnow12yearslaterandheisfine.ThePSA
testisnotperfectbutitistheonlytestthereisrightnow.Bytestingearlycancercanbe
detectedbeforeitisoutoftheprostatecapsuleandspread.
Therewasnofamilyindicationofprostatecancerashisfatherlivedtobea101
yearsold.Myhusbandwasfeelingfineasprostatecancerhasnosymptomsintheearly
stages.OnlyaPSAtestandRDE,andthenabiopsyfoundthecancer.Itiseasier(and
cheaper)totreatthecancerintheearlystages.
Bob
ThePSAtestisavital1ststepinthedetectionofprostatecancer.Duringmyyearly
physicalmydoctorsawmyPSAhadincreasedmarkedlyfromtheyearbefore.Iwenttoa
urologistwhoupondigitalexamfeltalumponmyprostate.Asubsequentbiopsyshowed
definitecancer.AfterhormonalandradiationtherapyIhavebeencancerfreefor8years.
IfIhadnothadthatPSAtestasafirststepIwouldnothavehadacluecancerwasthere.
PSAalonewouldnotbeconclusive,butitisthebestwaytofindoutifthereisapossibility
ofcancerandthefollowuptestscanconfirmordenyit.
John
PSAtestingsavedmylife.At61IhadaslightincreaseinmyannualPSAtestlevel
andmyprimarydoctorthoughtitwouldbegoodforanurologisttocheckitout.After
severalmonthsofmonitoringbythedoctor,abiopsywasperformedandcancerwasthe
diagnosis.Atthehospital,itwasdeterminedthatremovaloftheprostatewasthebest
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actiontotake.Uponremovalandtesting,itwasdeterminedthatifIhadnothadthe
operationwhenIdid,thecancerwouldhavebeguntospreadtosurroundingorgans.
Fiveyearslater,Iamcancerfree.
Anonymous
AStheresultofaroutinePSAbloodtest,myhusbandwasdiagnosedwithprostate
cancerwithaGleesonof8.Hehadradicalsurgerywithin2months.Heiscancerfreeand
doingverywell.Thetestsavedhislife.
Themostencouragingfollowuptohisstory,tome,isthatbyhavingaPSAtest
yearly,wewillknowifthecancerhasreturnedanywhereelseinhisbody.Anycancers
cellswouldstillshowupinthePSAbloodtestasprostatecancer.Idonotknowofany
othercancerthatwouldshowupthatquicklyoraccuratelyinabloodtest.
Anonymous
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3yearsagoonmyregularyearlyphysicalmyPSAindicatedajumpfrom2.4to4.8ina
years’time.IwasreferredtotheUrologistforinvestigation.AtthetimeIwas57andhad
alonghistoryofProstateCancerinmyfamily.Grandfather(diedofPCa)Father.3uncles
onmyDad’ssideand2firstcousinsonmyDad’sside.Oneofthemdiedattheageof43
fromPCa.
AbiopsywasdoneandcamebackpositiveGleason3+4andhighgradePIN.
DiscussedtreatmentsandIdecidedthatthebestbetisgetitoutofmybody.3yearsout
myPSAisZerotheonlydownsideisED.WhichIdonottakelightly.IknowthatthisPSA
savedmefromaterribleprogressionofcancerinmybody.Thedecisionoftreatment
shouldbeadecisionbetweentheDr.andthePatientnotagovernmentalprocess.
Bythewaymy34yearoldsonalreadyhasabaselinePSA.Heknowstowatchit
andkeephisDocintheknow.
Alex
ThePSAtestisourmostvaluabletooltodeterminetheprogressionofprostate
cancer(PC).MyPCwasdiscoveredduringaroutinephysicalwhichincludedaPSAtest.I
was54yearsoldandhadsymptomsIattributedtoaging(difficultyurinating)which
turnedouttobehighgradePC(Gleason9).PAStestingshouldcontinue.Theresults
shouldbehandledtowardsthepatient’sbenefitratherthanthedoctor’senrichment.
Anonymous
MyhusbandhadaroutinetestofhisPSAduringhisannualphysicalinDecember
of2002.Itwas6.6atthattime‐doublewhatithadbeenthepreviousyear.Heimmediately
scheduledabiopsywhichwaspositive.Wetookseveralmonths,didatremendous
amountofresearch,andawholelotofpraying.Aftertalkingwithbothamarvelous
radiologistaboutseedimplantandanequallymarvelousurologist,wedecidedon
surgery.
Myhusbandhadsomespreadfrombeyondtheprostatecapsuletotheseminal
vessels.Heisalive,9yearslater.HisverylowPSAsignaledwhatwehavesincefoundout
isanextremelyaggressiveformofprostatecancer.Herecoveredverywellfromhis
surgeryandiscompletelycontinent.Sincethenhehassalvageradiation,hormone
therapywhichfailedashewasandrogenresistant,
Provenge,radiationforbonepainasaresultofmetastasis,andhewillbestarting
docetaxelinaweek.Icansaywithoutashadowofadoubtthatifhehadnothadthat
routinePSAandthefollowingbiopsyattheageof57,hewouldbedeadnow.Itis
completelyrecklesstonolongerhaveaPSAdoneasapartofroutinephysicals.My
husbandwaswithoutanysymptomsthatwouldhavesignaledanyproblems.Yes,the
biopsywasanunpleasantexperiencebutdeathismuchmoreunpleasant.Ifdoctorsneed
moreeducation,educatethem.
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Ifpatientsneedmoreeducation,educatethem.Encouragementotalktoeach
other.
PSAtestinghasgivenmyhusband9yearsoflife;ithasgivenme9yearsmorewith
theloveofmylife;ithasgiven2additionalgrandchildrentimewiththeirfavoriteguy.We
maynothavemuchmoretimeleftashisPSAdoublingtimeisnow1monthbutwhatajoy
thelastyearshavebeenandwhatajoythetimethatisleftwillbe.
Jerry
WithoutthePSAtestIwouldhavebeenwalkingtimebomb,MyPSAlevelwent
from1.5to5.8inoneyear.HadsurgeryonAugust3rdofthisyear.WithnoPSAtestI
wouldneverhaveknownuntilitwastoolate.EliminatePSAtestingislikedoomingmany
mentoanagonizingdeath.
Brian
WhileImyselfhavenotexperiencedprostatecancer,mydadandoldestbrother
have.Inbothinstances,thecancerwasfoundafterroutinePSAtesting.Mybrotherchose
totreathiscancerwithradiationtherapywhereasmydad,inhis70'swhenhiscancer
wasfound,chosehormonetherapy.Neitherofthemarecompletelycancerfreeandthey
continuedtofollowupwiththeirdoctorsandmonitortheirPSAlevels.Iwillturn40this
yearandfullyintendoninsistingmydoctordoaPSAtestatmynextphysicalexam.Iwill
makesureallofmyfriendsandfamilydoesthesame.
Themedicalcommunity(andsocietyingeneral)providesaverysharp,double‐
edgedswordtomeninregardtotheirhealth.
Ononehand,theyarecriticizedandevenridiculedfornotpayingenoughattention
totheirhealth.Yet,ontheother,themedicalcommunityviewsmenassecond‐classto
womenandwomen’shealthconcerns.Howmanyhospitalscanyounamewithactual
physicalMen’sHealthCenters?Menviewthismixedmessageasnagging(whichis
ignored…)becauseiftheirhealthtrulywereinjeopardy,surelytherewouldbe
organizationsandprogramsinplacetohelpsupportit.
Anonymous
Atage61,IbecameapatientwithPCa[18bonemetastases]withonlyADTas
treatment,justbecausemyPSA[turnedouttobe50]wastestedforthefirsttime,having
nocomplaints.Withoutthisand1yearlaterImighthavefalleninadisastrous
complication.Iwouldpropose:everymanfromage50every5yearsaPSAtest.
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Paul
ThePSAtestwastheinitialwarningthatIhadaparticularlyaggressivetypeof
prostatecancer.ShortlyafterabiopsyIhadprostatesurgery,atwhichtimeitwasfound
thatthecancerwasevenmoreaggressive(neartheupperendoftheGleasonscale)than
originallymeasuredinthebiopsy.Thatwasfiveyearsago.IfeelfortunatethattodayIam
stillcancer‐free.
Rick
DREwasfine.PSAwentfrom4to5.Internistsentmetourologistforbiopsywhich
waspositive.Didexternalradiation.FouryearslaterPSAstartedtoriseto1.Metstolung
&slightlytobone.Wouldn’thaveacluewithoutPSAtest.
Anonymous
IfitwasnotformyPSAtest,IwouldhaveneverfoundoutIhadprostatecancer,
myMD,didnotperformrectalexamsuntilafteryouwere50,Iwas48whenthey
discoveredmycancerandwithoutthePSAmycancerwouldhavebeenmuchfurther
alonguntilitwasdiscovered.
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Anonymous
Asa63yearoldmanwithfriendswhohaveprostatecancer,thePSAtestgivesme
someassurancethatIamstillcancerfree.
Anonymous
During2008IhadaPSAreadingof6.2.SoonafterIhadacompleteblockageand
couldnotemptymybladder.Followingextensiveexamandtestingdoctorsaidhedidnot
thinkitwascancer.Late2008IhadaTransurethralResectionoftheProstate.Everything
workedoutfine(nocancer).MybodyhasfewsideeffectsandmylastPSAreadingwas
2.6.
Anonymous
ThePSAtestingidentifiedmyprostatecancerwhichledtoroboticsurgeryand
removalofthecancer.IamcancerfreenowforthreeyearsbecausethePSAtesting
allowedmetotreatitearly.Itsaveslives.Yes,theremaybesomeinstanceswheretesting
leadstounnecessarybiopsiesetc.,buttheseconsequencesarefarintheminorityand
worththeriskuntilabettertestcanbefound.BeforemycancerdiagnosisIactuallyhad
twopriorbiopsiesbeforethecancershowedup.Itwasabituncomfortablebutnotreally
abigdeal.BetterthangoingtothedentistIsayasacomparison.
Istillcan’tbelievethatPSAtestingisbeingquestioned.Manymenwillsufferthe
consequencesifthisreductionintestingbecomesareality.
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Del
Atage71myPSAhadspikedto6.2.Thissuddenchangealertedmetofurther
investigationinmyprostatehealth.AfeePSAtestrevealedascoreof13.7andthena
biopsyrevealedaGleasonscoreof7(4‐3)andthentoIMRTradiationtreatments.Today
myPSAis0.63.Untilsomethingbetterisdeveloped,PSAscreeningisthebestwarning
signalwehaveforProstateCancerandshouldcontinuetobecoveredbyHealthInsurance
carriers.
Robert
MyhistorywiththePSAtestbeganabouteightyearsago.Myurologistnotedthat
myPSAwasrisingandIwasalsosufferingfromprostateenlargementthatwasforcingme
togetupfiveorsixtimesanight.WediscussedallofmyoptionsandIdecidedtohavea
TURPdone.Ihadtheprocedureandwhentheyanalyzedthematerialtakenfrommy
prostate,theyfoundcancer.Aftertheprocedure,myPSAdroppedbelowzeroandithas
stayedthereeversince.
WithoutthePSA,Iwouldnothavediscoveredthecancer,norwouldIhaveany
indicatorsthatwouldsuggestthatIhadit.Mycurrenturologistthinksthatitislikelythat
theTURPprocedureremovedthecancerentirely.Regardless,InowhaveaPSAdone
everysixmonths.Withoutit,Iwouldberelyingtotallyonthedigitalexam,whichprovides
verylittleinformation.Ithinkthatuntilanewtestisdevelopedandprovenasareliable
indicator;thePSAtestmustcontinuetobesupported.
Christopher
IwasdiagnosedwithPCattheageof58inMay2008.Thebiopsywasmythird
afterarisingPSAandthetwopriorbiopsiescomingbacknegative.Atthetimeof
diagnosismyPSAhadrisento7.7.Theresultswereonecorepositivewith5%
involvementandaGleason6.
SincethediagnosisIhavehadfourmorebiopsies.Twowiththesameresultsand
thelasttwowerenegative.MyPSAwentupto11andAvodartlowereditto5.5.
IstoppedAvodartafterthelastnegativebiopsyandthePSAwentupto11.4.
Inmycase,IhavehadarisingPSAbutnegativebiopsies.Thesixbiopsieshavenot
beenpleasantthelastonebeingtheworstwithconsiderablebleedingbutnoinfection.
SomyrisingPSAhasresultedin6biopsiesandnoconclusiveevidencethatIneedtohave
treatmentforthePC.
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Matt
I’man11yearprostatecancer(PCa)patientcurrentlydiagnosedasendstage,
however,stillgenerallyingenerallygoodhealth.In2000mydiagnosisstartedwith
numeroustests,whichincludedseveralPSAtestsbothpreandpostbiopsy.In2001Ihad
radicalprostatectomyalongwithaPSAat6weeksand12weekspost‐optodetermineifI
hadaresidualPSAandifthesurgerysuccessful.
OvertheyearsthePSAtesthasbeenaninvaluabletoolformydoctorsin
determiningtheiruseofandtypeoftreatmentsforme.Aftercompletingallthestandard
PCatreatments,todayI’mtakingZytigaandhaveaPSAtestevery4‐6weekswhichisused
tomeasuretheZytigaeffectivenessandtobesurethatitcontinuestowork.
Throughoutmytreatmentandstillatpresent,PSAhasbeenandisanextremely
importantdiagnostictoolforthedoctors.Theyuseittohelpdetermineifaspecific
treatmentisworkingorfailingandthetiminganduseofmoreexpensivediagnostictests,
includingMRIandCTscans.
PSAisanextremelyimportanttooltobothPCapatientsanddoctors.Tolimitthe
useofPSA,untilwehaveanequalorbetterdiagnostictest,wouldbedetrimentalforall
involved.
Gary
Ihadnosymptomsinthebeginningofthesummerof2011.Ihadnoinsurance,but
asaninformedmaleover40,Ipaidthe$100forthePSAtest.Itmayhavesavedmylife,as
Ihadstage3prostatecancer.IfoundaprostatecancerforumtolearnasmuchasIcould
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asfastasIcouldaboutPCA.Iwasamazedathowmanymembersarebetweentheagesof
40and59.THISISNOTJUSTANOLDMAN’SDISEASEASIHADTHOUGHTBEFORE.
Tulia
InDecember,2006,atage57,duringaroutineannualphysical,myPSAwas4.2.
SincemyPSAthepreviousyearwas1.57,mydoctorsuggestedthatIseeaurologist
becauseoftherapidincreaseinthePSAduringtheprevious12months.
TheurologistadvisedthatIshouldhaveabiopsyperformed.Theresultscame
backwithacancerdiagnosisin6ofthe12samples,withanoverallGleasonscoreof6.
Twomonthslater,Ihadaroboticradicalprostatectomytoremovetheprostate,
whichdeterminedthatthecancerhadbrokenthroughthecapsuleoftheprostate,buthad
notyetenteredthelymphnodes.Luckily,thesurgeonobtainedclearcancer‐freemargins.
Thepost‐surgeryGleasonscorewasa7.
HaditnotbeenforthePSAtest,thecancer,withinashortperiodoftime,would
havefullyspreadtothelymphnodesandoutsidethepelvicarea.Thecancerwasan
aggressiveform,andwithoutearlyPSAdetection,Iwouldnotbealivetoday.
Theside‐effectsofthissurgeryareminimalcomparedtonotbeingalivetoday.
MywifeandchildrenarethankfulforthePSAtestthatsavedmylife!
Tom
Iamasurvivor.ThePSAtestisbutonesmalltoolintheoverallfightagainstPCa.
It’sgrosslyoverusedbyurologistsandoftenasjustificationforimmediateradical
treatment.
Qualifiedoncologistsshouldbetreatingthisdiseasewiththemanytoolsattheir
disposal.ThePSAtestisbutonesmallpartoftheiroverallarsenal.Oncologistsprovidea
muchmorebalancedandenlightenedapproachtothetreatmentofPCa.
Patricio
Everysixmonths,IandmyfamilyexpectthevaluesofmyPSATest,IamaProstate
CancerSurvivorandafteralltheprocessofsurgery,recovery,radiationandcollateral
effects,Ipraythatthosevaluesremainzero.PSATestbecamethemostimportantand
expectedvalueformeandmyfamily,achangeinitsvaluesisachangeinourlives.
Jim
Ihaveprostatecancer.Mycancerwasfoundattheageof55throughaPSAtest
frommyprimarycarePhysician.MycancerisanaggressiveGleasonscore8.Ihavebeen
blessedtobetreatedbythewonderfulmedicalstaffatmylocalhospital.Currently,Iamin
thelastweekof24weekclinicaltrial.
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Ihavehad2injectionsofLupronandinthe12weekoftakingstudydrug
abirateron.MyPSA#wasAHIGHOF11...lasttestitwas.3cancerisnegligible.Radical
prostatectomyisscheduledforOct20...noradiationnochemoandlimitedsideeffects…I
indeedfeelblessed.AftersurgeryIhopetohelpstudentsineducationinsomecapacity
afterhavingretired.IthanktheLordthathehasgivenmemoretimeandIamwritingto
sharethegoodnessofPSAtestingasimpletestbutadigitalrectalexamdidnotshow
evidenceofcancer,Ifelthealthyatthetimebutwithoutthistestingandactingonthe
cancer.Iwouldhavebeenfacinganuphillbattletofightmyaggressivecancer.PLEASEall
menshouldbetestedbytheageof50.PSAtestinghelpmetodiscovermycancer…Iwill
beacancersurvivor.
Mike
Iam68andenjoyreasonablygoodhealth…theVAperforms/administersmyPSA
testannually,andgivenacceptableannualresults,relievesmeofpotentialworryre
ProstateandassociatedCancerissues…IhaveaslightlyenlargedProstate,andlikemost
menmyageafflictedwiththiscondition,endurethechallengeofvoidingthebladderina
timelymanner…butknowingIdoNOThaveCancerrendersthischallengeacceptable,and
manageable….IwouldNOTbeawareofmyProstatestatusifnotformyannualPSAtest
results…PEACEOFMINDisCOMFORTINGandINVALUABLE…
Jason
Iwasdiagnosedwithprostatecancerabout15yearsago.MyPSAgotupto13and
sureenoughatumorwasdetected!IfnotformyrisingPSAthistumormaynothavebeen
discoveredforyears??So,Ihadradiationanditlaydormantforafewyears,thenthePSA
startedtoriseagain.Myprostatewasfine.ButthisincreaseinmyPSAindicated
somethingwashappening.SoIhadacatscanandcancerormetastaseswerediscovered
inmybackinthreeplaces.Now,tellme,withoutthePSAhowwouldthathavebeen
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discovered.PossiblywhenIbecamecrippled?So,with15years’experiencewithprostate
cancer,PSAcheckingshouldbeamust.Andwhatisthebigdeal?Itonlyinvolvesablood
test!!
Joseph
IhadnosymptomsbutarisingPSAwasdetectedatanannualphysical.Iwassent
toaurologistforfollowupandafterayearofwatchingIhadabiopsy(April2008)and
theresultswere3outof12coreswerepositiveforcancer.IhadaprostatectomyinJuly
2008thepathologyshowedthecancerhadspreadtoothersectionsoftheprostateitwas
evaluatedasT3A.Ifitwasn’tfortheearlydetectionofthePSAtestwherewouldIbe?
Anonymous
In2005,Iwenttomyprimarydoctor,awonderfuldoctorinBayHarbor,Florida
foraPSA.TheresultswereaverylowPSA.Aboutthreemonthslater,bymistake,Dr.D.
orderedanotherone,asIwenttohimforgeneralbloodworkbecauseIwasn’tfeeling
well.TheresultsofthePSAwereagainlow,but30%higherthanthelasttest.This
alarmedmydoctor.HestronglysuggestedthatIgoforabiopsy.Ithoughtthatthiswasa
bitextremebecauseIhadnosymptomswhatsoever!Myfriendswhoaremedicaldoctors
thoughtthatitwasprobablyunnecessarytogoforabiopsy.
Mywife,anRN,insistedIgo.Ihadthebiopsyandmyprostatewascancerous!If
notforthePSA,andthefactthatIhadthetestthreemonthslater,Iwouldbeinmajor
troubleasIwouldn’thaveseenmydoctorforatleastanotheryearortwo.Iamabeliever
inandacancersurvivorbecauseofthePSA.
Anonymous
Myhusband’sPSAdidnotgoabove3.5,andhehadittestedeveryyear.Thecancer
wasfoundbythephysicalexambythedoctorfeelingalumpandthenhavingthebiopsy.
Itturnsoutthathiscancerwastheaggressivecancerandwecaughtinjustintimebefore
itwentintothemargins.AsIlookbackonmyhusband’slabresultsIcouldseethatisPSA
wasrisingveryslowlybutIassumedourfamilydoctorwouldhavecaughtthat,butthen
againitneverwentabove3.5andthestandardforflagsgoingupis4.Inhiscasethe
doctorwhoperformedthephysicalexamineswastheonewhosavedhislife.Everycaseis
different.
Myhusband’scasewasnotthenorm.Anytestorteststhatwillsaveaperson’slife
shouldnotbequestionedordeniedbecauseofthecostofthetest.Howdoyouputadollar
figureonhowmuchalifeisworth?
Evenifthecanceristheslowgrowingtypethatwillprobablynotkillyoudoesn’t
themanhavetherighttochoosewhathewantstodowithhislife?Ifindthisjustanother
costcuttingmeasureandit’sjustdisgusting.Youspendmillionsdevelopingthesetestto
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preventmenfromdyingandthenyouturnaroundandsaytheyarenotnecessary.This
muststop.DotheyrealizehowmanymenwillnownotonlyhavetheirPSAtestbutwill
nothavethephysicalexaminedonebecauseofthissocalledfinding.
Anonymous
PSAsavedmyhusband’slife.At50hisDr.didarectalbutdidnotbothertodoa
PSA.Wewentforlifeinsuranceandat51foundhisPSAtobe15redflagcalledDr.andhe
saidwewouldwaitforanothernextPSA23inafewweeks.Ourprimaryandaurologist
stillinsistedthatitwasaninfectionsincemyhusbandhadNOothersymptoms.
Theywantedhimtowaitforabiopsysincetheyweresobackedupbutthroughmy
intuitionasawifewedidone.Gleason9.Whenwegotthebadnewsweweretoldtojust
getoutoftheareatotreatitnothowwhywhenwherejustfindsome‐oneelse.Weended
upwithsurgeryfollowedthen5yearslaterradiation.Myhusbandfollowsaveryhealthy
dietworksouteverydayandisdoingaswellaswecanbedoing.ButPSAchartswherewe
areinhiseverydaystruggle.Thisshouldbeapersonalchoice.
Stuart
AmaterialincreaseinmyPSAindicatedthatabiopsyshouldbeperformed.We
wereabletodiagnosethecanceratanearlystage.Attheageof59theroboticmethod
wasusedtoremovetheprostate.Ihavehadnoproblem,thankstothatprocedure,with
incontinence.Moreover,withcontinuedmonitoringofmyPSA,3yearslaterwehave
determinedthat,todate,Iaminremission.
Anonymous
Ifitistrue,wehavenosubstituteandthisisitotherthandigitalexams,whatinthe
hellaretheythinking?Normallysuchmovesarenotmerelypoliticalitisallabout$.So
howmanytestsaredoneyearlyandpaidforbypublicentitlementprogramshowmany
arepaidforthroughprivateinsurance?Whatistheaveragecost?Iamsuresomebean
countersomewhereisengagedinacostbenefitanalysis.
SohowmanylivesweresavedorotherwiseimprovedduetothePSAtests.Isay
thatifonelifewassparedduetotheearlydetectionprovidedbythistest,theonly
scientifictestpresentlyavailable,thenleaveitinplaceuntilwedevelopaviable
alternative.Butweneedthetruefactualbasisforthisproposedpolicychange,andan
alternative.Toomanyofmenareatrisktothishorribledecease.
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Paul
DuetoPSAtestingmyprostatecancerwasdetectedearlyatage50(PSA4.4).
Iwentthroughbrachytherapyanditisgone.ItakeaPSAtesteverysixmonthstobesure
itdoesnotre‐occuranditwouldbeaburdenifmyinsurancedidn’tpayforthePSAtest.
Richard
IwasdiagnosedwithstageIVprostatecancerandtreatedsuccessfully.Itall
startedwitharoutinePSAbloodtestin2005.Mylevelshadelevatedsignificantlysince
2001(mylastprevioustest.)Abiopsyindicatedthatelevenoftwelvecoresampleswere
cancerouswithanoverallGleasonof7.Ihadaradicalprostatectomyin2006.PSAlevels
wereundetectablepostop(afterasuitablewaitingperiod.)IhadroutinePSAbloodwork
every6monthseversincethenand,in2010,thelevelsstartedrisingagain.Following
radiationtreatment(IMRT)myPSAlevelsarenowverylowandhaveremainedso.
Ihaveseveralsonswhohavebeentestedandwillcontinuetodoso.Ibelievethat
detectingviaabloodtestandfollowingatregularintervalswillbetheirfirststepat
treatmentshouldanybeneeded.
Johnny
Iamaprostatecancersurvivorofnineyears.Iampositiveinmyparticularcase
thatPSAscreeningsavedmylife.Ihadaveryaggressiveformofcancer,diagnosedin
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stage2.TheaggressivenatureofmycancerwasevidentbyaPSAriseof3.0to15.0ina
threeyearperiod.AsismostcasesIhadnoideaanythingwaswrong.
IfitwerenotforthePSAtestthistumorwouldhavesurelymetastasized.I
underwentasuccessfulradicalprostatectomy,andexternalbeamradiation.Icontinueto
getPSAtestannuallywhichindicateaPSAof<0forthepastnineyears..
IfwediscontinuePSAtestingmanydeadlytumorslikeminewillgoundetected.I
believethattoidentifysuchtumorsareworththeriskofso‐called“needless”biopsies,
anxietyandevenovertreatmentresultinginundesirablesideeffectsinsomemen.And
pleasekeepinmindthatthesesideeffectsarearesultofthetreatmentNOTthe
screening…
David
Twoyearsagoatage55IhadaroutinePSA.Thelevelwasequivocal;fractionation
showedittobemostlyprotein‐boundsoIunderwentabiopsy.Sevenoftwelvecores
werepositive,withpositivecoresinallquadrants.Ihadaradicalprostatectomy.The
pathologyshowedcanceruptobutnotquitethroughtheprostaticcapsule.Ihadno
symptomsatthetimeofsurgery.
HadInotbeentesteduntilIhadsymptomstheoddsarethatIwouldhavehad
metastaticdiseasewiththepossibilityofwidespreadmetastases,afairchanceofdeath
andthelikelihoodthattreatmentwouldhavebeenfarmoreofanordealthanthesurgery
provedtobe.
Asitstands,Iamcontinent;recoveringsexualfunctionandIhavea22%chanceof
recurrenceoverthefifteenyearsaftersurgery,withonly1%oddsofdeathfromit.This
meansthatIstandareasonablechanceofsomedayseeinggrandchildrenandwatching
themgrowup.IthanktheNPwhoorderediteverytimeIseeher.Noonecantellmethat
thatroutinePSAwasnotmoneywellspent.
Manny
In2004,atage74,myPSAwentfrom4.0to5.1inthespanof4months.Ihadno
physicalsymptomsandtheDREwasnegative.ATransrectalultrasoundshowedthatmy
prostatewasnotbigenoughtoaccountforthehigherPSAandalsoshowedasuspicious
shadow.Abiopsywasdoneandfoundcanceronbothsides,withaGleason9scorewhere
theshadowwas.
Iwastreatedwithexternalradiation(IMRT)plushormonaltherapy.Sincethen,
myPSAhasshownnotendencytorise,stayingwithinthe0.10–0.20range.Also,Ihave
noresidualeffectsfromeithertreatmentandIfeelfine.Infact,Iwasingoodenough
conditiontofightoffanattackofnon‐Hodgkin’slymphomain2010.
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Richard
IhadPSAtestingatage62,anditwasonly4.2.ThePSAwentupslowly,anda
Prostatebiopsy2yearslaterwasnegativeforcancer.However,sinceIdidhaveanodule
intherightsideonthedigitalrectalexam,andmorePSAtestsweregoingupto4.8ng/ml,
Ihadarepeatbiopsy3yearslater,atage69.Thiswaspositive,withaGleason3+3=6,4
corespositive,2lessthan5%and2at20%.Then,thePSAwentupto5.2,andthenodule
wasslightlylarger(althoughtheprostatesizewasstillonly60CC).So,atage71,Ihad
anotherprostatebiopsywhichnowwasGleason4+3=7,with6positivecores,4over20%.
Alaparoscopicradicalprostatectomywasperformed.Theexcisedprostateshowed
cancerhadextendedthroughthecapsule,butnottothesurgicalmarginsbecausethe
surgeonexcisedthenervebundleandmoretissueonthesideofthenodule.MyPSAhas
remainedundetectablefortwoyearspostoperativeandIwillNOTdieofprostatecancer.
However,ANYsignificantdelayingettingtreatmentwouldhaveresultedin
positivesurgicalmarginsandaVERYhighriskofmydyingofmetastaticprostatecancer.
Allofmymaleancestorslivedtoage93orolder.Iwouldhavelikelydiedofprostate
cancerbeforeage84withoutthePSAtests,prostatebiopsies,andtimelytreatmentcancer
thatwasgrowingwasdiagnosed.
Michael
IhadnothadaPSAtestfortenyears.Ontheinsistenceofmydoctor,Ihadone
threeyearsago,anditwas7.9.AbiopsyfoundStageIIIcancer.Ihavehadaprostectomy,
hormonetherapy,andradiationtherapy.MyPSAreadingsarenow0,butIwillbehaving
biyearlytestingforawhiletoseeifthecancerhasbeenstopped.IowemylifetoPSA
testingandmydoctor.IdonotunderstandthereasonormotivesagainstPSAtesting,
unlessitisamovebytheinsurancecompaniestosavemoney.IfPSAtestingisdropped,
manymenwilldiethatcouldhavelived.
Paul
Iwas49justbeforemy50thbirthdaywhenmydoctorincludedaPSAtestwithmy
cholesteroltest.Itcamebackelevatedhesentmetoanurologistwhodidabiopsythat
camebackpositiveforcancer.AftertalkingwiththedoctorandmuchsoulsearchingI
decidedtohavetheprostateremoved.Surgerywentwellandthepathologyreportcame
backthatcancerwascontainedintheprostate.AyearlaterIhavenoEDorincontinence
problems.TheroutinePSAtestsavedmylifeandthesurgerydidnotruinmylifeeither.
Sheldon
ThePSAsavedmylife.IhadanannualPSAtestsincefifty.Iwasdiagnosedwith
prostatecancerin2003,atage56,fromabiopsyofmyprostateglandthatwas
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precipitatedbyayearoveryearrapidriseinmyPSAlevel.Ihada4+3Gleasonscorethat
indicatedthatIhadanaggressiveformofprostatecancer.Fortunatelybecauseofthe
earlydetectionandagreatsurgeontheprostatectomyremovedtheentirecancerous
growth.
NoweightyearslaterIhavehadnorecurrenceofthecancerandhavehadnoneof
thesideeffectsassociatedwithaprostatectomy.Ihaveregainedallfunctioningandam
leadingafullandactivelife.
Ron
IhadayearlyPSAtestdonefrom2001(whenIturned60).Itroseslowlyeachyear
untilbyMay2007whenitwas4.1.ByNovember2007itwas6.8atwhichpointabiopsy
wasdone.Theresultscamebacknegative.Itheldat6.8untilSeptember2008atwhich
pointitbegantoriserapidlyandbyJanuary2009itwas12.Anotherbiopsyfoundcancer
cellsGleasonscore3+3andtheadvicewas“waitandwatch.”Ihadhadsomuchpainand
discomfortIsoughtasecondopinionandhadtheprostateremovedinMay2009bythe
robottechnique.OnadmissiontothehospitalthePSAhadrisento30.
Postoppathologydisclosedthatthecancerhadburstthecapsuleandwasahighly
aggressivecancerwithaGleasonscoreof4+5.Abonescanrevealedthatthecancerhad
metastasizedtotheleftiliaccrest.Responsetoandrogendeprivationtherapywasswift
andsuccessful.
Oneinjectionevery3monthsforayearandthePSAwasbelow0.Itremained
therefor7monthswithnotreatmentandthenPSAbegantoclimbagain.InMarch2011I
had13radiationtreatmentsontheonelesionontheiliaccrest.Thehopewasthat
radiationwouldkillthecellsthereandthatperhapstheprogressofthediseasewouldbe
haltedforsometime.
Thatisnottobethecase.AlthoughthePSAdroppedafterradiation,during
July/August2011itbegantoclimbevenmorerapidlythanbefore.Abonescandone3
weeksagoshowsthattherearenowlesionsinmyhipjoints,ilio‐sacraljoint,atlumbar
3,4,5,atthorasicT6andonseveralribs.Androgendeprivationtherapyhasbegunagain
andIamnowwaitingtoseeifitwillbeaseffectivethistimearoundaslast.
Inmycaseithasn’tbeenaquestionofhavingaPSAtestdoneornot.Whatisclear
isthattheinterpretationofthetestiscrucial.Forfartoolongthehospitalmonitoringme
dismissedmyfearsaboutthehighPSAcountwhenitwas6.8sayingitwasprostatitis.
Whatisequallyobviousisthattheymissedthecanceratfirstbiopsy.Thecancer
sourcewasontopofthegland,underthebladder–aplacewheretheynormallydon’t
takeanysamples–oratleastthehospitalmonitoringmedidn’ttakethemfromthere.
FromwhatIreadthereisalsoalotofscaremongeringgoingonwithtalkof
incontinenceandimpotencepostoperation.Thatneednotbethecaseatall.Andevenifit
is,I’dratherbealiveandimpotentthandead.Butimpotenceandincontinencewasn’tthe
caseformepostop.Thesurgeonsparedthenervebundlesononesidewhichallowedme
tohaveafullerectionpostopbutofcourseandrogendeprivationtherapyknocksthe
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libidoout.Becausethesurgeonmadesurethattherewasalongenoughconnection
betweenbladderandpenisaftertheprostatewasremoved,Ihadnocontinenceproblems
fromday1afterthecatheterwasremovedandthathasbeenthecaseeversince.
Myadvicetoallmenover40istohaveayearlytest.IfthePSAgoesover4then
someformofextrascreeningshouldbedone.IfthePSAsuddenlyincreasesanddoubles
withinashorttimethenthereisrealcauseforconcern.TheamountoffreePSAshouldbe
comparedwiththePSAitself(whichwasnotdoneinmycasedespitemyaskingthatitbe
done.TheanswerIgotwas“wedon’tdothathere.”Ishouldhavegoneelsewhereright
then.)Comparisonofthosetwopiecesofdatacangiveabetterindicationastowhether
thereiscancerpresentornot.
