Get that Prostate check please !

[Olddaddy]

I see prostate cancer in men has risen .

Please guys go get a PSA blood test and a rectal exam.

The last few days I have noticed increased urination myself I'm thinking possibly prostate cancer and have booked in to see a Urologist next week!!!

Please ask your doctor for a PSA blood test  ASAP to determine your prostate level .

Look to be honest it appears going by Google they can't do anything anyway if you have the cancer but least they can slow it down .

I have booked in with a young Asian urologist which will cost me around $400 but better to be safe than sorry .

He will do the physical rectal anal exam of putting his finger in my bum to feel my prostate .

 

[unicorn]

This is a very complex subject. First of all, there are countless (well, quite a few) conditions which cause an increase in urination, only some which involve the prostate at all. If the prostate is involved in increased urinary frequency, it's because the prostate is preventing you from emptying your bladder completely. The other symptoms which will go along with that are what are called "obstructive symptoms": straining while urinating, a less forceful urinary stream, a sense you aren't completely emptying your bladder, and dribbling after you finish, for example. Other symptoms might point to alternative diagnoses. Irritation and urgency would be more suggestive of infection, for example, and increased thirst and/or volume of urine would be more suggestive of diabetes (of which there are different types, including non-sugar related types). Blood in the urine would suggest either bladder infection or bladder cancer as a cause. Even within the prostate, there are different prostate-related causes, with non-cancerous growth and prostate infection being more common than the (still common) prostate cancer. 

Getting a PSA level checked is certainly a good idea for men over 45 or so with urinary symptoms, especially if the symptoms are obstructive. That being said, this does NOT mean it's a good idea for men without symptoms to get PSA levels checked on some sort of routine level. I would urge board members reading this to get their health advice from public health officials whose job it is to evaluate all of the scientific facts, instead of relying on emotional stories or discussions. 

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening

Benefits of Early Detection and Treatment
The goal of screening for prostate cancer is to identify high-risk, localized prostate cancer that can be successfully treated, thereby preventing the morbidity and mortality associated with advanced or metastatic prostate cancer.

Adequate evidence from randomized clinical trials (RCTs) shows that PSA-based screening programs in men aged 55 to 69 years may prevent approximately 1.3 deaths from prostate cancer over approximately 13 years per 1000 men screened.3, 4 Screening programs may also prevent approximately 3 cases of metastatic prostate cancer per 1000 men screened.3 Current results from screening trials show no reductions in all-cause mortality from screening. There is inadequate evidence to assess whether the benefits for African American men and men with a family history of prostate cancer aged 55 to 69 years are different than the benefits for the average-risk population. There is also inadequate evidence to assess whether there are benefits to starting screening in these high-risk groups before age 55 years.

Adequate evidence from RCTs is consistent with no benefit of PSA-based screening for prostate cancer on prostate cancer mortality in men 70 years and older.

Harms of Early Detection and Treatment
The harms of screening for prostate cancer include harms from the PSA screening test and subsequent harms from diagnosis and treatment. Potential harms of screening include frequent false-positive results and psychological harms. One major trial in men screened every 2 to 4 years concluded that, over 10 years, more than 15% of men experienced at least 1 false-positive test result.5 Harms of diagnostic procedures include complications of prostate biopsy, such as pain, hematospermia (blood in semen or ejaculate), and infection. Approximately 1% of prostate biopsies result in complications requiring hospitalization. The false-positive and complication rates from biopsy are higher in older men.3 Adequate evidence suggests that the harms of screening and diagnostic procedures are at least small.

PSA-based screening for prostate cancer leads to the diagnosis of prostate cancer in some men whose cancer would never have become symptomatic during their lifetime. Treatment of these men results in harms and provides them with no benefit. This is known as overdiagnosis, and follow-up of large randomized trials suggests that 20% to 50% of men diagnosed with prostate cancer through screening may be overdiagnosed.3 Overdiagnosis rates would be expected to increase with age and to be highest in men 70 years and older because older men have high risk of death from competing causes.

Harms of prostate cancer treatment include erectile dysfunction, urinary incontinence, and bothersome bowel symptoms. About 1 in 5 men who undergo radical prostatectomy develop long-term urinary incontinence requiring use of pads, and 2 in 3 men will experience long-term erectile dysfunction. More than half of men who receive radiation therapy experience long-term sexual erectile dysfunction and up to 1 in 6 men experience long-term bothersome bowel symptoms, including bowel urgency and fecal incontinence.3 Adequate evidence suggests that the harms of overdiagnosis and treatment are at least moderate.

Adequate evidence shows that the harms of screening in men older than 70 years are at least moderate and greater than in younger men because of increased risk of false-positive results, harms from diagnostic biopsy, and harms from treatment.

