My Daily Prompt Blog

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Findings Along The Way Part II

It is been a week and still no word on the bloodwork.  It is back, it just has not been read yet.
The test we are specifically waiting for is a PSA test.

The PSA test is used primarily to screen for prostate cancer. A PSA test measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced in the prostate, a small gland that sits below a man’s bladder. PSA is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood.

The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels.

There is a lot of conflicting advice about PSA testing. Ultimately, whether you have a PSA test is something you should decide after discussing it with your doctor, considering your risk factors and weighing your personal preferences.

Results of PSA tests are reported as nanograms of PSA per milliliter of blood (ng/mL). There’s no specific cutoff point between a normal and abnormal PSA level. Your doctor might recommend a prostate biopsy based on results of your PSA test and digital rectal exam, along with other factors.

Variations of the PSA test

Your doctor may use other ways of interpreting PSA results before making decisions about ordering a biopsy to test for cancerous tissue. These other methods are intended to improve the accuracy of the PSA test as a screening tool.

Researchers continue to investigate variations of the PSA test to determine whether they provide a measurable benefit. Variations of the PSA test include:

  • PSA velocity. PSA velocity is the change in PSA levels over time. A rapid rise in PSA may indicate the presence of cancer or an aggressive form of cancer.
  • Percentage of free PSA. PSA circulates in the blood in two forms — either attached to certain blood proteins or unattached (free). If you have a high PSA level but a low percentage of free PSA, it may be more likely that you have prostate cancer. This test is primarily used for men with a PSA level in the borderline range between 4 and 10. It is especially useful when determining the need for re-biopsy rather than in an initial screening state.

Talk to your doctor

Before getting a PSA test, talk to your doctor about the benefits and risks. If you decide that a PSA test is right for you, ask your doctor:

  • When you will discuss the results
  • What kinds of recommendations he or she might make if the results are positive
  • How often you should repeat the test if the results are negative

Discussing these issues beforehand may make it easier for you to learn the results of your test and make appropriate decisions afterward.

Prostate cancer is the most common nonskin cancer in men, and it’s the second leading cause of cancer-related death in men after lung cancer. Early detection may be an important tool in getting appropriate and timely treatment.

Men with prostate cancer may have elevated levels of PSA. Many noncancerous conditions also can increase a man’s PSA level. Although the PSA test can detect high levels of PSA in the blood, the test doesn’t provide precise diagnostic information about the condition of the prostate.

The PSA test is only one tool used to screen for early signs of prostate cancer. Another common screening test, usually done in addition to a PSA test, is a digital rectal exam. In this test, your doctor inserts a lubricated, gloved finger into your rectum to reach the prostate. By feeling or pressing on the prostate, the doctor may be able to judge whether it has abnormal lumps or hard areas.

Neither the PSA test nor the digital rectal exam provides enough information for your doctor to diagnose prostate cancer. Abnormal results in these tests may lead your doctor to recommend a prostate biopsy. During this procedure, samples of tissue are removed for laboratory examination. A diagnosis of cancer is based on the biopsy results.

Other reasons for PSA tests

For men who have already been diagnosed with prostate cancer, the PSA test may be used to:

  • Help decide if and when to begin treatment
  • Judge the effectiveness of a treatment
  • Check for recurring cancer

Benefits of the test

A PSA test may help detect prostate cancer at an early stage.  Cancer is easier to treat and is more likely to be cured if it’s diagnosed in its early stages.

But to judge the benefit of the test, it’s important to know if early detection and early treatment will improve treatment outcomes and decrease the number of deaths from prostate cancer.

A key issue is the typical course of prostate cancer. Prostate cancer usually progresses slowly over many years. Therefore, a man may have prostate cancer that never causes symptoms or becomes a medical problem during his lifetime.

Limitations of the test

The limitations of PSA testing include:

  • PSA-raising factors. Besides cancer, other conditions that can raise PSA levels include an enlarged prostate (benign prostatic hyperplasia, or BPH) and an inflamed or infected prostate (prostatitis). Also, PSA levels normally increase with age.
  • PSA-lowering factors. Certain drugs used to treat BPH or urinary conditions may lower PSA levels. Large doses of certain chemotherapy medications can also lower PSA levels.
  • Misleading results. The test doesn’t always provide an accurate result. An elevated PSA level doesn’t necessarily mean you have cancer. And in some cases, a normal PSA level does not completely rule out prostate cancer.
  • Overdiagnosis. Studies have estimated that between 17 and 50 percent of men with prostate cancer detected by PSA tests have tumors that wouldn’t result in symptoms during their lifetimes. These symptom-free tumors are considered overdiagnoses — identification of cancer not likely to cause poor health or to present a risk to the man’s life.

A number of major professional organizations and government agencies have weighed in on the benefits and risks of PSA testing. The American Cancer Society, the American Urological Association, the American College of Preventive Medicine, the Centers for Disease Control and Prevention, and the U.S. Preventive Services Task Force all recognize the controversy surrounding screening with the PSA test and the lack of firm evidence that screening can prevent deaths from prostate cancer. Other points of agreement include:

  • Screening needs to be an individualized decision. All of the organizations recommend that doctors discuss the benefits and risks of PSA testing with men at a certain age or in high-risk groups. Doctors should help men make their own decisions about screening, based on age, risk factors, life expectancy and personal preferences.
  • Older men may not need to be screened. Some organizations recommend that screening isn’t necessary for men age 75 and older or those who aren’t expected to live more than 10 years. The American Cancer Society advises that this decision should be made on an individual basis. It is very important, however, to keep in mind that decisions need to be individualized and not assume that all prostate cancer screening must stop once a man is in his 70s.
  • Men at high risk should discuss screening at an earlier age. Some groups recommend earlier discussions for men in high-risk groups — those with a family history of prostate cancer and African-American men.