SoenoughoftheemotionalandhystericalhypeoverPSAtesting.Getitdone.Insist
thatitbeavailableandthathealthinsurancecompaniespayforit.Acceptnothingless.
Alvin
Iwasdiagnosed(withPSAtesting)andtreatedatmilitarymedicalfacilities,and
haveremainedinremissionforover10years.NOTtestingmenforPSAatafairlyearly
ageshouldbeclassedascriminalnegligence,andinsurancecompaniesnotsupporting
paymentfortheprocedureshouldbefinedinthemillions(negligenthomicide)forEACH
lifelost.Testing(automaticallywheneverbloodisdrawnfromaman)beginningatage40
seemsmostreasonable.Asa“doublesurvivor”(lungcancerinremissionfor3years)I
wouldbeirresponsibleifIdidn’tpassmystrongbeliefintestingalongtootherpotential
victims.
Jim
IaskedmyphysiciantogivemeaPSAtestwhenIwas48yearsold.Ihadnofamily
historyofprostatecancer,butIhadreadthatsomeresearchersthoughtthatestablishing
abaselinenumberandplottingPSAvelocitywasawaytodeterminethepossibilityof
cancer.MyfirstPSAwas3.7,consideredwithinnormalranges.15monthslaterduringmy
annualphysical,IlearnedthatmyPSAhadspikedto7.3.Afterrulingoutbenigncauses
(prostatitisandenlargedprostate)myurologistconductedabiopsywhereitwas
determinedthatIhadprostatecancerwithanaggressivelyratedtumor.
Threeyearsaftersurgery,thereisnoevidenceofrecurrence.Mysurgeon
remarkedthatitwasfortuitousthatIhadpushedfortheearlyPSAtestandthatI
probablyalreadyhadcancerthen.IamconvincedthatthePSAtestsavedmylife.Ican
understandthatPSAtestingmightbeworrisomeforoldermenwhomightultimatelydie
fromanothercause.Itmakesnosensetomeforinsurancecompaniestostopcovering
PSAtests.Intheabsenceofabettertest,resortingbacktodigitalrectalexamsor
advancedsystemslessonsthelikelihoodofagoodoutcomeformenwithprostatecancer.
Inmyopinionsuchamovewouldbereprehensible.
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Anonymous
PSA7yearsagowas3.5upfrom1.5previousyear.Biopsyshowedcancerwitha
Gleasonof43(7)hadsurgeryandpathologyresultswerealso(7)but34
Ignoringanytreatmentorfailuretodiscoverwouldhavelikelyresultedinmydeatha
coupleofyearsago.Iamcurrently0.2after5yearsofbeing0.0soIlikelywillbedealing
withthisagainbutIhavenoregretsandbelieveIhaveconsiderablyprolongedmylife.
Anonymous
WithoutPSAtestingovertime,Iwouldneverhavecaughtmyworseningprostate
cancersituation.Irealizethatitalsocanleadtofalsefindings,butonbalance,ifitkeeps
peoplelikemealive,doesitmakesensetodoawaywithit?
Evenmorerelevant,PSAtestingforthoseofuswhodohaveprostatecancer,
especiallyinadvanced(systemic)stages,itistheONLYwaywecanmonitorwhatis
happeningand,withappropriateintervention,keepthecancerfromreachingtumor
stage.
Anonymous
IwasdiagnosedwithprostatecancerviaaPSAtestaspartofaroutinemedical.
ThePSAwasonlyslightlyelevated,(3.7)butmythoroughdoctorscheduledan
investigationwhicheventuallyfoundatinyamountofcancerinmyprostate.Itwasearly
enoughthatIcouldhavesurgery,whichwassuccessful.That$30testsavedmylife.
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Austin
WithoutPSAtestingmyprostatecancermayhavegoneundetected.Butwith
frequenttestingtomonitormycondition,biopsieswereorderedwhichledtothe
detectionofprostatecancer.ThiswasdonewhenIwas62yrs.old.Nowalmost7years
later(approaching69yearsold)Iamcancerfreethankstoearlydetection.
Robert
IhaveprostatecancerforeighteenyearsandItakeaprostatetesteveryyearto
seethatmycancerstayat0.4,Ifmyprostatecancergoover4.0Iamintroublethatthe
cancerwillgotomybones,IfthathappenIwillbeinallkindofpainordeath.PSAtestis
veryimportanttoallProstateCancerPatients.IamasurvivorforEighteenyearsbecause
ofPSA.
Arek
IbelievePSAtestingsavedmylife.Iwas41whenIaskedforaPSATestbasedona
“hunch”(hadnosymptomsatall).Itcamepositive,thecancerwasveryaggressive.Ihada
radicalprostatectomy&amdoingfinenow,nearly5yearspostop.
IwastoldifIdidn’tdiscovermycancerwhenIdidIwouldprobablynotmakeitpastmy
45thbirthday.
HereinAustraliathedeathratefromprostatecancerhasdroppedwhenthePSATesting
expanded.
Jim
Itcertainlysavedmylife.ThreeyearsagoadigitalrectumexamandnoPSAand
thedoctorsaidallwaswell.Flashforwardlessthanoneyearatanotherdoctorwhodida
PSAtestandfoundthatIhadanelevatedPSA(around10.00).Furthertestingrevealed
thatIhadprostatecancerandIalsohadextracapsularinvasionmeaningithadspread.
WithoutthePSAtestingandthensubsequenttreatmentIwouldbeinverysevere
difficultiestoday.Thediscoverywasjustabouttwoyearsago.
Iwasahealthymale,non‐smoker,non‐drinkerandwasexercisingandswimming
atleastfourdaysaweek.
IrefusetobelievethatPSAtestingisoflittleornovalue.PerhapsIamananomaly
butIdon’tthinkso.
Icreditthescreeningwithsavingmylife.
Jim
Iam62andinoverallgreathealth[exceptforrecentlydiagnosedPC].Iworkoutat
agym5timesaweek,feelgreat,andhavenofamilyhistoryofProstateCancer.Mydoctor
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recommendedayearlyPSAtestandmyscorehasbeenslowlyrisingatabout0.25per
yearforthepasttenyears.Ihitthemagical4.0ayearagoandwastoldtoseeaurologist.
AfterfurtherbloodworkIhadabiopsy,revealingearlystagecancer.Iamvery
gratefulforcatchingthisearlysoastohaveoptionsandamnowbeingmonitoredon
activesurveillance.Iwouldnothavebeenabletodetectthiscanceratanearlystagesoas
tohaveoptionsifIhadwaiteduntilsymptomsappeared.Torecommendthatmennotget
PSAtestsseemstometobeirresponsible.Yesthereareotherthingsthatcantriggera
highPSA,butthatiswhereagooddoctorhelpsdeterminewhatiselevatingthePSA.
Harold
PSAtestingwasveryimportanttome.Itsavedmylife.AfteraPSAreadingthat
indicatedImayhaveprostatecancerIhadabiopsythatindicatedaggressivecancer.Ihad
aradicalprostatectomyandradiationandstillmyPSAwasrising.IamnowonADT
(hormonetherapy).MyPSAisnowundetectable.ThePSAisnowtheonlytestthatwill
indicatemyprostatecancerremainsdormant.
Anonymous
In2002myGPdoctornoticedthatmyPSAwaselevatedsignificantlyfromthe
previousseveralannualexams.SixmonthslatermyPSAwaselevatedevenmore,somy
doctorsentmetoaurologist.Afteranother3months,myPSAwaselevatedmoreyet.A
biopsyconfirmedthatIhadcancerinmyprostate.Ihadneverhadanysymptomsor
problems(enlargement,troubleurinating,pain,etc.)Infact,duringmyregularphysical
withaDRA,mydoctorstatedthatmyprostatewas“niceandsmall.”
Neitherofussuspectedcancer!OnlytherateofriseofmyPSAvaluesalertedmy
doctorsthattheremightbecancer.WithouttheannualPSAtestsfromthemid‐1990s
through2002,mycancerwouldhavegoneunnoticeduntilwhoknowswhen,butmost
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probablytoolateforsuccessfultreatment.Arecurrencealsowascorrectlydiagnosedbya
rapidly‐risingPSAin2009.
Bob
PSAfollow‐upafterradiationisabsolutelynecessarytodetermineprogress.Ask
yourradiologist!
Daniel
Iwasdiagnosedwithprostatecancerat54solelybecauseofthereadyavailability
ofthetest.Ichosetohavesurgeryandsubsequentlydiscoveredthatthecellsthatwere
removedwereofatypelikelytobemobileandcauseadvancedmetastaticdisease.Now2
yearspost‐surgeryandcancerfree.
IagreethePSAisfarfromaperfecttest,buthaditnotbeenreadilyavailabletome
itislikelymyqualityoflifeandpossiblymylifespanwouldbeconsiderablyimpaired.
EliminationofPSAscreeningisthewronganswer,particularlyforyoungermenwho
apparentlyhaveasomewhathigherriskofhavingaggressivetumors.Weneedto
certainlyfindbettertestsbutdon’tmaketheonlyscreeningtoolwehaveunavailable
becauseofactuarialmath.Suretherearerisks,butsomelevelofinformeddecisionis
betterthansurpriseyouhavemetastaticdisease.
Mel
Iwastestedinthe1980’sandearly1990’s.In1994myPSAwentuptoover5.I
wasadvisedtoseeaurologist.IhadabiopsywhichshowedPCa.Ihadaradicalretro
pubicprostatectomy.SureIhavehadsomeproblemswithafteraffects.ButIandmy
doctorsbelieveIamcancerfree.Ihavemarriedoffadaughter,haveseen2grandchildren
beenborn,survivedbeingattheWTCon9/11,retiredfrommyformaloccupation,have
beenvolunteeringformanyorganizations,ambeginninganewcareer,mademanynew
friends,andenjoyinglife.
Margo
Myhusbandwasdiagnosedwithprostatecancerthreeyearsago.Hehadno
symptoms.HewentinforaphysicalandtheydidaPSAtestonhim.Thatwastheonly
symptomhehad‐highPSAnumbers.Hehadabiopsyanditindicatedatumor.Itwasonly
aftersurgery,thatwelearnedtherewasanotherspotbyhisbladderthatdidn’tshowup
inthebiopsy.
Wefeelveryfortunatethatthiswasdiscoveredintime.WithoutaPSAtest,his
cancerwouldnothavebeendetecteduntilitwastoolate.Heisdoingwellnowandgoes
inevery6monthsforanotherPSAtest.
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Dennis
IwasgivenmyfirstPSAtest6yearsagoattheageof55.Thetestshowedthatmy
PSAwas8.4.ShortlyafterthisPSAtestabiopsyofdonewhichshowedthatIclearlyhad
prostatecancerandthedoctorsIvisitedrecommendedbecauseofmyagethatIshould
considertreatmentforthiscancer.Ididquiteabitofresearchandvisitedmanydoctorsto
learnallthatIcouldabouttreatmentoptionsandthendeterminedthatIwouldhavethe
RoboticRadicalProstatectomysurgery.ThiswasdoneinMayofthatyear2005.Sixweeks
laterIwasbacktowork.
ItturnedoutthatmyGleasonscorewas7wherethebiopsyhadshownittobe6.
Forsixyearsnow,Ihavelivedaverynormallifewithveryminimalsideeffectsthatcome
withthistypeoftreatment.
Nowaftersixyears,myPSAhasstartedtoriseagain,soIhavestartedtreatmentto
completelykilltheProstatecancerthathasreappeared.Iampositivethatthistreatment
willworkandthatanysideeffectswillbeminimal.IamsopositivethatIhaveagreedto
participateinaClinicalTrialsothatinthefutureothermencanbenefitfromwhatis
learnedfromthisstudy.
Myonlyregretis,ifIhadknownsoonerthatthePSAtestwasavailable,Iwould
haverequestedtothedoctorthatthetestbedoneatayoungerage.Detectingthecancer
soonerwouldhaveprobablymadeitpossibletoeliminatethecancerbeforeithadtimeto
spread.
Dennis
Myfatherandhisfatherhadprostatecancerandbothdiedofthedisease.Bythe
timethediseasewasidentified(noPSAtestsatthattime)itwasmostlyunmanageable
andhadmetastasized.
FortunatelyformethePSAtestwasavailableandovertimeIwatchmyPSA
increasetothepointthattreatmentwasindicated.PSAiscriticallyimportantifused
correctly.Imeanasingletestdoesn’tsaymuch.Ittakesseveralteststodeterminevelocity
ofthecancerandonlyPSAhastheabilitytomakethosefactsavailable.
Chet
PSAtestingfirstalertedmydoctorandmetothepossibilityImighthaveprostate
cancer.AftersubsequenttestsprovedIdidhavethecancer,Iunderwentprotonbeam
radiationtherapyandnowusePSAtestingtomonitorthedestructionofthecancercells
andthepossibilitythattheymightrecuratsometimeinthefuture.
WouldIbebetteroffifIhadneverhadanyPSAtesting?Idon’tknow.Ihadno
symptomswhichwouldhavedirectedmetoseeaurologist.Afterprotonbeamtherapy,I
havenosideeffectstospeakof,andmyPSAlevelissubstantiallyreduced.Thetreatment
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waspainlessandnottooinconvenient,butmaybeIwouldhavelivedjustasnormalalife
ifIhadneverbeendiagnosedwiththisslow‐developingdiseaseinthefirstplace.
Anonymous
WithoutPSAtesting,Iwouldn’thaveknownIhadprostatecancerprobablyfor
years.ArmedwiththeknowledgethatmyPSAwashigh,Ihadabiopsyandradical
prostatectomy.PSAtestinglaterrevealedthatthecancerwasstillthereandfiveyears
later,itindicatedmetastasis.InowneedPSAtestingtoindicatehowwellandrogen
deprivationtherapyisworking.PSAtestinghasservedmewell.
Diane
MyhusbandisalivebecauseofaPSAtestat49,andthat’sonlyafterotherdoctors
failedtodooneearlierwhentheyshouldhave.Finallyfoundagooddoctor.StageIVbut
nowfiveyearsundetectableaftersurgeryandchemo.What,shouldhehavewaiteduntilit
hadspreadtohisbonestosparehimthesideeffectsofsurgery?He’salivetodaybecause
ofsurgeryandtreatment.Heparticipatedinatrialwheretheygivechemorightafter
surgery.
James
Atage40(in1988)Ihadmyfirstprostatebiopsy.Therewasnocancer.Thefirst
PSAIhaverecorded,though,wasin1994.By2001myPSAhadrisento4.2.By2008it
was7.8.SinceIhadbeentakingAvodartformanyyearsIunderstandthatthisscoremust
bedoubled.AlongthewayIhadatleast6biopsies.Nonerevealedcancer,althoughsome
ofthemshowedhighPIN,untilthebiopsyinearly2009.Ihadlotsofprostatecancerin
Prostatesection1andsomeinProstatesection2.MyGleasonscorewas3+3.
TheurologistorderedbonescansandMRI’s,andneitherrevealedanycancer
outsidetheprostate.Ihadasecondopinion,andstilltherewasnocanceroutsidethe
prostate.Ihadmysurgery(laparoscopic)inApril,2009.Thesurgeonfeltasmyurologist
didthattheoperationwasasuccessandthecancerwascontained.However,whenthe
biopsycameback,thecancerwasinthemarginsbutnotintheseminalvesiclesandthe
lymphnodes,etc.ByDecemberof2009myPSAhadquadrupled,andradiationwas
recommended.IfinishedmyradiationinJune,2010.Inthepasttwoorthreemonthsmy
PSAhasrisen,andthedoctorsarejustwatchingeverythreeorfourmonthswithPSA’sto
seewhatisgoingtohappen.
AsonecanseefrommytestimonialthePSAhasbeenimportantalltheway
throughandwillcontinuetobeinmonitoringmyprogressorlackofit.Yes,Iwishthere
wasabettertestthatcouldidentifythoseofuswhohaveaggressivecancerandthoseof
uswhodon’t,butwearenotthereyet.Ialsowishthatbettertechniquescouldbe
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developedtotakecareoftheimpotencethatIhaveandwillcontinuetohaveaccordingto
whatIhavereadofthosewhohavehadaprostatectomyandradiation.
IalsowishthatIhadtotalcontinence,althoughIamblessedthatIhaveonlyslight
problems.Menneedtoriseupandmakecertainthatthesethingscometopass.Inever
dreamedthatmysexlifewouldchangesodrasticallybymytreatments.However,thePSA
mustbeavailableforallmenbeginningatleast40untilsomethingbettercomesalong.
EvenwiththePSAmyprostatecancerprogressedtoofarbeforeIhadsurgeryeven
thoughIknowIhadagreaturologistwhowaswatchingoutforme.
Bruce
PSAtestingledtobiopsy,biopsyledtosurgery,andonlyatsurgerycoulditbe
determinedthatmyprostatecancerhadalreadymetastasizedtothebladder.No
symptomsexceptrapidriseinPSA.Howadvancedandwide‐spreadwouldmycancer
havebeentoresultinsymptomsthatindicatedprostatecancer?It’strue,deadmendon’t
needPSAtests.
Nancy
ThemanIlovehasstage4prostatecancer;thisishowtheyfounditalthoughit
wasalreadyintheadvancedstagesbythetimesymptomswereoccurring.Icannot
imaginenothavingPSAtestsavailableformen,anymorethanIcanwomannothaving
mammograms.
Jamie
InJuly2010abloodtestrevealedanelevatedPSAcountandIwasreferredtoan
Urologist.AbiopsyoftheprostatewastakenandforwardedtoJohnHopkinsanalysis.The
biopsyrevealedaGleasonscoreof9,requiringthatfurthertestingbedonetoinsurethat
thecancerhadnotspreadtootherpartsofthebody.
Thecancerwasisolatedtotheprostate,andvarioustreatmentoptionswere
offered.IoptedforRadiationtreatments(44sessions);andaseriesof6Hormone
injections.AyearhaspassedsincemylastRadiationtreatment,andallsubsequentPSA
testscoreshavezeroorless.MyfamilyandIfeelthatthePSAtestwasalifesaverandI’m
forevergratefulofitsavailability.
Kenneth
MyPSAtestdiscoveredcancerafterabout15yearsoftesting.Myfatherand
brotherhaveallhadprostatecancer.
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Ed
PSAsavedmylife;savedmefromalingeringpainfuldeathduetoprostatecancer.I
aminahighriskgroup–mypaternalgrandfather,father,uncleandoneofmybrothers
haveallhadprostatecancer.Myfather,brotherandIwerecaughtintime.Mygrandfather
diedbeforeIwasborn,myunclecommittedsuicidewhenthepainofstageIVandthe
futilityofthestrugglebecametoogreat.
Myfatherhadaprostatectomyatage64.AsadirectresultofthatIbegangetting
annualPSAtestsinmymid‐thirtiesandreceivedatimelywarningwhenmyreading
jumpedatage50.AbiopsyrevealedGleason7cancerintheleftlobe,adigitalexamwas
inconclusive.Itoldthephysiciantotakeoutasmuchrealestateashefeltnecessary;I
enjoyanactivelifewithmanyinterestsand
Hadnointerestincheckingoutinmyearly50's.Impotencewasahighpricetopay,
butthesurgerywassuccessfulandIamstillenjoyingmylife.Accordingtothesurgeon,
thecancerwasamillimeterawayfromexitingtheprostate,haditnotbeenimpliedby
PSAandconfirmedbybiopsy,butinsteaddiscoveredlaterbydigitalexam,Iwouldbe
writingamuchdifferentnotetoday….ifIwasaliveatall.
IsupportPSAasascreeningtoolatleastforthoseofusathighrisk.
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Jay
Attheageof53,IhadnoindicationthatImightbehavinganissuewithmy
prostate,butwhileundergoinganannualphysicalformypilot’slicense;mydoctordida
PSAtest.Hesavedmylife.ThatPSAsetinmotionaprostatebiopsyandsubsequent
prostatectomythatresultedintheremovalofaveryaggressiveandfastmovingformof
prostatecancer.
HadwenotfoundthecancerthroughthatroutinePSAtest,thecancerwouldhave
metastasizedandIwouldbefacingamuchshortenedlifespan.Iowemylifetomy
doctor’sdecisiontodothisroutinetestatthetimetheydidit.Underthesenewguidelines
Iwouldbeastatistic,notasurvivor.Ican’thelpbelievethatonceagainmoneyand
afewgreedyinsurancecompaniesarewillingtoallowchildrentoberaisedwithout
fatherssotheycansavemoneyinsteadofencouragingmoreofthesetypesoftests.
Robert
In1998IhadaPSAtestdonethatreflectedareadingofborderlinehigh.However,
thedoctoradvisedthateverythingwasnormal.AyearlatermyPSAwasquitehighand
testsshowedthatIhadstageIVprostatecancer.I’mcertainthatayearearlierhadthe
doctorrecommendedfurthertesting,suchasabiopsy,mycancerwouldhavebeencaught
earlyenoughtobetreatable.
Fortunately,Ihavesurvivedfor12yearssofar,nothankstotheoriginaldoctor’s
everythingisnormal”.Imaybeanexceptiontothe“norm”asIhavebeentold,butyou
can’tbetooaggressiveindealingwithcancer.
Anonymous
Iamanineyearsurvivorofprostatecancersurgerybycryo‐ablation.IbeganPSA
testsin1998(atage60)onanannualbasis.In2002followingaslowbutsteadyrisein
thePSAnumbers(3.4to5.8)IunderwentaDREandsubsequentlyabiopsy,witha
positivediagnosis.Ifoundcryo‐ablationtobeminimallyinvasive.Icontinuetogetan
annualphysicalexaminationandinsistonaPSAtesteachtime.
Thereadingshavesofarbeenminiscule(0.023etc.).Icontinueatage73toenjoy
relativelygoodhealth,andcreditearlydetectionviaPSAtestingtomystillbeinghere.I
havesincelostthreeclosefriendswhoseprostatecancersweredetectedtoolateforthem
todomuchaboutit.Iremainaferventadvocateofthetest,butwouldbedelightedifa
betteroneweredevised.
Anonymous
Hello.IamfromIndia.Myfatherhasbeenoperatedforprostatecancerandthe
treatmentiscalledhormonalsomething.HehasbeenfollowingPSAtestsincemanyyears.
Becauseofthistestonlythepresenceofcancerwassuspected.Thereafterothertests
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confirmedit.Afteroperationevery3or6monthsPSAtestisdone.TillnowthePSAtest
showsbelowborderlevel.Heisnothavingmuchinconvenience.Thedoctoralsoinformed
usthathehasseenpatientshavingPSAashighas5000SURVIVING!
SothepointisHighPSAneednotbeafactortoworry.
Anonymous
IbelievethatwithoutthePSAtest,Iwouldbedeadbynow.Afterradiation
treatmentdidnotcureme;Ihadcryosurgeryandbiochemicalfailure.Iamdoingactive
surveillanceuntilIneedhormonedeprivation.WithoutthePSAtestyouareplaying
Russianroulettewithyourlife.
Tim
Atage42,onaHalloweennightIreceivedacallfrommydoctorthatnooneever
wantstoreceive…youhaveCancer.
Iwasdevastatedandjustbrokedownandcried.Howwasitpossible?Ihadno
symptoms–alldigitalexamswerenegative.Nosignsofanykind.
IfeelthattheONLYthingthatsavedmylifewasaPSAtestwhichmydoctorjusthappened
togivemeuponafluke,asPSAtestsarenotnormallygivenuntilage50.
Withalevelof4.9itwashighlyelevatedforsomeoneofmyage.Biopsiesdefinitely
showedcancer,andafterradicalprostatectomysurgerytheyfoundIhadavery
aggressiveProstatecancer,withaclinicalscoreofT2C&Gleasonscoreof7.
Ifmydoctorhadn’ttakenthePSAtestwhenhedid,IhonestlyfeelIwouldnotbe
aroundtodayhadtheynotgivenmethatPSAtestandwaiteduntilthestandardageof50.
APSAsavedmylife.
Anonymous
InMarchof2008at51yearsoldIwentinformyyearlyexam.IhadaDREanda
PSAtestdone.TheDREwasnegativebutadaylaterIreceivedacallfrommyDr.andwas
toldthatmyPSAwas6.5.AbiopsywasdoneandinMayIreceivedmyresults.Gleason
Score3+4=7,T1c.IhadsurgeryinAug2008andnow3yearslatercancerfree.
Myfatherhadprostatecancerbutitwasasurpriseandshockingformetohaveit
atmyage.Thingsaregoingbetternowbutthefirstyearwasadifficulttime.
Bettertofindoutearlierthanlater.
Stephen
Ithankmyprimaryphysicianforalwaysaskingatmyannualphysicalfromaround
age40ifIdesiredaPSAtestincluded.Heabsolutelygavemethechoice,whichIaccepted.
Overtheperiod2005‐2007heobservedan“acceleration”inPSAvaluesfrom2.2‐5.9‐7.9,
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atwhichpointIwasreferredtoaurologist,followedbythedreaded(anddreadful)
biopsy,andmanyothertests.Iwashealthy,58yearsold,andgivenwhatIfoundoutfrom
theradiologyreports(andseveralopinions)“watchfulwaiting”wasnotawisechoice.I
wouldnotlikelybeoneofthosewho,untreated,would“diewith”ratherthan“dieof”
prostatecancer.
IthankPSAtestingforgivingmethefouryearsandcountingthatmyfamilyandI
haveenjoyed.
Larry
PSAtestingworkedforme:WhenIwas60,IhadmyannualPSAtest.Althoughthe
PSAwaslow,ithadrisenveryquicklyinthepastyear.Afollow‐uptestshoweda
suspiciouslyhighpercentageoffreePSA.AcarefulDREdetectedahardarea.Abiopsy
foundcancerinthreeadjacentcoreswithtwoofthecorescontainingover70%.
TheGleasonscorewas7.Imagingshowedatumorthatwas“unexpectedlylarge”
withcapsularinvolvement.Onetest,notknownforitsspecificity,suggestedextra
capsularextension,seminalvesicleinvolvementandapositivenode.Iwastreatedwith
radiationandayearofandrogendeprivation.Ithasbeenfouryearssincealltreatment
ended.MyPSAisundetectableandtherearenosignsofrecurrence.
Ipaidaprice:Treatmentcausedurinaryurgencyandfrequencywhichresponded
welltoFlomax.Ialsohadmildbutfrighteningrectalbleedingwhichwasstoppedwith
radiofrequencyablation.And,finally,IhaveEDforwhichIuseLevitra.
I’llneverknowifIwasover‐diagnosedorreceivedthebesttreatment.Whodoes?
ButIdoknowthatIchosemytreatmentthoughtfullywiththehelpofamedicaloncologist
whohadnovestedinterestinanymodality.Itwasareasoneddecision.
Myconclusionsarethese:PSAcanbeagoodscreeningtestifPSA
velocity/doublingtimearecalculated,freePSAismeasuredwhenappropriate,and
follow‐uptestsandtreatmentsarechosenrationally,withacarefulweighingofrisksand
benefits.PSAtesting,likeanytool,isnobetterthanthepersonwieldingit.Clinicianswho
relyononeisolatedPSAvalue,outofhistoricalcontextandwithoutfollow‐up,giveita
badname.Thoughtless,cursoryuseofsuchtoolsisaproblem
Rusheddecisionstotreat(ornottreat)withoutcarefulstaging,grading,risk‐
benefitanalysisandadisinterestedsecondopinionarealsoproblematic.Butthese
problemsareendemictoAmericanhealthcare.Perhapsweshouldaddresstheminstead
ofblamingourtools.
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Bill
In2005abiopsydeterminedIhadprostatecancer.Withinayear20friends,near
andfarwerealsodiagnosed.Sixarenowdead.TheyallhaddelayedhavingPSAblood
work.Theother14,Iincluded,hadregularPSAtesting.Eachofushadtreatment.Mostof
us(thosewhodiedaswell)hadorhavesideeffectswithvaryingdegreesof
unpleasantness.But,witheachPSAtestingsincetreatment,wewhoarealive,fearthe
cancerwithinlessandcandevoteourenergytodealingwiththeotherpartofhaving
prostatecancer:incontinence,impotence,radiationsicknessoreventhemoremundane
unstoppableflatulence.
TakeawayourPSAtestingandwewon’tknowifthecancerwithinistameor
triumphant.Keepitfrommenyetuntestedandtheywon’tknoweither.Mysixdead
friendswouldlikelyhavechosenthepossibilityofsideeffectsfromtreatmenttodeathif
theyhavebeenabletomakethatdecisionintime.
John
PSAtestingsavedmylife.Ihadskippedannualphysicalsforafewyears,whenin
2004mywifeinsistedIgetone.Iwasage52.ThatroutinephysicalincludedaPSAtest.
MyPSAwas114(notatypo).Ihadnosymptomsofdisease.Follow‐upswithaurologist
(ultrasoundandbiopsy)confirmedcancer.
Iamnowa7‐yearsurvivor,havinghadmyprostateremovedon12/1/04.PSA
testssincethenconfirmaPSAof0(notmeasurable).
Iwaslucky,andoweitalltoaroutinePSAtestincludedinaroutinephysical.
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Ray
IknowthatcurrentlythePSAtestistheonlytoolwemenhavetodetectapossible
problemintheProstate.Ifitwasn’tforthePSAtest,Iwouldnothavehadnoticedthere
maybeaprostateproblem.ThebiopsyconfirmedthatIhadprostatecancer.THEREISNO
OTHERWAYTODETECTAPROSTATEPROBLEM!!!!
Iamaprostatecancersupportgroupleaderandseethedifferenceofsurvivalin
menwhohavedetectedProstatecancerearly,thruPSAtesting,andmenwhohavenot
hadaPSAuntiltheProstatecancerwasadvanced.
Carol
Duringthe90smyPCProutinelytookmyPSAduringmyannualphysical,andmy
PSAusuallywasborderlinehigh.Butin1997,itjumpedtoabout7whichtriggered
furthertestsandabiopsy.Thebiopsyindicatedprostatecancer.Ihadradical
prostatectomy.Afterrecovery,myPSAwasroutinelycheckedanditremainedbelow0.1
forabout10years,butthenitspikedtoabout20.Afteraretest,toseeiftherewasalab
error,myPSAwasuptoabout22.Afterseveraltests,itwasdeterminedthattheprostate
cancerhadreturned.Iwasputonhormonetherapy(HT),andamonthlyZometainfusion.
Carl
Mygrandfatherdiedtwoyearsafteranorchiectomyduetoprostatecancer.
MyfirstPSAtestescalatedtobiopsyandroboticradicalprostatectomy.
Iamverylucky.Mygaypartnerof14yearsremainsatmyside.
Iremainfunctionalsexuallyandlackincontinence.
IconsiderPSAtestingassavingmylife.Itrunsinthefamily.
Ilosthalfofnerve,sparingfunctionbutthecancerwascaughtbeforeitthreatenedmylife.
Aggressivecancerisdeadly.Onlytakes2years.
Whyshouldn’tmysongetaPSA?HedidandtheDoctorsaidcomebackin5years.
Testingsaveslives.Itsavedmine.
William
IamatestimonialtotheeffectivenessofPSAtesting.IwatchedmyPSAlevel
graduallyriseoveranumberofyears.Whenittookasuddenlargerise,myDoctor
performedabiopsywhichindicatedatypeofcancer.Ihadradioactiveseedimplants
whichkilledthecancerandleftnosideeffects.Iconsidermyselfveryfortunatetohave
earlyrecognitionofcancerandtheensuinggoodresults.
Mynextdoorneighbordidnothaveprostatecancerdetectedearlyenoughand
subsequentlydiedofit.
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Howard
MyPSAwas6.6inSept.2008.IaskedmyV.A.doctorforlastyear’sresult.Hehad
togobackto2andahalfyearstomarch2006tofindthelasttestwhichwas3.3.Mypost
oppathologyrevealedGleasonninewithseminalvesicleinvasion.Ihadtohaveradiation
andHormonedeprivation.IftheyhadbeencheckingmyPSAonaregularbasisIcould
havebeendiagnosedintimetohaveasurgicalcure.IamafirmbelieverinPSAtesting
andbelieveitshouldbeencouragedinTVadslikebreastcancerawarenessisforwomen.
Joe
APSAtestgotmestartedontheroadtotreatment.WithoutitIwouldnothave
knownthatIhadthedisease.
David
Aswithallcancersthekeytotreatmentisearlydetection.Whywaituntilitistoo
latetostart?Donotpassadeathsentenceonmenwhomaybecompletelyunawareofthe
dangertheyarein.Whatyoudon’tknowCANhurtyou.
Howard
IhadyearlyPSAtestfordecadeswithoutproblem.In2003,myGPsawthatmy
PSAalmostdoubledinthelastyearthoughitwasstill“normal”foramanmyage–63.He
sentmetoaUrologistwhofeltsomethingminorbutdecidedtodoabiopsy.Itappeared
fromthebiopsythatsurgerywasnecessary.Heassuredmethatitwasbeingcaughtearly
enoughthatitshouldbetotallyeffective.Itturnedoutthattheadvanced,aggressive,
grade5;cancerwasoutsidetheprostateandintotheseminalvesicles.IrequiredHAT,
followedin2008byradiationandHAT.
IfIdidnothaveannualPSA’s,thiswouldn’thavebeendiscoveredintimetosave
mylike!
Louis
ThePSAtestisaverycrudescreeningtest.Swollenprostateorprostatitisalsocan
causeelevationofthenumbers.JustasinitialaidsscreeninghastheWesternBlottestfor
confirmation,thereisthefreePSA(morecostlythanstandardPSA)thatisusedby
urologisttohelpdetermineifthesomewhatinvasiveandcostlyprostatebiopsyis
warranted.Inmycase,myPSAhadbeenapproximately10forseveralyearsbeforeI
becameeligibleforMedicare.
ThefreePSAtestresultsformewereontheborderlineforpredictingcancerrisk.
TheDREexamhadbeenpalpablelumpfree.AssoonasIbecameeligibleforMedicare,the
neededprostatebiopsywasdoneforwhichearlycancerwasfound.Surgerywaschosen
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becauseofitsproventrackrecordandlong‐term,thesideeffectswouldbelessthanwith
radiationtherapiesshouldtheinitialsideeffectsresolvethemselves.Whatshouldreally
bedoneisthatbeforebiopsyisperformed,thefreePSAtestbedonefirsttohelp
determineifthereisanynear‐termneedforthebiopsy.
