Johns Hopkins Health Alert
How Old Is Too Old For an Annual PSA Test?
If you are an elderly man, you may wonder if you should continue to have an annual PSA test to screen for prostate cancer. Here are the latest guidelines.
The U. S. Preventive Services Task Force recently recommended that doctors not screen men age 75 and older for prostate cancer. The panel weighed the potential benefits and harms of PSA testing in this population and concluded that the screening was more likely to have a negative impact on these men than a positive one.
The rationale: Prostate cancer is a slow-growing malignancy that may take 10 or more years to produce significant symptoms. Many elderly men will die of another condition before their prostate cancer becomes life threatening. Thus, an abnormal PSA test would lead to the pain and discomfort of a prostate biopsy and unnecessary worry if no cancer is found. If cancer is found and treated, the man will have to contend with side effects, such as sexual dysfunction and incontinence.
Other medical organizations recommend annual screening for men at average risk for prostate cancer beginning at age 50, but they do not address when screening is no longer necessary. And still others recommend screening for all men with a life expectancy of at least 10 years.
Bottom line advice: If you are age 75 or older, discuss the risks and benefits of PSA testing with your doctor. If you get tested and are diagnosed with a low-grade cancer, keep in mind that active surveillance is an option that allows you to be closely monitored but treated only if your disease progresses.
Posted in Prostate Disorders on October 15, 2009
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I am shocked- the 70s are the new 50s. This demonstrates the axiom: old = expendable! I am 72 just diagnosed with stage T2a- Gleason score 7(4-3)- 6.2 psa. No family history of prostate cancer, both parents lived to age 92. I work out at a health club (with many members in their mid to high 80s or I hike in the mountains, near home, 7 days a week. Eat healthy- 152 pounds- 5'9". If today's cancer stats were 4 years into the future, when I would be age 76, or even be more aggressive- undetected- where would I be? What right does the medical community have to rob me of my goal of living at least as long as my parents to age 92. The medical profession should continue extend PSA testing to all reasonable healthy older men without setting an arbitrary age limit on PSA testing. I would sincerely hope this would not become the standard for PSA testing.
Posted by: suvdel | October 15, 2009 11:21 PM
I am 73 years of age. I have had an annual PSA and DRE since age 50. At age 68 my PSA was above 4.0 and I had a prostate biopsy procedure. This was a very painful procedure even with sedation. One has pain starting at the groin, down to the feet, back to the base of the neck, and then back to the groin! My Brother-In-Law informed me that they would make 6 passes to collect the required tissue sample. A funnel is placed in your rectum and instruments inserted to extract the prostate sample by shooting a needle through the rectum wall into various parts of the Prostate Gland. When 6 passes had been made on me, my Urologist, assisted by a Licensed Technician, informed me we were half way through the biopsy procedure. Wow! I suffered thru 6 additional passes. On the way out through the waiting room full of men and while I am still groggy (I wear hearing aids and still talk loud), I stated "I wouldn't wish this biopsy procedure on my worst enemy!" My test came back negative for cancer! My dad lived to 98 and his younger sister to 102. I intend to keep getting annual PSA and DRE the rest of my life whether Medicare B and TRICARE FOR LIFE pay for them or not - I will pay the cost myself!
Posted by: neelmc | October 17, 2009 7:47 AM
12/19/09, To Start Scr..., Not to worry about biopsy procedures; I've had several. Also, cystoscopies were done on me since age 50--all painless. I'm now 62; I've got BPH. I see my urologist twice a year & take Avodart and Cardura. Among other things, I eat lots of tomatoes & garlic. ~Enjoy Xmas & New Year. .......Preston Weiters.
Posted by: p.weiters | December 19, 2009 7:33 AM
"The U. S. Preventive Services Task Force recently recommended that doctors not screen men age 75 and older for prostate cancer."
Isn;'t is 75 and YOUNGER? Please correct this document.
Posted by: Regnad Kcin | January 7, 2012 12:05 PM
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Start screening by age 40, not 50! I had stage 2C Prostate cancer at age 43. Men my age can die in 2 years without treatment! Low Vitamin D levels and exposure to BisPhenol A in epoxies, thermal paper, fire retardants, bottles & cans bring the disease to younger men.
Posted by: tetech | October 15, 2009 7:42 AM