Fifty Plus (50+) - You May Be Too Old To Have Your Prostate Checked

You May Be Too Old To Have Your Prostate Checked

They are now saying that anyone 75+ does not need to have their prostate checked as they are about to die anyway, so who cares - you will die before the cancer kills you.

Well, not exactly, but it comes pretty close to all the fancy words they are putting aorund this issue.

http://www.nytimes.com/2008/08/05/health/research/05prostate.html?_r=1&em&oref=slogin

My wife is getting the same feeling about her knee replacement. "Use it all you want, wear it out - your life expectancy is less than the life of the knee replacement."

Makes one feel rather weird!

It won't be long before Medicare won't cover prostate exams and PSA checks and prostate cancer treatments for anyone over 75.

I always felt that once you passed the age of 80, you shouldn't even buy green bananas.

Yeah, the prostate information sheet given to me by my doctor today pointed out that the majority of men with prostrate cancer would die from something else. The other interesting thing I remember reading about prostrate cancer is its most frequent method of detection: autopsy.

When I was having mine removed at 58, another fellow of 73 years was having his done on the same day. He was having too much fun running a ranch in Texas and flying his plane back and forth between his ranch and where I live in Panama City, Florida to risk an ever increasing cancer. This was 11 years ago and he was advised back then that at his age, there was no hurry.

I'm glad that I had mine removed. The cancer returned though statistically it should not have. I had to undergo radiation 6 years later. I rode my first metric century midway through the radiation and was doing a three week canoe trip (just the wife and me) in Canada three months after the operation. That included multiple daily portaging 100+ pound loads and 28 mile paddles into head winds on some days.

Obviously, neither the operation or the radiation were all that bad. If the cancer ever leaves the prostate cavity, they can't track it or find it. When it gets into the bone, you suffer a painful, lingering death. Not for me nor that 73 year old.

A friend of my wife's son got it in his 40's. He was dead in less than a year. The problem is that there are different varieties.

Had I wanted until my PSA was over 10, I would have had to have a far more invasive operation with greater risks of side affects. It's can be a tricky business.

I suspect that if you get it at 75, you'll die of other causes IF you live the normal life expectancy for your age group. But, if you don't have the typical couch potato lifestyle and especially if you are a strenuous and regular exerciser, you could last 10 to 15 years longer. Then I wonder if you'll die of other causes. It would likely be preferable too.

Al

It is all about population statistics, cost, side effects, and broad public health policy. Ultimately, each individual should still have the right to make his own health decisions, but the more the U.S. moves toward European style single payer universal health insurance ("Medicare for all"), the less choice each of us may have.

I learned only after my dad's recent passing that he had prostate cancer. It was first detected several years ago when his PSA was high, and was told that it progresses very slowly in older men. He never mentioned it to me though he kept a close eye on his health and (unlike most men) didn't put off going to a doctor, so I'm assuming he was satisfied with its slow progression since he didn't appear concerned. My mom said he was concerned at first but all the docs said "You have nothing to worry about.... something else will take you before prostate cancer will." What ultimately took him was the furthest things from our minds, but I'm glad he didn't ever have to suffer from a lingering illness.

This thread reminds me of an ad I saw today. It read "The average life expectancy today is 77.8 years. So who wants to be average?"

It is all about population statistics, cost, side effects, and broad public health policy. Ultimately, each individual should still have the right to make his own health decisions, but the more the U.S. moves toward European style single payer universal health insurance ("Medicare for all"), the less choice each of us may have.

You said it perfectly. There's a big debate now about even doing the periodic and cheap PSA test on younger men because of the false positives. False positives should never be an issue as nothing is done until they get a positive biopsy.

The process for me was first the rising PSA, then a second PSA, then a more discriminating type of PSA (Free & Total), then a sonogram which showed negative as did all the "finger" tests. About a year went by with the PSA increasing steadily. Then a positive finger test then a positive biopsy.

There was no rushing in to the expensive stuff with out a lot of confirmation. Of course I live in a smaller town and the doctors here seem to take the necessary time for communication and deliberation. I was fortunate that my doctor was at the time one of only five in the country doing a new type of much less invasive surgery which was being practiced in Europe. Far better than the type advocated by Johns Hopkins at the time. That was a beast.

