Another reason to be cautious about early PSA screening

Another reason to be cautious about early PSA screening

Some researchers now advocate starting PSA screening for prostate cancer at age 40, rather than 50. The idea is to establish a baseline that is useful in interpreting scores later on. I expressed my objection on the basis of the stress of false positives. However, I didn’t think about the potential pain of the biopsy itself until I saw Tara Parker-Pope’s Health Mailbox column about it in the Wall Street Journal. Lots of readers wrote in and a good number had something unpleasant to say about the procedure. It’s anecdotal information but worth considering.

First, on the positive side:

“It was totally painless. I would suggest that routinely calling it a painful procedure is a mistake. It depends on the doctor’s skill and how the patient reacts to the anesthetic, and can range from totally painless on up.”

“I just went through the procedure yesterday… Piece of cake…”

Others were less encouraging:

“…I had six biopsies, and each was worse than the last. True, I had no anesthetic, and I can tell it you, it really smarts. Then for quite a while you have bloody red ejaculate, which is another turn-off they don’t seem to mention.”

“The biopsy was for me terrible. I have learned that like so many things with prostate cancer it varies greatly from one man to the next. The prostate surgery itself was a piece of cake by comparison.”

From my perspective, it’s worth taking into account the physical and emotional downsides of a biopsy when deciding whether to have a PSA test in the first place.

Disclaimer: I’m not offering medical advice. Figure out with your doctor what makes sense for you.

November 27, 2006

2 thoughts on “Another reason to be cautious about early PSA screening”

  1. Doctors should explain to patients that PSA test results are influenced by sexual arousal over the past several days, possibly due to effects of pressure build-up of fluids produced by the prostate. If arousal is held constant, results are easier to interpret, but some physicians will biopsy based on bad data.

  2. I am a microbiologist whose research on a particular bacteria, mycoplasma, has given me insight into this “supposedly” non-pathogenic organism. Using a 2 week therapy of Zithromax (azithromicin) reduced my PSA level from nearly 10 to 5.0. I now sleep through the night and my stream is increased remarkedly. Check with your doctor and try this therapy. You will be amazed. Mycoplasma DOES infect the urinary tract and lungs. This may work miracles.

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