Before consenting to screening (which is different from testing when there are symptoms), it's important to be aware of both the potential benefits of screening (which, if you read the USPSTF, are quite minimal), as well as the potential harms--which are numerous and much more likely. So, yes, the original poster should probably get a PSA done due to his symptoms (especially if they're obstructive), and I hope he keeps us updated. However, the takeaway message should NOT be that all men over 50 should rush in and get this testing. There are some pretty significant harms that can come from screening, especially since the vast majority of prostate cancers never affect the life of the  man who has it. There is a massive amount of science which has looked into this question, and professionals have spent large amounts of time actually reviewing the data. 

[Olddaddy]

Still better to be safe than sorry and get a check, same with a colonoscopy every 5 years .

 

[t0oL1]

The digital prostrate exam is not as fun as it sounds…

Cleveland Clinic does an IsoPSA that gives better results and prevents some unwarranted biopsies that really aren’t fun.

But dying doesn’t sound like fun either.

After prostratectomy, injectable ED medication therapy 2-3 times a week raises erection recovery to 50% by a new smaller study.

[tm_nyc]

12 hours ago, Olddaddy said:

Still better to be safe than sorry and get a check, same with a colonoscopy every 5 years .

Yes!  Agree 100% on both.  And, no, the 'digital' exam is no fun at all.

[Olddaddy]

2 hours ago, tm_nyc said:

Yes!  Agree 100% on both.  And, no, the 'digital' exam is no fun at all.

Mmmmm...one of my reasons for going regular is the finger(s) up the bum 👍🤣

[floridarob]

15 hours ago, Olddaddy said:

same with a colonoscopy every 5 years .

 

Until 75....

[unicorn]

18 hours ago, Olddaddy said:

Still better to be safe than sorry and get a check, same with a colonoscopy every 5 years .

 

Again, please get your information from public health professionals and professional advisory guidelines, not from forum posts. If you're using colonoscopy as the screening tool for colon cancer, the evidence shows screening should be every 10 years, not 5. Colon cancer screening is the most effective cancer screening there is, precisely because there is a very long period from polyp to pre-cancerous polyp to cancer to invasive cancer, which is why 10 years is the official recommendation. While it may feel you're being "more clever" by doing it every 5 years, colonoscopy has a pretty high rate of serious complications (about 1 in 1000 result in perforation), which is why 10 years works out best. "Intuition" is not what one needs to make these decisions. Guidelines come from statistics and hard facts:

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

Direct visualization tests
Colonoscopy	Every 10 y	Evidence from cohort studies that colonoscopy reduces colorectal cancer mortality Harms from colonoscopy include bleeding and perforation, which both increase with age	Screening and diagnostic follow-up of positive results can be performed during the same examination Requires less frequent screening Requires bowel preparation, anesthesia or sedation, and transportation to and from the screening examination

 

And, again, with prostate cancer screening, the facts are known and well-summarized for anyone who cares to look into the details of the previously-provided link. While it may intuitively feel as if knowing if you have prostate cancer is useful information, it's a statistical fact that this knowledge does NOT increase lifespan. The vast majority of prostate cancers discovered by prostate cancer screening will never affect the life of the person with said cancer. Discovery of these cancers is more likely to harm the patient than help the patient. This is absolutely a matter of fact, and not a matter of opinion. 

Now, if you see the statement "PSA-based screening programs in men aged 55 to 69 years may prevent approximately 1.3 deaths from prostate cancer over approximately 13 years per 1000 men screened" and you feel it's better to take the chance on being one of those 1.3 per 1000, rather than in the overwhelming majority who will be harmed (and even have his lifespan shortened) due to the screening, now that is a matter of personal values and opinion. But it's best to make such decisions fully informed, and with one's eyes wide open, because the consequences are serious. 

[Olddaddy]

Well guys went to a GP yesterday, about my prostate .

He said gay men and listen to this ,he said gay men have HIGHER PSA levels because they have gay sex and it massages the prostate !!!

I had no idea !

Anyway rather than a rectal or blood test again ,he gave me a urine test ,didn't know you can get these for prostate so I will await the result 

[unicorn]

On 9/7/2022 at 3:02 PM, Olddaddy said:

Well guys went to a GP yesterday, about my prostate .

He said gay men and listen to this ,he said gay men have HIGHER PSA levels because they have gay sex and it massages the prostate !!!

I had no idea !

Anyway rather than a rectal or blood test again ,he gave me a urine test ,didn't know you can get these for prostate so I will await the result 

Yikes! You should strongly consider getting a new GP. First of all, there's NO evidence gay men have higher PSA levels, whether they bottom or not. In fact, studies have shown that ejaculating more frequently seems to LOWER the risk of developing prostate cancer (which makes sense, intuitively, because you're clearing out your prostate more frequently):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040619/

"...These findings provide additional evidence of a beneficial role of more frequent ejaculation throughout adult life in the etiology of PCa...".

Also, if a person, knowing the risks and modest benefits of prostate cancer screening, still wishes to undergo this screening, a blood PSA level is the only way to do it. This screening cannot be done with any urine test. 

[Lucky]

Lets all ejaculate!