The American Cancer Society recommends that doctors provide information about prostate cancer screening to men at average risk starting at age 50, while men at higher risk could benefit from this information at age 40 or 45. The American Urological Association recommends that men consider getting a baseline prostate cancer screening, including a PSA test and DRE, beginning at age 40.

The American Urological Association (AUA) recommends against PSA screening in men under age 40, and it doesn’t recommend screening between ages 40 and 54 for men at average risk. For men ages 55 to 69, the AUA recommends shared decision-making between men and their doctors about when to begin screening. The AUA guidelines state that the greatest benefit of screening appears to be in men ages 55 to 69, and it does not recommend routine screening beyond age 70.

The U.S. Preventive Services Task Force (USPSTF) recommends against PSA-based screening for men who do not have symptoms that are highly suspicious for prostate cancer. The USPSTF states that PSA testing in healthy men, regardless of age, offers no net benefit or that the harms outweigh the benefits. This has been a very controversial point of view, and many experts in the field of prostate cancer do not agree with the USPSTF recommendations.

We went with just the blood work for the findings rather than the full biopsy.  While they were screening for this they also ran a screen for pancretic, liver and kidney.

By doing just the bloodwork first it is less evasive and the patient really does not have quite the anxiety that they do with the biopsy.

Hope this was informative.

Part three will be next week of the Melanoma treatment in Nashville and Vanderbilt Hospital.

Till then eat healthy and appreciate your loved ones.

Tammye Honey


Daily Prompt: Right to Health Or Is It?

Daily Prompt: Right to Health

by michelle w. on February 7, 2013

Is access to medical care something that governments should provide, or is it better left to the private sector? Are there drawbacks to your choice?

This is a difficult question to answer as I have been in the private sector of life.  Having been self employed, I can understand the hardships suffered by a small business that does not have employees that is struggling to make ends met.  Having the government step in and tell you that you must have a medical care plan added to your life that you do not have the added money for in your budget can feel overwhelming.

The other side of the coin on this is having one surgery.  This could set a family back for years to come with bills that they would never have saved for.

Working for an employer who provides medical care coverage sometimes is worth it’s weight in gold.  Those jobs are becoming rare in our society.  Due to the high cost of medical care.

I can understand the need that our government feels to step in and want to take control over the medical care needs.  However, the way that some politicians have gone about it has left a bad taste in a lot of voters mouths.

If we were to look at Socialized medicine in other countries and how it is working there, perhaps a fresh view of the situation would stumble upon our feet.  This would also not be accepted with a popular vote, however.  This also has it’s draw backs.

People do not realize in this country that we already have a form of socialized medicine with the military and the VA Hospitals.  The military only see Military Doctors.  They get their medications on post.  They sit and wait to be seen and sit and wait for their medications because the price is right.  The doctors are highly trained.  Why not take advantage of this right to be seen.

Even being retired, they still have the right to be seen.  Compared to going out into private sector where the copay would be as much as $50.00 twice a month for a prescription.  The choice on a fixed income becomes simple.  The wait is long but pays off in the end.

I am on the fence with this decision.  It is different for each family.  To say that someone has to do something might make their situation worse, not better.

Would love to hear your views on this.  Let me know.

Here are some other views that were posted on this same topic so be sure to check them out as well:

  1. Healthcare – right or privilege? « Q the Adult
  2. For All The Sick Penguins Out There… | All Those Small Things
  3. Government Hospitals suck « Right Down My Alley
  4. Ow | One for the Big Guy.. sometimes.
  5. Daily Post: Right to Health | tel-uh-vizh-uh-ner-ee
  6. Daily Prompt: Right to Health | Daddy’s Naughty Little Girl
  7. The Evolution of Medicine « theseeker
  8. Here’s to good health 🙂 | Random Encounters of an Inquisitive Mind
  9. Medical care: a God given right? « Melanie Ryding – Ryding2Health BLOG
  10. Daily Prompt: Right to Health, A Nurse’s perspective on why I think healthcare should be universally awesome! | Kul World Daily Drivel
  11. My Solution to the Healthcare Crisis | Mind of a Mouse
  12. Daily Prompt: Right To Health « Pride in Madness
  13. Putting Cancer on the Rwandan Agenda | Aphro Junkee
  14. Daily Prompt: Right to Health | I really just pretend to know stuff
  15. Right to Health: Govermental Sector | بيسان
  16. DP: Right To Health « Life of Me and Mine
  17. Short Ramblings of a Blue-Leaning Redhead | Sorta Ginger: Ramblings of a Quasi-Redhead
  18. Daily Prompt: Right to Health « Chronicles of an Anglo Swiss
  19. Daily Prompt: Right to Health | Tita Rita
  20. Right to Health | Drama Queen Under the Sun
  21. Daily Prompt – The Right To Health – Poem / Poetry – “A Public Toast To Your Health” | toofulltowrite (I’ve started so I’ll finish)
  22. Healthcare… | jaycee68
  23. On Health Care « Fish Of Gold
  24. Daily Prompt: Right to Health « A Western Buddhist’s Travels
  25. Right to Health | The Nameless One