Hopefullybettersecondarytestswillbecomeavailablethatwouldhelpdistinguish
betweennon‐aggressivecancersandthosethatneedtobeaddressedsoon.
Arthur
Asamanwhosefatherandgrandfatherbothhadprostateissues,Ireally
appreciatebeingabletogetmyPSAleveltested.
AlthoughmyPSAlevelwasonlyslightlyhigherthannormal,thetest,alongwithabiopsy
onmyprostatewashowIfoundoutthatIhadcancer.LuckilyitwasfoundearlyandIwas
abletogetitearly.
AsafatheroftwoyoungmenIhopetobeabletoencouragethemtogettheirPSA
levelstestedatayoungage.InsurancecoverageforPSAtestingisveryimportanttome.
Gary
PSAtestingfoundprostatecancerforme.Mygrandfatherdiedofthediseaseandit
wasaverydifficultandpainfulwaytodie.Iwas65whenitwasdiscoveredandIhadmy
prostateremoved.Thesideeffectsofsurgerywerenothingcomparedtowhatmy
grandfatherwentthruandIwoulddothesameifIhadtodoitoveragain.RecentPSA
testsareveryminutesothecancerisgonefrommybodyforwhichIamgrateful.
Bryant
ItwasaPSAtestthatledtothedetectionofmycancer,andnowaftertreatment
(externalbeamradiation)IhavePSAtestsevery6monthstomonitormyprogress.Not
payingforPSAtestingisgoingtohaveaseriousfinancialeffectonmeasthetestisthe
bestoptiontodetectanyre‐occurrencesothatIcanbeginadditionaltreatment.
Anonymous
hePSAtestsavedmyHusband’slife.Thedoctorsenthimtolocallabtodrawblood
asastandardprocedure.WhenthetestresultscamebackhisPSAwas10.1whichisway
outoftherangeofNormal.Wehaditrunagainandonlytoseeitwentupevenhigher.
ShortlyafterthathewasseenbyaUrologistandwasdiagnosedwithProstateCancer.He
didn’thaveanyofthetypicalsystems,soneedlesstosaywewereshocked.Atthetimehe
wasonly49yrs.old.Aftertwosurgeriesandaseriesofradiationprocedure,thankyou
Lordandweareblessed1.5yrs.later.Asofmatter,wehadanotherPSAjustdoneandthe
resultscamebackhisPSAwas‐.01whichisperfect.AgainwithoutthePSAtestingand
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coveragebyourinsurancecarrieritmighthavebeentoolatetodoanythingandwe
wouldnotstillhavemyHusbandwithustoday.
Anonymous
Aftermybrother,age76,wasdiagnosedwithprostatecancerthatwasveryfast
developing.Afterhisdeathat78IbegantohaveaPSAtestaboutevery3mos.MyPSA
wasaround2.6formanyyears,butroseto4.2in3mos.whenIwas77.MyGPsentmeto
aUrologistwhodidabiopsywhichshowedcancerontheleftsideofmyprostatewitha
Gleasonratingof7.
IimmediatelywentintoradiationtreatmentonanIMRTmachineandhavesince
beencancerfreebasedonaPSAnearzerofor3yrs.IbelievemonitoringmyPSAmay
havesavedmefromgoingthroughthehorrorthatmybrothersuffered.I’dhatetoseethe
PSAtesteliminatedincaseslikeminewherethereisasiblingorfamilialconnection.In
thosecasesPSAtestingfrequencyshouldbesteppeduptodetectasuddenchange.
Dan
EightyearsagoIwasthefifthmaninmyfamilytobediagnosedwithProstate
Cancer.Now,threemorehavebeendiagnosedandsuccessfullytreated.Beforemy
experiencetwohaddiedfromProstateCancer.IamgladtosayIplayedasmallroleinthe
lastthreegettingtested,findingtheirelevatedPSAandfollowingthatupwithabiopsy
whichfoundallthreeneededtreatment.Theyweretreatedandweallaredoinggreat.
Side‐effects?Yes,butaliveandenjoyingchildren’sweddings,grandchildrenandgreat‐
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grandchildrenbeingborn,productive,richandfulfillinglives.Somethingthatmightnot
havehappenedifwehadnottalkedtoourdoctorsandhadourPSAtested.
Terry
IwasdiagnosedwithprostatecancerwhenmyPSAwas4.2in2002.Aftersurgery
thecancerwasfoundtohavespreadtothelymphnodesandseminalvesicles.Thesurgery
didnotwork,andtoday9yearslaterI’mstillfighting.IfIhadnothadthePSAtestitis
highlylikelythatbynowIwouldbedead.
Timothy
Between2004and2005,Isaw10patientsinaprimarycaresettingwithPSAless
than4butonexam,theyhadpositivefindingsontheirDigitalRectalExam(DRE).They
endedupgettingbiopsiedandbeingdiagnosedwithprostatecancer.IknowthatthePSA
isnotadefinitivetest.Fromthisexperience,IsetmyownthresholdPSAto2.5andif
greater,Iwillneedabiopsy.In2005,myPSAwas3andsoIrequestedtobebiopsied
sinceIwas45yearsoldandAfricanAmerican.
Unfortunately,Iwasdiagnosedwithprostatecancerfromthatbiopsy.Three
urologistssuggestedthatIwatchandwaitandnotdotreatmentbutfollowwithbiopsy
andPSAin6months.However,being45yearsoldatthattimewithtwoyoungsons
includinga1yearoldson,IdidnotwanttotakeachancetowatchandwaitsinceIknew
atleast2patientswhodiedintheirfiftiesfromprostatecancer.Fortunatelyforme,Ihad
aRoboticLaparoscopicProstatectomyandafter6years,Iamfortunatetonothaveany
problemwithincontinenceorerectiledysfunction.
IcontinuetoseemyurologistonceyearlyforaPSAandDRE.IamhappythatIdid
getthePSAtestandIrecommendthePSAasascreenformengreaterthan45yearsold.
Anonymous
ItwasonlymyacceleratingPSAin1997thatleadtothediagnosisofmyprostate
cancerearlyenoughtobeactuallycured.At13yearsaftertreatmentmyPSAisstill
undetectableandbecauseIchoseacenterofexcellence,Ihavenosideoraftereffects.Had
InotbeentreatedtheprobabilitythatmyGleason7cancerwouldhaveescapedthe
prostateglandwasveryhigh.
ThePSAtestisavaluablediagnostictool.Theonlyproblemsarecausedby
incompetentdoctorswhodonotknowhowtousetheinformationprovidedbythetest.
Anonymous
PSAtestdiagnosedmystage4prostatecanceratage42.WithoutthetestIwould
bemuchworseoffandmaybeevendead.
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Anonymous
ThePSAsavedmylife.Iama46yearoldAfricanAmericanManandmyfirstPSA
Testin2002.MyPSAwas10.AfterabiopsyfoundthatmyProstatewas85%cancerous.
(9of12sampleswascancerous)
Ididn’thaveanysymptomstoindicatethatIhadProstateCancer.IfIhadn’tgotthe
PSAmycancerwouldhavespreadbeyondtheprostate.
HowelsewouldIhavefoundoutthatIhadProstateCancer?
Joe
Atage50whenmyinternistfirstsuggestedaPSAtest,Iwasunawareofthetest.
For7yearsitslowlyincreasedbutwasbelow4ng/ml.BecausemyDRE’swerenegative,
myinternistthoughtitwasduetoanenlargedprostate.WhenIcontractedprostatitisat
age58anditdidnotresolvetotallywithantibiotics,hesentmetoaurologist.Bestthing
thathappenedasIhadanaggressivecancer,butwaswellcontainedinthecapsule.The
PSAhistorywasamajorreasonwhytheinternistsentmetothespecialist.
Mypointintellingthisshortstoryisthatthepatientisnotawareofwhattestsare
availabletohimwhenheishealthyandnotfocusedonanillness.Ifmyinternisthadnot
suggestedthePSAtest,hemaynothavebeeninclinedtosendmetotheurologistassoon
ashedid.Untilabettertestisdeveloped,weneedthistest.Oncediagnosedbasedona
biopsy,thereisenoughinformationavailabletomakegooddecisionswiththedoctorona
courseoftreatmentorwatchfulwaiting.
Ken
MyGPhadbeenorderingPSAtestsforquiteafewyearswhenat54myPSAwent
from3.2to3.8inoneyear.Notabigjump,buthehadmeseeaurologistforabiopsy.
Justasmallpercentageofcancerwasfoundinbothlobes,Gleason6.SoIoptedforaretro‐
pubicradicalprostatectomy.Post‐opbiopsy,stillGleason6butIhadapositivemargin.It
wassuggestedbymyurologistandoncologistthatIhaveradiation.
TheradiologistorderedaCATscananddiscoveredatumorinmykidney.Sounder
theknifeagain.WhenIwashealedfromthatIstartedradiationtreatmentandasthatwas
ongoingmyPSAroseslightly.SixmonthslatermyPSAstabilizedat0.02andit’sstillthat
atfourplusyears.
WhensomeonecantellmethatmyGleason6wouldnothaveturnedintoaGleason
7andthenan8,9or10andalsothatmypositivemarginwouldnothavespreadthough
outmybodyandmetastasizedthen,andonlythen,wouldIsaythatthePSAtestisnot
worthdoing.
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Greg
MyPSAwasstableat2.5foryearsandthenbeganclimbingto3.5andthen5.715
monthslater(age69).AttherequestofmyfamilydoctorIwentforabiopsywhich
showedT1cGleason6.AfterextensiveresearchandmortalitytablesthatshowedIhad21
yearslifeexpectancy,Ihadopenradicalprostatectomy,onMay19,2011.Thepost
operationpathology(Gleason7T2c)showedthecancerwasmorewidespreadand
advancedthanthebiopsyindicated.
Ihadnoadverseeffectsfromthebiopsyandminorincontinenceforthefirstthree
weeksafterthesurgery,withnonesincethen.Ihadanexcellenterectilefunctionpriorto
surgeryanditiscomingbacknowwithpenilerehabilitation.
Robert
AlthoughmyPSAneverwentabove5,IstillneededupwithProstateCancer.Itwas
5+yearsof2.5to3PSAlevels,apositivefamilyhistory(Myfatherhaditanddied10
yearsafterhisinitialsurgerywithcomplicationsofthecancer.),2negativebiopsies
although1ofthemhad“highPIN”andthenmyinsistenceoftheevenhighercosturine
test(isitPCAsomething?)thatfinallyconvincedmyurologisttodo‘onemore’biopsy.
Andthatonefoundit!
AllofthatsaidthesteadyriseofmyPSAandthatitwouldnotloweralongwithall
theotherImentioned,iswhatsavedmylife.
ThePSAandDREiswhatwehavefornow.Althoughnotperfect,bothhavesaved
manylives.Ihavemetprostatecancersurvivorsfrom38yearsofageto80.All,started
withahigherthanexpectedPSA.
Thisnewinformationwithoutfurtherexplanationwilldoundoubtedlyconfuse
manymenabouttheirneedtogetscreenedforprostatecancer.
Anymanwhohashadorhasdealtwithatheprospectofprostatecancerwilltell
youthattheywillgettheirPSAandinsistthattheirothermalefamilymembersdoso.
Anonymous
Iunderstandthattestingcanbedirectionalifthereisabigjump.
IalsoknowfromexperiencethatmenareovertreatedforPC.
I’monactivesurveillance–andusethePSAtestasaguide.Withadigitalexam.
Ihavehadtwobiopsies.
Thefirstshowedindolentcancercellsatapercentagethatmadesurveillancean
option(alongwiththeotherrequirements).
ThesecondbiopsyshowedonlyPINcellsoftheleastaggressivekind.Nocancer
cells.AndmyPSAhaddropped.
Thatwas3yearsago.Inthemeantime,myPSAhasbouncedaroundbuthasstayed
inthisrange.
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SoIknowthatunlessthere’sabigjumpinthePSA,Ican’tuseittodetermine
what’sreallygoingonanymore…orsomyDr.tellsme,sincehewantsmetotakeanother
biopsy.That’sthepractice–biopsyafterXyearstobesurethingshaven’tgottenworse.
Exceptgoto3biopsiesandthereisrealconsequencesforsexualfunctioning.
I’mnotsurewhattodoanymore.ButIdohavePSAtests2xayeartoseewhatmightbe
happening.
IftherehadbeenabigjumpIwouldunderstandtakingthenextstep.
Withoutajumpthough,Idon’tknowwhattodo.
Idoknowthathavingthefirstbiopsywastraumatic,beingtoldIhadcancerwas
traumatic,andthenfindingoutitwas“indolent”andIdidn’thavetodoanything…well,all
Icansayis,therehastobeabetterwayandbetterwaystodiagnose,image,etc.
Manuel
IamalivetodaybecauseofthePSAtest.IthoughtIwasperfectlyhealthy.APSA
andsubsequentbiopsyrevealedthreeaggressivetumorsinsidemyprostategland,
excisednearly17yearsago,oneofthetumorswasaboutreadytoescapethegland.Doing
nothingwouldhaveguaranteedmydemiseandaveryslow,painful,costlyandmiserable
death.
Yes!Ihadsideeffects,butbeingaliveandadjustingtomy“newnormal”througha
penileimplant,wasWELLWORTHIT.
Tom
FormethePSAtestservedasa“redflag”thataproblemcouldpossiblyexist.Inmy
casewemonitoredthePSAlevelsforoverayear.Duringthatyear,thePSAlevel
continuedtoincrease.AfterayearofincreasedPSAlevelsmydoctordidabiopsy,the
resultofwhichshowedthatmanyofthesampleswere“positive”forcancer.Itwasthen
thatweinitiatedradiationtreatment.
ThePSAtestinghaslimitations,ITISANINDICATOR,andshouldbemonitored
overaperiodoftime(likeinmycase)beforeadditionalactionistaken.
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Dave
IhadaPSAtest7yearsago,andmyDoctornoticedthatthruseveralyearsoftests
thatmyPSAhadmadeasignificantchange,sohesentmeforfurthertests.Thefurther
testsshowedthatmyProstatehadabulge,theytookasampleanditshowedcancercells.
Ihadaprostatectomyandfor5yearsmyPSAwas.0000,thenafter5yearsIstarted
showingsignsofPSA.006then.009,.08.07overthelast3years.MydoctorsaysIhave
cancercellssomewhere,butwehavenoideawhere.HeissuggestingHormonetreatment,
butIamresistingthistreatmentuntilmyPSAgoesover1.000
Phil
BecausemydoctorgavemethePSAtestatmyannualphysicalshesawanincrease
inmyPSAwithinoneyear.Iwenttomyurologistandhetook12biopsies.Oneshowed
signsofcancer.ThreemonthslaterIhadtheDaVinciroboticsurgery.Asmallofamount
ofcancerwasfound.Thatwas4yearsago.TodayIamcancerfreeandhealthy.Ifmy
doctorhadnotperformedthePSA’sIcouldbewalkingaroundwithcancer.Ifthecancer
hadnotbeendetectedearly,Icouldhavebeeninrealtroubleifthecancergrewand
spread.Slowgrowingorfastgrowingitisstillcancer.
Jan
Iwasdiagnosedatage41in1993,beforemosturologistsknewmuchabout
prostatecancer.LupronandADTatthattimehadonlybeenshowntogive12‐18months
extrasurvival.MypresentingPSAwas13.6.Surgeryseemedthebestoption,anditwas
basedonthatPSA.NowIknowthiswasamistake,aswastheexternalbeamradiation
thatfollowed.IshouldhavesattightandwatchedmyPSA,waitingtoseeifabiopsywas
reallynecessary.
Bothtreatmentsresultedinincontinenceandpartialimpotence,withtheradiation
causingrectalbleedingandincreasingincontinenceastheyearsprogressed.Ihavenever
beeninremissionthesepast18+years,buthaveusedthePSAtomonitorthe
effectivenessofthevariousformsofADTIhavebeenusing.
OnecouldargueIwouldhavehadthesamefinalresulthadInothadthatPSAat
age41,butat13.6andaGleasonof7thisseemsunlikely.ThePSAisusefulasa
monitoringtool.Toobadsomanyurologistsandradiologistsabuseitsoaggressively,
usingitasanexcuseforexpensivetreatmentsthatproducesignificantmorbidity.It’snot
thePSAtestthat’saproblem;it’swhatignorantorunethicaldoctorsDOwithitthat’sa
problemABIGproblem.
Garth
IdoubtIwouldbeheremuchlongerhadInothadaPSA,whichwasindicativeof
possiblecancer.ThebiopsysureshowedCancer.Andaftersurgery,itwasdetermined
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that(throughaPSAtest),ithadspreadbeyondthemarginsofmyProstate.Itwouldbe
simplyTRAGICtomanymenwhowouldsufferHORRIBLEpainandsubsequentDEATH,
withoutthePSAtest,earlydetectionisthekey.
Rex
Icouldprobablywriteabookbutnonewouldprobablybuyit.Wasdiagnosedin
1991byGPwhosaidIhadasmallpimpleonmyprostate.MyPSAtestcameinat11.6.
HadsurgeryonJuly11,1991.Allnerveswerecut.Incontinentforaboutoneyear.PSA
startedtoadvanceafter1996.MyPSAonJune2011measuredat2.8.Nowadvancing
about0.4perannumandam88yrs.younggoingon89andhopingtobeshotbyjealous
husband.
Tom
Haveyoueverwatchedamandiefromadelayeddiagnosisofprostatecancer?Itis
apainfulwaytodie.Iwatchedmyfatherdiefromprostatecancerthatwasnotdiagnosed
untilafterithadmetastasized.Hadhebeendiagnosedwhenthediseasewasstillina
treatablestate,hemightstillbewithus.
ThereareNOclearlydiscerniblesymptomstoprostatecancerbeforeit
metastasizes.IntheabsenceofregularPSA/DREscreeningandsubsequentbiopsies,
thereisnoothermeansofearlydetectionforthisdisease.Sountilyourtaskforcecan
recommendanothermeansofearlydetectionwhilethisdiseaseisstillinatreatableform,
therecommendationfromyourcommitteeisundulyharshandill‐conceivedand,if
followedbymeninthiscountry,willresultinmanyMOREneedlessearlydeaths!Living
longerwithmanageablesideeffectsispreferabletodyinganearly,painfuldeath.
Charles
AfterdoublingofmyPSAfrom2to4inoneyearandpositive12sitebiopsyofmy
prostate,Ireceivedaradicalprostatectomyatage68foraGleasonscore6cancer.Since
thenmyannualPSAhasbeennon‐detectable,and8yearswillbecomingupthis
November.Ihavehadonlypartialerectionssincesurgery,butthisismanageablewitha
pumpdeviceandtherearemanyotherwaystointimacywithmywife.Thereisnowayto
knowwhatmyhealthwouldbenowifIhadneverhadaPSAtest,butwhatiscertainis
thatthecancerwasremoved.Ithankmyexpertsurgeonforsavingmylife.
Anonymous
PSAtestingsavedmylife!Iwas49yearsoldwhenaroutinephysicalcheckup
includedPSAtestingduetomyage.ResultcamebackataPSAof5.Doctorindicatedthat
weshouldre‐checknextyearandseetrend.IsaidNO!Let’sdomoretestsnowtoseewhy
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PSAof5.Twoweekslater,resultscamebackofcancercellsdetectedat4of12core
samplestaken.
PSAtestingsavedmylife.Now,12yearslater,IhaveaundetectablePSAlevel.
Bruce
WithoutPSAtesting,IwouldbeDEADnow.Ihadnosymptoms,nourination
problems,butmyDr.,after3straightslightincreasesinmyPSA,foundatinyhardspoton
myprostate.BiopsyshowedGleason3+4.Startedonhormoneblockers,thenseed
implantsafterEBR.PSAdownto)for5years,thengraduallyincreasedto11.5in2003.
Hormoneblockerswouldnotworkanymore=hormonerefractoryprostatecancer.
StartedonKetaconazole,Avodart,ZometaandLupron.PSAwentdownto0.3andhas
stayedbelowthatlevel
WithoutPSA,weareconsigningmanymentohighGleasonandlittlehopefor
prolongedlifeinatradeforalittle(verylittle)painfromabiopsy.Afteralltests,watchful
waitingisstillpossiblesowhytakethechancethatyourcancerwillbefoundtolate.
Bob
Iama73‐year‐oldmanwhowasdiagnosedwithProstateCancerinthespringof
2010.ThediagnosisresultedfromarisingPSA,forwhichmyurologistrecommendeda
biopsywhenitmovedfrom3.73to4.75insixmonths.NothingwasdetectablebyDRE.
ThebiopsyrevealedprostatecancerwithaGleasonscore7(3+4).Ididalotofreading
andthoroughlyinvestigatedtheoptions,includingactivesurveillance(whichmyurologist
thoughtwouldbeareasonablechoice).
Idiscusseditallwithspecialistsininternalmedicine,urology,medicaloncology,
andradiationoncology,aswellaswithnumerousotherprostatecancersurvivorswho
hadundergonevariousformsoftreatment.Onthebasisofallthisinformationand
medicaladvice,Ielectedtoundergoacourseofexternalbeamradiationtherapyusingthe
Calypsosystem.Fifteenmonthsaftercompletionofthetreatment,myPSA,whichhas
beentestedeverythreemonths,appearstohavestabilizedbelow0.4.
IhavebeenactivelymonitoringmyPSAformanyyearsbecausemyfatherdiedof
prostatecancerin1974attheageof63.ThiswasbeforePSAtestingwasavailable.
HisdiseasewasdiscoveredbyDREafterhebegantoexperienceurinarysymptoms.By
thenitwastoolate;ithadalreadymetastasizedtothebone.Animmediateorchiectomy
wasperformed,andhewastreatedwithsome(thenveryexperimental)chemotherapy,
whichmadehimverynauseousandunabletoholdfooddown.Aboutayearandahalf
later,ashisbonepainandotherformsofsufferingbecameunbearable,hefinallydecided
toendhisownlife.
Myfatherwasacardiovascularsurgeonandaprofessoratourstate’sonlymedical
school,sohewasmedicallyknowledgeableandhadaccesstotheverybesthealthcare.He
wasphysicallyfitandcarefulabouthishealth.IbelievethatifPSAtestinghadbeen
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availabletohim,hewouldhavehaditasaregularscreeningmethod,detectedhiscancer
muchearlier,andmighteasilyhavelivedanother25or30years.
Twoyearsago,mybrother‐in‐law(andclosefriendofalmost60years)diedof
prostatecancerafteralongbattleagainstthedisease.Histreatmentincludedaradical
prostatectomy,subsequentandrogendeprivationtherapy,severalclinicaltrials,andin
theend,intensivebutlargelyunsuccessfulpalliativecare.
Heexperiencedseverepainbeginningabouttwoyearsbeforehedied.Hewas
completelybedriddenforthelastsixmonthsofhislife,aboutfourmonthsofwhichhe
spentinthehospitalwithlargelyuncontrollablepain.Notonlywasthisaparticularly
miserabledyingprocess,butI’mcertainthatthecostofhismedicalcareafterdetectionof
thediseasemusthavebeenwellinexcessofamilliondollars.Inhiscase,allofthiswas
theresultofhisownlackofinformation(orcarelessness,dependingonone’s
perspective).
HewasnotregularlymonitoringhisPSA,andthediseasewasdiscoveredonlyas
theresultofalifeinsurancephysicalwhichrequiredthetest.Iconfidentlybelievethatif
hehadbeenmonitoringhisPSAregularly,hisdiseasecouldhavebeendiscoveredintime
forsuccessfultreatmentandhewouldbeenjoyingahealthylifetoday,justasIam.
I’mwellawarethatifIhadchosennottohavemycancertreated,Imighthavelivedjust
aslongasIwillnow,andwithoutsomeoftheunpleasantsideeffectsthatIamnow
experiencing.Butitwasmychoicetomake,basedonasmuchinformationasIcould
gather.
IamsatisfiedwiththechoicethatImade.IhaveapeaceofmindthatIwouldnever
havehad,givenmyfamilyhistory,withoutthebenefitofPSAscreening.Iwouldnothave
beenatallhappytohavebeendeniedascreeningtoolthatwoulddetectthiscommon
formofcancerandenablemetomakeaninformeddecisionregardingtreatment.
Iamfranklyoutragedbythepanel’srecommendationthatroutinePSAscreening
bediscontinued.Admittedly,it’sanunassailablefactthatPSAscreeningleadstosome
invasiveandexpensivetreatments,oftenwithdifficultandundesirablesideeffects,of
menwhosecancerwouldnothavebeenfatalifleftuntreated.ButIalsoknowthatmany
thousands,perhapshundredsofthousands,ofmenarealivetodaywhowouldotherwise
havesufferedugly,painfuldeathshadtheynothadthisinvaluablescreeningtool
availabletothem.
It’scrystalcleartomethattheanswerisnottodiscontinuescreening,butratherto
screenasmanymenaspossible,andmakesurethatthosewithelevatedPSAarefully
informedoftheoptions,including,incasesofearlystageand/orlow‐gradecancer,active
surveillanceorevensimplenon‐treatment,andthepotentialconsequencesofeachoption.
Therearealsovaluableprognostictoolsavailable,suchastheMemorialSloan
Ketteringnomogram,toaidmeninassessingtheprobableconsequencesofeachoption
basedontheirindividualdiagnosticprofiles.
Withfull,objectiveinformation,itshouldbethepatient’sdecisionhowtoproceed.
Manyofuswhohavebeensuccessfullytreatedasaresultofearlydetectionandare
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leadinghealthy,activelives–andespeciallythoseofuswhohavewatchedlovedones
suffertheagoniesofdeathfromthishorribledisease.
David
Atahealthfairin1994Ipaid$25togetaPSAtest,thinkingitwasunnecessary
becauseIfeltsogoodandhadnosymptomsorproblems.IwasshockedtofindIhada
PSAof15.4andadvisedbymydoctorbrothertohaveaneedlebiopsywhichrevealed
mediumgradecancer.
HadInottakenthatPSAtestI’dbedeadnow.
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Michael
Ihadbloodworkdoneaboutayearago,andthePSAresultswereprovidedtome
asa“mistake.”Thenumbershoveredaround8.0,theyarenowunder4.0.Ireadaloton
line,joinedonlinecommunities.Ispokewithaurologist,andafterallthetalkandscary
information,Ichosetomonitormynumbersovertimeinsteadofdoinganyinvasive
procedures.IhavehadseveralDRE,allcomingbacknegative.
ProstateCanceristypicallyoneoftheslowestformofcancersoutthere–andin
myhumbleopinion,Iseealotofover‐treatmenthappening.Couldtherebesomething
there,sure,andImayalsodieofsomethingtotallyunrelatedtoProstateCancer.Inthe
end,itisapersonalchoicethatwemake–andwesternmedicinedoesnothavetobethe
onlymannerwithwhichtodealwiththeissue.
Robert
Mydigitaltestwasnegative,butIhadothersymptoms,painatorgasm,frequent
urination,soPSAtestwasprudent.ResultwasPSAof18andfollowupbiopsyshowed
fourquadinvolvement.Prostatectomyfollowedandtumorhadspreadtoseminaland
beyond.Radiationfollowedfouryearslaterandnowafter22yearsIhavestarted
hormonesat86.MyaddedyearsIowetoPSAalert
Randy
PSAbeingcheckedsavedmylifefromProstateCancer.Iwas47whenIwas
diagnosedbyabiopsy.Ididn’tthinkaboutmyprostatebeingwheremybodywould
developcancer.LosingbothmymotherandaunttocancerIassumedIwasatriskbutI
didn’tknowaboutPSAtesting.ThankfullymyDoctorfoundthePSAincreaseandreferred
metoaUrologist.RadiationBrachytherapydidn’tkillitbutthispastJulyIhadaradical
prostatectomytoremovemyprostateandthecancer.Myfirstpost‐operativePSAwas
lessthan0.1.
TheonlywishIhadisamorehumanewayofdiagnosisvs.thecurrentbarbaric
biopsy.Ihad2performedandIdon’twishthatonanyman.
Ray
IwasdiagnosedviaPSAwithprostatecancerin1993andhadaprocedurein1994.
HadInothadaPSA,IfeelsuremycancerwouldhavespreadandIwouldnotbehere
today.PSAisnotasurething,butIdon’twanttobetheonehavingprostatecancer,not
knowingitandallowingittospread.AslongasthepatientandDoctor'sdiscussthe
gains/losses,goods/badforalltheprocedures,thenthepatientshouldhavethefinal
decision.
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Anonymous
InJanuary2007,attheageof67myPSAhadgoneupfrom2.41to3.78in16
months.MyGPreferredmetoaurologistwhoperformedabiopsy.Theresultwascancer
in2outoftwelvenodesGleason8.InFebruaryof2009,Ihadnon‐nervesparingrobotic
surgerytoremovetheprostate;thepathologyreportconfirmedtheGleason8.Ihadextra
prostaticextensionbutnegativemargins.Sincesurgery,myPSAhasbeenat.005.Ifit
wasn’tforthePSAtestmyaggressiveGleason8PCawouldhaveprobablyspreadtoother
partsofmybodyincludingmybones.Icountmyblessingsforfindingoutaboutthissilent
killerwhenIdidandIthinkthePSAtestandmydoctor’sawarenessiswhatledtomy
discovery.
Anonymous
Myfatherandgrand‐fatherbothhadprostatecancer.Ihavetestedeveryyearfor
thisviaasimplebloodtest(inexpensive,too).Whenthetrajectoryheadeduponmychart,
thedoctordidabiopsyandfoundcancerinmostsamples.MyPSAhadgonefrom1.0to
11overa5yearperiod.Haditnotbeenforthis,Iwouldnothavehadabiopsy.
Robert
MyPSAnevergotoutofthe“normal”rangebutoverthecourseoftwoyearsmy
PSAwassteadilygoingupafewpercentagepoints.Thankstomyurologisthe
recommendedabiopsy,foundcancer,removedtheprostateandafterwardsfoundoutthe
prostatewasloadedwithcancer.Iwas50yearsoldatthesurgerydateandamnow53!
PleasedonotdoawaywithPSAtesting.
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Max
IthinkthatwhoeverdecidedthatPSATestingisnotnecessary,isjustplainstupid.
Iaman8yearprostatecancersurvivorwhowouldnothavebeenherehaditnotbeenfor
aPSAtest,therebyfindingoutearly.Thesamehappenedtomewithachestx‐raythat
foundamalignantspotinmylungtherebywhichmeantIhadstage1Alungcancerwhich
isnotfinesinceitwasdetectedearlyandamnowdoingwell.PSAtest,thoughnot100%
accurateiscertainlybetterthannotestatall.
Mark
PSAtestingwastheonlythingthatcaughtmyprostatecancer,whichtheurologist
toldme,was“slowgrowing”….butpost‐surgeryturnedouttohavesomeslowgrowing
cells,butmostwasaggressive!Therealsowasvirtuallynonoduleandwasnotpickedup
onrectalexamasitwasontheinternalsideofthegland.
ThePSAtestisfarfromperfect,butitisthebestwehaveatthemomentandmadethe
differenceinmylife.
Jim
In2001,whenIwas46,ourfathertoldusthathehadbeguntreatmentforprostate
cancer.Imentionedittomydoctoratmyannualphysical,andhetookaPSA,whichcame
backat16.8.Ihadabiopsyandcancerwasdiscovered.TheDREwasnormal.Iunderwent
aprostatectomyandradiationafterwards.Tenyearslater,I’maveryhealthy56‐year‐old.
IfIhadn’thadthePSA,IbelieveI’dbedeadorsufferingfromterminalcanceratthisage.
Anonymous
MyhusbandrequestedthePSAin2004becauseofhisfamilyhistory:hisfatherand
severaluncleshadprostatecancer.Hisprimaryphysicianwasreluctanttorunthetest
sayingitwasexpensiveandinaccurate,butheranthetestanywayanditwaswellwithin
thenormalrange.ThefollowingyearhisPSAwasrechecked—againreluctantly—and
hisPSAhaddoubled.Asaprecaution,hewasreferredtoanurologistforabiopsy.His
Gleasonscorewasasurprising9.
HeunderwentTomotherapywhichdestroyedthetumorandhisprostatein
January2006andwasdeclaredcancerfreethatyear.However,in2007thefollow‐upCT
andBoneScansrevealedthecancerhadmetastasesthroughouthisskeletalsystem.After
alloftheavailablestandardtreatmentsandanexperimentaltrialofIMC‐A12with
Mitoxantrone,andaverybrieftrialofaPARPinhibitor—thediseasemetastasesthrough
hisspinalcord.
Weknewfromthebeginningthathisparticularprostatecancerwouldwininthe
end—butheparticipatedinseveralexperimentaltrialsandbasicallygavehislifefor
research.WouldhehavebeenbetteroffwithoutthatinitialPSA?No,hewouldhavedieda
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miserabledeathwhilehisphysiciansdeterminedthecauseofhisvagueachesandpains.
Anyonewho’shadbackpaincanattestit’sjustnottakenveryseriously!Theopportunity
forvaluableresearchwouldalsohavebeenlost.Itangersmethatsolittleemphasisis
placedonmen’shealthandwellbeing.
Anonymous
Afterseveralyearsofbeingtreatedfor“prostatitis”andPSAreaching8.7,abiopsy
camebackwithPCAandanumberof“abnormal”cells.Consideringthepossibleoptions,
familyhistoryofcanceranddiscussionswithotherswhohadchosendifferenttreatments,
Ichosetohaveitremoved.Thedeedwasdone7‐2002.TherearedayswhenI
thinkadifferentchoicemighthavebeenbetter,butoverallmychoicewasbestforme.
ThereisnodoubtinmymindthatthePSAtestisthereasonmydiagnosiswasmadewhen
itwasandIfeel,extendedmylife.
Ifmemoryservesmecorrectly,ithasnotbeenthatmanyyearssince
mammogramsforearlydetectionofbreastcancerwerecontroversial.Untilanoted
person,wasitBettyFord,wentpublicwithherdiagnosis,breastcancerwasnotthat
public.Myfeelingis,untilmencanbecomemorepublicindealingwiththesideeffectsof
PCA,thefighttocontinuecoverageofthePSAtestwillprobablybelost.Foralmost10
yearsmyPSAhasbeen“undetectable.”
Anonymous
IampresentlybeingtreatedforD2stage4prostatecancer.Myprimarycare
(FORMER)justblewitoffwhenmyPSAwentfrom2.4to22anddidn’tsoundanyalarm
evenwhenitwentupto55.IthinktostoptestingforPSAisthedumbestthingNextthey
willbetellingwomennottohavemammograms.
