PROSTATE & PSA

[nicholson]

Since prostate cancer is by far the most common cancer in males - about as common and deadly as breast cancer is in females - the following paper may be of interest.  It is ten years old now, but finally the full text is available free.  I had not seen the full text before and I find its contents remarkable.

 

It is well known that a PSA value above 4.0 is considered in many places a number a person needs to pay serious attention to.  Here where I am, for anyone over the age of 70, 6.5 is regarded as THE threshold number.  But this paper seems to say something quite different.   It was conducted in Montreal, Canada among 313 caucasians between the ages of 40 and 80, asymptomatic, apparently in good health and with no clinical evidence of prostate cancer.  So it seems reasonable to suppose it may have relevance to many people here.

 

Its PMID is: 16831142  .....Full text PDF:  http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2006.06193.x/epdf

 

Among these 313 individuals the median PSA values for those in their 40s, 50s, 60s and 70s were:  0.70, 0.90, 0.97 and 1.47 respectively.  Since autopsy studies of men who died from causes other than prostate cancer show that the overwhelming majority (90+%?) of males who live long enough (and most of us expect to) do eventually get prostate cancer (but understanding that the majority do not die from it), I would have thought it might be a good idea to pay attention if your PSA is above the median values listed above.  Those numbers are dramatically lower than the thresholds commonly talked about.

 

In addition, Figure 1A in the paper shows that among the subjects in the lowest 99% of PSA values in this group there was not one, at any age, with a PSA above 1.5.  Seems to me then that any value above 1.5 should be considered anomalous.  Their note attached to Figure 1A says:  "....  the curve shows that PSA levels should be <1ng/ml for men aged <70 years."  Based on these data it would be difficult to disagree.  They also say that free%total PSA - a measure shown to be better than PSA at predicting the presence of prostate cancer - should be greater than 30%.

 

Their data also show that even in their 70s some subjects have a PSA as low as 0.2.  Someone needs to check out what is different about these people.  Perhaps it is their genes, but possibly might it be a modifiable factor?

 

Rodney.

[nicholson]

I just love data.  I especially like those that not only speak, but veritably scream in your ear.  Such as this one:

 

"In the United States, prostate cancer accounts for 32% of all incident cancer cases in men (3), whereas in Shanghai, prostate cancer accounts for less than 1% of all cancers in men."

 

SOURCE: ol. 7, 83-84, January 1998 Cancer Epidemiology, Biomarkers & Prevention 83
 
Letter to the Editor:
Rising Incidence of Prostate Cancer in Shanghai, China
Ann W. Hsing,’ Susan S. Devesa, Fan Jin, and Yu-Tang Gao
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-7374 [A. W. H., S. S. D.], and

Shanghai Cancer Institute, Shanghai, China 200032 [F. J., Y-T. G.]

[Jim Pearce]

At 61 my last VA fasting labs PSA was 0.29. I didn't know what any of my labs were until recently taking the time to look them up. Don't know why it's so low or if it had anything to do with diet. I've tried with varying degrees of success to restrict calories since January of 2015. I succeeded more than I failed; my weight now fluctuates a few pounds in either direction at a level around 100 pounds less than when I got serious. 

My goal? I got my disability a year or two before that, so somewhere around 5 years ago now. I intend to try like heck to live long enough to draw my VA check and my social security for at least 50 years while at the same time building a portfolio of stocks paying well covered growing dividends. 

The first HALF of my life wasn't so great after all the good jobs disappeared. I'm up for round two...and so far it's turning out much better.

[Michael R]

Jim, your message is straining at being on-topic for the thread . ? But congratulations on your moves into CR, and your zeal for life.

[Jim Pearce]

Yeah, I strayed from the PSA topic. My bad. I'm new here.

[Matt]

I came across this article the other day http://www.urologytimes.com/prostate-cancer/5-ari-use-reduces-prostate-ca-risk-16-years

"The Prostate Cancer Prevention Trial (PCPT) was a placebo-controlled, double-blind randomized controlled trial showing that using the 5-alpha-reductase inhibitor finasteride (Proscar), 5 mg daily for 7 years, could reduce the risk of prostate cancer by 25%. The trial duration was limited to 7 years of treatment and follow-up due to the substantial cost and burden of randomized controlled trials. However, some questions had emerged, such as whether the trial duration was sufficient to demonstrate the maximum benefit of finasteride. Another concern was whether the reduced risk of prostate cancer would be maintained after discontinuation of finasteride at the end of the trial."
 

I've been taking finasteride at 1.25 mg per day for a while now. Although initially, I was taking 2.5 mg per day for a while. No side effects, thicker hair. ?