No more finger in the rear!

[masraum]

I just turned 48. I went in for a physical today because we get $200 credit to use towards medical expenses if we do. I was told that testing for prostate cancer either through a blood test, finger test or both is now voluntary. He said that in 2012, it was determined that checking for it and finding it was not shown to increase life expectancy or improve quality of life and it could even be detrimental.

The theory is that prostate cancer is so slow, that it's usually discovered late in life and takes forever to cause any issues. So finding out that you have it and getting treated probably won't improve your quality of life or extend your life expectancy, and knowing that you have it could actually be detrimental due to the stress of it always being in the back of your mind.

The Dr said that his dad had it and at 71 had surgery, and died when he was 89. He'd have probably lived that long without the surgery and treatment. The Dr doesn't want the stress of knowing about it.

[Zeke]

Tell that to 2 men I have known that died of cancer that started in the prostrate. They reached their 70's but dying in the hospital of cancer is usually a terrible affair.

[recycled sixtie]

Yes it is a big oversight not to get checked. My brother in law died in his late sixties of prostate cancer. Why? Because the small community he lived in did not have the expertise to properly check him out. He went through the misery of cancer for five years before he passed. He had one kidney removed due to cancer spreading.

Rectal exam is easy peasy. Nothing to be afraid of. Let the docs chime in here....

[looneybin]

my urologist told me that 90% of men will die WITH prostate cancer, but not BECAUSE of it
it's very common, and very slow growing, and quality of life of not possibly being incontinent and/or impotent sometimes outweighs just living with it
that being said, i get PSA draw and jelly fingered every year

[Steve Carlton]

Prostate cancer killed my dad. Maybe knowing it's there merits more monitoring, I don't know. My dad also was going south with Alzheimer's, so in a way having both was a good thing.

[gchappel]

One big problem with prostate cancer is most, but not all, prostate cancers are slow to progress and often cause no problem.
There is, however, a small but real percentage of these that are very aggressive- and kill.
We can detect these malignancies pretty easily.
But, we can not separate the aggressive from the non aggressive forms until it is too late.
So if you ignore it in a large population of older men most will do fine. Unless you are the one that doesn't.
I lost a distant friend to prostate CA- he was 54.
Gary

[TimT]

Frank Zappa

[umgang]

Doctors i know say the PSA test has many question marks and is not entirely accurate.
The finger thing is still the best way for a qualified doctor to feel if something is abnormal.

Story: A good friend of mine had just his yearly physical, and PSA numbers were good.
By chance, the company he works for had him go do a mandatory physical exam with their physician for insurance purposes a month later. That doctor did the finger thing and found a hard mass.
Gleason number was 8 ;which is close to terminal.
He had surgery immediately and survived.
Doc told him if he had waited another year for his yearly physical / PSA he would have been dead.
Reckon it is a crap shoot no matter what, excuse the pun.

[speeder]

Just make sure that he doesn't have two hands on your shoulders when he does the exam.

[Steve Carlton]

[bkreigsr]

Not to trivialize a serious subject, but....

Most doctors use one digit for the exam.
Why do some use two fingers?

They're getting a second opinion.

Bill K

[A930Rocket]

My best friend was diagnosed with prostate cancer at 47. Fought it for 9 years before he passed.

BTW, how do docs learn to check for prostate problems? Check each other? Check themselves? Volunteers?

[hcoles]

There are is growing and not so bad and there is bad prostate cancer.
We are dealing with the bad type right now with my wife's brother.
PSA numbers going up was the start of it.

[Geoz1]

I do not agree with that Dr. It runs in my family. My dad had robotic surgery to correct it at 57. My grandfather died from it at 68. I don't consider 57 "late in life". I like having my dad around at 72 going on 73. Dad changed the bank 2 rear O2 sensor on his 11 2500HD, in the driveway, today.

With early diagnosis, even in the early 1990s, my Grumps would have lived well into his 70's, if not 80's.

[livi]

Mass screening is an extremely complex topic frequently further confused with anecdotal bias. The so called evidence and clinical experience is flying in all directions. Although I am in that general field I am still not sure what is best practice.

[Bill Douglas]

I'd rather know and make lifestyle choices appropriate to what I'd been told.

I get the finger treatment once a year. Haven't had to ask for a second opinion (thank goodness).

[Geronimo '74]

Originally Posted by livi

Mass screening is an extremely complex topic frequently further confused with anecdotal bias. The so called evidence and clinical experience is flying in all directions. Although I am in that general field I am still not sure what is best practice.

As a pediatrician, I’m guessing/hoping you don’t perform many prostate exams...

I think it is strange that with all the modern techniques in medical imagery, a finger up the keester is the best way.
The quickest way, cheapest way, sure.
But surely, not the best way, is it?

[wdfifteen]

I would not take that doctor’s opinion seriously. It verges on malpractice to discourage a man from at least getting the finger wave.
The psa (blood) test isn’t a very accurate screen for cancer. I’ve had high psa numbers for years and had numerous biopsies as a result. No cancer.
The recommendations for screening have evolved over the 20 years I’ve had screening done, from blood test only, to finger wave only, to blood test and finger wave and a biopsy if any of the screenings indicated a problem. Now I get an annual finger up the behind and the doc will send me for an mri if he feels something concerning.
If you think the finger is bad, try a biopsy.

[NY65912]

Bad move. You need to get it done. Period. Was the OP's doc a Urologist?

[livi]

Originally Posted by Geronimo '74

As a pediatrician, I’m guessing/hoping you don’t perform many prostate exams...

That is a correct observation.