David
Myfatherdiedahorribledeathfromprostatecancer27yearsagobeforethePSA
testwasavailableashewasnotdiagnoseduntilhiscancermetastasizedthroughouthis
body.HisfinalunspokenmessagetomewastomonitormyselfsoIhavebeengettingthe
easyandinexpensivetestsfor23years.In2007myPSAspikedandithadgoneupover
.75intheprevioustwoyears.
Ihadabiopsyandhadprostatecancerinthreequadrantsbutitwascontained.I
receivedradiationtreatmentswithCyberknifein2008andamdoingverywellfouryears
later.MyPSAis.30andIamneitherincontinentnorimpotent.ThePSAtestallowedmeto
monitormyownhealthsoIdidnothavetoexperienceahorribledeathlikemyfather.
ThePSAtestisonlyaguidelineforprostatecanceritisnotaprobleminitself,in
factitdoesformanymenwhatitdidforme,alertedmeaboutprostatecancerbeforeit
metastasized.Theproblemiswithhowdoctorsinterpretit.Thereareotherissuestobe
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consideredlikethevelocityofchange,theGleasonscore,andfamilyhistory.Doctor’sneed
tobetrainedandtheyneedtoinformpatientsonhowtogatherinformationandeducate
themselves.Yourtargetforconcernisfocusedonthewrongpartofdiagnosis;thetestis
simplyatest.Howitisinterpretedandusedistheissue.
IamwalkinglivingproofoftheimportanceofthePSAtest;itshouldnotbe
abandonedatalluntilabettertestisfound.
David
MyPSAbeganaslowupwarddriftatage55.At57itwasstillonly2.64,butthe
rateofchangewasnoticeablefromtheyearbefore.Myfamilydocsaid,we’llwatchit,and
checkagainnextyear.IaskedforafreePSAtestwhichwasonthelowside,butdidnot
suggestcancer.FamilydocdidaDREwhichwasnegative.Ihadnoothersymptomsof
prostatecanceratthistime.
Iwasstillconcerned,soIwenttoseemyurologist.Healsosaidthatwewould
watchit,butfirstwantedtodoaDRE.ItoldhimthatIjusthadone,buthewasinsistent.
Hediscoveredanodule!AbiopsyrevealedaGleason9!
HadInotbeendiligentwithPSAtesting,Iwouldhavehadfullblownmetastatic
prostatecancerbeforeitwasdiscovered.
PSAtestingabsolutelysavedmylife.
Eldon
Twenty‐oneyearsagoIattendedafreeprostatescreeningeventanddiscoveredI
mighthaveprostatecancer.APSAtest,ultra‐sound,andbiopsyconfirmeditandIhad
surgery.RegularPSAcheckupsrevealedarapiddoublingvalueandfouryearslaterI
underwentradiationtherapy.ThentwoyearslaterwithstillrapiddoublingIhad
completehormoneblockagewhichIfollowedfortwoyears.Duringthistimeeverysix
monthsmyPSAremainedataverylowlevel.Ihavecontinuedthesixmonthtestand
threeyearsagomyPSAbeganrising.ItookLupronshotsforthreeyearsandnowam
watchingaslowrise.Withoutmysixmonthtests,Imaynothavemadeitthislong.
Myfatherdiedofprostatecancer,soIfeelthetestgivesmehopeandguidancefor
treatmentfrommyurologist.Iwouldbefearfulwithoutthetest.
James
EarlystageprostatecancerHASNOSYMPTOMS.Yet,earlystagecancercanbe
treatedandcured.Latestagecancercannotbecured.
Atage50,inprimehealth,Ineededaphysicalforanewposition.Itrequireda
physicalexam.MyenlighteneddoctorsuggestedaPSA.Theyweredrawingbloodfor
othertests.
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MyPSAcamebackat39withaGleason8.IwassuccessfullytreatedandIamhere
toseemychildrengetmarried,grandchildrenborn,andfinishmycareer.
IFIDIDNOTHAVETHATPSATEST,IWOULDNOTBEHERETODAY.
MenhavetheRIGHTtoknowiftheyhavecancerandiftheydotomakeatreatment
decisionthatisrightforthem.
Anonymous
InJune2010myhusband,whowasthen59,hadbeensufferingwithdreadfulpains
inhisbackandlegsplusnauseaformanymonths.
AmonthearlierhehadbeenadmittedtohospitalwithsuspectedGallbladder
problemswhichprovednegativeandhadalsobeentreatedwithphysiotherapyfortheleg
painforweeks.HisPSAondiagnosiswas67,ifhehadbeenofferedthissimplebloodtest
fromage50whichiswhatourconsultantsuggestsshouldbeavailableforallmenwe
wouldpossiblybelookingforwardtoalongandhappyretirementinsteadofavery
uncertainfuture.
HewasfinallydiagnosedwithAdvancedMetastaticProstateCancerafterabone
scan.
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Bob
ItwasmyfirstPSAtestatage50thatledtotheultimatediscoveryand
confirmation18monthslaterthatIhadcancer.AnditwascontinuedrisingPSAresults
thatkeptthedoctorsinvolvedandonthepathtoadiagnosis.Sowithoutthatsingle/first
PSAtestandsubsequentrisingPSAtestresultsdrivingthedoctorstocontinuelookingfor
theissue,there’snowayanyonewouldhaveknownIhada4+3Gleasonscoretumor.
AndIcertainlywouldnothavepursuedanycourseofaction.LikewhywouldI?Never‐
everwerethereanyphysicalsignsthatanythingwasamiss….talkaboutasilentkiller.I
canseeitnow.“HiDoctor,I’minthebestphysicalshapeofmylife,myhalfmarathon
timescontinuetoimprovemonthaftermonth,sopleasewouldyouconsiderdoingsome
exploratorysurgeryorinvasiveanalysisjusttomakesureIdon’thaveprostatecancer?”
Yeah,right.
InthepasteightyearsIhavetestedvirtuallyzerowhenitcomestoPSA,andnow
wonderwhatI’msupposedtodoasafollowup;hope,trustintheallmightythatthere’s
nochanceofrecurrence,waittillthere’ssomeotherphysicalsign,whatexactlyamI
supposedtodo?Whattheheck,whydoanytestingforanything,ifnottodriveearly
possiblediagnosisandincreasedlevelsoftesting?
Finalthought.
Isawmyfatherpassduetocomplicationsfromprostatecancer,andwhilethe
officialcoroner’sreportstatedheartfailure,itwasheartfailureduetothosecancerbased
complications.Andwhilehefoughtcancerformanyyears,Icanonlythinkwithouthis
earlyPSAtests,andthefollowonprocedures,theprostatecancerwouldhavekilledmany
yearsearlier.
Clifford
MyprostatecancerwasnotdetectedbyaPSAtest.MyPSAlevelsremained
relativelylowthroughtheyears.Butsymptomsleadmetoayoungurologistthatfoundan
abnormalprostatefromaDREexam.Abiopsyconfirmedanearlystageprostatecancer.
I’minfavorofusingsciencedatatobestdeterminewhoneedsmoretesting.Family
history,symptoms,andDREarebetterindicatorsthanthePSAtest.
Weneedabettertestforcancerouscells.Insteadofspendingmoneyunnecessarily
onPSAtests,let’sspendthatmoneyondevelopingabettertest.
Anonymous
ProstateCancerhasaffectedmyfamilyinahugeway.Mypaternalgrandfather
passedawayfromprostateCancermanyyearsago.Myfather,nowage72wasdiagnosed
withprostatecanceralmost14yearsago.Heunderwentsurgeryandisdoingwell,but
hasnobladdercontrol.Hissurgerywasmajor,asthenewtechniquesofroboticsurgery
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weren’tavailableatthattime.Hedevelopedkidneycancerasaresultoftheprostate
canceralmost7yearslater.
Thekidneycancerwasdiagnosedwhenheattendedanultrasoundscreening
hostedbyhischurch.Ididaseriesof9ultrasoundscreeningsonthebodyallwith
ultrasoundtechnology.Alargemasswasfoundonhisrightkidney,whichagainresulted
inanothersurgery.Thankfullythecancerwascontainedinonlyonekidney.Mybrotherat
age45wasalsodiagnosedwiththisterribledisease.Hedidhavetheroboticsurgeryand
otherthanbladderissuesisdoingwell.
Havingthesescreeningsdonearesoveryimportant.Theyarepreventive,but
shouldbedoneannuallyateveryannualphysical.Insuranceshouldbecoveringthese
screeningsastheyarelifesaving.Thesescreeningskeepusawareofwhatisgoingonand
ifabnormalitiesarefound,helpidentifythembeforetheybecomemajor.Theysavelives,
period.
Carl
WithoutPSAtesting,myprostatecancer,aGleason9,wouldnothavebeenfound
untilitwastoolateandIassumeIwouldnotbealivetoday.
PSAtestingshouldnotbedroppeduntilabettertestisavailable.
Michael
Iwasoneofthelowriskmenwhoundertheproposedruleswouldnotgettested.
At51yearsold,withnocancerinmyfamily,mydoctororderedthetest.PAcamebackat
14.28,asubsequentbiopsyshowedaGleason9,aggressivecancer,andIamstillhere
aftersurgery,radiation,hormoneandadvancetherapies.Mycancerwasfoundintimeto
control,nottocurebecauseithadalreadyspread.
Today,15yearslater,Iamimpotent,butIamalive,Ihaveseenmygranddaughters
growupandwhilewearewatchingthecancerstarttospreadasthetreatmentsfailaPSA
testboughtmesomegreatyearsthatIwouldhavemissedwithoutit.Aslongasthe
doctorsunderstandwhatthetestresultsmeanandcanprovideareasonableexplanation
oftheneedforrepeatedtestsandcarefulconsiderationofwhattodoifPSAisrisingand
whatthesideeffectsoftreatmentcanbe,thereisnobettertesttohelpsavelives.
Anonymous
Inmyannualphysicalin2000,myprimarycarephysicianperformedadigital
rectalexamination.Hefelthardnessononesideofmyprostate.IgotaPSAtest.Itwassix
plus.Iwasreferredforabiopsy.Theresultsshowedaggressivecancer.IhadanMRIanda
bonescan.Bothindicatedthecancerwasstillencapsulated.Formethechoicewasclear
—surgicalremoval.Iwantedtobecancerfree.Iamstillhere.ThePSAtesthelpedme.In
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myviewitisagoodtooltohaveinthetoolbox.Let’skeepitinmedicineuntilsomething
betterisfound.
Steve
Mystoryisalittledifferent.MyPSAdidnotrisesignificantlyandmyprostatewas
notenlarged,yetIwashavingdifficultyinurinating.Myurologistdidascopeandfounda
smallgrowthinternallyinmyprostate.Headvisedmethattheyweremostgenerally
benignandadvisedmetohave“green‐lightlaser”surgery.Thisprocess“burnsthegrowth
awayandissupposedtomakeiteasiertourinate.Healsosaidthatthissurgerynegatively
affectstheabilitytogetanerectiononlyabout1%ofthetime.PSAwas2.25.
ThisiswhereImademymistake!Ibelievedthatthis“doctor”knewwhathewas
doing.Ihadthegreen‐lightsurgery,nobiopsywasdone,andIwentdowntheroad
thinkingeverythingwasgoingtobepeachesandcream.Ihaven’thadanerectionorbeen
abletohaveintercoursewithmywifesince!Congratulations,I’mpartofthe1%!
Now,fastforward21/2years.IhadmyPSAcheckedinAprilof2009anditwas
2.5.Iwastoldthatwasnormalforaman58yearsofage.DuringthemonthofJune,I
won’tboreyouwiththebuild‐up,abouthowsickIgotandcouldn’tfigureoutwhyIwas
alwaystired,hadnoenergy,ambition,weakandhadaheadachethatonlyice‐packswould
relieve.Ifinallywentmyfamilydoctortohaveabloodtesttoseeifitmightbespinal
meningitis.
Tomakealongstoryshort,bynowtheprostatecancerhasspreadtomybone
marrow….throughoutmyentirebody.MyPSAis285andI’mtoldthatIhave11/2to2
yearstoliveandthatthecancerhasbeengrowingfor3‐4years.
Itellyouallofthistosay…PSAtestaren’tperfect.Theydon’tworkallofthetime.BUT…
it’sthebestdamnthingthatwehavegoingrightnow!Thatandbeyourownbest
doctor!!!!Don’tjustsetbackandbelieveeverythingyour(possibledumbass)urologistor
doctormighttellyou!Bewillingto“FIRE”yourcurrentdoctorifyoudon’tfeel
comfortablewithwhathe/shemightbetellingyou.
Thegoodnewsisthatithasbeennearly21/2yearssinceIwasdiagnosedandI
amfeelingGREATandhopetobestartinganewtreatmentthatIexpecttogiveme3–5+
moreyearsofgreatliveandISTILLDOMYOWNRESEARCH!!!Newtestingisonthe
horizon,betterthanPSAbloodtesting;therearenewandexcitingtreatmentsthatare
comingdownthepipeline……Juststaypositive,stayinformed,stayeducatedand“STAY
INCHARGEOFYOUROWNHEALTH!!!”
Anonymous
Iwasdiagnosed17yearsago.ThankstoalowPSAIremainedrelaxedand
continuedtolivea‘normal’life.WithnoPSAIsuspectmyconcernwouldhavebeenfar
greater.Itallowedmetofunctioninanormalmode.
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Jack
IhadmyfirstPSAwhenIwenttomyUrologistforakidneystoneproblemandI
thinkIwasabout53yearsold.MyPSAwas3.5andmyurologistsuggestedIgofora
biopsyjusttomakesureeverythingwasalright.SoIdidandeverythingwasfine.Atthe
timemyuncleonmymother’ssidehadProstateCancerhewasabout70yearsold.Then
mybrotherwhowas10yearsolderthanmehadProstateCancer.Ididn’tgotomy
urologistforacoupleofyears,butIhadbloodworkdoneformyregulardoctor.
WellIhadthePSAscriptstillinmywalletandgaveittothelabwhenIhadthe
bloodwork.MyPSAwentto4.5andmyurologistsuggestedthatIhaveabiopsydone
becauseitwentupandtomakesuretherewasnocancer.IaskedhimifmyProstatefelt
differentandhesaidno,infacthesaidhedidn’tthinkthebiopsywouldshowIhad
cancer.WhenhecalledmeandtoldmeIhadcancerIcouldn’tbelieveit.Ifitwasn’tforthe
PSAtestthecancermighthavemovedoutofmyProstateandmademylifemiserable.
PerhapsIwouldn’tbearoundtotellyoumystory.
ThePSAtestsavedmylife.
John
FiveyearsagoIwenttomydoctorforanannualphysical.Theonlyabnormality
discoveredinmyexamwasaPSAlevelone‐tenthofapointintotheabnormalrange.My
doctorsaiditwasprobablynothing,buthesuggestedIcomebackinafewmonthstohave
itcheckedagain.WhenIwastestedagainmylevelhadrisen.Iwenttoaurologist,who
suggestedIgetabiopsyonmyprostate.ItturnedoutInotonlyhadprostatecancer,butit
wasgrowingatsuchanabnormallyfastratethatitwasalmostatthepointof
metastasizing.Ihadtohaveaprostatectomyassoonaspossible.HadInothadthatfirst
PSAtestandthenthreemonthslaterafollow‐upsecondone,Iwouldnotbeheretoday.
Rick
Ifitwasn’tforPSAtesting,Iwouldprobablybedeadorclosetoitbynow.Backin
2008,Iturned65andarrangedfortheMedicaresponsoredmedicalexam.Ihavebeena
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healthymalewithabsolutelynohealthissuesthatIwasawareof.Aspartofthemedical
exam,bloodwasdrawnandmydoctorselectedPSAtestasoneofthetestcriteria.The
PSAtestresultcamebackas34whichwasabigredflagthatsomethingwasup.
ImmediatelyafterthatIvisitedtheurologistwherehedidthefingerwaveanddidfeelan
abnormality.AbiopsylaterdeterminedthatIhadstage4advancedprostatecancer.
Ofcoursemyprognosisisnotgreat,butwithoutthePSAtest,Iprobablywouldnothave
gottenthestartonattackingthecanceruntillateronandtimeisoftheessencehere.
GettingridofthePSAtestjustdoesn’tmakeanysensetomeasitseemslikeitwilldo
moregoodthanharm.
Wendy
Myhusbandwasdiagnosedin1996attheageof46.HehadaGleason9andabase
PSAof24.4.Ahardnodulewasfoundwhileattheurologistforanothercondition.
PriortothatwehadnoknowledgeofprostatecancerorofthePSA.HediedatApril2007
attheageof561/2.Heleftbehindthreesonswhowere18,19and23atthetime.There
isnodoubtinmymindthatifhehadstartedhavingyearlyPSAsandDREsthathewould
stillbealive.Insteadhewasgivenadeathsentence.ThePSAmaybeflawedbutitsaves
lives.ThedeathstatisticshavedecreasedsincethePSAhadbeenused.
Sam
ThePSAtestprovidedanalertinthatitdoubledfrom1.8to3.6intheyear
betweenphysicals.AftereliminatinginfectionsandotherreasonsforaPSAtorise,a
biopsyconfirmedthattherewasatumor.TheTumorhadinvadedthecapsulewalland
wastryingtoexit.AfterremovaloftheprostatethepastnineyearsofPSAtestshas
confirmedthatthethreatofprostatecancerspreadingappearstobegone.
ThePSAtestnotonlygavemeearlywarningbeforethecancercouldspreaditalso
reassuresmethatthecancerhasnotreoccurred.
Giventhatsuccessinfightingcancerisearlydetectionwhileitiscontained,why
wouldanysanepersonremovethisearlywarningfrombloodtests?
Bob
PSAtestmaynotbethegreatestbutitisallwehavefornow&isaguidelinefor
Urologisttogoby.WithouttheTestmyprostatecancerwouldnothavebeenfound.
Iamnowintreatmentbecauseitwasfound&havehighhopesthatallwillbegood.
Idon’tknowwhoyoupeoplethinkyouaretodoawaywithoneofthefewguideswemen
havetofindprostatecancer.Prostatecancercaseseachyeararemore,thenbreastcancer
butbreastcancergetsalltherecognition.
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Anonymous
MyPSAtesttaken10yearsagowasat10,inaweekitmovedupto12.Ithenhada
DRE,andabiopsy,bothconfirmingIhadcancerwithaGleasonscoreof4+5=9.Follow‐
upsurgery,radiation,hormone,andmostrecentlychemotreatmentshavekeptmealive.
InparticularthechemodramaticallyloweredmyPSAscore,andalsoreducedthe
numbersofmets,andsizeofthecancer.Thereducedmetsandcancersizewere
confirmedwithboneandCTscans,andcoincidedwiththePSAdroppingfrom130.31to
2.21.
ThePSAscoresarenotfullproof,butthey’rethebestwehavefornow,andhelp
menandtheirdoctorsdeterminecourseoftreatment,ifany.
Erik
Iwasdiagnosedwithprostatecancer2and1/2yearsagoatage55,becausemy
then‐primaryphysician,whomIsawevery4monthstomonitormytype2diabetes,was
unbeknownsttomerunningaPSAtest,somethingIknewnothingof,everytimeIsaw
him.Atonemeeting,ashereadthebloodtestresults,whichweresofarexcellent,he
suddenlymurmuredanominous,“Oh,oh,”andproceededtotellmethatImighthave
prostatecancer,duetoarapidriseinmyPSAacrossashorttimespan,explainingthetest
tomeforthefirsttime.Hesentmetoaurologistofhisrecommendationfortesting.
Abiopsyrevealedminuteamountsofextremelyslowgrowingcancerinmy
prostate.Nevertheless,theurologistinsistedthatImustgettreatmentimmediately,either
intheformofsurgeryorradiationseeds.Heforcefullyrecommendedsurgery,sayinghe
didn’tdotheradiationhimself,thinkingitnotasgood,buthedidsayhecouldrecommend
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adoctortotalkwithwhodiddotheradiation,ifIwanted.Idid,andtookhis
recommendation.Atthesametime,Iaskedwhy;ifthecancerwassosmallandso
nonaggressive,wecouldn’tjustkeepaneyeonitforawhile.Hereactedforcefully,telling
methatdosowouldbe“irresponsible,”probablyfatal,andthatIwouldhavetofind
anotherdoctorifIwantedthat.
Theradiationdoctorenthusiasticallyinsistedthathistreatmentwasbestandbid
hardformypatronage.WhenIandmyhusbandaskedhimwhywecouldn’tjustmonitor
thesituation,hesaidthatthatwasn’tdonebyrespectablephysicians,thoughhecouldn’t
explainwhytooursatisfaction.
Ireturnedtomyurologist,thistimewithmyhusband,afterresearchwedidonthe
Webrevealedthe“watchfulwaiting”and“activesurveillance”approaches.(Ihadnot
knownaboutthemwhenIaskedmyquestionsaboutmonitoring.)Heprofessedneverto
haveheardofthem,norcouldheansweranyofmyquestionsabouthowsurgeryor
radiationmightaffectmysexuallifeasagayman.Indeed,despitepracticingformany
yearsinManhattan,hesaidthathehadneverbeenaskedsuchaquestionbefore.WhenI
toldhimthatIwasmostinterestedinfindingadoctorwillingtoatleastentertainsuchan
approach,hesuddenlysaidthatifIwanted,hewoulddoactivesurveillancewithme,
despitehavingsoforcefullycondemneditinthepreviousvisit.Ideclined.
Iwantedadoctorwhohadactuallydoneitbefore,ifIwasgoingtopursuethat
course.
OntheWeb,IdiscoveredsomethingcalledHiFU,offeredinEurope,Canada,the
Caribbean,andSouthAmerica,thatwasstillinclinicaltrialsinAmerica.Ifoundonesuch
trialwasacceptingapplicants.ImadeanappointmenttoseeifIwaseligibleforthattrial.
Uponmeetingwiththedoctorrunningthetrial,Ialsoaskedaboutactivesurveillance.
Afterthoroughdiscussion,heagreedthatIwasanidealcandidateforit,after
explainingthatevenHi‐Fu,thoughlessinvasive,hadpossibleunpleasant,permanent
consequences.Hetoldmethathehadbeenusingactivesurveillancewithqualified
patientsformorethan20years,andthatnoonehadeverprogressedtometastasized
cancer,thoughobviouslysomehadeventuallyhadtohavesurgeryorradiation.
Ihavebeenpursuingactivesurveillancewithhimsince,andallhasbeenfine,with
myPSAtestsconsistentlythelowesttheyhaveeverbeen,andsubsequentbiopsies
showingevenlesscancerthanpreviousones.IoftenthinkthatifIhadneverhadthose
PSAtests,IwouldbeunawarethatIhadanycancerandwouldnothavetogothrough
twiceyearlyvisitsandbloodtests,aswellasperiodicbiopsies.
It’snotformetosaywhetheranybodyshouldorshouldnothaveaPSAtest.ButI
cancompletelyunderstandthereasonsbehindtherecommendation,particularlybecause
myfirsttwourologistssofiercelytriedtopushmeintotheirtreatmentspecialty,without
concernformyparticularneeds.Ihavenohistoryofprostatecancerinmyfamily,andam
generallyinexcellenthealthexceptforthediabetes,whichIcontrolwell.YetIwaspushed
forcefullytodoaggressivetreatmentthatcouldchangemylifeforever,andnotforthe
better.
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Ittookalotofmentaleffort,andmuchemotionalaggravation,toresisttheir
pressure,researchthingsformyself,andthinkclearlyastowhatwouldbebestforme.I
amveryhappywiththechoiceImade.Istillregrethavinghadtomakethechoiceatall.
Jim
WithoutPSAtestinginOctober2003,Iwouldnotbeherewritingthis.Duringa
routinecheckup,thebloodworkcompletedshowedaPSAof16.Initiallyitwasthoughtto
beaninfectionbutwhenIwenttoaurologistitwasdeterminedthatabiopsywas
necessary.Ihadnosignsofanyproblemsandthoughtthatthediseasewasan“oldman’s”
disease.Formy51stbirthdaythediagnosiswasprostatecancer.Itwasaggressiveandmy
prostatewasremovedinFebruary2004.Exceptfora“bliponthescreen”in2005
everythinghasbeenfine.IoftenthinkwhatwouldhavehappenedwithoutthePSA
screening.Asmyurologisttoldme,bythetimeIwouldhavehadsymptomsitwouldhave
beentoolate.Althoughpeoplethinkthisisnotthebesttestavailable,itisastartingpoint.
John
Myfatherdiedofprostatecancer,beforetheadventofthePSAtest.Mybrother
hadhisprostateremovedafterarisingPSAindicatedthepossibilityofcancer,anda
biopsyconfirmed.
Withthisfamilyhistory,IbeganaroutineannualtestofPSAatage50.Byage61,
myPSAbegantorise.Initialbiopsydidnotrevealanymalignancy,butmyPSAcontinued
torise.Asecondbiopsy6monthslaterrevealedmalignancy,andIbeganProton
treatmentsinApril2004.
IcontinuetoannuallyreviewmyPSA,whichremainsbelow1.0sincetreatment.
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Linda
MyhusbandDavehasastrongfamilyhistoryofProstateCancer.Hisfatherpassed
awayfromPC.HistwobrothersalsohavePC.DavebeganhisPSAtestingatage50
becausebackthenthatwaswhatthedoctorsrecommended.Hewasdiagnosedatage58
whenhehadaspikeinhisPSA.He’snow61andstillbattlingthebeast.Ifhehadn’thad
thePSAtestperformedIwouldbeawidownow.ThePSAtestisanabsoluteMUSTuntil
anotherdiagnostictoolisavailable.
Richard
IfIwouldhavebeengivenaPSATestalongwithmyphysicalsmyprostatecancer
wouldhavebeenfoundearlier.IwasgivenaPSATestonlyafterIhaddeveloped
symptoms.Iwishinsurancecompaniesanddoctorshadbeenmorewillingtopayfor/give
thetest.
Anonymous
MyPSAwasalwaysverylow(aroundthe1.0range)untilage71‐72,whenalow
readingdoubledinlessthanayear.BiopsyrevealedGleasonscoreof4+3.Prostatectomy
andfollowupradiationdidnotrenderPSAundetectable,sohadtotakeLupron.PSA
undetectableforabout9months,butnowPSAbecamedetectable,sobackonanother
Lupron.PSAisnowthesoletesttogaugeifexistingcancercellsaredormantorgrowing.
Milton
Inthesummerof2003,whenIwas85yearsold,aroutinePSAshowedasharprise
toabout6.Abiopsyshowedanaggressivecancer(Gleasonnumber9).IunderwentIMRT
radiationandchemicalcastrationandwassymptomfreeforaboutfiveyears,afterwhich
myPSAbegantoriseagain.Ithenhadcryotherapywithresultsthatdidnotlast,following
whichIwenttoamedicaloncologist,whoputmeonprednisone,whichappearstobe
working.Iamapproachingmyninety‐thirdbirthdayandamhavingunrelatedheart
problemsthatcouldbefatal,inwhichcasemycancerwillbecured’
Ihavesurvivedforeightgoodyears.IamconvincedthatifIhadnotbeentestedfor
PSAIwouldnowbelongdead.
Louis
ThankstothePSAtestmyprostatecancerwasdetectedearly.WithoutthetestImaynot
beheretoday.Ifeellikeitsavedmylifeandwillsavemanymore.Rightnowit’sallwe
haveanditneedstobecontinueduntilthereissomethingbetter.Itindicatedariseinmy
PSAandthedoctorfeltitwasreasonenoughforfurthertestwhichprovedIhadProstate
Cancer.EarlydetectionisthekeytosurvivalandthePSAtestwillhelpdojustthat.
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Anonymous
Myinternforthepast10yearshasbeentestingmyPSAwiththelipidpanelformy
annualphysical.ThePSAIneverreallyknewwhatitwas.However,onetimeIlookedat
mybloodtestandInoticedmyPSAwas2.86anditwasalwaysaround1.3forthepast10
years.Mydoctorsaidnottoworryaboutit.Iwas59yrs.oldatthetime.Iwenttoa
urologistformyannualexamandhegavemesomeantibioticsthinkingitmightbean
infectionfrommyrecentkneereplacementsurgery.ThePSAdidcomedownto2.3.He
thentestedme90dayslateranditwas2.6.
Hesaidhewouldnotworryaboutit;howeverIdidandgota2ndopinion.This
doctortesteditin90daysanditwas2.0andthen2.6.Afterayear,thedoctordecidedI
neededabiopsywhichIreallydidnotwant,buthesaidthatwouldbetheonlywayto
reallyverifyifIhadcancer.IhadthebiopsyandyesIhadtwocoresthatwereverysmall
butcancer.
IfreakedoutandthereisnotadaythatgoesbythatIdonotthinkaboutit.Ihave
hadtwobiopsiessincethefirstandthecancerisstillshowinghoweverIchosetodo
watchfulwaiting.ThedoctorsaysIqualifyforthathoweverthereisnosurewayof
knowingifthecancerisaggressiveornot.ItisagambleandIknowit.Howeverthe
surgeryistooscaryformerightnowandalltheliteratureconfusesme.IwenttoCityof
HopeandtheheadsurgeonnationallyacclaimedsaidIwoulddowellwiththesurgery
andwantedtooperate.Iwenttoamajormedicalcenterandmetwiththetopsurgeonof
theGoldenStandardnervesparingapproachandhesaidIcoulddowatchfulwaiting.
Everydoctorhasadifferentopinionanditisreallyuptotheindividual.Mostofmy
friendssayIamcrazy,getitout.Iamtakingitonedayatatimeor90daysatatimeuntilI
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havemynextPSAtest.Ichangedmyeatinghabitsandeatallgreens,whitemeat,nosugar,
nosweets,(cheatalittle)noalcoholorsmoke,exercisedailyandmyPSAwentaslowas
1.0ThedoctorsaysthatreallydoesnotmatterandIstillhavecancer,howeverhefeelsif
itstartsseeingactivityinthePSAupwardandthebiopsy(every12‐18months)shows
morecoresorGleason7thanIamhavingthesurgery.
ThePSAtesthaschangedmylife!Nottothebetterinthiscase.Iwouldratherhave
notknownandjustlivedlife.Ontheotherhandmaybeitwillsavemylife,howeverthe
effectsofthesurgeryarenotpleasant.TheolderIgetIcantaketheeffectsandtheyare
morepercentagewisetohappen.Theyoungeryouarethebetteryouwillbounceback.I
amtoldfromonedoctorwhowasveryhonestwithmeisthatincontinencewillgoaway
withinayear95%ofthetimeinmyagegroup60‐70.Impotencyoddsarenotsogoodand
thatthe%ofimpotencyinmyagegroupis35%evenwithtakingViagra.
Esteban
ThePSAtesthassavemylife.ItwasaPSAtestresultof35andthebiopsythat
foundstage3cancerinmyprostate.Myprostatewasthenormalsizeforamanmyage,
55yrs.oldatthetime,butthebiopsyshowedcancer.MyDoctorexplainedallthe
treatmentsandtheirprosandcons.Ielectedto“removethedamnthing.”
WellthankstotheDaVinciRoboticprocedure(Ihighlyrecommendit)Iamstillhere.
Theyfoundtheprostatewas75%cancerous;ithadspreadtomylymphnodes,
seminalvesicles,someofthenervesintheareaandaspotonmycolon.Allremoved.YesI
cannothaveanerectionandamabitincontinent,butitisasmallpricetopayforbeing
alivetobewithmywifeandplaywithmygrandchildren.
Anonymous
In2002Iwasdiagnosedwithprostatecancerandwastreatedwithimplantationof
radioactiveseeds.Sofarsogood.Every3to6monthsIamcheckingmyPSA,theonly
evidenceatthistimethatIamstilloffthehook.Untilitwillbeanewtestwhichcould
provethesameasPSAtest,forthepeaceofmineofpeopleasIam,thePSAtesthastobe
legalandpayablebyinsurance.
Roger
AsuddenriseinmyPSAalertedmydoctortosuggestabiopsy.Thebiopsy
indicatedthatindeedIdidhaveprostatecancer.Ithenchoseroboticsurgery,whichIfeel
ultimatelysavedmylife.ThepathologyreportaftermysurgeryindicatedthatinfactIhad
afastgrowingformofprostatecancer.Thistookplaceoverfouryearsago.My
surgeon/urologisthasmesubmitPSAresultseverysixmonthstomakesurethatthereis
norecurrence.IthinkmyfamilyphysiciansavedmylifebyrequestingPSAresults.The
digitalexamdidnotgiveanyindicationthattherewasaproblem.
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Patrick
IhadaroutinePSAtesteveryyearstartingatage60,itstayedat4.0untilage65
whenitjumpedto5.0.MydigitalexamshowednothingandIhadnoothersymptoms.I
optedforabiopsyandwefoundGleason7cancer.Iwastreatedwithradiationandseeds
andhavebeencancerfree(PSAat.2)eversince.Ihavehadminimalsideeffects.
BottomlineregularPSAtestingsavedmylife!!!
Brian
PSAtestingledtomydiagnosisofanaggressiveGleason8cancerin2005thathad
spreadbeyondtheprostatebed.ThePSAratingof4.34wasbarelyabovethe4.0
thresholdusedbymostfamilydoctorstodiagnoseapotentialproblem,butwasenoughto
refermetoaurologistforabiopsy.Subsequentradiationandhormonetherapyledtoa
goodoutcome.SinceIhadnosymptomsotherthanahighPSAnumber,thattest
absolutelysavedmylife.
Anonymous
MyhusbandwentinforhisyearlyexamandhadaPSAtest.Thatwas2yearsago.
HisPSAcamebackextremelyhigh.Hehadabiopsywhichcamebackcancerous.Thebone
testanditshowedthecancerhadalreadyspreadtothebone.Hewasimmediatelyputon
atreatmentplanand“sofarsogood.”IfnotforthePSAtestfinding,Ihavenodoubthe
wouldnotbealivetoday.
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Glen
MyfatherhadprostatecancerasdidI.ThePSAtestsfollowedbyabiopsylast
DecemberconfirmedmycancerwithaGleasonscoreof4+3=7!Atahealthy73yearsof
ageandseveralancestorswholivedintotheirlate80sandmid‐90s,mycancerneeded
treatmentlestIdieyoung!WithoutmyPSAtests,Iprobablywouldhavebeengonein5to
10years.NowIhave25years+/‐tolookforwardto.Ifinishedmyprotontherapyat
LLUMCwithnosideeffectsonJuly1,2011.ThePSAtestwillmonitormyfuture.
