General Discussion

I was trending from 3.5 toward 4.0 from age 59 through 63. There was no extra screening in my case, but I also got no push-back when I asked for annual PSA tests, and as soon as the test over 4.0 emerged, we moved into action. That suggests strongly to me that the idea of doing nothing before 4.0 is really a bad guideline. I would strongly suggest anybody over 2.5 insist on annual tests, and if they see a more-or-less linear trajectory toward 4.0, insist on additional screening sooner -- don't wait for 4.0 if the data is pointing that direction. In our system, the patient might have to fund that out of pocket, and I know not everybody can do that.



I agree. The problem is the guidelines, not the practitioners. The guideline is based on an assumption of a very slow-developing cancer, and that is just not valid. There are millions of men in the US population today who will have fast-progressing prostate cancer at some point, and their options and outcomes are much better with earlier detection.

I agree with you about Biden's privacy. But I think part of the attention comes from the question, "If the former President can go undetected before metastasizing, what chances do regular people have?" What I am trying to communicate is that this can be very manageable for most people, but men need to be their own advocates here.