It’s good at what it does - measure PSA. What happens after that is what counts.
I don’t disagree but we didn’t have it until recently and you can only play with the cards you have.
My point was that the number of PSA tests has risen hugely in recent years which has led to a much higher rate of diagnosis in that time. I haven’t seen any evidence that the age corrected number of prostate cancers has actually increased. I guess that’s impossible as many more would have died without a diagnosis.
PSA is a screening test, not a diagnostic. The problem is not the test or the marker, but the interpretation of the result.
Absolutely right, I like to describe it as a check engine light. It tells you that something is going on but not what. Also complicated by the fact that some prostate cancers don’t generate much PSA.
I refer you both the the brothers I mentioned earlier, PSA is not a reliable screening test either. The biopsy proceedure is painful, expensive and carries risk, Bring on the PSE.
Anecdotes aren’t data so, while it might be an interesting story, it doesn’t really tell us much.
I think only the misinformed believe that it is. All it tells us is that PSA is high (or not). Too many believe that it’s a diagnostic test.
It still seems to be very expensive for mass screening but presumably that would drop with economies of scale.
I must remember that when I visit our friend who is coming home from his treatment session today, bound to cheer him up
Whilst comparing cost, the PSA is cheap, probably as you say due to economies of scale, the Biopsy and staff envolved dont get any cheeper and factor in 20+ wasted ones on my friends brothers.
As john said, it’s a signal to investigate further, probably using other markers than biopsy first. An absence doesn’t mean all is well as the anecdote helps confirm, but rather that it’s simply not causing a high PSA level.
You know that I’m well aware of the impact of prostate cancer but I prefer to make decisions based on scientific data rather than anecdote. Sorry if that’s a bit blunt but everyone needs to make their own decision based on what works for them.
Thats our friends problem, low to normal PSA therefore no problem, give it a few years for the cancer to grow, now a much bigger problem. I hope I am making myself clear. Any support for the PSA test could slow down the adoption of the PSE test.
The other brother no cancer has a high PSA and 20+ biopsies.
Yes and if you can stop being so ……and realise how the PSE test could really change lives? At what point did you make the decision what worked for you? Or was it more you were carried along by the professional(s) all well and good but we now need to support the PSE test that is simply far better by magnitudes and if caught earlier far better outcomes. Why is is so difficult to dump what doesnt work in favour of does.
Erm, I think I already agreed that up there 
After lots of reading of actual science and asking lots of questions of said professionals. Don’t get me wrong, I still question if I should just have gone for radiotherapy in the first place but that’s mostly based on hindsight and information after the event.
If people want to choose a therapy route based on Bill next door then good for them, I prefer a bit more rigour.
I’m not sure where this is coming from as, again, I’ve already agreed that the PSE is a good thing.
The PSA test worked for me. Being “at risk” I had very regular tests and the results were up and down. Then I had three on the trot all heading steeply in the same direction. This (plus other symptoms) led to a “digital” test which confirmed I needed the op.
Err, detection of a tumour is not the therapy route, thats later, I am talking about being able to detect it in the first and possibly the earliest stage where outcomes are very often far better.
Just for the record its not Bill, its my friend John. No cause for alarm as PSA was normal, only it wasnt and now its aconsiderably worse situation as I as sure you can understand.
It takes time to educate medics and convince them of the added value of newer tests. Most clinicians genuinely want the best for their patients, but may be reluctant to adopt new tests and methodology. Then there’s the ‘nobody got fired for buying IBM’ attitude. Testing for PSA is entirely valid and appropriate, but it should be part of a panel rather than a lone marker.