Thomas
IhaveprostatecancerwhichwasdiscoveredwithaPSAtest.Thepathologyreport
aftersurgeryindicatedthatmycancerwasmoreaggressivethanthebiopsy(postPSA
test)hadindicated.IfnotforthePSAtestIwouldnothavehadanytreatmentandIexpect
thatmylifewouldhavebeensignificantlyshortened.
Paul
ThePSAtestwasresponsibleforearlydetectionofhighgradecancerin2000
which,asaurologicaloncologistmyself,Iamcertainwouldhavebeenlesssuccessfully
treatedifallowedtopresentclinically,withsymptomsthatanadvancedstageprostate
cancerpatientwouldhave.
David
At41yearsoldIwenttomyDr.forbloodworktocheckmycholesterol.Without
evenaskingme,hecheckedPSAanditcamebackatan11.IhadatumorwithaGleason
scoreof9/10.Itis21/2yearslaterandifhedidn’tchecktheboxforPSAthereisavery
goodchanceIwouldnotbehererightnow.
Itisincomprehensibletomewhytheymightputlimitationsonthistest.How
wouldIhaveknownthatIhadadvanceprostatecancerat41yearsold?Icertainlyvalue
mylifeandsodomytwoboyswhoarenow9and10yearsold.
Anonymous
PSAtestingandfamilyhistorywerethetwofactorsthatenabledmetobe
diagnosedearly,treatedandcuredofprostatecancerattheyoungageof49.The
combinationofthosetwofactorsallowedmetowatchmyprogressovera7yr.periodofa
PSAbaselineof1.0thatjumpedto1.6andthen2.3ina3monthtimeframe.Theensuing
biopsyconfirmedmydiagnosisofprostatecancer.Iwasotherwisesymptom‐less.
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Terry
PSAtestinghaskeptmealive–literally!Atage51IswitchedPrimaryCare
Physicians,andmynewdocorderedaPSAduringmyopeningphysicalwithhim–itcame
back4.5–slightlyraised.Yes,thiscancomefromanumberofissues–notonlyProstate
Cancer…sowebegana3monthwait–andthenranthePSAagain…a5.3.Ok–itwentup–
why?Gotoseeaurologist,whodoesultrasoundanalysisofmybladderandtheProstate
area…startamonthofCiprotoseeifitmightbeinflammationoftheProstateoranother
BPHrelatedproblem.
RedrewthePSAaweekfollowingtheendiftheCipro,andit’snowa6.9…NOWit
wastimeforabiopsy…thePSAwasadiagnostictoolusedtodeterminethiscourseof
treatment.
Asitturnedout,mybiopsywaspositiveforCancer–andalthoughinAugustbone
scanandMRIshoweditcontainedwithinthecapsule,bythetimeIhadanopenradical
prostatectomyinthefirstweekofOctober,ithadescapedthecapsule,starteduptheneck
ofthebladder,wasinthemusclewallsurroundingtheProstate,andhadinvadedthe
seminalvesiclesand2lymphnodes…mybiopsyGleasonscoreswerea6,four7?sandan
8,butfollowingpost‐oppathology,itwasdeterminedthatIactuallyhadaGleason9
cancer–thescalegoesfrom1‐10,with10beingmostaggressive,somine’sreallybad!I
wentfromnothinginFebtofull‐oncancerin6months.
Isthisslowgrowing?Absolutelynot!IfIhadnotbeentestedwhenIwas,Itruly
believeIwouldbeneardeathnow–IhadNOsymptomsofanysort–andsincediagnosis,
I’vemetmanypeoplewithGleasonscoresof7orhigher.Whereonearthdothese
“experts”gettheirdata?YesIknowpeoplewithverylowPSAnumbers,butthisshows
theydon’tneedtogoanyfurther.
Gunther
In1998,anundertheradar3.56PSAleadtothediagnosisofastageIVcancerthathad
invadedtheseminalvesiclesandbladderneck.Now,Imonitorrecurrentcancerwiththe
PSA.IamthankfulIhavethetool.
Marvin
ThePSAisonlyonetoolandthelessaggressivetoolthatwehavetoday.
IdonotrememberwhenIstartedhavingPSAasapartofmybloodwork,butin2005it
becamehighenoughthatIhadbiopsydone.Thatisveryaggressivetome.Itcameback
positive.SowithoutPSAandDRAIwouldnotknowifIhadprostatecancer.
Isit100%–no.
Itisonlyonetool.
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Ed
MyfatherdiedofPCaatage72.IhavebeengettingPSAtestssinceearly50's.In
2006PSAshowedasignificantincreaseandabiopsyshowedPCainsmallamount.Iopted
foractivesurveillanceandhavebeenonthatsince.IgetPSAevery3mos.andabiopsy
annually.IandmyurologistusethePSAasaguide.Ithasremainedrelativelystableandif
itshowssignificantincreaseweagreetoanotherbiopsy.
PSAhasbeengoodforme,butIunderstanditandonlyuseitasaguide.Without
thePSAIwouldhavenoguide.Iam70nowandhavebeenonASforfiveyears,butgrow
increasinglyconcernedasIapproachtheagemyfatherwaswhenhedied.Iwantto
continuetousethePSAasaguideunlesssomethingbettercomesout.Iaminexcellent
healthandhopetostaythatway.
Al
Iwasinmy60’sandwasbeinggivenaDREatthetimeofaneachannualphysical.
WhenImentionedthatmyfatherhadprostatecancer,IwasthereaftergivenaPSAtestat
eachphysical.Iknewonlythatmyfatherhashisprostateremovedandjustassumedit
wasduetocancer.Atage66myDREwasnegativeforcancerbutmyPSAhasrisen
considerably.AsaprecautionIwasreferredtoaurologist.AsonogramandDREappeared
tobenegativebutabiopsywasdone–resultspositive.Asecondbiopsywasdonetoseeif
thecancerhadspread–resultspositive.Anoperationforlymphnoderemovalwas
carriedouttoseeifIwastreatable–withresultsfinallynegative.Afterbriefhormone
therapyandradiationtreatmentanaggressiveformofprostatecancerhasbeen
eliminated.Inowhavebeencancerfreefor10yearsandenjoygoodhealth.
IfIhadnothadanannualPSAtestdone,IfirmlybelieveIwouldbedeadand
unabletomakethisresponse.
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George
Ican’timaginenotbeingabletohaveannualPSAtests!Althoughtheyhavealways
beennegative,thepeaceofmindtheybringispriceless.It’sonelesscancerthreatto
worryaboutwhentherearesomanycancersthatcannotbedetecteduntilit’stoolate!At
myage,impotence&evenincontinence,isasmallpricetopayvs.thealternative.I’mtold
allmeneventuallygetprostatecancer,butit’sstillimportantthatwepreventitaslongas
possible.
Maybe,ifmenhadmorenationalawareness&recognition(suchasa“prostate
cancermonth”or“marchesonprostatecancer”asaredoneallthetimeforwomen),we
mightsomedayhaveaslongalifeexpectancyaswomen?
Robert
Myprostatecancerwasdetectedatanearlystage.Givenmyrelativelyyoungage,
surgerywasrecommendedanddone.Becauseofthistest,Inowhavealongerlife
expectancy.
Steven
IfIhadnothadmyPSAtestdone,Iwouldnothavefoundmyprostatecanceruntil
itwastoolate.Itincreasedby.6in1monthandwasconsideredprettyaggressive.Yes,my
daddiedofothercausesat82andhadprostatecancer.Buthiswasslowgrowing.
Howisonetoknow?Rollthedice?Ithinknot.Womenaren’tbeingaskedtoforegotheir
mammograms(theywereaskedtoacoupleyearsago)andwhyshouldmenforegotheir
PSA’s…allinthehopethattheydon’thavecancer.Iwas59whenminewasfound.With
mylifeexpectancyof80orso,wouldIhavelivedthatlong?
Inmycase,itwasn’tlikely.WhyshouldIoranyonehavetotakeachancewiththeir
lifelikeisbeingmandated.Mustwemenfaceaterribledeathforthesakeoftesting?
TherearemanyoptionstofollowupanelevatedPSAtest.Ihadbiopsiesthatconfirmed
mydiagnosis.Ifithadn’tbeendetected,theoutcomewouldhavebeenmuchworsethan
theEDI’vesuffered.
Don
IamalivetodayduetoaPSAtestdoneduringaregularphysical.Itcaughtmyvery
aggressivecancerinitsearlystagebeforeithadescapedfromtheprostate.IfIhadgone
muchlongerwithoutitbeingdetected,thecancerwouldhavebeenoutinmybody.
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Ben
Istartedscreeningforprostatecancerbecausemyfatherhaddiedofit.Ihadno
symptomsrightupuntilIwasdiagnosedwithStage4prostatecancer.IfIhadnotbeen
screenedIwouldprobablynotbewritingthistoday.
Gerry
MyPSAbeganescalating9yearsagowhenIwas68yearsold.Arectalexamnoted
anoduleandabiopsyfoundcancer.Gleasonscoreof8Twospecialistdeterminedthatthe
cancerhadnotlefttheprostategland.Ichoosetriplehormoneblockadetreatmentwhich
workedwellbutin2007thecancerappearedtobeactivesoIhadradiation.Tothispoint
myPSAhasremained0.01.
Mybiggestproblemisverylowtestosterone.Icouldnotagreewithmypresent
doctorthatshotsandthenpermanentimplantswouldbethebestsoIamseeinganew
doctornextweek.IbelieveifundetectedbyPSA,thecancerwouldhavespreadandI
wouldnotbewritingthisnote.
George
ItwasthechangeinmyPSAvaluethatrevealedthatIhadearlystagePC.Ihad
roboticsurgeryandhaveneverlookedback.Fullfunction,noincontinenceandthebest
partwasthatIgotridofsomethingthatnevergotalongwithmemostofmyadultlife.
Anonymous
I’maquadriplegic.Anormalphysicalprostrateexamcancausemetohave
AutonomicDysreflexiawhichinturncausesextremelyhighbloodpressurethatcancause
strokeorcardiacinfarction.PSAistheonlyalternativetomeotherthataphysicalexam
undergeneralanesthesia.
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Anonymous
AfteraPSAscoreof4.9myDoctorrecommendedaBiopsyatage67,theBiopsy
turnedoutnegativetomyreliefandnofurtheractionatthistime.Atmyfirstcolonoscopy
atage50IlearnedIhadanenlargedprostateandlaterlearnedthathavinganenlarged
prostatewillgiveyouahigherPSAreadingsojustbecauseyouhaveahighreadingit
doesn’tmeanyouhavecancer.
Mary
InAprilof2005,myhusbandwenttohisdoctorforageneralcheckup.Hehad
checkupsyearly.Whenthebloodworkcameback,hisPSAwasan8.Hisdoctorsuggested
afollowupwithaurologist.Twomonthslater,aftermany,manytests,theurologist
utteredthesewords,“well,it’sprostatecancerandit’sbad.”Thosewordsareforever
etchedinmymemory.
HewasdiagnosedwithStage4prostatecancerthatday.Billstartedtreatments
withLupronandrespondedbeautifully.Hefeltbetter,PSA’scamebackbetter.
Thenafterabouttwoandahalfyearsthenumbersstartedcreepingupagain.Thenext
treatmentforhimwasTaxotere.Again,herespondedwell–forawhile.Afterashorttime
inaclinicaltrialandvariousattemptsatdifferentchemo’s,mydearsweethusbandwho
wastheloveofmylifediedalmostfouryearsafterbeingdiagnosed.
IfitwerenotforthePSA,hewouldhavehadnoideahehadprostatecancer.I
cannotimaginewhyanyonewouldthinkofdoingawaywiththePSA’sbecausetheyare
not100%.Irememberhearingatonetimethatmammogramswerenot100%,yetnoone
thoughtaboutdoingawaywiththem.Why?Becausethatwastheonlythingwehad.
IfeelthesamewayaboutthePSA’s.Myhusbandhadnoriskfactors,nofamily
historyofthisdisease,yetheisdeadfromit.IhavetoldmysontoinsistuponPSAtesting
bythetimehe’s35,evenifhehastopayforithimself.Myhusbandwas49whenhewas
diagnosedand53whenhedied.Waytooyoungtodiefroman“oldman’sdisease”.Thank
youfortheopportunitytotellmystory.
Anonymous
Sincemyfatherandolderbrotherhavehadprostatecancer;Iamkeenlyawareofa
yearlytestingforprostatecancer.Idothisyearly!IfthisisnolongeravailableIamata
substantialriskoncomingdownwiththisdisease.
Anonymous
I’maprostatecancersurvivor.I’dhaveverylikelybeendeadwithoutthistest.My
diagnosisofprostatecancerallbeginwithaPSAtestthatwastoohigh.Insteadofcutting
backongivingthistesttomen,itshouldbemademoreavailabletolowincomemenwith
governmentsubsidies
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Anonymous
Ihadseedimplantssome5yearsago.MyPSAwentfrom4.9tomypresentday
levelof.005;therefore,I’mbeingdischargedthismonth.HealthwiseIfeelfine;however,
itnowisdifficultformetomaintainanerection.Doingnothingwouldhavebotheredme.
I’mgladIhadtheprocedure!!
George
IhadbeengettingannualPCscreeningswhenmyPSAstartedrising.Whenit
reached4.7IoptedforabiopsyandwasdiagnosedwithPC.AfterlengthyresearchIopted
forsurgeryandamgladIdid.Imeetmonthlyinaprostatecancersupportgroupwithmen
whohavebeendiagnosed,goingthroughtreatment,posttreatmentorinrecurrenceand
theyalsoaregladtheymadetheirdecisions.IrecommendmengetthePSAannually.
Mark
Iturned40yearsoldandfelthealthierthanIhadeverfeltinmyentirelife.My
workplacesponsoredahealthfairandofferedmultiplebloodscreeningsatadiscounted
price.Idecidedtohavetheentirebloodpanelrun,andthePSAwasoneofthosetests.
AllofmybloodworkshowedthatIwashealthy,butmyPSAscreenwashigher
thanwhattheyconsidereda“normal”range.Thenursewhoshowedmemyresultsatthe
healthfairsuggestedthatIshouldseemydoctortofurtherevaluatewhythePSAwas
elevated.
antibioticshopingitwasaninfectioncausingtheelevatedscore.Irana2ndPSA
aftertheantibioticsandthePSAwasactuallyhigherinsteadoflower….Ithenaskedforan
f‐PSAtohelpnarrowdownifthecauseofmyelevatedlevelwasactuallycancer…Thef‐
PSAwasactuallylow,andIknewthenthatImostlikelyhadProstateCancer.Iwas
referredtoaurologist,andtheDREwasactuallynormal.Therewasonlyonewayatthat
pointtoknowifIhadcancerwhichisabiopsy.Thebiopsyconfirmedthatmyrightsideof
myprostatewasengulfedwithcancer.Ihadnosigns,nosymptoms,andIwashealthy!!!!!
ThePSAthatwasrunsimplybecauseitwasofferedatmyworkplacehasnodoubt
addedyearstomylife!!!!!!
HowintheworldcouldanyonearguewithmethatthePSAscreenisn’tneeded?
Mystoryisonethatshouldscreamfromthemountaintopsthatourdoctorsshouldutilize
thePSAfaithfully,often,andpromoteitforallmenstartingatage40.Ifmenhaveafamily
historyofcancer(especiallyifamanhasfemalerelativeswithbreastcancerandmen
withprostatecancer)IbelieveaninitialPSAscreenshouldbedoneatage35.IthankGod
andmynurseforthePSAscreen!
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Bob
BecauseofaPSAtestshowingaratherhighreading,Iwentaheadandhada
prostatebiopsy.ThatbiopsydidindicatethatIhadprostatecancer.Afteralotofresearch
ofthevarioustreatments,Iselectedthebrachytherapyprocedureandhadtheradioactive
seedsinsertedjustseventeenmonthsago.Sofar,myPSAhasbeendownquitelowbutifI
amnotabletogetfurtherPSAtests,howwillIknowifthecancerhasremaineddormant
orifithasstartedgrowingagain??
Robert
ThePSAtesthelpedtouncovermycancerandwasjustbelow5atthetimeofmy
surgery.AftersurgerymyPSAwentdownto.02andIhavecontinuedtogettestedevery
3months.MyPSAhasrisenveryslowlysincethenandasthenumbersrosegraduallythe
pacequickened.ThishascausedalotofstressbutthenIlearnedthat1/3ofmen
experience“biologicalfailure”aftertreatment,meaningthatthePSAriseswithoutany
actualevidenceofcancer.ItisnowovertenyearssincemysurgeryandmyPSAis1.91
buthasbeenabitmorestableinthelastyearorso.Doctorsdon’ttellyouthatyourPSA
mayriseandyetnotindicatecancerandthiscontributesgreatlytothestress.
Kent
PSAstartedgoingupoverafewyearsoftesting.Whenitgotto7,mydoctor
startedcheckingforcancerbytakingprostatesamples.Thesecondtimearound,hefound
cancer.Theindexcheckneverindicatedanyproblem.ThePSAwas,inmycase,thebest
waytoalertustoaproblem.MysuggestionistostartPSAearlierenoughtohavea
measuresticktouse.Cancerwasremovedusingradiationtreatmentsandalsoinserting
pellets.
Daryl
BecauseofPSATestingIwasabletofollowmyrisingPSAuntilitspikedupto6.9in2011.
Iwas58yearsoldatthetime.MybiopsyfoundaGleasonscoreof7(3+4)with40%ofthe
sampleGleasonGrade4.ThisisnotbenignProstateCancerthat“youdiewith”Itisthe
kindthatcankillyouifnotcaughtintime.IfithadnotbeenforroutinePSAtestingI
mightnotbeheretoday.Ihaveknownafewmenthatwerenottesteduntilitwastoolate,
andIwouldprefertodiefromsomethingelse.
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Don
Attheageof58IhadneverhadaPSAtest.Atthetimetherewasalreadymuch
discussionabouttheneedforandthevalidityofsuchatestforanotherwise“healthy
male”.IhadnosymptomsofPCaandwasattheurologistforafollowuponafirstever
kidneystonediagnosis.HesuggestedaPSAtestandI,reluctantly,agreed.Camebackwith
a21andsubsequentbiopsyrevealedcanceroustissuein12of12sampleswithaGleason
gradeof7.ScansindicatedpotentialinvolvementofiliaclymphnodesandDREpositive.
IhavesincehadradiationandHTasprimarytreatmentthatfailed.Iamonmysecond
roundofHT.QOLisOKbutnosexualfunctionandhavedevelopedpre‐diabetesasaresult
ofhormonenottomentionincreasedpotentialforcoloncancerandheartdisease
resultingfromRTandHT.
Notcurableatthistimeandnewer“vaccines”areoutrageouslyexpensiveforlittle
ornobenefit.Mostlikelyhavenotextendedmylifeexpectancybasedonmyownresearch
buthaveimpactedmyQOL.
PerhapsmystorywouldbedifferentifIhadtestedatage50asrecommended.By
thewayIhavenoinsuranceandhavepaidforallofmytreatmentoutofpocket.
James
I’vebeengettingPSAtestsforyears.Irealizeitisn’tthemostaccuratepredictorof
PCa,butit’scertainlybetterthannothing.Ialsorealizethattherearefactorsbesides
possibletumorsthatcanskewthetest.Andtheyneedtobetakenintoconsiderationand
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addressed.MyPSAwentupayearagoanditturnedouttobeaurinaryinfectionthatwas
treatedwithCipro.Aftera30daycourseofCipro,myPSAwasonceagain“normal”fora
71yearsofage.
Mymainconcernisthatinsurancecompaniesgladlytakeourmoneyintheformof
premiums.Buttheydotheirutmosttokeepfrompayingoutaftersaidpremiumsare
banked.
Anonymous
ItwasthroughPSAtestingthatmyprostatecancerwasfirstdiscovered.Thehigh
numbersledmyurologisttootherspecificteststodeterminetherealpresenceofthe
cancer(biopsy).Withoutthefirst“flag”fromthePSAtest,Iwouldn’thavebeentreated
(hormonetherapy‐seedimplant‐radiation)andbelivingcancer‐freetoday.
Jeanette
At41yearsofage,withnopreviousfamilyhistoryorsymptoms,myhusbandwas
diagnosedwithprostatecancerthankstothePSAtest.Surgeryrevealedhisprostategland
was80%cancerous.WithoutthePSA,there’snowayhewouldhavejustcelebratedhis
60thbirthday.Iunderstandtherearerisks,costsandmanyunknowns,butprudentPSA
testingshouldcontinuetobeavailable.Youneverknowwhoselifemaybesavedbyit.
Jim
IhadaPSAreadingofaround4formanyyears.Thenafternotgettingtestedfora
coupleyearsthenexttestshoweditwasabitover6.MyPCPthoughtthatmightbe
indicatingsomething,eventhoughnothingshowedontheDRE(digitalrectalexam).Sohe
sentmetoaurologist.AnotherDREshowednothingbutnowthePSAwashitting8.Soa
biopsywasdone,whichshowedcancerin3of8cores.
IfPSAwasnotroutinelydoneIwouldneverhaveknownaboutthiscancertill
somethingshowedonaDRE,whichlikelywouldhavebeenwhenthePSAwasupover
100andpossiblynotuntilthecancerwasuntreatable.
ThedeclineinProstateCancerdeathssincetheimplementationofPSAtestingis
SOclearIcan’tbelieveanyrationalpersonororganizationwouldsuggestthatweno
longerroutinelytestforPSA.TwoofmyfriendshavealsofoundearlyPCfromPSAtesting.
Oneoftheirfathersdiedfromprostatecancer–yeshewasold,buthedidnot“diewith
it”,hediedbecauseofit.
Anotherfriendofminesfatherdiedmanyyearsagoof“backcancer”.Itwaswhat
wewouldnotrecognizeasatypicalmetastasisforPCtotheback.Hediedbeforehewas
60yearsold.
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Barry
AlthoughthePSAtestisnotanexactindicationofcancer,itisatleastaguide
towardsmakingadecisionastoidentifypotentialproblems.Forthoseofuswhoalready
havecanceritisanindicatorofimprovementorthedeceasegettingworse.
Charles
PSAtestingisperfectlyOKifdoctorswouldlearnhowtousetheinfo.Mydoctors
werealwaysreadytodosurgeryorradiation.Ichoseadifferentpath.
Ibeganatreatmentprotocolofmyowndesignafterlotsofresearch.Iused
BromocryptineandProscar.Thisisnotarecommendationforanyoneelsetotrythis
unlesstheyfullyunderstandhowtousethesedrugs.Ifindmostdoctorsdonot.Tenyears
laterIfounditnecessarytoproceedwithcurativetreatment.
OncetreatmenthasbeendonePSAistheonlywaytotrackonesstatus.ThusPSA
mustbecoveredatthattime.
PSAisnotanindicatorofcancerandthereinlaystheproblem.Doctorsand
patientsalikewanttotiePSAdirectlytoProstatecancer.Bettereducationofpatientsand
doctorsalikewillgoalongwaytoimprovetreatment.
Paul
ThePSAtestabsolutelyidentifiedtherewasaproblemthatledtobiopsythat
identifiedaGleason9cancerthatledtoradiationthatledtotriplehormonesthatledto
Cryothatledtolighthormonesthathascontributedtomybeinghereafter12years.In
thebeginningandallthestepsinbetweenthePSAwastheguide.
Ifwehadatestthatwouldidentifyalowgradecancerthenpropersurveillance
wouldbeappropriatehoweverIamunawareofanysuchtest.Thenewrecommendation
suggestsitisthetestthatisatfaultforovertreatmenthoweveritiswhatisdonewiththe
resultsofthetestthatmaybeinerror.
Iwillcontinuetorecommendtheroutinetomychildrenandgrandchildren.
Richard
Itgivesmepieceofmind;mydaddiedapainful&awfuldeathfromprostate
cancer!!!!Mygrandfatherhadit’aswellasmydad’sbrother,&it’sonmymother’sside
too!!!!Itisoneofthevaluabletoolsindiagnosingit,&earlydetectionsavelives&money,
whichinsurancecompaniesdon’tliketopayoutmoretheyabsolutelyhaveto!!!!
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Joseph
CheckingmyPSAiswhatledtomycancerdetectionin2004.MyPSAstartedrising
in2007indicatedareturnofthedisease.Whatothermethodcouldtheyhaveusedto
detecttheoriginalcancerandlaterthereturn?NONE.It’stheonlymethodmyoncologist
hastowatchthecancerdoublingtime
John
IhadaPSAtestduringaroutinephysicalthatshowedelevatedPSAnumbers.This
leadtoabiopsyoftheprostate.Thebiopsyshowedcancerintheprostate.IhadRobotic
surgerytoremoveprostate.Uponremoval,mydoctordiscoveredthroughtestofthe
prostate,thatthecancerwentuptotheborder.HadInothadthePSAtest,mycancer
wouldnothavebeencaughtandcouldhaveescapedtheprostate.PSAtestisallwehave
fornowanduntilwehavesomethingbettertoreplaceitwithweshouldcontinuewith
whatwehave.Findareplacementnotaeliminationplease.
Philip
Ihadaradicalabout3years,ago.MydoctorwasalertedbyanacceleratingPSAto
schedulemorefrequentappointmentsforDREsandPSAs.Anindurationinmyprostate
wasfoundearlierthanotherwiseifPSAshadnotbeendone.
Paul
BecauseIhadaPSAover15yearsago,andthenhadseedtreatment,mylifewas
saved.Iamwelltoday,activeandvolunteeringinthePCsupportarea.Iamstrong
advocateofPSAforallmen.Theresultsshouldthenbeusedtomakeaneducated
judgmentastowhattreatmentshouldbeundertakenorwatchfulwaiting.
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Anonymous
Iwas59years‐oldwhenIwasdiagnosedwithprostatecancer.Ilearnedthatmy
PSAwas5.0andmyGleasonwas3+2or5.Ididnotknowanythingaboutprostatecancer
thenandmywifeandIwereveryscared.Therewereveryfewoptionsinthosedaysfor
primarytreatmentandI(andmywife)optedtohavearadical(“nerve‐sparing”)
prostatectomy.Laparoscopyandroboticswerenotavailablethen.Inallofthoseyearsmy
PSAhasbeen0.0to0.05andIknowIwillnotdieofprostatecancer.
Ihavebeenoneoftheleadersinourlocalprostatecancersupportgroupforyears
andaboardmemberofthestatewideprostatecancercoalitioninourstate.IfeelthatI
haveagoodtoexcellentknowledgeofthediseasethesedays.Mysurgeryleftmeimpotent
andwithurinaryproblems(difficultyinemptyingmybladder).
IfIhadittoagainknowingwhatIknownow,Iwouldhaveoptedforactive
surveillanceevenwiththeavailabilitytodayofbrachytherapy,cryotherapyandrobotics.
IbelievethatallmenshouldhavetherighttohaveannualPSA’scoveredby
insuranceiftheyfeelthatitwouldbebestforthem.Ourcoalitionistryingtoeducatethe
publicinthestatewithenoughinformationtoallowforintelligentdecision‐makingfor
non‐medicalpeople.
Anonymous
ThoughIamalive,thankfully,becauseoftreatment,IamnothappythatIwaslied
tobymydoctors.Thesideeffectsofimpotenceandincontinencewereminimizedatbest
bythesurgeonandotherphysicians.Surgerywaspromotedasthe“goldstandard”of
treatmentoptions.Notsogoldenbymystandards;morelikeoneofthebasermetals.At
theageof53,Iwasnotpreparedtogiveupmysexualfunctionortodealwithurinary
incontinence.
AsforthePSA,myPSAscorewas1.0,verylowandnothighenoughtoalertanyone
thattheremightbeaproblem.Itwasonlythroughdigitalrectalexamandbiopsyfollow
upthattheGleasonscore7cancerwasdetected.
Dale
Seemslikehavingabloodtestisawisething.ItwasformebecausemyPSAwas
increasingfrom4to30over10years.Abiopsyrevealedcancerat74.Iwastreatedwith
drugsandradiationanditdidnotaffectmysexlife.IfIwouldhavesurgeryasadvisedby
somedoctors,sideeffectscouldhavebeensevere.Justbecausesomemenarepanicked
intodrasticmeasures,itdoesn’tmakesensetoeliminatewhatmightbealifesavingtest
forothers.
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Judy
Myhusband’sprostatecancerwasdetected14yearsagoatage45.Yes,45!!Yes,
white,healthyyoungmantotallya‐symptomatic.Butbecausehisdoctor’sbrotherhad
prostatecancer,thedoctorbelievesinbeginningPSAtestingat45ratherthanwaiting
until50.Yes,thelastingeffectsoftreatmentshavebeenlessthanwonderful,butheis
alive!!Andnewtreatmentsforprostatecanceraresurfacingmorefrequentlytogiveus
moretimetogether.
KeepPSAtesting,butchangethewayphysicians,especiallyurologists,rushinto
treatmentsbeforeallthepossibleavenuesareexplored.
James
Iamadoctorandmilitaryofficerwhodiscoveredandsuccessfullytreatedfor
prostatecancerbecauseofthePSA.Ihaveafamilyhistoryofprostatecancerandwas
gettingserialtests.Afteraperiodofanincreaseinscoreorvelocity,eventhoughmyvalue
wasstillnormalat3.1,Igotaprostatebiopsy.Thebiopsywaspositiveforcanceratjust
46.IwascommendedbythechairmanofUrologyatamajorhospitalforimpeccable
monitoringandintervention.Iwastheidealcandidateforasurgicalintervention.My
outcomewasperfect.Cancerwithintheorgan/gland.Fullrecoverywitherectileand
urinaryfunction.WithoutthePSA,mystorycouldhavebeenverydifferent.
Anonymous
PSAtestinghasbeenpartofmyannualphysicalexamformanyyears.In2010,
whenIwas69andinexcellenthealth,itshowedanunexplainedincreasefromlevel2,
whereithadbeenconsistently,tolevel4.Thisresultedinareferraltoaurologistwho,
aftertakingmyhistoryandinputtingitinhiscomputer,opinedthattherewasonlya35%
chanceofthereasonbeingcancer.Hepresentedtheoptionsofwatchfulwaitingaswellas
furthertests.Ioptedforaprostatebiopsywhichdisclosedthepresenceofcancerinwhat
wasthoughttobeabout3%oftheglandandGleason7(3+4).
Afterextensiveresearch,Ielectedsurgicalremovalthreemonthslater.Post‐
operativeexaminationofthesurroundingtissueshowednoevidenceofspread.Pathology
confirmedGleason7butrevealedtheaffectedareatobe10%ofthegland.
WhileIwillbemonitoredforthreeyears,Iammostlikelyclearofthecancernow.I
attributethisapparentgoodfortunetoearlydetectionandpromptaction.WithoutPSA
testing,thiswouldnothaveoccurred,astherewerenosymptomsindicatingthepossible
presenceofcancer.Itisunknownforhowlongthecancerhadbeenpresentorhow
rapidlyitwasgrowing,butwithoutsurgicalinterventionitsurelywouldhavecontinued
togrowandeventuallyspreadbeyondthegland.
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Anonymous
IbelievethatPSAtestingandearlydetectionsavedmyhusband’slifeandIam
countingonittodothesameformyson,sinceamanwithadirectrelativewithprostate
cancerisatsignificantlyincreasedriskfordevelopingithimself.Untilwehaveabetter
test,itisimportantthatdoctorscontinuetorecommendthatallmenhaveaPSAtestand
thatinsurancecompaniescontinuetopayforit.
Yes,therearesideeffectsfromthetreatment,butIknowthatmyhusbandand
mostothermenwillinglydealwiththeminexchangefortheopportunitytohave
additionalyearsoflifeandthejoythattheyderivefromsharingthesemuch‐appreciated
yearswiththeonestheylove.Allofusknowsomeonewhohasbeentouchedbycancer.
Althoughthereisstillmuchworktobedone,Iamthankfuleverydayfortheenormous
stridesthathavebeenmadeincombattingthisrelentlessdisease.Ibelievethatitis
unconscionabletodenyanyindividualthebestpossiblechancetosurviveandthatstill
remainsearlydetection.
Doris
MyhusbandwasinaPSAtestingprogramandwasdiagnosedwithPCin1992.He
hadaprostatectomyandsincethattime,hehasbeenonandoffthehormonetreatment
whichhaskepthisPCundercontrol.HehasbeendealingwithPCfor19yearsandisnow
89yearsold.WithoutthatPSAscreeningprogramIfeelmyhusbandwouldnothave
knownhehadPC,andwouldundoubtedlyhavediedyearsago.
John
MyprostatecancerwasonlydetectedbyuseofthePSA.Digitalexamandallother
symptomswerenegative..TothinkI’mincapableofgettingatestresult,evaluatingthe
alternatives,andmakingmyowndecisionforactionisincredible.Idonotwantanyoneto
preventmyson’s(andIhavethree)fromgettingthetestingtheyneedtomaketheirown
informeddecision.Thisislifechangingdecisionandshouldbemademyeachindividual
withthebestinformationavailable.
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Rick
Withoutscreening,wewilllosemorethanthe33,000menpredictedtodieforthis
year;withoutaPSAtest,Icouldhavebeenoneofthem.
Tracy
Mydadwasdiagnosedwithprostatecancerwhenhewas55yearsold.Thiswas
discoveredbyafreePSAscreeninghealthfair.Hehadsurgery.Fastforwardtoage66his
PSAwaselevatedthenstartedtreatment,alotofchemoandradiation,hediedattheage
of68.WearethankfulforthePSAtest.Iambotheredthatthereisnotmoreofapushin
prostatecancerresearch.IamthankfulforSusanKomenbutit’stimetoraisemillionsfor
themeninourlives.
Michael
Iama57yr.oldmanwhosePSAreadings,alongwithanabnormalDRA,afterbeing
watchedforawhile,hadabiopsywhichdidconfirmProstateCancer.Ichoseexternal
radiationin2009,andmyprostatelevelsandDRAaregood.Ifeelthatthistool,tempered
withgoodreasoningandguidance,isofvalueandshouldnotbediscarded.
Anonymous
ThesolutionisnottostoptheimperfectPSAtesting…itistoeducatephysicians
howto1)interprettheresults2)followup/ornotdiagnosticallyinaninformedand
intelligentmannerand3)respondinalike–andethical–manner.
Thetestisnotonlyintrinsicallywanting;itisappliedinadiversept.population
andinthecaseofconfirmedCaP,toatumorandmicroenvironmentofexceptional
heterogeneityanddynamicadaptability.
Still,itseemshighlyinadvisabletonotuseatoolthatsaveslivesinthehandsof
intelligent,wellinformedphysicians.
TheopinionofaStage4patient.
Ben
Myfatherwaiteduntilhehadsymptomsbeforehesawadoctor.Hewasdiagnosed
withPCainJanuaryanddiedahorrible,degradingdeathinJulyatage71.
