Question
I'm 73 years old. My brother had prostate cancer. In the past my PSA tests were normal, and I finished doing them after I turned 70. Should I start screening again?
Oh There is not any right or improper answer. You and your doctor have followed the 2018 guidelines from the US Preventive Services Task Force.
The task force recommends that men ages 55 to 69 make a joint decision with their doctors about routine prostate cancer screening, which normally means periodic screening for prostate-specific antigen (PSA). Blood tests must be done. The task force advises men to stop screening after they reach age 70.
Although such recommendations help guide physicians' decision-making, they don't dictate what motion must be taken in a selected situation. In addition, some recent studies suggest that this general guideline may have to be revised.
Before offering advice, listed here are two questions I ask men, no matter age, before ordering a PSA blood test:
1. Are you able to proceed with a prostate biopsy if the outcomes show you might have prostate cancer?
2. Would you would like to get treatment instantly if the biopsy showed cancer cells, even very low-grade cells?
If a person over age 70 answers “yes” to each questions, is otherwise in good health, and is at the least 10 years old, a PSA test could also be an affordable selection. If he answered “yes” to query 1 and “no” or “not sure” to query 2, I might ask if he would consider periodic slightly than immediate treatment if a biopsy shows low-grade prostate cancer. Will be satisfied with supervision. (Periodic monitoring includes regular PSA blood tests and maybe repeat prostate biopsies.)
But other aspects have to be considered. Men with a family history of prostate cancer (especially if a first-degree relative had prostate cancer before age 60) and African-American men usually tend to develop prostate cancer. So even at older ages, these men will probably want to proceed regular prostate cancer screening beyond age 70.
But back to my two questions. No matter the way you answer them, it's essential to think about the restrictions of PSA testing. More often, a mildly elevated PSA occurs in men with an enlarged prostate or a cause aside from cancer. And even when cancer does occur, many older men are more likely to have a low-grade version that doesn't change their quality of life or longevity.
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