PSA Testing

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Olivia Rendall
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by Olivia Rendall on Tue Nov 01, 2016 1:15 pm

PSA Testing

What are your thoughts around the PSA testing controversy?

Do you think the benefits outweigh the risks?

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Mr Christopher Eden
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Joined: Mon Nov 21, 2011 3:03 pm
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by Mr Christopher Eden on Tue Nov 08, 2016 6:02 pm

Re: PSA Testing

PSA testing is indeed controversial at present but we have very good evidence that despite PSA not being wholly specific and/or sensitive for prostate cancer, screening with PSA saves lives. The survival advantage at 14 years in the European ERSPC trial was 44% at 14 years compared to men with no screening. The risk of over-treatment has been dramatically reduced by offering active surveillance as the default option for low-risk (less aggressive) prostate cancer for the past 5+ years. Prostate cancer is still a cause of significant mortality in men in the UK: 10,000 death a year or one every hour.

PSA is never used to diagnose cancer, merely as a means to identify men who need greater scrutiny. In 2016 this means an MRI scan and then, depending on the result, a biopsy or not.
Professor Christopher Eden
Consultant Urologist

http://www.talkhealthpartnership.com/on ... h_2013.php

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Mr Benjamin Challacombe
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Joined: Mon Nov 12, 2012 2:41 pm
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by Mr Benjamin Challacombe on Thu Nov 24, 2016 12:34 am

Re: PSA Testing

PSA testing definitely saves lives but also causes big issues with over diagnosis and effects of treatment.
I would recommend a PSA test if you have a family history of prostate cancer or breast cancer
If you are from a African or Caribbean background as the incidence is higher
If you are worried about prostate cancer and are 40-70 and generally fit.
Don't have a PSA and consider action without a rectal prostate exam as it enables the doctor to estimate the size of the prostate.
Don't have a biopsy without an MRI first if you can get it
Definitely don't have a second biopsy without an MRI
Don't have treatment for low risk disease unless you are ver young.
Mr Benjamin J Challacombe
Consultant Urological Surgeon and Honorary Senior Lecturer

http://www.talkhealthpartnership.com/on ... acombe.php

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