Waitingforsymptomscanbesuicidal.
Anonymous
HadbeengettingannualPSAsfor~10years,startingaroundage54.Levelstayed
flatuntillate’09andthenstartedrising.Mid’10hadbiopsywhichfound3outof12
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positives,noneover20%,andnospreadtootherorgans.ButIhaveaGleasonof6‐7.Took
6+monthstoanalyzeoptions,got2ndand3rdopinions(includingindependenttestsat
differenthospitalanddoctor)anddecidedtotakeIMRTradiation(45treatmentsspread
over9weeksendinginmid~’11).
PSAdroppedby70%.Nohormonesneeded.Mostmajorsideeffect:nomore
ejaculation,butsexstillenjoyable.Uncleartomeifanyofthiswasreallynecessaryas
highestPSA(priortoIMRT)was7.7(butthatwasdoublefromprioryear).
Atage64,however,itseemedbettertoproceednowthanlaterwhenheavierduty
treatment(e.g.,surgery,hormones)mightinsteadbenecessary.ThinkPSAtestingisstill
goodidea,butsuggestminimalpossibletreatmentneededtogetonwithlife,ratherthan
jumpingattheso‐called“goldstandard”ofirreversiblesurgery.
Pam
MyhusbandwasdiagnosedwithprostatecancerinJanuaryof2011.Ifithadn’t
beenforthePSAtesthiscancerwouldnothavebeendiagnosed.Hesubsequentlyhad
roboticsurgeryandiscancerfree.ThePSAtestsavedhislife.
Ronald
Theageof65Iwentinforaroutinephysicalexaminationwhichconsistsofblood
workandphysicalexamination.MyPSAnumbersatthattimewere2.9consideredinthe
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NormalRangeformyagegroup.MydoctorsuggestedthatIhaveaultrasoundanda
biopsy.ThebiopsyprovedpositiveeventhoughmyPSAnumberswereverylow.Ihad
radiationandseedimplants.Iam80yearsoldandifthatwasforaroutinephysical
examinationandaPSAbloodtest,Idon’tthinkIwouldbeheretoday.
John
ItistruethatthePSAtestdeliverstoomany‘falsepositives’and‘falsenegatives’to
qualifyitforfinaldecisionmaking.But,ithasvalueasapreliminaryindicatorfor
proceedingwithmoredefinitivetests.Forexample,ahighPSAbutnoothersymptoms
associatedwithenlargedprostatemightbea‘falsepositive,’butifassociatedwithother
symptomsshouldsignalfurthertests.Particularly,ultrascanwithbiopsies.
AhistoryoflowPSAsfollowedwithasteadilyincreasingPSAnumberscouldalso
beindicative.IagreethatfinalrelianceonPSAisnotareasonableposition.
IhavehadtwonegativebiopsiesandtwoTURPs.
Anonymous
THEPSATESTSAVEDMYLIFE.At63myPSAbegantoshowarise,nevergetting
above2.2.Ihadabiopsyreluctantly,andshowedpositivewithaGleasonscoreof7.I
electedtohaveIGRT/IMRT.
Keith
IfIhadnotbeenscreenedIwouldNOThaveknownIhadaGleason8cancer…and
at48,that’swaytooyoungtohavethatgradeofcancer.Iwasatbaselinefor3years
beforemyPSAjumpedto8atmyannualexam.IfIhadmissedthatannualexamandnot
hadmyPSAcheckedIwouldhavegoneanotheryearwithaGleason8,6corepositive
cancer.AsitwasIhadsurgeryandthemarginswerepositive…so48radiationtreatments
later…nowit’sgone!IamconvincedthathavingmyPSAcheckedsavedmefromhaving
morecomplicationsorevendeathifitwasundetected.
Dominic
Iwasdiagnosedatage47withaGleason8.DespiteanRP,IMRT,Chemo&ADTmy
diseaseisrecurrent.Ifitweren’tforaPSAIwouldlikelyhavebonemetsorworse.Ihave
friendslikemethattoohavesimilarstoriessowithbonedisease.Untilthereisabetter
indicator,IstronglybelieveinPSAtesting.
Allthebesttothosefightingthisdisease.Itnotonlyimpactsmenbuttheirloved
ones.
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Anonymous
MyhusbanddidnotgetaPSAbecausehisGPsaidexactlywhatthearticledid–he
feltitledtounnecessaryTX.So,at65,becausehisurinestreamwassoweak,Isenthimto
MD(differentone)thinkingbenignprostatichypertrophy.PSAwas60.Onemonthon
antibioticanditwasupto61.Biopsyshowedcancerineverysample.Ifithadbeencaught
earlier,wewouldhavehadmoreoptionsforeffectiveTX.Itseemstheproblemisn’tthe
PSA.TheproblemiseducatingpractitionersontreatmentoptionsafteranelevatedPSA.
Charles
Iwastheposterboyforputtingoffmedicalscreening.Ihadaphysicalforan
insurancepolicyatage60.ThebloodworkrevealedPSA5.1.Tenyearsprior,thePSAwas
notdetectable.Duringfollow‐up,myurologistfoundacolo‐rectaltumor.Chemotherapy,
EBRT,and7surgeries(includingbrachytherapy)havebroughtmetothisstage.Myfive
yearsurvivalrateforstage4coloncancerwas8%.
Iamnowinmy8thyearofsurvival,ingoodphysicallyactivehealthwithregular
monitoring.ThePSAtestwasthefirstcriticalstepinmysuccessfulsurvival.Ishouldhave
beenlookingatannualteststomonitoritsdevelopment.Ifeelthatallmenshouldhavea
historyoftheirPSAlevelsuntilthereisamoreaccuratetestavailable.Treatmentfor
elevatedPSAisanotherstory,andshouldbecarefullymanagedonanindividualbasis.
James
Iama51yearProstatecancersurvivorof3weeksnow.GoodthatIhadaPrimary
caredoctorthatnoticedaspikeinmyPSA.SherefereedmetoaUrologistandIhada
Biopsy.Smallamountsofcancerwerefound.BythetimeIhadmynextbiopsyayearlater
myPSAhadgoneupanother1.96to4.96.Ihadsurgeryon19September2011andI’m
recoveringquitewell.PSAtestingprobablysavedmyLIFE!
Bruce
In2008IwasdiagnosedwithmetastaticprostatecancerwithaNORMALPSA.It
was3.2,upfrom2.0thepreviousyear‐Iwas51yearsoldatthetime.Nosymptomsor
causeforalarmandIhavetakenyearlyphysicalssincetheageof30.
WithoutaPSAtestbackthenIwouldcertainlyhavepassedawaybynowleavingayoung
familyof4.
Howmuchiseachlifeworth?
Iwillturn55nextweekandmyoncologistisencouragedaboutmysurvivalfor
another10yearsbasedonmyresponsetomycurrenttreatments,hormonetherapy,
completionayearagooftheProvengeprotocolandmostcertainlythenewdrugsonthe
nearhorizon.
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Jeff
Iama7yearsurvivorandIhadn’thadmyPSAtakenatmynormalannual
physical,Iwouldhavediedwithintheyear.Minewasveryaggressive,butduetothe
screeningIamaliveandwell.Ittriggeredtheconcerntolookfurther.
Anonymous
MybestfriendwentfromaPSAofnormalinoneyeartohighlyelevatedoneyear
laterandsoondiedfromaveryaggressiveformofprostatecancer.Wasthepriortesta
falsenegative?Idon’tknow;butifitwehadamoreaccuratetestitmayhavesavedhim.I
don’tknowifthisishelpfulbutIthoughtI’dtellthestory.
Edward
PSAtestingsavedmylifeanddictatedfurthertestingwhichrevealedaggressive
prostatecanceratage73whichwaseventuallytreatedintimewithradiation.Iamnowin
remission.
Dean
BecausemyPSArosefrom2.5to4.0inafiveyearperiod,mydoctorreferredmeto
aUrologist,whofeltIneededabiopsy.TwoweekslaterIwastoldIhadProstateCancer
(Gleason7).Ataboutthesametime,mytwobrotherswerealsodiagnosedwithprostate
cancer,discoveredbyariseinPSA.Thatwas8yearsagoandIamstillalive,continuingto
getmyPSAcheckedonceayear.Itisstill
Daniel
WereitnotforPSAtesting,IwouldnothaveknownthatIhadprostatecancer.This
informationledmetosupportgroupsMalecare,fromwhoseleadersandothermembersI
learnedwhattreatmentswereavailableandrecommended,andwasdirectedtothe
appropriateinstitutionsandphysiciansforcare.Iwouldlikelynotbealivetodaywereit
notforthePSAtest.
Untilabettermethodisavailable,thesimplyperformedPSAtestformenin
middle‐ageisvitaltotheirhealthandwell‐being,andhasthepotential,likethe
mammogram,tosavelives.Over‐reactiontoapositivefindingisregrettableandmore
oftenthannotunnecessary,andeasilyenoughavoidedbycontactingthesededicated
supportgroups.Knowledgeispower.
Ignorance,inmattersofhealth,isnotbliss.
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John
MyprostatecancerneverdidrevealitselftoaDRE;itwasonlyamonitoringofmy
PSAatregularintervalsthatresultedinmyhavingabiopsyandadiagnosisofalready
advancePCaatage55in2006.
Asaresultofcatchingitwhenwedid,Iamstillaliveandstillreasonablyfunctional
goingonsixyearslater.
WouldIbeeitherofthoseifwehadn’tcaughtitwhenwedid?Itishardtoprove
onewayortheother,butIcan’timagineI’dhavefeltanddonebetterifwe’dwaiteduntil
itbegancausingbonepainbeforewe’ddiscoveredit.AtleastforawhileIcouldenjoythe
hopeofgettingcured.Onceitwasinthebones,itwasclearlynotcurable.Thatwouldhave
beenaterribleshock.
Thetreatmentsforprostatecancerarenopicnicinthepark;theyhavetakenatoll
onme.Butastreatmentsimproveitwillmakemoreandmoresensetocatchandtreat
prostatecancerearlierratherthanlater.Ican’timagineacircumstancewherelivingin
ignoranceabouthavingthediseaseisbetterthanknowingaboutit.
David
ThePSAtest,requestedbymyGeneralPractitioner,endedmyspecialists4year
beliefthatIhadprostatitis,whichhewastreatingwithantibiotics,whileIsuffered.
Iunderwentsuccessfulradiationtherapy12yearsago.
Norman
PSAtestinghelpedmefindcancerearlyandItrackeditforyearsuntilitspiked.
WithoutthetestIwouldnothaveknownIwasindanger.ThankyouforPSA.Itmaynot
beperfectbutneitheraremammograms.Whytakeawaytheonlyearlywarningtoolwe
havetoday.
Dan
InFebruaryof2003,myPSAdoubledfromtheprevioustesttwoyearsprior.My
urologistcouldfindnoirregularityinmyDRIandIhadnoothersymptoms.Wedecidedto
doabiopsy–12of12corestestedpositiveforcancer(fortunatelyGleason6)!Iwas
treatedwithradiationandbrachytherapyinthefallof2003andtodaymyPSAin
undetectable.
IfeelthatthePSAtestSAVEDMYLIFE!
Turk
InFebruaryof2003,myPSAdoubledfromtheprevioustesttwoyearsprior.My
urologistcouldfindnoirregularityinmyDRIandIhadnoothersymptoms.Wedecidedto
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doabiopsy–12of12corestestedpositiveforcancer(fortunatelyGleason6)!Iwas
treatedwithradiationandbrachytherapyinthefallof2003andtodaymyPSAin
undetectable.
IfeelthatthePSAtestSAVEDMYLIFE!
Anonymous
Diagnosedat47bymyGeneralPractitionerwhoincorporatesPSAtestingforall
hispatientsover40.Myincreasewasonly1.5overthepreviousyearbutmyDr.was
cautiousandreferredmetoaurologistwhothendidabiopsy.Hadroboticprostatectomy
andnowIamcancerfree.WouldneverhavethoughttoaskforaPSAtestonmyown.It’s
crazynottotestunder50–itprobablysavedmylife.
John
Iwasdiagnosedin2004attheageof5withaGleason7andPSAof4.1.Atthat
diagnosismyurologisttoldmethatwithoutthePSA,Iwouldhavewaiteduntilsymptoms
appeared.ThatmeantIwouldnothaveseenhimforanotherdecadeandthenitwould
havebeenamatteroftryingtoseehowmuchlongerthemedicalestablishmentcould
keepmealive.
Ihadaradicalprostatectomyin2004.Sevenyearslater,myPSAis0.6andIhave
decadesoflifetolookforwardto.
David
PSATestingisavitaltoolwhichmustbemaintainedinthefightagainstprostate
cancer.Iforoneambeingtreatedutilizing“ActiveSurveillance”.ItisimperativethatI
receivePSAtestingaswellasdigitalexaminationstomonitortheactivityofmyprostate.
ThePSAisatoolwhichhasguidedmeninanefforttosavelives.Earlydetectionusing
PSAanddigitaltestingisthefrontlineintreatmentandmustbecontinueduntilabetter
provenmethodofmonitoringtheprostateactivityisdeveloped.
Mary
WhenmyhusbandfinallyhadaPSAtestforPCa,itwasafterhavingtwoyoung
docswhosaidhisDREwasfinesononeedtohaveaPSA,andhisPSAwas61.
IfwehadwaitedmuchlongerhewouldprobablynotbeaPCasurvivortodayfiveyears
posttreatment.SomuchforDRE’sbeingallthatareneeded.
Iamthankfulformyhusbandbeingherewithmetodayandthedocwhothought
attheageof65heNEEDEDaPSA.
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Douglas
MyPSAwascheckedregularly.OneyearmyDoctornotedachangeandsentmefor
abiopsy.Surgicalremovaloftheprostatefollowedwithtwomonths.Thecancerhadjust
startedtoescapetheprostatebutwascompletelykilledbysubsequentradiation.Thereis
nodoubtinmymindthattheregularPSAtestsincreasedmylifespanandqualityoflife.
Asaresultofmyexperience,mybrother’sprostatecancerwasdetectedandisbeing
treated.TheideathatmenshouldnothavePSAtestsisludicrous!
Fred
Iwas51yearsoldwithNOsymptomswhenthecombinationofPSAtestanddigital
rectalexamdetectedatumor.Ihavebeencancer‐freefor12yearsandIbelievethatthe
PSAtestmighthavesavedmylife.
Victoria
Iamthewifeofaprostatecancersurvivorwhowastreatedin2003afteraseries
ofroutinePSAscreeningswhichindicatedrapidPSAvelocityabiopsyestablishedcancer,
wellaheadofmetastasis.Hewastreatedwithbrachytherapyandhormoneablationand
is,tothisday,cancerfree.
Recently,ataconference,Imetamanandwifewhosestoryistheexactoppositeof
ours.
ThismanneverhadaPSA,buthadsomedifficultyurinating,sobookedan
appointmentwithaurologist.Thedoctordidarectalexamandfoundcancerwhichhad
metastasizedtoadangerousdegree–themanhadaGleasonof,Ibelieve,8.
Oururologisttellsusthat,inthebygonedaysbeforetherewasPSAscreening,that’show
prostatecancer–thedangerouskind–wasalmostalwaysfound,viatheDRE,andbythenit
wasoftentoolate.
SomehowthemanImethaslived,goingfromradiationtochemotopalliative
treatments,whichheiscurrentlyon.Hemethiswifethedayafterdiagnosis.
Theyknowthat,althoughthesetenyearshavebeenablessing,heis,inessence,undera
deathsentence.Iheardthemsaytheotherday,“Inournextlife,wejusthopewemeet
earlier…”Theyarebravepeople:whoevercomesnextinthisfightagainstcancerdeserves
theheads‐upthatPSAscreeningaffords.
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Ken
In2008Iwasdiagnosedwithprostatecancer.Luckily,mydoctorbelievedinPSA
testinganditwaspartofmycheck‐up.IfhedidnotscreenforPSA,Imaynotbehere
today.TwocoreswerecancerousandIhadmyprostateremoved4monthslater.Ithad
notspreadtothemarginsandIconsidermyselflucky.Threeyearslater…fastforward.I
continuetogettestsandallhavebeennegative.Idon’tevenwanttoimaginewhatmay
havehappenedhadInotbeentested.
Anonymous
In2006attheageof55,IhadnosymptomsbutarisingPSAscore.Mydoctor
orderedabiopsyandtheresultsshowed11outof20sampleswerepositiveforprostate
cancer.Ididmyresearchtalkingtodoctorsandpatients,andIreadseveralbooksand
visitedmanyinternetwebsites.Iwasagoodcandidateforsurgeryorforradiation
therapy.Iconsideredactivesurveillanceforabout5minutes.Allofmytestsshowedthat
waitingwasn’tanoption.MydoctortoldmeIcoulddonothingandwouldthenhave
serioushealthproblems,possiblydeathin5‐7years.Iamaliveandcancerfree5years
laterthankstothePSAtest.
1outof6menwillgetprostatecancer.5outof6won’t.Theproblemis,howelse
wouldyouknowifyouarelikeme,theunluckyoneofthesix?Whywaitforsymptoms
thattellyouit’stoolatetogetridofthecancerorthatyouwillhavedifficultandpainful
timesaheadlivingwiththecancer?
Anonymous
IdidnotgetmyPSAtestedfromage42to54.WhenIwastestedandsubsequently
biopsied,Ihadstage3prostatecancer.IbelieveifIhadgottentestedmoreregularlyI
couldhavestoppedthediseaseinstage1.Iamnowsubjecttotakingseriouslybad
medicinemaybefortherestofmylife.Ialsospentasmallfortuneonradiationandmeds.
IfIhadnotevergottenPSAtestsIbelieveIwouldsoonbeinstage4anddeadin5years.
Asimplebloodtest10yearsagowouldhavesavedmealotofgriefandmaybeextended
mylife.Nottomentionmywallet.
Anonymous
Mygreatgrandfatherdiedatage92ofprostatecancer.Hehadsurgeryinhis80's.
Myfatherhadextracapsularadvancestageprostatecanceratage79.Hetreatedwith
externalbeamradiation.Thatsaidhecontinuestohaveaftereffectsandhashadto
undergoanti‐androgentherapytomaintainreasonablecontrolnumbers.
Iwasthereforenotsurprisedatage54tohavebeendiagnosedwithPCA,dueto
theyearoveryearincreaseinmyPSA.Thebiopsywasayearagothispastweekandwas
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positivebutshowedonlylimitedcancer.IhadsurgeryinJanuaryofthisyear(2011).The
pathologyreportfollowingthesurgerymovedmystagetoT2findingthatthetumorwas
onbothsidesofmyprostate,andconsiderablylargerthananticipatedbythebiopsy.
WhileIamstilldealingwithissuesrelatedtoimpotence,Irecoveredcontinence
withinsixweeksofthesurgery.
Allthingsconsideredandwithmyfamilyhistory,IhavetobelievethatthePSAtest
savedmylifeandallowedmetoavoidtheclearfatethatawaitedmeinthefuture.
TheresultsofthePSAtestworkedforme.MaybeIaminthesmallgroupwhobenefited
fromthePSAtest.Itallowedmetobetreatedatanagewhentreatmentwasbothpractical
andeffective.
Richard
WithoutPSAIwouldnothaveknownIhadCancer.IhadaPSAtestforthefirst
timein2001itwasa8andledmyDR.todoaDREandhefoundnodulesandsentmetoa
urologist.
ItestedpositiveforaggressivecancerandhadCRYOin2002.Iamstillcancerfree
9yearslater.PSAisnottheonlytesttogobybutitisastartandsavedmylife.
Paul
IstronglysupporttheearlyandcontinuingPSAtestingformenoverage40and
evenearlierwithahistoryofprostatecancerintheirimmediatefamily.IdidnotstartPSA
testinguntilaboutage50duringwhichtimeIhadBPH.ThePSAlevelwasmoderateand
relativelyconstantfor6years(aged56‐62).HoweverfromFeb08toJun08,aperiodof4
monthsthePSAjumpedfrom2.67to3.99(anincreaseof1.32pointsor49%),
precipitatingabiopsywhichconfirmedprostatecancer(atGleason4+3=7).AnotherPSA
inSep08revealedaPSAof6.07(anfurtherincreaseof2.01or50%within3months).
Ididnottaketheresultslightly,suspectingIhadanaggressiveformofprostate
cancer.Iwassubsequentlytreatedwithprotonbeamtherapy.Ihavehadnosignificant
sideeffectsandmycurrentPSAafter2.5yearsis1.01,whichIamcontinuingtomonitor.I
don’tknowofthepotentialforrecurrence,butIliveforeachdayandamthankfulforthe
opportunity.
Steven
At47yearsold,IneverconsideredthethoughtofProstateCancer.While
undergoingtreatmentforaurinarytractinfection,IhadaPSAtestdonewhichwas
understandablyhigh.SinceIalsohadtroubleemptyingmybladderandfrequentlygotup
atnight,IgaveinanddeterminedtohaveanotherPSAtestdoneseveralmonthsafterthe
infectionwasgone.Itcamebackat8.7.
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IfIhadnotdonethis,Iwouldhavelikelylivedwiththeinconveniencesofthe
symptomsbutnotfollowedupwithtesting.Imightalsobedeadbynow!PSAtesting
savedmylife;there’snowayaroundthatfact.
David
Iam59.IhavebeenslowlywatchingmyPSAclimbforthepast10years.2years
agoitwas8.7,andmyGPreferredmetoaUrologist.Ihadnosymptomsatall.Ifeltfine.I
failedtorealizetheimplications,ortheimportanceofwhatwashappeningtomybody.I
nevergotaroundtomakingthatappointment.
LastNovember,IhadanissuewhichrequiredavisittomyGP.Itwasnotrelatedto
mysoon‐to‐be‐discoveredPC;however,itdidstartachainreactionofsubsequenttests.
ThebloodtestrevealedaPSAof64.Needlesstosay,IgotthecallfrommyGP.Sheasked
whetherIhadseentheurologist18monthsago(atthetime).Isaidno,Inevergotaround
toit.Well,youMUSTgoimmediately!Sheremarked.
Firstcametheultrasound,thentheCTscan,thenthebiopsy,andthen……..”I’m
afraidtosaythatyouhavePC”fromtheurologist.Priortohisconfirmationofmydisease,
hewassayingthathewouldoperate(theoldfashionedopensurgeryway).Followingthe
biopsy,Ihadabonescan,thenanMRI.
Thebonescanwasclear;TheMRIrevealedthatthecancerhadbeguntospread
fromoneside.ThisurologistthendecidedNOTtooperate.Hewasafraidtofindthatit
hadspreadbeyondhisabilitytooperatesuccessfully.Hispreferredoptionwasthenfor
nuclear/hormonetreatment.Thisrevelationpretty‐muchshatteredme,tosaytheleast.
Afterall,Iambullet‐proof!Thismustbesomekindofcrueljoke…surely!My
obviouscollapseofcomposureinhisroomsledhimtoofferreferralstoasmanyother
doctorsandoncologistsasIneededtohelpcometotermswithwhatIshoulddoaboutit.
Isawtwoothersurgeonsandoneoncologist.Theyallagreedthatitwasoperable.So,I
choseonewhohadthemostscalpsonhisbelt,andhadmykeyholelaparoscopicradicle
prostatectomyperformedinAprilofthisyear(6monthsagotoday!).
After2PSAtestssince,myscoreis0.Continenceisalmostnormalagain.Working
ontherehabissuestodowithEDisongoing.Togothroughthischapteronone’sownisa
hugeloadtobearalso.Butforthesupportofsomereallygoodfriends,andmyson,I
wouldhavestruggledmuchmorethanIhave.
ThegoodthingaboutallofthisisthatbecauseofPSAtesting,Iwillhavealifewithoutthe
traumaofametastasizedcancer.Lifeisdifferent…yes.Itcanstillbegoodthough.
Lars
Iwasdiagnosed1995withPSA58,Gleason9and60gramgland.6monthsto
live!!!WetreatedwithLupronandwhenPSAwasdowntoaboutIhadradicalsurgery.
ContinuedLupronandaddedCasodexadded.Then,radiationoftheprostatebed.Hadthe
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bestradiologistandagainPSAdowntobelowdetectableforaboutfiveyears.HowcouldI
havebeenabletomonitormyPCwithoutPSAtests?
David
Diagnosedin2004withahighlyaggressive,locallyadvancedPCa,Ihave
completedabout3yearsofADT,withnoreturnoftestosteroneafterstoppingADT3
yearsago,andunderwentafullprogramofradiationtherapy.
ThesideeffectsofthehormonedeprivationtherapyhavebeenDraconianandhave
significantlydamagedvirtuallyeveryaspectofmyqualityoflife.Otheradverseside
effectsresultedfromtheradiationtherapy.Atthetimeofmydiagnosis,littlewasknown
aboutpossibleADTsyndrome,soIcouldhavenothavepossiblymadeanintelligent
choice.
IamahealthcareproviderinpediatricssoIhadnotreviewedadultinternal
medicineinmanyyearsatthetimeofmydiagnosis.Onbalance,now,Iconcurwiththe
USPSTFrecommendations.
Attheveryleast,asymptomaticmenshouldcarefullyconsiderwhethertheycan
dealwiththelikelyconsequencesofgettingascreeningPSA.Wemustfinallyadmitthat
scantevidenceexiststhat,evenforrelativelyaggressivecancers,testingandtreatment
willlikelyhaveminimaleffectonoverallmortalitybutarevirtuallyguaranteedtoresult
inadverseeffectsonapatient’slife.
Thisviewwouldchangeif,in5‐10years,wehavemustmoreeffectiveandsafe
targetedtherapies,immunotherapies,orotheroptions,butfornow,mostmenshouldnot
beencouragedtogetPSAscreening.Ourreachhasexceededourgrasp,andwehaveacted
withmorezealthanwisdom.It’stimetostepbackandseriouslyconsiderthewisdomof
routinescreening.
Rich
AbovenormalPSAreadingsontwoseparatetestsledmetoabiopsywhich
revealedprostatecancer.Withoutthisinformation,Iwouldnothavebeenabletobenefit
fromearlydetectionandtreatment.
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Havingmenscreenedforprostatecancerisagoodideathatissharedbymedical
professionalsforotherdiseases.Peoplewithheartconditionshavestresstestsand
cholesterolscreenings.Womenhavemammogramstotestforbreastcancer.
TherealissueisformentofollowtheirPSAovertimeandtostayintouchwith
theirdoctor(s)iftherearechanges,especiallyaconsistentmoveupward.Thoseofusin
theprostatecancerawarenesscommunityadvocateaholisticviewaboutdetectionand
treatmentofprostatecancer.
Onepieceofdataintime(asinglePSAreading)isnotenoughtopaintapictureof
prostatehealth.ItneedstobeaccompaniedbyaDRE(digitalrectalexam)and
consultationwithadoctor.AvoidingPSAscreeningsaltogetherinthenameofmen’s
healthisreallyaPSA–positivelysillyapproach.
Anonymous
Sincemy40’s,mydoctorshavedoneanannualPSAcheck.Threeyearsagothis
baselinebecamevaluable(Iwas61then).MyPSAstartedtorisewithnoindicationofan
enlargedprostrate.Afteracoupleofannualtreatmentswithantibioticthatreducedmy
PSA.MyPSAjumpedtoa6soa12samplebiopsywasperformed.Nofindings,butayear
laterPSAwenttoa9.Asaturationbiopsywasperformedwithonepositiverated6.Inow
havehad43radiationtreatments.
WithoutthePSAbaselinethecancercouldeasilybeoutofmyprostrateinto
untreatableareas.
AneighborneverhadaPSA.Bythetimeitwasdiscoveredthathehadprostate
cancer,itwasinhisbonemarrow,sonowheisdyingwithuntreatablecancer.
IhavetoldmybrothersthattheyneedtohavePSAandColonoscopydoneasprescribed.
Cancercansuckthelifeoutofyouquickly.
Kurt
Iwentintodoacolonoscopybecausemyfatherhadcoloncancerat50.Thiswas
my3rdone.WhenIawoketheDoctortoldmemycolonwasfinebutIhadProstateCancer
atage50.IdidnotknowwhataPSAtestwasbuttheDoctorhaddoneonewiththeColon
test.6monthslatermyprostratewasremovedrobotically.TodayI’mcancerfreewithno
sideeffects.
Rick
ThePSAtestsavedmylife.At47yearsoldIhadnosymptomsandnofamily
history.MyPSAcameback11.1.TheDREfoundnothing.
I’mhealthandlivingaftersuccessfulsurgerywitha0.0PSAthreeyearslater.
WithoutthePSAtestIwouldbeonmywaytobeingdead.Itisjustthatsimple.
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Anonymous
MygrandfatherandfatherhadPCandIbeganPSAtestingin1990.Thenumber
roseyearly.InMar2004itwas3.2andinOctitwas5.7.Ihadabiopsywhichindicated
cancerwithaGleasonof3+3.IhadaRPdoneinJan2005.ThepostGleasonwasstill3+3
butthepathologistindicatedthatthecancerhadspreadtotheouterextremityofthe
prostatebutdidnotbreakthrough.IFIDIDN’THAVEAPSAEXAMITWOULDHAVE
SPREADANDIWOULD’NTBEWRITINGTHISMESSAGE.
PSAtestingistheonlyadequatemethodtodeterminePC,butontestwillnotgivea
definiteindication.
Thetestingmustbedoneoveraperiodoftimetodetermineifitwasaflukeora
treaddevelopinwhichcasefurthertestingwouldbenecessary.TheGleasontestwould
beagoodindicatorofthegrowthandlocationofthePC.
Itisimpossibletoahaveastudytocorrectlystatetheresultsingeneralterms.Eachcase
ofProstateCancermustbediagnosedandtreatedindividually.
Sue
EverytimeProstateCancerisinthenews,itisreinforcedthatitisslowgrowing,
notlikelytokillyou,canbewatched,etc.,etc.,etc.Itangersmeandsickensmeeverytime.
Myhusband,wasdiagnosedwithProstateCancerat52yearsofage,andwasdeadat53
afteritspreadtolymphnodes,bones(entireskeleton),brainandliver,encroachingonhis
spinalcordandparalyzinghim.
HisProstateCancerwasnotslowgrowing,itwasextremelyaggressive.Ittook
downavibranthardworkingfarmerintheprimeofhislife.Weweretoldhe’dhave15
yearseasily,andatleast5yearsbeforeanychemoorradiationwouldevenneedtobe
considered,buthehad17months.
ProstateCancerDOESkill,andwhenitisaggressiveitkillsyoungandmiddleaged
menwithfamiliesandcareers,notjustlongagoretiredmeninthetwilightoftheirlives
who‘maybekilledbysomethingelselongbeforeProstateCancerwillkillthem’asisso
oftentouted.Heleftbehindasonincollege,adaughterjustoutonherownandstarting
hercareer,a14montholdgranddaughter,andhewasthesoledrivingforcebehindthe
familyfarmthathisfatherstartedfromnothing–nottomentionmyself,hiswifeofover
28yearsstillinshockandleftholdingthebag.
Myhusbandwasonlydiagnosedbyaccident,hisdoctordid‘routine’bloodwork
duetohishavingsomeflulikesymptomsoff&onforabout6weeks.TherewerenoPC
symptoms.
WhenthedoctorcalledourhousethedayafterThanksgivingtoreportthefindings
ourliveswereturnedupsidedownnevertoreturn,buthadthePSAtestnotbeendone,
whoknowshowlongitwouldhavetakentobediscovered,andwouldtheprimarycancer
haveeverbeendetermined?Wouldhehavebeenabletolivelongenoughtoknowhis
onlygrandchildbornjustmonthsafterhisinitialdiagnosis?
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MaybethePSAtestwill‘only’save1manoutofthousandstested.SOWHAT??!!
Eachandeverylifelostispreciousandmeaningfulandnottobediscounted.Thetestis
simpleandnotexpensivesowhatistheharmintryingtopreventthehorrorthatour
family,andcountlessothers,havehadtoendurewhenperhapsitcouldhavebeen
different?
Bill
Iwasinmymid40’sandchangedfamilydoctors.ImentionedmyFatherhad
prostatecancer(diagnosedinismid80's)andthenewdoctorsaidIshouldhaveaPSA
everyyear.Inmyearly50's,myPSAhadaprettygoodjumpeventhoughitwasrelatively
low.Wedidaneedlebiopsyanditcamebackwithalotofprettyaggressivecancer.Ihad
theprostateoutin2000tumorwas“tothemargin”.Aboutayearandahalflater,PSA
startedshootingupagainsowedidradiationandthenontohormonedeprivation.Idid
chemolastyear.ItlookslikeitisheretostaysincemyPSAisontheriseagain.Iwasin
Vietnamforayearandmycancerhasprettymuchfollowedrightdownthelinewhatthe
VAsayswhathappenswithAgentOrangerelatedprostatecancer.
Inmyopinion,ifIwasnotgettingayearlyPSAtest,Iwouldnotbewritingthis
today.
Gary
Whileapplyingforaninsurancepolicy,IwasrequiredtohaveaPSAtest.Iwas65
andhadneverbeentestedbeforeandmyresultswere105.MyUrologistimmediately
startedmeonADT;30dayslaterhadaRRP.Thepathologyreturneda4+5=9Gleason
score,stagingofpT3b,NO,MX.Thecancerhadalreadyescapedthecapsuleandwasinthe
seminalvesicles.Twomonthsaftersurgery,IhadIMRT,40treatmentsandstayedonADT
for2yearsbeforeIwasabletostopthattreatment.OnlybyPSAtestingdidIfindthatI
requiredfurthertesting(Biopsy)whichresultedwithfollow‐uptreatments.
Tri‐monthlyPSAtestingafterradiationdeterminedwhentoendADT,andthePC
hasbeeninremissionnowfor2years.WithoutmonitoringPSA(whichthelevelisnow
startingtocreepup)Iwouldnotknowwhentorenewmytreatmentsinordertosustain
life.Withouttheoriginaltesting,andwithnocausetoinvestigatefurther,thereisno
doubt;Iwouldbeinafinalstageofcanceratthistime.PSAandDREexamsaretheonly
inexpensivetoolsmenhaveavailable.WeshouldbePROMOTINGtheirexistenceloudly.
Chris
IwasdiagnosedwithProstateCancerin2001becausemyprimarycarephysician
recognizedthatmyPSAwasabovethethresholdstandard(4.0).Atage52,mywifeandI
appreciatedthatwehadtheoptionoftreatmentorwatchfulwaitingatthattime.Theway
wesawitthenisthatitisthepatient’schoiceandthatthepatientshouldhavethe
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informationabouthishealthstatus.Ifwedidnothavetheinformationaboutthegrowing
cancerthatthePSAalertedusto,thenatwhatpointwouldweknow?
