Join Date: Jan 2013
Location: Livonia, MI (suburban Detroit)
Bikes: 2013 Specialized Seceur Elite, Soma ES custom build
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One of the things that disturbs me about this issue - similarly for the screening mammograms for women - is that the what gets communicated is that the testing is contra-indicated. The problem is that the overly-aggressive, defensive knee-jerk response to any kind of "positive" test result is the problem, not the testing. The testing allows you and your medical advisor to make informed evaluations as to the state of your health, and to make decisions about whether treatment is warranted, and if so, to make decisions regarding a course of treatment. Automatically rushing into a biopsy simply on the basis of test results is what has caused the testing to be made suspect. Testing is black-and-white - the results are either within the normal range, or statistically outside of that range. The decision as to what to do in response to an out-of-range result requires a physician who can view their patient as a human being not a lab experiment, a physician who can look at a multitude of factors and indicators, not just the results of a single test, and a patient who understands that we do not live in a black-and-white world and can deal with the uncertainty.
I believe that the reason "the medical establishment changed it's advice to just the opposite" is due to the fact that most people don't have the intelligence or the knowledge to understand issues surrounding probability, uncertainty and the fallibility of medical opinion, and too many doctors are mechanics, not healers so organizations like the CDC have to fall back on simplistic, black-and-white pronouncements that I completely ignore. I'm intelligent enough to a) communicate regularly with my physician, b) understand the state of my health and the meaning behind every out-of-bounds result for any test administered, and c) am fully prepared to take an active role in managing my health in partnership with the medical professionals I work with.
I have a slightly elevated PSA, not inconsistent with my age (I'm 63) and a slightly enlarged prostrate with no other symptoms. I see my PCP for a full physical annually and a follow-up every 6 months, and we continue to monitor the situation. In the absence of any changes in the size or texture of my prostate, or any significant change in the level of my PSA, my doctor and I believe that the risk of a biopsy outweighs the advantages at this point.
The bottom line, Curtis, is that if you question the preparation for the test by all means seek a second opinion (or do some research on it, but carefully evaluate the information sources), and if necessary, put off the test until you get past your current 30-day challenge, BUT GET THE TEST DONE! You can't make informed decisions about your health by ignoring a possible condition, especially when the testing has zero side effects. A biopsy is an entirely different matter, and needs to be undertaken only when the benefit outweighs the risks, and you need to be fully and rationally informed as to that risk/benefit equation and be engaged in that decision.
But a simple PSA test, given the minimal inconvenience of the preparation being suggested is simply prudent.
Just my $0.02 and worth every penny you paid for it...