PSA is not an absolute test, I have prostate cancer and my PSA is .75, should have a DRE yearly is over age of 50

I wish the medical community would stop calling the current options available to prostate cancer sufferers a "cure". What is offered today by western medicine are ways of ridding a man of prostate cancer by removing or destroying his prostate, and, thereby, fundamentally changing his sex life, and very possibly leaving him incontinent. As a young (51) man with a positive biopsy, I'm not exactly ready to give up my virility, and I would hardly call a choice between mutilation or death, a "cure".

Although not a "cure", if Prostate Cancer is detected in early stage, and if certain qualifications are met, pro-actively following the Johns Hopkins' "Expectant Management with Curative Intent" program, led by Dr. H. Ballentine Carter, may preclude the need for surgical removal of the prostate, or alternate options.

Glad to read your Alerts.....I am new to this site and this is my first question. I am 59 years old and just received the results of my annual physical exam. The test showed a PSA level of 5.13. Report showed that the test was repeated from same sample. Is this a major concern since I had sex the night before the test? (Not knowing that I shouldn't). My doctor recommended that I see a Urologist but thought to call him and ask to repeat the test on a new sample keeping in mind to not have sex for the recommended 72 hours this time. Do recommend to see a Urologist or repeat the test? Here is the history of my PSA tests over the last few years:

Year PSA velocity 2000 2.4 2002 2.6 0.2 2003 2.4 -0.2 2005 2.6 0.2 2007 3.8 1.2 2008 5.13 1.33 Verified by repeat test from same sample

What do you think?

I find your alerts very thought provoking and at the same time, reassuring. I realise I am not alone, and the thoughts and emotions I have are shared by others.

I was fortunate to be diagnosed with Prostate Cancer (by biopsy) about 15 months ago - when it was at an early stage. (Gleeson 6 (3+3) / T1C) For the record I had a PSA of 1.5. and was on a research project to find better ways of early detection and treatment of Prostate Cancer.

In the UK, PSA monitoring is NOT a regular event, therefore it is impossible to check the PSA Velocity over 10 to 15 years.

I endorse the comments of Silversmoke - though I have to say it is a fine balance between active monitoring and proactive treatment.

I have changed my attitude towards treatment following consultations with a couple of oncologists - each with very different attiudes.

My Treament Plan is now based on Active Monitoring backed up by Brachytherapy (against the original plan of urgent surgury).

As one of the oncologists explained to me - when the side-effects of the treatment (not cure) are worse than the symptoms, why go through the pain (of the treatment and side effects), and anyway, over time more appropriate treatments may arise with less intrusive side effects that may revise the decisions.

It seems clear the PSA velocity has more significance than the PSA value itself. One risk I noted was when a 3.1 PSA(2007) moved to 8.1(2008) which resulted in a referral to a urologist. He wanted to schedule an immediate biopsy and scan. I decided to think about it for a while and two months later called our family doctor and repeated the PSA - 3.8. Without a judgment on the DRE before the blood test, a reasonable person might suggest a confirming test with an increase like that. The repeat test was relatively inexpensive and quick and avoided a risky and unpleasant test that very likely would not have shown anything. I waited 2 months for arbitrary reasons. My family doctor speculated about prostitus but I also had a urinalysis.

For xbearx: I had a radical prostatectomy 3 months ago, and while I'm still getting back to normal, I can "see normal" from here in terms of both continence and sexual function. Mutilation is way too strong a term for surgery that can work well, work poorly, or somewhere in between, and which does have a decent probability of extending your life. Within a few weeks of being diagnosed with early prostate cancer, I met three different people who lost immediate relatives to prostate cancer...and none of them had good last years. Made it easy for me to decide. It's your call how you deal with it, but don't assume that life stops after a prostatectomy...it doesn't necessarily!