Tenyearslatermyprimarycarephysicianwouldbeusingthedigitalrectalexam
duringmyannualphysicaltofindalump.
Personally,asthepatient,IwouldprefertohavetheoptiontointerveneSOONERthan
whenthePCPfindsalumpbecauseearliertreatmentcanmakeadifference.Fortunately,
myPSAremainsatlessthan0.01todayandIcontinuetousethePSAtestevery6months.
Iamactivelyinvolvedinmanagingthediseasethroughexercise,dietand
meditationandusethePSAtomonitorforanychange.Irecognizethatitisnotaperfect
toolbutuntilabettertoolbecomesavailableIthinkphysiciansshouldletthepatient
decideaboutusingthePSAandtheyshouldnotmakethechoiceforthepatient.
George
Iam64yearsold.IhadbeenhavingannualPSAtestsdonebymyPCPforatleast
tenyearsbeforeitwentover4.0inearly2009.Ithadjumpedfrom2.8to4.1inayear,and
mydoctorsuggestedthatIseeaurologist,althoughshefeltthatthelikelihoodofPCawas
low.Theurologistperformedabiopsy,andinMayof2009IwastoldthatIdidhavePCain
fouroffourteentestedsites,withaGleasonof3+3.
AfterdoingaLOTofresearch,IdecidedtotreatmyPCawithexternalbeam
radiation(IMRT);Iwasnotagoodcandidateforseedimplantation,andIknowtoomany
menwhohavehadcomplicationsfollowingsurgery.
AlmosttwoyearslatermyPSAremainsunder1.0,andIhaveittestedeverythree
monthsbymyurologist.IfIhadn’tbeenhavingannualPSAtesting,myPCawouldn’thave
beencaughtatsuchanearlystage,andmyprognosismightnothavebeenasgoodasitis.
Barry
WithoutPSAorareplacementtestitwillbeadisastertobeinthatsetofmenwith
risingPSAandaggressiveprostatecancer.Personally,becauseoftheoldguidelinesthe
bloodtestresultswasmyfirstindicationofveryaggressivecancer.CurrentlyIamquite
hopefulofkeepingmyaggressivecanceratbaywithtreatment.Withoutthebloodtest
menwithsimilarlyaggressivecancerandrisingPSAwillhavenowaytoknowthe
jeopardytheyarein.Howwilltheyknowwhentocomeinfortreatment?Donotleavemy
sonsontheouts.
Anonymous
WhenyouarefirstdiagnosedwithstageIVPCyouwonderhowlongyouwilllive.I
withdrew,criedallthetime,andcouldn’ttalktomywife,myfamily,andmyfriends.My
wifewasandismyadvocate…..PSAscreeningcansavelives.Icannotbelieveitwouldbe
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onthechoppingblock.Especiallyfromdoctors.PCcutslivesshortasitis…..don’ttakethe
onlytoolwehaveaway,please.
David
Iwasdiagnosed3yearsagoatage56andonlybecauseroutinePSAtesting
showedanincreasefrom2.6to3.8in1year.MybiopsyrevealedadangerousGleason
scoreof9(5+4).3yearsaftersurgerymyPSAis0.02.OnlyroutinePSAtestingrevealed
thisaggressivecancerbeforeitcouldspread.
Anonymous
MyPSAwentfrom10to20inoneyear.Abiopsyshowedtreatableprostatecancer.
IdonotthinkthatIwouldhaveknownthiswithoutthePSAtesting.
Whatisthealternativeasinmycasetherewasnosymptoms.
Bruce
Helloandletmesayfirstandforemost,“ThankGodforPSAtesting.”
Nowmystory,Iwashavingdifficultyafterdoingshortburstsofanyunrelatedworktasks
aroundthehouse.Iwasaround70or71atthetimeandmyPSAreadingswerebetween
high2’sandlow3’s.IhadexaminationsandfoundIneededheartsurgeryinvolving
stents.
Aftercompletingthisandseeminglyonahealthyroadtorecoveryitwas
discoveredthroughregularPSAtestingthatmyreadingsweregettinghigher(low4’sand
low5’s)OfcourseIwasindenial.Myprimaryphysiciansentmetoaurologistalongwith
mymostrecentreading,5.2orsomethinglikethat.Myurologistwantedtodoabiopsy
immediatelybutduetomyrecentheartstentimplantsandbeingonPlavixandhaving
diabetes,itwasdeterminedtobetoosooninordertoguardagainstanyinternalbleeding
thatmightoccur.
Afterafewmonths,IhadthebiopsyandIdidhaveprostatecancerassuspectedby
myurologist.Ihadthecryotherapytreatmentandamnowlivinganalmostnormallife.
YesIammostlyimpotentbutthatisminorconsideringIcouldbedeadorsufferingvery
badlynow.Iamnow75andveryfewpeoplecantellunlessIinformthemofthatfact.
Anonymous
PSAtestingsavedmefrommuchpainandtreatment.IhadmyPSAtestedannually
foranumberofyearsandwhenitdoubledafterayear,myprimarycarewantedit
checkedagainwithin6months.Atthattest,ithadnearlydoubledagainsoIhadabiopsy
doneandPCwasfoundin3coresbutnotoutsideoftheglanditself.Therefore,aftermuch
homeworkandmanydiscussionswithPCsurvivors,EBDandtheimplantingofseedswas
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thetherapyIchose.MyPSAiscurrentlyunder.02andhasbeenforawhile,now.Have
experiencedsomeside/aftereffectsthathavechangedmylifestylealittle.However,
withoutthePSAtesting,Iwouldprobablynotevenbewritingthis.Averyminor
procedurethatcansavepeople’sliveswouldseemtobesomethingthatshouldbe
availableforanyonewhowantsit.
ThesefoolsthatwanttoeliminatethePSAtestonmendon’tseemtohaveany
conceptofwhattherealworldisactuallyallabout.Iwonderhowmanyofthemhave
actuallyexperiencedanyreal‐lifesituationsinvolvingprostatecancer(oranyother
cancer,forthatmatter.).
Anonymous
MypartnerandIhadbeendatingoneyearwhenhewasdiagnosed.Hehadrobotic
surgeryandwewerepromisedeverythingwouldbejustfine.Yes,thecancerisgone,but
soarehiserectionsandhisabilitytoholdurine.Prostatecancerhasemasculatedhim.It
wasveryhardonourrelationship.Becausesincehecouldn’tgetanerection,hestopped
wantingsex.Wehadtoworkonthatforalongtime.Prostatecancertookmostoftheman
outofmyman.
Harold
MybrotherisoneyearolderthanmeandcalledtoinformmeafterhisPSAwas
donethathehadPC.Hewas58atthetime.WiththatstunninginformationIranmyPSA
andwasmuchworsethanhim.SinceIhavesurgeryandradiationandhormoneoblation.
MyDr.wasn’ttestingPSAandifitweren’tformybrothers’testIwouldbedeceasedby
now.Tosaythistestisn’teffectiveiswrong.Therealproblemismistreatmentandover
treatmentbyamedicalestablishmentthatknowslittleabouttheappropriateprotocol
Mare
MyhusbanddiedthispastDecofAdvancedProstateCancer,hisageafewmonths
past58,hewasdiagnosedat51theendof2003onlybecauseIforcedhimtogeta
checkupbecauseweweremovingtoAlaskaintheBush.HisPSAwas15whenhediedhis
PSAwas784.Hehadradicalprostatectomy,non‐nervesparing,alifewithoutsex,buta
lifeforanother7years.Hewasintwotrialstudies,hadthebestdoctors.Ifhehadgone
soonerforacheckup,perhapshewouldbeheretoday.I’manadvocateforearlytesting…I
missmyhusbandverymuch.
Gary
InaroutinePSAtestsixyearsagowhenIwas63,followedbyabiopsy,Iwas
diagnosedwithprostatecancer.MywifeandIweremorethanalittleworried.Icontacted
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severalcentersforsurgery,andinvestigatedotheroptions…finallysettlingonrobotic
prostatectomy.Thesurgerywassuccessful,negativemargins.Iwentthroughseveral
monthsoftherapyforincontinenceandaboutthreeyearsofEDtreatment.Allispretty
much“normal”now,exceptfornothavingejaculations.
Ireallydon’tknowhowaggressivemycancerwas,butlivingwithitwould
probablyhavebeenverystressful.Ithinkwearebothveryrelievedthecancerwas
detectedandremoved.ContinuedPSAtestsarenegative.Hoorayforthat!!
Lynn
PSAtestingsavedmylife.AroutineinsurancephysicaldetectedahighPSA.Avisit
toaurologistfollowed.Abiopsywasdoneandafastgrowingcancerwasfound.Robotic
surgerywasdoneandtheprostateglandwasremoved.OverfouryearslaterIamstill
aroundbeingthebesthusbandandfatherIcanbe.
Jeff
Whenmydaddiedofcancer,thepostmortemrevealedthathislungs,liverand
prostatewereheavilyinvolvedwithcancergrowths.Althoughprostatecancerusually
progressestothebones,thereisnomentionofbonecancerinthewrite‐up,butthis
occurredaround20yearsago,andIdon’tknowiftheywereevenlookingforthat.
Itisquitelikelythatthecancerbeganwiththeprostateandmetastasizedtothe
otherorgans.So,whenmyPSAnumbersbegantoincrease,Istartedhavingbiopsies.They
werenegativeuntilallofasudden,atasixmonthinterval,theyweren’t,andshoweda
Gleasonscoreofbetween6or7.Mybrotherisnineyearsyounger,andhisproctologist
keepscheckinghimregularly.
Howelsewillheknowwhetherhisprostateglandbeginstogocancerous?The
speedwithwhichminedevelopedwasalarming,andI’msurethattheseedimplantsplus
radiationplushormonetreatmentsIreceivedhavesavedmylife.BlockingregularPSA
testingisirrationalandisameasureofthenegativeimpactthattheinsurancecompanies
aretryingtoexertonourlivestoourowndetriment.
Steve
Iwasdiagnosedwithprostatecanceratage53.Bythetimeitwasdiscoveredbya
digitalexam,ithasspreadbeyondtheprostate.HadIfollowedtheguidelineoftestingPSA
atage50,Imightnotstillbedealingwiththecancerbecausethetreatmentsmighthave
putitintoremission.
Therewasnoprostatecancerinmyfamilyhistory,whichsomewouldsayisa
reasonnottohaveaPSAtest.Myopinionisthattheyarewrong!”
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Bill
WhenIretiredfromtheAirForce,theVAHospitalperformedaPSAtest;the
resultswerealittlehighformyageof39.WhenIsawaAFdoctoronmyexitphysical,he
saiditwasnotanissue.At40,Ihadsomeotherhealthissues;Irequestedacomplete
physicaltoincludeaPSA(Iaskedforit).Itcamebackhigherthanpervious,8.9.Iwassent
toaspecialist,tookmedicationsfor30daystoseeifitwasininfection.PSAwasat9.0
afterwards.Afterabiopsy,itwascancer.Ielectedfortheremovaloftheprostate,which
happenedtwomonthslaterandthecancerhadbrokentheouterbarrieroftheprostate.If
notforthePSAtest,thecancerwouldhavegoneundetecteduntilitwastoolate.Ihadno
otherindicatorsthattherewereanyproblems.ItwasalsobecauseofPSAtestingthatfive
yearslaterthecancerwascaughtinitsearlystage.
IamafirmbelieverinthePSAtestingandrecommendthatmengetitperformed
earlytostartabaseline.
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Tim
MyfamilyphysicianstartedPSAtestingwhenIwas40,aspartoftypicalblood
workformybloodpressureprescriptions.3yearsbackthenumberwentover4,andthey
gotconcerned.Sentmeofftourologistforfurtheranalysis,andIagreedtobiopsybeing
bestoptionforanswers.12samplesandnothingfound.Now,3yrslater,PSAtestingcame
backwithnumberover8.
Backtourologist,andnosymptomstoworkwith.So,anotherbiopsywasagreedas
thechoicetofindoutifanythingwasgoingon.Thistime,1samplehascomeback
positive.Gleasonscoreis6.I’mgladtheycaughtthisearly,aswearenotawareofthere
beingafamilyhistoryornot(myfatherpassedawayatage48fromheartdisease,and
prostatecancerwasnotevenontheradarwithhim).Iamgoingwiththesurgical
removal,andexpectingtheywillgetitall.Iturn47inDecember,andwaspleasedtohave
options.
Iwastoldthatwecoulddonothingtoday,andIprobablywouldn’thavesymptoms
foratleastanother10yrs.However,after10yrs,thesituationwouldlikelyhavebecome
moreadvancedandhavedifferenttreatmentoptions.Beingthetypewhopreferstodeal
withsituationsbeforetheybecomedifficult,I’mmuchmorecomfortabletakingcareofit
today.
Afterthefirstbiopsy3yrsago,IwasabitskepticalaboutPSAtesting(went
throughtheprocessandnothingwasfound–well,thatwasn’tfunatall).
Iwentthroughthesecondround3yrslater,becauseIwantedtodowhatIcouldbe
aroundformywifeandfamily.Havingnowfoundthecancerwiththesecondround,I
haverevisedmyopinionandisasupporterofPSAtesting.Sure,thereareotherthings
thatcancontributetoarisingPSAandprostatecancerisusuallyslowgrowing.But,I’d
ratherbeinconveniencedandtaketheavailabletests,ratherthanignoreit.IfIwas20yrs
older,I’msureIwouldseethesituationdifferently.Untilthereisabetteroptionto
replacePSAtesting,Isayitissavinglives(especiallyinthe“”under59?”demographic).”
Paul
IhavebeenhavingannualPSAtestsaspartofannualcheckupsprettymuchever
sincethetestbecameavailable(Iamnow72).Theresultswerealwaysnormal(below
1.0)until2008,whenthereadingwasabout2.5.Thesuddenchangecausedmydoctorto
recommendabiopsy,whichshowedanearly‐stageprostatecancer,notdetectablebya
digitalexam.
Afterdueresearch,Ichosetomonitortheprogressofthecancer.
Whenthenextreadingcameinat3.3,Idecidedtreatmentwasindicated.AgainIdidmy
research,andconsultedwithaurologistandaradiationoncologistaswellasmyprimary
carephysician.Takingallthefactorsintoaccount,Ioptedforexternalbeamradiation
therapyinthesummerof2009.
Thankstostate‐of‐the‐artequipmentatmylocalhospital,andanexcellentteamof
physiciansandtechnicians,Ihadabsolutelynosideeffectsfromthetreatment.MyPSAis
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nowbelow1.0again,andIhavenoreasontobelievethatthecancerwillcausemeany
problemsinwhatremainsofmylife.
IfirmlybelievethatIamhealthiernow,andhavealongerlifeexpectancy,thanI
wouldhavebeenwithoutearlydetectionandtreatmentofthecancer,thankstothePSA
test.IfIhadwaitedforthecancertobedetectablebyadigitalexam,itmightwellhave
beentoolatetoeradicateit.
Havingreadthenewsstoriesabouttherecentcommissionreportrecommending
againstregularPSAscreening(butnotthereportitself),Isuggestthattheproblemtobe
addressedisnotgivingmentheinformationthePSAtestprovides,buthowtheydealwith
thatinformation.Certainlynobodyshouldimmediatelysubmittosurgeryorradiationon
thefirstindicationofanelevatedPSA.Iwouldsayoneshouldevenwaitforabiopsyuntil
afterasecondPSAreadingthreeormoremonthsaftertheinitialalarm.
Doctorsshouldmakeitcleartopatientsthatprostatecancersgrowslowly,and
thereisplentyoftimetodecideonthebestcourseofaction.Iftreatmentisindicated,
doctorsshouldfullyexplaintheentirerangeofoptionsandtheprosandcons,therisks
andbenefits,ofeach.Andpatientsshouldmaketheirfinaldecisionabouttreatmentin
consultationwithaphysicianwhohasnofinancialstakeinthechoice.Butdenyingmen
theinformationavailablefromaneasy,reliabletestbecauseoffearsabouthowthey
mightusethatinformationisnotasensibleorhumanesolution.
Anonymous
Prostatecancerisreadilycurablewhendetectedearly.Withouttheearlywarning
PSAtestingprovides,mylow‐riskprostatecancermighthaveeasilyprogressedbeyond
cure‐certainlevels.Typically,prostatecancersymptomsarenotapparentduringtheearly
phases.Myannualandsemi‐annualphysicalsofferedinsightsthatguidedmychoiceson
medication,additionaltesting,cancertreatments,dietexercise,etc.
NewtestsnowindevelopmentmaysoonreplaceexistingPSAexams,theypromise
improvedaccuracywithfarfewerfalsepositives.Untilthemedicalcommunityapproves
andadoptsthesenewtestingentries,thenowcommonPSAandDREtestingmethods
shouldalwaysbeemployed.
Robert
IhadbeenhavingmybloodtestsdoneaspartofmybeingintheAirForceReserve.
AspartofthenormalbloodworkbaseonmyagetheDoctoralsoorderedaPSATest.
WhenitcamebackmyPSAwas15.TheDoctorcalledmeinandrecommendedIseea
Urologistrightaway.AfteranumberofothertestshetoldmeIHADPROSTATECANCER,
anditstillmightbecontainedintheProstate.IhadthesurgerytoremovemyProstate,
andforfourandahalfyearsthePSAwasZero.
Thenthenumberstartedtorise.By2001ithadrisentoTEN,whentheDoctor
recommendedIhavesalvageradiation.ThisdidknockdownthePSAnumber,butagain
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startedtorise.AboutFouryearsagoIstartedonLupron,andthishadkeptthePSAbelow
one.
IhadnosymptomspriortothefirstPSAtest.IftheDoctorhadnotorderedthePSA
testImostlikelywouldeitherbedeadbynoworinclosetodeathandinalotofpain.
IthankGodthatmyDoctororderedthetest.
Sharon
MyhusbandwasdiagnosedwithadvancedprostatecancerafterhisfirstPSAtest
atage53.Hehadonlyafewvaguesymptoms.Earlytestingtoestablishabaselineand
thenregulartestingaftermighthaveallowedustodiscoverthecancerwhileitwasstillin
acurablestage.
Whilenotfoolproof,theinexpensivePSAtestisatoolthatwouldhaveallowedus
togetmoreinformationandmakeinformeddecisions.
Thereshouldbeveryfewmeninthisdayandagediagnosedwithadvancedprostate
cancer.”
William
IwasdiagnosedonApril4,1999followingaDRE……DXwaslumpsonbothsides
ofthegland,thenPSAwas16.7,thenBiopsyshowedcancerwithaGleasonof7&Grade
T3.
DotopersonalreasonsIwaiteduntilMarchof2000tostarttreatment.Atwhich
timemyPSAhadincreasedto23.X,duetoaboutofBladderinfection.
Treatmentwas3D‐EBRTat78graysplusLuproninjectionsfor1year….
IhavesincemonitoredwithPSAonly...1strecurrence,afterapprox.5years,Itreatedwith
6monthofEligard…2ndrecurrence,afterapprox.3years,Itreatedwith6monthsof
Eligardplus30daysofCasodex…3rdrecurrence,afterapprox.2years,Itreatedwith6
monthsofEligardplus6monthsofCasodex..
Thatbringsmeuptodate,Survivorof12years!!ImpotentduringHormone
treatmentbutrecoveredafterthefirst2boutsanddon’tknowaboutcurrentrecoverydue
toadvancedage(notCancer)….Noincontinenceatanytime...
Ineglectedtostatemyageatdiagnosiswas63,currently75...
MyOpinion,sequenceofdiagnosingshouldbe:RepeatedchangeinDRE,thenPSA
test,thenBiopsy,Thendiscussion(inDepth,especiallyaboutsideeffects)withyourDr.,
thenTreatmentofYOURchoice...Researchshowsverylittledifferenceintheoutcome…
IfIhadittodoover,IprobablywouldhavestayedonHormonesforalongerperiodof2
years.
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Michael
PSAtestingalertedmyphysiciantopossibleprostatecancerproblems.The
urologistIwasreferredtoaurologist,whodidabiopsy.Thebiopsyindicatedasmall
numberofmalignantcells.Evenso,Ioptedforsurgerytoremovetheprostate.Even
thoughIactedinatimelymanner,thepathologyreportdeterminedthatthecancerwas
breakingthroughthecapsule.Surgicalmarginswerenegative,however.
Iwas53yearsoldatthetimeofsurgerywithnophysicalindicationofprostatecancer.
Thiswasalmost10yearsago.MyPSAcheckssincethenhavenotbeendetectable.
IthinkregularPSAtestssavedmylifeandsavedmefromapainfuldeath.
ButfortheregularPSAtesting,thecancerwouldhaveescapedtheprostateandspread
beforeitcouldhavebeendetectedbydigitalrectalexam.
Dealingwithsurgeryandstrugglingwithincontinenceanderectilefunctionissues
hasbeenastruggle,butnothingcomparedtobeingdiagnosedwithadvanced
metastasizedprostatecancer.
ItwouldbeirresponsibleanddownrightstupidtoNOTmonitorPSAbeginningat
age50,age40wherethereisafamilyhistoryofprostatecancer.
RegularPSAtestingandbiopsywhereindicatedcandeterminewhetherprostatecanceris
present.Thisisinformationthatempowersthepatient.
Whatthemedicalcommunityneedstodeveloptohelpthatpatientisawayto
determinewhetherthecancerisasmalltumorthatisslowgrowingandnotanimmediate
healthrisk,oracancerthatisaggressiveandisgoingtoprogressquicklyoutsidethe
prostatecapsuleandbecomeadvanceprostatecancer.
Paul
IhadaroutinephysicalexaminationandbecauseofaPSAtestIwastoldtoseea
Urologist.WhobecauseofthistestdidabiopsyandhadastageDprostatecancer.
Prostatecancerispainlessuntilitgetssobad.Ihavenowsurvived20yearsoflifedueto
PSAtesting.
Christopher
Test,test,test!
PSAtestsrevealedanescalatingscoreoveraperiodofseveralmonths.
Accordingly,abiopsywasconductedindicatedaGleasonscoreof8—veryaggressive.
Surgeryandhormonetherapyfollowed.PSAhasbeenundetectablesincesurgeryovera
yearago.WithoutthePSAtesting,Iwouldneverhaveknownaboutthecanceruntiltoo
late.
Ican’trecommendtestingenough.
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Anonymous
PSAtestingquiteclearlyhassavedmyhusband’slifeoratleastsavedhimfroman
earlierunnecessarydeath.Attheageof44hewasgivenaPSAtestbyaGPaspartofa
generalscreening.HisPSAwasalreadyat4.0,afterfollowingitforthenext2yearsand
watchingitriseandraiseitultimatelywentto21atwhichpointheunderwentabiopsy
andwasgiventhediagnosisofStageIIIPCa,withaGleasonscoreof10(thehighestscore
possibleforaggressiveness).
Duringthe2yearsofregularPSAscreeninghewastoldonmanyoccasionsthat
menhisagedoesnotgetPCaandthatitwasprobablynotcancer.Atthetimeofdiagnosis
andbysomestrokeofluckhiscancerhadnotyetspreadtohisbonesorlymphnodesbut
hadalreadymovedoutsidetheprostateitself.
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IamcertainthatifhehadnothadthePSAtestat44andwaiteduntilthe“usual”
ageof50theywouldhavefoundthatthecancerhadalreadyspreadtohisbonesand
othertissues,makinghisprognosisextremelypoor.Hehasnowhadtheabilitytoundergo
treatmentandfightthecancerwhichinhiscaseisveryaggressiveandwouldhavesurely
takenhislifewithinacoupleofyearsifhehadnotknownofitandthereforenot
undergoneanytreatment.
Mike
MyPSAwasgraduallyincreasinginmylate50'sandfinallyhit5.0.Mydoctor
ordereda“”free”"PSAtestwhichindicatedcancer.MyUrologistwasreluctanttodoa
biopsywithjustthePSAdata,butwhenconfrontedwiththe“”free”"PSAdatawentahead
anddidit.TurnsoutIhadcancerinbothlobeswithaGleasonof6.Ielectedtohavea
radicalprostatectomyasthepredictionwasforthecancertospreadoutsidetheprostate
withinthenext3years.
Iamsixmonthspost‐surgeryandmyPSAisundetectable.Ifeelgreat.Andmy
continenceismuchBETTERthanbeforesurgery.PriortosurgeryIwouldhavetheurgeto
urinateeveryhour.Nowitisaboutevery4hours.Also,Icansleepthruthenightwithout
theneedtogetup.Mypotencyisgraduallyreturningtonormal.WithoutthePSAtest,and
the“free”PSAtest,Iwouldbelookingatyearsofmisery.
Anonymous
Iama23yearsurvivorofPCa.IwasdetectedthroughaDREbecausethePSAtest
wasnotyetusedasadetectionmethod;ratheritwasusedasadiagnostictooltotrackthe
activityofProstatecellsafterafailedprostatectomy.Atthattask,itworked(andstill
works)verywell.
ItseemstomethatalltherecommendationsoftheTaskForce(whichIhaveread
hasnoUrologist,noRadiologist,norOncologistonboard)arebasedonfailureto“”save
lives”";thattherearetoomanylevelsofPCaforthetesttobeeffective.Butinordertobe
adjudged,thepatientmustfirstknowthelevelandthereforehaveundergoneatestto
knowwheretostart.Theearlierthetestinboththepatient’sageandstageof(IF)PCa,the
morelikelyagooddiagnosisis.
ThePSAtestservesessentiallythesamefunctionasaSmokeAlarm.Somethingis
notnormal.Thediagnosisistobebasedonthephysician’sfurtherinvestigation.So,we
haveatool–imperfect,butuseable.Whatneedsbedoneistodevelopabettertool–now
beingresearchedintensively–andbetteruseofthetoolthatwehave.
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Joe
Frommy40’sonIhadaphysicaleveryyear.WhenIwas59Ichangedmyprimary
caredoctor.ThenewdoctoraskedifIhadeverhadaPSAtest.Isaidno.HedidthePSA
testalongwithathoroughdigitalexam.PSAcamebackat5.4.Hereferredmetoa
urologistwhorecommendedabiopsy.Itcamebackpositive,Iwastreatedandremained
cancerfreefor10years.PSAstartingrisingagainandIamnowonhormonetherapy.Iam
surethatifIhadPSAtestingdonefromthetimeIwas40,thecancerwouldhavebeen
caughtmuchearlier,andIcouldhavehadabetterlongtermresult.
Anonymous
MyfirstPSAwas4.45in1993overtheyearsitwentaslowas2.5andashighas
5.5in1998Ihadabiopsywhichshowednocancerbuthadpincellsinsomesamples.The
biopsywasrepeatedinDec98andpcwasdetected.AfteraradicalinFebruary1999my
PSAbegantoriseandIwentonhormonetherapy,whichIamstillon.Thedigitalrectal
nevershowedthepc.
Anonymous
Whileit’struethatPSAscreeningwhenwecan’ttellhowacancerwillprogressis
currentlyresultingintreatmentsthataresometimesunnecessary,thealternativeisthatif
peoplearen’tscreened,theyhavenowayofknowingtheyhavecanceruntilit’susually
toolate.Screeningisthesmarterchoice–nowweneedtoputourresearcheffortsinto
beingabletodeterminewhencancerswillgrowandwhentheywon’t.Sideeffectsfrom
myprostatecancertreatmentaresometimeinconvenient,butgettingacancerdiagnosis
whenit’sbeyondtreatmentwouldbemuchworse.AsaresultofPSAscreening,I’ma
cancersurvivor,notacancervictim.
Ed
DuetoayearoveryearsignificantriseinmyPSAscore(3.4to7.0)Iwasadvisedto
havea12shotbiopsy,whichshowedonlyonecancerresult(.05%).Givenmyfamily
historyofprostatecancer–Fatherdiedofit,andtwoyoungerbrothersdiagnosedinlate
50s/60s–Ioptedtohavemyprostateremoveddespitetheoptionofwatchfulwaiting.
Goodthing,thepostoppathologyreportindicatedthatmyprostatewasriddledwith
cancerandhadspreadbeyondthecapsule–butfortunatelynotbeyondthemarginsofthe
surgery.ThePSAtestisnotperfect,butuntilsomethingbettercomesalongitshouldbe
madeavailablethroughmedicalcoverageprograms.Follow‐upPSAscreeningsare
importanttoo!!
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Richard
Asahealthy53yearoldthePSAtestsavedmylife.Afterbiopsyconfirmedcancer
withaGleasonscoreof9,Ihadroboticsurgery.Thecancerwasstage3havingescaped
theprostatebutallmarginswereclear.Now2yearslaterIhavenoongoingissuesrelated
tothesurgery.Mymom,sister,twodaughters,fourgrandchildrenandmypartnerareall
verygratefulthatIhadthetestthatsavedmylife.WithoutthePSAtestmylifewouldbe
endingsoon.
Rick
Becauseofmyfamilyhistory,PSAtestingcaughtmycancerveryearlyandgaveme
manyoptionsfortreatment.IfPSAtestingisdiscontinuedformostmenpeoplewilldie
becauseofthatdecision.That’sthebottomline.
Dean
PSAtestingdone19monthsagosavedmylife!!!!Marchof2010IfoundoutIhavea
PSAreadingof8.22,afterthisIhadadigitalexamwhichindicatedIhadprostatecancera
biopsywascompletedlocatingwherethecancerwas.Fortunatelyitwascontainedwithin
myprostateandnotoutsidethemargins.IhadsurgeryonJuneof.ItisnowOctober,2011
andIremainingoodhealthfollowedbymyDoctormonitoringmystatus.
AccordingtomysurgeontheygotallthecancerandIremaincancerfree.Hadit
notbeenforthePSAIhaddoneduringaroutinephysicalasavolunteerFiremanIwould
hadneverknowntherewasanythingwrongandthecancerwouldhavegoneundetected.
Anonymous
Myhusbandhadfewmedicalproblemssorarelysawaphysician.Thefamily
practicephysicianmanagedtodoacompletephysicalonhimincludinghisfirstPSAtest
in2005whenheturned67.Somehowtheresult[7.0]anditsimportancewerenot
communicatedtomyhusband.
Thefamilypracticephysiciandiedshortlyafterandyearswentbyuntilhewastold
toseeanotherfamilypracticephysicianbecauseofhighbloodpressurein2009.Ihad
beenfussingwithhimforyearsaboutwhatIwashearinginthebathroominthemiddleof
thenighttonoavail.ThesecondcompletephysicalincludedaPSAtest.
Thisdoctorrefusedtobeignored.ThePSAwas40.5andfurthertestingwasscheduled.
Theprostatecancerhadmetastasizedtotheretro‐peritonealperioticlymph
glands.Thelocalurologistandmedicaloncologistagreedthatsurgeryandradiationwere
nolongerpossibleandputhimonCasodexandLupron.
WetracedbackhismedicalrecordsandfoundthefirstPSAresultsandwere
devastatedtolearnthathecouldhavebeentreatedforacurein2005.Instead,thedeath
ofthedoctorwillcausethedeathofmyhusbandsoonerandpossiblymorepainful.He
continuestoteachandisworkingonhis“bucketlist”,writingnovelsfuriously.Bytheend
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of2010thePSAwasrisingagain.RightnowweareenjoyingarespitewiththeCasodex
withdrawalresponse.Butitishardtoplananything,notknowinghowlongthe“”good”"
timewillbe,knowingthe“”bad”"timeissurelycoming.
Weworryaboutoursonwhosematernalgrandfatherdiedofprostatecancer
beforeourson’scollegegraduationwithhonorsandmaternalunclefoundhisprostate
cancerearlyenoughforseedradiationtherapy.At40,hehasn’thadaPSAtestyet.Will
thisnewrulingsendhimdownthesameroadashisfather?
Don
Iwasdiagnosedwithadvancedprostatecancershortlybeforemy70thbirthday.I
hadradicalsurgerythatdidnotgetitall.Thecancerwasoutsidetheprostate
necessitatingthatIsurgicallybecomeincontinentandimpotent.Myprostatecancerisin
mylymphnodes.Iamnow2.5yearsintohormonetherapytokeepitatbay.
Unfortunatelythistherapydoesnotworkforever.StatisticallyIhavelessthan3
yearstolive.TodayIamveryactive,creativeandproductive.It’sdiscouragingtoexpectit
couldendthatsoon.
Formorethan20yearsIwassohealthythatIfailedtoreplacemyprimarycare
physicianwhoretired.DuringthoseyearsIwentto2or3specialistsbrieflybutnoneof
themsuggestedIgetaPSAorDRE.Ineverhadthetypicalsymptomsthatprecedea
diagnosis.MyfirstPSAtestwasnotaccompaniedbyaDREbut4monthslateritwasand
thedoctorsentmeimmediatelytoaurologist.
HadIretainedaprimarycarephysicianorhadanyofthespecialistssuggested
testingmyfuturewouldlookawholelotbetter.Iamnow73.Myfatherdiedat83andmy
motherdiedat99.RoutinePSAandDREtestingnodoubtwouldhaveresultedinearly
detectionandaprobablesurgicalcure.InsteadIhaveahorriblypainfuldeathtolook
forwardto.PSAtestingisverysimpleandshouldbepartofroutineexaminations.The
problemtodayisnotfailureofthetestbutinappropriatefollow‐upafterpositiveresults.
Ihaveanolderbrotherwhoseprostatecancerwasdiscoveredinroutine
examinationbyhisprimarycaredoctorshortlybeforeminewasdiscovered.Hewasinthe
earlystagesandisinwatchfulwaiting,andhisPSAisonthedecline.Notonlyishis
prognosisbetterthanmine,hislifequalityismuchbetter.Imayneverreachtheagehea
hasalreadyattained.
PSAtestingisaMUST.Wisefollow‐upisevenmoreofaMUST.
Anonymous
Myhusbandwas49upondiagnosis,andonlybecauseofanotherissuedidhis
primarysendhimtoaurologistwhodidaPSA.HisPSAwas69.5andcancerwent
undetectedeventhoughhisprimarydiddigitalrectalexamseveryyearfor5years!My
fatherinlawjustdiedofprostatecancerat95….buteitherhaditanddidn’ttellanyoneor
wasnevertested.Hadhebeentestedorhadweknown…..myhusbandmayhavehada
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PSAalotsooner.HisfinalGleasonwas9/10.Hehadradicalsurgery,numbersup,45days
ofradiation,andLupron.It’salmost5yearsandhisnumbershavejuststartedtogoup
again.IthankGodfortheselast5years.AndI’mhopingforadvancesthatwillhelp
managehimforthefuture.Weareveryrealistic.