Al

The comment about restricted choice in Europe is pretty much off the wall. I have no idea what information you've based that comment on but I can assure the medical care and social security system here in France alone is more than enough to guarantee I would never move back to the states. I had prostrate cancer, had it removed via the system that is in general use here (and has been for maybe 20 years only obviously it's evolved and improved with time), and I'd hazard a guess that our out of pocket costs for all the exams, the surgery (my choice what I wanted, who I wanted to have do it, etc.) the hospitalization, the follow-up exams, etc. may have come to 200 euros though I suspect probably considerably less. In fact it would have been less but we elected to go with a private clinic rather than a public hospital so consequently there was a slight increase in our expenses. I was also hit in the eye by a small rock around 10 years ago and had 3 major surgeries, etc. and the out of pocket costs for that were so little that we have no idea how much, less than 100 euros for sure. That was all done under the public system from beginning to end. Believe me, if you knew how the system here in France really worked and what you get from it, you'd be blowing up with anger at the politicians in the usofa who continually do their utmost to assure that the american public doesn't have universal health care. And yes, I'm an american and know the two systems. In fact my brother whose wife is also french moved to France from California from a house they loved to one they don't love nearly as much, from a climate that was all they ever wanted to one that isn't at all what they really want, all because of the health care advantages here.

The comment about restricted choice in Europe is pretty much off the wall. In fact my brother whose wife is also french moved to France from California from a house they loved to one they don't love nearly as much, from a climate that was all they ever wanted to one that isn't at all what they really want, all because of the health care advantages here.

It appears from my readings that the French system is on of the best in the world for both coverage and results. That makes it unique among the European systems. It's far better than the UK or Canadian system and far better than that of the US.

The US system costs something like 2 to 3 times per capita than the French system, yet something like 1/6 of the US population has no coverage and likely another 20% has poor coverage. Something like a third of the cost of the US system is overhead. When you consider the medical errors (estimated to kill 100,000/year), the over medication, the spiraling costs, the US system is broken.

When we were vacationing in Canada some years back, we would hear on the radio how long these folks had to wait for an MRI. In one mid size city, it was up to a year. Neither the Canadian nor the Brit system is the answer, but the French System might be far better than what we have now. I believe that costs are reasonably contained, but the doctors do apparently make less.

Al

I browsed the information the other day, and it is interesting.

As I recall from my scan, even with biopsies, it is difficult to determine whether a prostate cancer is of the slow or rapid growing type. I still have many years of keeping close track before I will start to relax, but it is nice to know that if anything is detected that it is likely that I have time to consider my options... perhaps even waiting for more advanced treatments if something is on the horizon.

Now as long as I stay on top of colon cancer with my colonoscopy in another 8 years or so, and any of the others as tests arise, I hope I can die of something nice and benign.

As I recall from my scan, even with biopsies, it is difficult to determine whether a prostate cancer is of the slow or rapid growing type.

And that's a big problem with lots of cancer. Now that there's more early detection of lung cancer, some doctors have come to believe that sometimes it is of a type likely to never grow or progress, and should just be monitored like some early prostate cancer. But because most lung cancer is so aggressive it isn't even found until it's become terminal, there haven't been many doctors or patients willing to adopt a wait-and-see stance when even a very small tumor has been found. There's still just a lot that doctors don't know.

Along the same lines, I've seen OLD people at nursing homes being administered Lipitor to control their high cholesterol. If you're dying of Alzheimer's or are so frail with age that you can't get out of bed, what's the worry that you might die of arteriosclerosis in 20 years? It seems to me that by that age, you're either having problems or you never will, regardless of your LDL/HDL numbers.

I browsed the information the other day, and it is interesting.

As I recall from my scan, even with biopsies, it is difficult to determine whether a prostate cancer is of the slow or rapid growing type. I still have many years of keeping close track before I will start to relax, but it is nice to know that if anything is detected that it is likely that I have time to consider my options... perhaps even waiting for more advanced treatments if something is on the horizon.


The Gleason Score of a biopsy will tell you the aggressiveness of prostate cancer. However, a low grade can change into a higher grade with time.

"EX" Prostate Cancer person here and In January 2001 I went to the Doctors with a slight problem. PSA Test & DRA showed a slight problem and the Biopsy confirmed PCa with a gleason of 3.3 Took a little while to get the scans- MRI and other X Rays etc done (National Health does not work rapidly over here) and I had surgery to remove the prostate.

Now PCa is not a problem- providing it stays in the prostate. If it breaks out- that is when the fun starts.

So 6 months from start of the problem till the op. It was 5 years later when I found out that On the P.M. of the Prostate-It was just about to break out.

I was lucky in a way but I do not know how long I had the problem. Could have been a rapid growing form- Or I may have had it for years.
Only way to keep eye on it (No Quips please) is to be regularly checked and tested. Any rapid increase in PSA levels will show that there is cause for concern. And most males die with PCa and not because of it.

Agree with D'Fox!
The guvmint/Medicare wants to NOT pay for PSA tests/biopsy/surgery. Hell we paid into the system!