IwillmakesurethatmysonhasaPSAat25andeveryyearthereafter.To
recommendforegoingPSAtestingisaboutmoney,nottreatmentordiagnosis.The
governmentiswillingtoletpeoplelikemyhusbanddieordiealotsoonerby
recommendingtheyNOThaveaPSA.Likeeverythingelse,thecourseoftreatmentwillbe
determinedbythepatient.HadmyfatherinlawhadhisPSAorsharedit,myhusband’s
outlookandlifewouldprobablyhavebeenalotdifferent.Mysonnowhasachanceto
overcometheodds.
Iffornootherreason,PSAisneededforyoursons.Sotheyknow,sotheycanbe
diagnosedearly.Everyoneknowsthatearlydiagnosisofanytypeofcancerisessentialif
youarelookingforacure.Iwantallofourhusbandsandsonstohavethatopportunity.”
Robert
InAugust2007Iwasnotifiedbymyphysicianthatmyannualcheck‐upshowed
thatmyPSAhadrisenfrom3.2to4.2.Thedigitalprobeindicatednoabnormalities.Iwas
advisedtogotomyurologistandhaveabiopsy.Iputoffthebiopsyfor30daysdueto
pressingwork.InthemeantimeasecondurologistrecommendedarepeatPSAinsix
months.
Afteranothercallfrommyprimaryurologisturgingmetodothebiopsy,we
completeda12pointbiopsyoftheprostateinlateSeptember2007.OneweeklaterIgot
thecallthatbiopsywaspositivein6samples‐mostlyrightsideconcentratedtoward
apex.Twosampleswere80%canceroustissue.MyurologistinformedmethatIhadan
“”aggressive”"cancer.
Overthenext6weeksImetwith8urologists,surgeonsandoncologiststo
determinebestpath.Everydoctorhadachancetoviewtheslidesbutnotuntilmylast
doctordidhecarefullyreview,alongwithhisexpertteam,theslides,thelocations,etc.As
wewereleavinghisofficehestatedtome“donottaketoolongtodecide”.WhenIasked
himwhyhestated“Youareoneofthoseaggressivecases,withouttreatmentyoumaybe
deadinacoupleofmonths.”
Weoperatedon23November2007.OpenRRP.Aweeklatermysurgeoncalled
andtoldmethatwewereluckyandwegotitall.WhileIsufferedwith100%incontinence
foroneyear,themaleslinghasputmebacktonearlyfullycontinent.IhadEDissues
beforesurgeryandcontinuetoworkthatproblem.
IchosethemostexperiencedsurgeonIcouldfind.Hewasalsothesurgeonwhotoldme
nottowait.
IamabsolutelyconvincedthatIwouldbeastatistictodayifnotforthetwodoctors
whounderstoodandbelievedinPSAaccelerationandaggressivecancersign.MyGleason
wasonly7(4+3),buttheotherfactorsprovidedstrongevidence.”
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Steven
I’mprettysurethatwithaGleason9,6outof6corespositive,andpostpathology
showing30%to40%oftheprostatebeingmalignant,thatIwouldhavebeenconsidered
tohavepotentiallylethallyprostatecancer.Iwasrelativelyyoungat58in1995and
consideredas,healthy.Iunderwentsurgeryandthingsworsenedbecausepostpathology
showedextracapsularpenetrationandpositivesurgicalmargins.Ifollowedsurgerywith
radiation.
WithoutthePSAtest,biopsy,andtreatment,theoddsareextremelyhighthatI
wouldnotnowbealiveat74andwouldhavesufferedfrombonepainalongtheway.
Yes,Ihavehadsomeofthesideeffectsofsurgeryandradiation.Thesearerelativelymild
andcontrollable.Deathisnot.
David
Myfatherdiedofprostatecancerin1958atage58.PSA’s,notavailablethen,
startingat40yearsofagewouldprobablyhavesavedhislife.IstartedgettingPSA’sat40.
Atage57myPSAcamebackwithareadingof13.7(thepreviousyear,itwas4.0).Biopsy
showedcancerwithsomesegmentsshowingaGleasonscoreof8.0(veryhighactivity).
MyprostatewasremovedinJuly2000andIamnowataPSAreadingof0.0.Iamnowan
11yearcancersurvivor.
David
Iamaprostatecancersurvivor.WithoutroutinePSAtestingIwouldnowbein
agonywaitingtodie.Imissedcheckingoneyearandanaggressiveformofcanceralmost
gotaheadofme.Igottreatmentjustbeforethecancerbrokeoutoftheprostate.Addmy
voicetothosecallingforincreasedPSAtesting.Itisasprevalentasbreastcancerandcan
easilybetreatedifcaughtintime.
Anonymous
Insummerof08myPSAwas2.1.Insummerof09itwas21.Thenamonthlaterit
was28.
SoinOctIhadmyprostatetakenout.Thecancerhadspreadtolymphnodes.
Mycancerwasgraded8‐9ontheGleasonscore.
BecausethecancerwasveryaggressiveIfeelifIdidn`thavethePSAtestthe
cancerwouldhavespreadthruoutmybodybynow.”
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Mike
I’ma59yearoldwhitemale.In2008,aftermonthsofsmallandusuallynon‐
descriptsymptoms,Iwenttothedoctorforacheckup.Mysymptomswere:lowgrade
feverseveraltimesaweek,feelingflu‐ishi.e.boneandmuscleaches,nomorning
erections,veryweakstream,anddis‐chargeofsmallamountsofsemenafterurinating.
ThefirstdoctorIsawpasseditoffasnothing,possiblyfromtheuseofanti‐histamines’
knewthattherewassomethingwrong.Iwentbacktothedoctoragain2weekslater,and
insistedonaPSA.Thefirstdoctorwouldnotgivemeone,eventhoughIrequestedit.She
statedthatitisonlyrequiredonetimeayear,andIwasnotcoveredfor2testsperyear.
Butonthesecondvisit,Isawadifferentdoctor,andshedidthetestasIrequested.
Twodayslater,Iwascalledtocomeinforabiopsy;myPSAhadtripledinalittleover7
months.Iwasdiagnosedwithasmallcell,highgrade,grade8cancer.Averyrapidly
growingcancer.HadInotseentheseconddry,andhadthePSA,Iwouldhavehadless
thanayearleft.Thatwas3yearsago.Iamnowcancerfree,andamabletoperformasa
man.Ipraythatallmengetchecked.
Lawrence
Ihaveafamilyhistory(father‐62andtwoofhiscousins‐70's)ofmenwhodied
fromprostatecancerbeforePSAscreeningwasavailable.SoeventhoughIwasvery
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“tunedin”PCa,e.g.readingscientificAmericanarticlesdatingbacktothelate90's,itwas
arapidlyacceleratingPSA(from.5to2.5inoneyear)thattriggeredfurtherinvestigation
withabiopsy(digitalrecitalexamdetectednothingofcourse)thatverifiedCancer.My
prostatewasremoved4yearsagoandnowCONFIRMINGPSAtestshaveshownsofarso
good.
Anonymous
MyPSAtestinApril,2005atage50savedmylife.Itspikedfrom3.5to4.5in1
year.MybiopsyconfirmedIhadanaggressivetypeofProstatecancerwithaGleason
scoreof7(4+3).
IhadanopenradicalprostatectomyatMemorialSloanKetteringanditwas
discoveredthatthecancerspreadoutsidethecapsule.However,mysurgicalmarginsand
lymphnodeswereclear.
IfIhadnottakenthatPSAtest,thecancerwouldhavemetastasizedtomybonesand
possiblyotherorgansinmybody.
AsanactivememberofalocalProstateCancersupportgroup,Ihaveseen
firsthandthetremendousvalueofthePSAtest.Severalofourmemberspassedawayasa
resultofnottakingthePSAorbeingmisdiagnosed!
Walter
3yearsago,myPCPtoldmethatthePSAtest(0.9)andthedigitalexamwere
normal;howevermyenzymelevelwaselevated.IdecidedtoseeaUrologistforasecond
opinion.TheUrologisttoldmetheenzymelevelwasnormalandthathewantedtodoa
digitalexam.Iagreedandhefoundafirmspot.Hesuggestedthatabiopsybedone;itwas
subsequentlydonethesameday.Ofthe16samples,1camebackpositiveforProstate
Cancer.
Onthenextvisit,wehaddiscussedmyoptionsandhisrecommendations.Iopted
forroboticsurgery.Whenthepathologyreportwascompleted,itwasdeterminedthatmy
prostatewas10%infectedwithCancer.ConsideringtheinconveniencesthatIhaveto
dealwithonadailybasis,Ihopetobearoundformanymoreyearstoenjoymy
grandchildren.
Ihavebeencancerfreefor3years,andIdon’tregretthedecisionthatImadeat
thattime.IurgeALLmentogettestedandchecked,regardlesshowimperfectthePSAtest
is.Itisbetterthangoingthroughthepainandagonyofthedisease.
Carl
Ifeelthatevenifthereareproblemspre‐treatment,afterexternalbeamradiation
thenumberaccuracywasn’tanissue,itwasaquestionofwhetherthenumberwent
down.Thereisaccuracythere.
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Jim
ThePSAtestsavedmylife.
IhadacompletephysicalwhenIwas50yearsold.NoPSAwasdone.Thenexttotal
physicalwasdone9yearslaterwithaPSAdone.Itshowedittobe34!
WithoutthetestresultsIsurelywouldbedeadbynow.AGleason8wasfoundandthe
appropriatetherapiesweredone.
Iamcontinuingtherapyandamholdingthebeastsomewhatatbayalmost10yearslater.
Robert
2yearsago,normalDRE,PSA6.4andrising,Proscarstudyparticipant,biopsywith
2positivecoresoutof12,ProtonBeamRadiotherapyandPSAnow0.38.Veryaggressive
cancerdetectedandtreatedthankstoPSAtestthatwouldhaveotherwisegone
undiagnosedanduntreated.I’monly74andwereitnotforregularPSAtestingIwouldbe
lookingatmetastasesinthenearfuturewherenowIhavealifetolivecancerfreewith
mywife,childrenandgrandchildren.Thepatientandtheirphysicianshouldbethe
decidingpartiesontesting.
Anonymous
MyrisingPSAwasignoredandIfirstlearnedIhadprostatecancerAFTERI
discoveredIhadbonemets.Thiswasacaseofmedicalmalpracticeanditwenttotrial.
Themeritsofthecaseweresubstantiatedincourt.Butthatfactisirrelevant.What
mattersarethatthetreatmentsIhavehadtoundergosincethenhavebeengrimandlife
threatening.Hadthetreatmentsbegunearlierthecancermayhavebeenpreventedfrom
migratingtothebones.
SincemybonesarebreedingcancercellsIamatriskforcastrationresistantcancer
developingearlier.FurthermorehadthetreatmentsbegunwhenthePSAwasrisingI
wouldnotbeatriskfornecrosisofthejawcausedbyZometa.Hadtreatmentsbegun
earlierIwouldnothavehadtohearthatIhad6monthstotwoyearstolive(8yearsago).
Hadtreatmentsbegunearliermybloodwouldnothavebeencompromised.Had
treatmentsbegunearliertheinsurancecompanymayhavehadtospendlessthan
429,000dollarsandthehospitalwouldnotpayalargemalpracticeclaimsubsequentto
sloppyrecordkeeping.
Idon’targuewiththeexpertsthatearlyPSAtestsleadtounnecessarytreatments
andharm.Butthisproblemhasmoretodowithoverlyaggressiveoncologists,urologists,
radiationoncologists,andsurgeonsandscaredignorantpatients.Ourfearofdeathand
theDocsneedforaplentifulsupplyofpatientshavemadeforaperfectstorm.
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Jerry
IbelievethatPSAtestingsavedmylife,16yearsagoandthankmyurologistforthe
testsandtheradicalprostatectomythatfollowed.Ifsomedoctorsareoverlypushingfor
treatmentthatshouldnotbedone,shameonthem.ButtoclaimPSA’sarenotsavinglives,
that’swrongandthemediashouldbepresentingabalancedstorynotascaryheadline
thatmakesnewsbutcouldbekillingsomemen.
Jim
MyGPstartedPSAandDREtestswhenIwas70.TwoyearslatermyPSAjumped
from3to3.7intwomonthsbutmyDREwasnormal.Iwasbiopsied,cancerwas
discoveredandIhadaGleasonscoreof6andthenhadBrachytherapy.MyPSAreached
1527monthslaterandIwasdiagnosedwithprostatecancermetastatictothelymph
nodesandI’vebeenonIntermittenthormonetherapyeversince.ItlookslikeIhavean
aggressivecancerandwithoutPSAtestingitwouldhavespreadmuchfasterandIwould
probablybedeadinsteadoflivingareasonablynormallife.
PSAtestinghasprolongedmylifesignificantly.”
Anonymous
Becauseofmyfatherandyoungerbrotherhadprostatecancermyurologist
recommendedthatIhaveaPSAtestsemiannually.Insucceedingtestsin1998‐1999my
PSAscoreswere.4,then.6andthen1.1soherecommendedasextantbiopsy.Onepick
showedcancer.Iunderwentbrachytherapy.WithoutthePSAtestsmyprostatecancer
mighthavegoneundetectedforyears.Whoknowswhattheconsequencesmighthave
been!
Mark
Iwasscreenedwhenthetestingthresholdwas4.0.Mycancerwasaggressivebut
threwoffverylittlePSA.
Wouldhavebeenbetteroffwithatestingthresholdof2.5
BytimemyPSAwasupto6biopsyshowed8outof10corespositivewithGleasonof8.
Joe
Iwasdiagnosedatage47.WhenIwas45Ihadaprostateinfectionandwenton
someantibiotics.AtthattimemydoctordecidedtodoaPSAtest.Thelevelwas1.7.He
decidedthatgoingforwardweshouldtestjusttokeeptrackofthenumber.
Atage46thenumberwentto2.2andatage47itjumpedagainto2.9.Becauseofthe
upwardtrendherecommendedIgoseeaurologist.Wetalkedaboutthenumbersand
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decidedthatitwouldbeagoodideatodoabiopsytolevelset.Wereallydidnotexpectto
findanythingbasedonthePSAandDRE.
Welloneofthecoresthatbiopsiedwasslightlypositive.Wediscussedeverything
fromwatchingandwaiting,toradiation,tosurgery.Iknewthatitwoulddrivemecrazy
doingwatchingandwaitingandoptedforsurgery.
Whileonlyonecorewasslightlypositive,over35%ofmyglandwascancerousbut
itwascontained.IcannotevenimaginewhatmighthavehappenedifIwaitedtillIwas50.
Sofar,myfollow‐upshavebeenverygood.Yestherearethesideeffectsthatyoudeal
withbutyoulearntolivewiththem.
IfIamgoingouttoplaygolfinthemorning,Iwillhavedecafcoffeeinstead,orwait
untilwemaketheturn.Overtimeyoulearnwhatyourbodycanandcan’thandle,andif
youarediligentaboutyourKegelexercises,yourecoverquickly.Istruggledthefirstfew
weeks,butwithinamonthIwasbacktowork,bowling,doingjustabouteverythingIdid
beforethesurgery.Iwouldratherthesideeffects,thenfindingoutatage50andpossibly
nothavingasmanyoptionsavailable.SincethattimeIhavetoldanyonewillingtolisten
aboutwhathappenedtomeandhaverecommendedtothemthateveniftheyarenot50,
gogetabaselinetestdone,sothatifyoudoctorwantstowaittill50tostartroutine
testing,atleasttheyhavesomethingtocompareitto.
Anonymous
Atage48Ihad3TcPC.AlthoughmyfirstdoctortookthePSAtestatage45andI
had3.4hedidnothing.At48myPSAwasstill3.4butabiopsyconfirmedPC.Thecolor
flowDopplerconfirmedstage3tc.SoifallIwascountingonwasthePSA–I’dbedead
becauseitdidnotmove.ImyurologistwhyifPCissocurablethenwhydo30kmenayear
die?Heaskedmethis;“Whatdoyoucallthedoctorthatgraduatedthetopoftheclass?”I
saidIdonotknow.Hesaid,“Adoctor.”Hesaid,“Whatdoyoucallthedoctorthat
graduatedatthebottomoftheclass?”IsaidIsupposeadoctor.Hesaid,“Rightandthe
pointisthatmanymenjustseetheworddoctorandthinktheyareallthesameandthey
arenot.”
Itookthistomeanthatweneedtoseekoutthebestdoctorswhenweareonthe
life/deathline.SotomeI’dsayitwasn’tsomuchthePSAtestbecausemyfirstdumb
doctormisseditandletitmoveupthestagesandwhenthesymptomworsenedandI
madeittootherdoctorsthesamePSAnumber–buttheyfoundcancerwithbetter
technologysuchascolorflowDopplerultrasound.Finalwords:didthePSAtestsaveme–
probablynotitwasthatIhadgreatdoctors
Anonymous
OnJan.122011Iunderwentaprostatebiopsy.NobigdealIthought.ME,prostate
cancer,huhthat’salaugh.OnMarch17,2011IwasdiagnosedwithPC.I’mnotlaughing
anymore.IhadaPSAof5.36andaGleasonscoreof7.Icriedfor2monthsandjust
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wantedtodieandgetitoverwith.May9,2011,underwentaRP.Spent2weeksinthe
hospital,1weekhome,then2moreweeksinthehospitalwithaUTIandGout.Came
homeandsufferedfor3monthswithdiaperrash,incontinence,impotency,cathetertube
andjustgeneralweaknessfromsurgery.Ijustwantedtodie.Ithasbeen5monthsnow
andundergoingradiationtreatment,(allthecancerwasnotremoved)Ifeelmuchbetter
physically(excepttheincontinencepart)butIhavebeentoldatbestonly10moreyears.I
ambeingtreatedformajordepressionandalwayswillbe.PLEASE,PLEASEgetyourPSA
checkedandthebiopsyisapieceofcake.Ileastyouwillputyourmindatease,hopefully.
P.S.Iama57yearoldmaleandmarried.
Michael
Atage48Iaskedthedoctortotestmeduetofamilyhistory.MyPSAwaselevated
andtwoweekslateritwasmoreelevated.ShortlyafterIhadabiopsytoconfirmcancer
andwithinamonthIhadmyprostateremoved.ItrulybelievethatPSAtestingsavedmy
life.
Dale
PSAtestingsavedmylife.In2010,myGPsawachangeinmyPSAnumbers.
Nothingsignificant,rangingfroma2.0toa4.5,andbackdownagain.MyGPturnedme
overtoaurologist,whomscheduledmeforabiopsy.ThebiopsyshowedthatIhad
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prostatecancer.Sixmonthslater,Ihadanopenradicalprostatectomy.Thebiopsyonthe
prostateshowedthatthecancerwasmoreadvancedthanoriginallythought.
WithoutthePSAtesting,Iwouldnowbefightingprostatecancer,whichmorethanlikely
wouldhavespreadtootherareasofmybody,throughradiationandorchemo.
John
Afterundergoingabiopsy,IwasdiagnosedwithinoperableProstateCancer.For
fiveyearspriortothediagnosis,Ihad6monthlyPSAanddigitalinspections,myPSAwere
5.0andhaveneverbeenhigher.
Atthefirstdigitalinspection,therewerelumpsinmyprostate,butIwastoldby
myMDthattheywerecausedbyage.ItwasonlyonmyrequestthatIwassentfora
biopsy.Eightspecimensweretakenandtheyallcamebackpositive.
MyGleasonscorewas4+4=8andthecancerhadmovedoutsidetheProstate.Iwas
toldbytheurologistthatIhadaveryaggressivecancer.TheonlyoptionsIwasgiven,was
hormonetreatmentandradiation.IwasonLupronfor6monthsthenreceived36
radiationtreatments.TheradiationdamagedmybowelandanusalsoIamImpotentand
haveED.
Iwashavingtri‐monthlyLuproninjectionsforaboutfiveyears,thenmyPSA
startedtoriseagainto5,IwasinformedthatmycancerwasintheadvancedstageandI
wasprescribedCasodex,aswellastheLupron.
Ihavebeenpassingquitealotofbloodinmyurineforthepast3years,butafter2
exploratoryoperationswhichfailedtostopthebleeding,IwastoldIhadtolivewithit,as
theycouldn’tfindthesourceofthebleeding.
Lastmonth(October2009)myPSAstartedtoriseagainandIwasadvisedtoseea
MedicalOncologistregardingtheadvancesinChemofortheproblem.Theoncologistdid
notrecommendthatIbetreatedbychemo,butsuggestedthatIgoonaTrial,beingrunby
CougarBiotechnologies,whoaretestingthedrug,AbirateronAcetateplusPrednisone
(CB7630).Ihaveagreedtotakeplaceinthistrial,butthereisa50%chancethatIwillbe
administeredaplacebo,asitisarandomizedDoubleBlindPlaceboControlledStudy,
whichofcoursemeansthatifIgetthePlacebo,Iwillnotbereceivinganymedicationfor
thelengthofthetrail,exceptmyLuproninjections(choices,choices).
Thecancerhasnowmovedintoa2.5cmlymphnodeinmyabdomen,soitis
spreading.IamnowinthelapoftheGods,wishmeluck!
Dick
MyFathertoldmethathehadprostatecancerwhenhepickedmeupforadrive
homefromcollegesome50yearsago.Hesaidnottoworry,thedoctorscouldcureit.He
wasinhislate50sthen.Ihearditcameback,butmuchdistanceseparatedus,thenhesaid
hewascuredagain.Wemovedcloserandfoundthecancerhadcomebackandspreadto
hisbones.Thenfollowedseveralyearsofwatchinghisslowdeclineandincreasingpain.
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Hewasstoicaboutthephysicalpain,tookhispainpills.Helivedathome,hadHospice
care,butoutlivedthetimetheycouldcoverhim,butsomehowtherewasanextension.
ThegreatestpainforDad,Isawinhisfaceandeyeswastheindignityofbecoming
dependent,ofturninghislivingroomintoahospitalroom,theindignityofnotbeingable
tobeclean.
Onedayhestoodupandhiscancererodedhipfracturedandspilledhimtothe
floor,Mothercouldn’thelphim.TheAmbulancetookhimtothehospitalwherethey
promptlygavehimahipreplacementimplant—andinsodoingclosedthedoorto
furtherHospicecare.Motheratage80triedtotakeover,toofrailtoproperlysupport
him.
Fortunately,(canIreallyusethatword?)themetastaseshadinvadedhisother
organsandtheirfailuretookhislife,endingthepaininhisbonesandheart.
Startingaboutage40(I’m71now)IhadannualPSAsandDREs;Iknewthatthefamily
historyincreasedmyrisklevel.ThreeyearsagomyPSAwentup,justover4.Although
Dadhadbeengonefor15yearstheverypresentmemoryofthehorrorofhislastyears
mademydecisionforme.Thecancerhadtobeoutofmybodyasfastaspossible.Ihad
IGRTandmyPSAshavedroppedtonegligiblevalues.Iknowwecanneverassumethat
thecancerwillnevercomeback,butIfeelI’vedonethebestIcansofartomakesuremy
familydoesnotsufferanythingliketheburdenofcarethatmyFather’scancerinflicted
uponmyMother.”
Paul
Duringanexitphysicalexam,acompanydoctorsaid,Paul,youaregettingkingof
old(age66).Iwantutogetabloodtestforprostatecancer.MyPSAwas4.Iwentintoa
watchfulwaitingmodeandenjoyedsexforseveralmoreyearswhilemyPSAwentupto
26.
IhadaprostatectomyJune1998.Therewere8cc’sofcancerinmyprostateglandand
twopositivemargins.Gleason7.Five&1/2yearslatermycancerreturned.Inowhave
advancedPCaandamonintermittenthormonetherapysuccessfulsofar.Myoncologist&
IallowthePSAtogofromnearzeroto10.ThenItakethehormonesandthePSAgoes
backtonearzero.Thenthetreatmentisrepeatedandrepeated.
IfirmlybelieveIwouldbedeadbynow(age84)ifitwasn’tfortheBoeingdoctor
recommendingIgetabloodtestforPSAwhenIwas66.Earlytestingforprostatecancer
shouldbeaccomplishedonallmenwhowanttodoitviaabloodtestforPSA,andadigital
rectalexam(DRE)forlumps.
Allen
TheVAtestsmyPSAeverythreemonthstoseeifmycancerhasstartedtogrow
again.WhenthePSAgoesuptoanunsafelevel,theychangemytreatment.Sinceprostate
cancerthrivesontestosterone,thereisashotyoucantaketostoptheproductionofit.
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WhenIamnotproducingit,thecancerdoesn’tgrow.Aftertwoorthreeyears,thecancer
mutatestogrowwithoutit.Whenthathappens,thePSAtestshowsit,andtheystopthe
shotandthecancerstopsgrowing,actuallybecomesdormant,becausethereis
testosterone.Inafewyears,whenthecancerstartsgrowingagainbecausethereis
testosteronethere,theystarttheshotagain.Thishasgoneonforover20years,andthe
PSAstillshowswhentostartorstoptheshot.Ifeelthatitisalifesaver.
Anonymous
Iwasdiagnosedwithprostatecanceratage45,underwentsurgery,andhave
enjoyedthelastnearlyeightyearswithlittletonosideeffects.
IwillalwaysfeelfortunatetohavehadaphysicianwhobelievedinstartingPSAtestingat
age40.Thefirstfewannualtestswerewithinthenormalrange,butbyage42,my
numbershadstartedtomoveup.Overthenextfewyears,myphysicianfolloweda
thoughtfulcourse:
*re‐testafterafewmonthstomakesuretheresultsweren’tafluke
*administerantibioticstotreatapossibleinfectionandre‐testafterafewmonths
*refertoaurologistforanultrasoundandDRE
*biopsy
ThebiopsyresultsshowedaGleasonScoreof6,whilethepost‐opbiopsyshoweda
GleasonScoreof7.Thiswasarelativelyaggressivecancer,andIfeelstronglythatIwould
notbeinmycurrentgoodhealthifIhadwaitedtostarttestingat50.Ihavebecomean
advocateforprostatecancerawareness,andparticularlyofgettingyoungermento
understandtheimportanceofstartingtestingat40.
AnelevatedPSAisn’tnecessarilyatriggerforimmediatesurgery,butitisanindication
thatyourprostateneedsmonitoring!
Kevin
MyPSA’swere4.5whenIwasfirsttested,Ioptedforthex‐rayradiationtreatment,
andLupronshot.NowmyPSA’sareat1.5.
IfinishedmytreatmentsinJune,thisyear(2011).Ihadabiopsyafterthefirsthigh
reading,andithadshowedthebeginningofprostatecancer.Idon’tknowwhatallthe
controversyisabout;asfarasI’mconcernedthetestworks.
Bill
Myfirsttestwasattheageof54…PSA4.1;followupbiopsyshowed9of12
samplespositive.Ihadsurgeryonemonthlateranditsavedmylife...whynotimprove
whatweDOhaveinsteadofdiscouragingtheuseoftheonlyreliabletestavailable?Men
needtogettested.
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Anonymous
ItsavedmylifeIwas49healthyworking6daysaweek12hr.shiftsandlifewas
good.IwentforaroutinecholesteroltestandmydocorderedaPSAIdidn’tevenknow
whatitwas.Camebacka10notsupposedtobeabovea4wenttoaurologisthadabiopsy
andhadtohavearadicalprostatectomyrightawaycancerwasaggressiveandmoving
fast.
IfmydoctordidnothavethisdoneIwouldnotbeherenow.Iam5yrs.recovering
hadtoretirebutlifeisREALGOODnownoworriesjustenjoyingmykidsandgrandkidsI
amatpeace.HaveaPSAit’sjusta1ststepandtherearemoreteststohavetoproveifitis
cancerornotbuthavethetestit’sastartthatcouldsaveyourlifetoo.
Christopher
Iwasadoptedasaninfantandhad/havenoknowledgeofmybiologicalfamily’s
medicalhistory.
Withnosideeffectsorsymptomsofanykind,myfirstPSAbloodtestatage47savedmy
life.
MyPSAwas62.7....Mybiopsyshowcancerin10or12coreswithGleasonscores
of7(3+4)and8(4+4),onewithatertiary9.
Mypost‐surgerypathologyreportpresentedasstage3Tb,withpositivemargins,seminal
vesicleandlymphnodeinvolvement–averyadvancedandaggressivestrain.
Iamluckytohavehaditcaughtatall.HadInotgonetomydoctorforanintestinal
infectionwhenIdid,insteadofwaitinguntilmyannualphysicalsomefourmonthslater–
myprognosiswouldnotbewhatitistoday.
Anonymous
Mydoctorshouldhavebeenalertedtomystage4PCawhenmyPSAdoubled.It
onlywentfrom1.8toastilllow3.6inayearbutmydoctorandmostotherdoctorsdid
notknowatthetimethatit’sthevelocitynottheactualnumberthatismoreimportant.A
mereninemonthslater,whenIwasexperiencingseverefatigue,aCTscanshowedan
enlargedlymphnode.AbiopsyofthatlymphnodeshowedthatthePCahadalready
metastasized.ThissameninemonthslatermyPSAwasnow4.2,intherangewheresome
doctorswouldnotevenbegintodotestingbutjustwatch.
FormeaPSAtestevery6monthswouldhavesavedmeandmyfamilyalotof
heartache.Ihavebeengiven3‐5yearstolive.Imagineif………
Charles
WithurinaryissuesIwassentforasonogramthatthereviewerconcludedwas
simplyanenlargedprostategland.SixmonthslaterIavailedmyselfofafree“screening”
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regardingtheprostatethatincludedaPSAtestaswellasdigitalrectalexamination(DRE).
TheDREwassuspiciousandtheUrologistsuggestedthatwhenthePSAresults
cameback,tovisitwithwhomeverUrologistIchose.PSAwaselevatedto6.8ng/mland
subsequentbiopsyfollowedbyradicalprostatectomydeterminedGleasonScore3+4/7.
However,atumorwasfoundtobeextendedinto“fattytissue”sosalvageradiationwas
administered.Yet,despitesurgicalremovalfollowedbysalvageexternalbeamradiation
mycancerstillrecurredthreeyearslater.
Imaginehowadvancedthiscancercouldhavebecomehadthefreeprostate
screeningwithPSAtestandDREnotbeenavailable.Withsubsequenton/off/on/off
androgendeprivationtherapyIcontinuetosurvive19yearslater.Beingawareofone’s
PSAlevelwasandcontinuestobeextremelyimportantasabiomarkerprovidingevidence
thatsomethingisoutoforderandrequiresattention.AccompaniedbytheDREthePSA
wasandcontinuestobeanappropriatemethodofidentifyingthepossibledevelopment
ofprostatecancer.
Nomanshouldbedeprivedoftheknowledgeofthepresenceofcancerinhisbody.
Theimportanceisinthediagnosingphysicianthenprovidingacomprehensive
explanationofwhatthediagnosticsindicateandalltheoptionsavailabletothepatient.
Ignorancemaybebliss,asthesayinggoes,butcertainlynotsowhencancermaybein
development.WecontinuetoNEEDthePSAbloodserumtestaccompaniedbytheDRE
untilsomethingequallyorbetterandascosteffectiveisdetermined.Physiciansarenotto
playGodandkeepfromusdiagnosticproceduresthatmaymakeadifferencetoour
continuedlivingorearlydemisebecausetheyfailedtomakeavailabletousasimple
procedureslikethePSAtest.
Anonymous
Wasdiagnosedwithanaggressivemucosal(noideahowtospellthatword)
versionofprostatecanceratage45.WhenIfinallygaveintohavingtheprostate
removed,attheageof47,itwasalreadyonthevergeofexitingtheprostate.Thank
goodnessIwasdiagnosedearlyenoughwiththePSAtesting,andthedoctorsremained
persistenttothepointIallowedthemtoremoveitwithintime.
David
IhadmydoubtswhenmyphysicianinsistedthatIhaveabaselinePSAtakenatage
40.Atage48,mybaselinehaddoubledandstartedincreasinggeometrically.Thankfully,
myphysician’svigilancecaughtmyprostatecanceratanearlystage,allowingmetohave
focalcyroablation.Ididn’trealizeuntilmuchlaterthathealsoprobablysavedmylife.
Twouncles,withwhomIhadlosttouch,eacharesufferingfrommetastaticprostate
cancer.TheydidnothavephysicianswhoinsistedonPSAscreening.
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Bill
IneverthoughtIwouldhaveprostatecancer.MyannualphysicalsshowedthePSA
numbersrisingfromthe3rangetothe4range,tothe5range,andfinallyintothe6range.
StubbornasIwas,Ifinallytookmyfamilydoctor’sadvice,sawaurologist,andhada
biopsy,whichshowed6coresoutof12positive,Gleason7(3+4).WithoutthosePSAtests,
Iwouldalmostcertainlynowfindmyselfwithmetastaticdisease.Instead,mycancerwas
organcontainedandmyprognosisisgood.
John
WhenIturned40IaskedmythendoctorforaPSAtest.Itoldhimmyfatherhad
diedofprostatecancerandIknewIwashighrisk.HeaskedmeifIhadurinaryorerectile
issues,towhichIrepliedno.Hesmiledandsaidwellifyoustarthavingproblemswe’ll
testyou.MywifeencouragedmetochangedoctorswhichIdid.Mynewdoctorgavemea
completephysicalincludingaPSAtestandarectaldigitalexam.Thiswasmyfirstexam
ever.ThedoctorfeltanoduleandIhadaPSAof1.0.Iwentthroughthebiopsyandwas
confirmedGleasonscore6prostatecancer.Ihadroboticprostatectomytoremovethe
cancer.HadmydoctornotdonethetestingIwouldbelookingatthesamedeathmy
fatherendured.Prostatecancertestingsavedmylife.
Joe
Hello,mynameisJoe,at37yearsold,myPSAwasat5.8,Ihadabiopsyanditwas
negative.Ayearlater,myPSAwas6.1,theydidadeeperbiopsywithmoresamplesand
that’swhentheyfoundoutIhadprostatecancer.I’msothankfulthatmydoctorwas
makingsureIwasgettingmyPSAchecked.Ihadtheroboticsurgeryand2yearslaterI’m
cancerfree.
.
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Nowthatyouhavereadthroughmanypatientandfamilystories,please
decideforyourselfifyouwanttohaveaPSAtest.
ThecostofPSAtestsiscoveredbyMedicareandmosthealthinsurance
plans.
Speaktoyourdoctororvisitalocalmedicalclinic.
ProstateCancerinformationandsupportfromhundredsofotherguyswho
havebeenwhereyouarenow,isonlyaclickaway,atwww.malecare.org
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