ExcelMale
Menu
Home
What's new
Latest activity
Forums
New posts
Search forums
What's new
New posts
Latest activity
Videos
Lab Tests
Doctor Finder
Buy Books
About Us
Men’s Health Coaching
Log in
Register
What's new
Search
Search
Search titles only
By:
New posts
Search forums
Menu
Log in
Register
Navigation
Install the app
Install
More options
Contact us
Close Menu
Forums
Expert Interviews
Questions for Specific Doctors & Experts
Ask Dr Rand McClain
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Reply to thread
Message
<blockquote data-quote="Rand McClain DO" data-source="post: 111893" data-attributes="member: 90"><p>Hi Blackhawk,</p><p>I am still not convinced that PSA is a valuable screening tool. Even the supposed inventor of the PSA test believes it should not be used as such (<a href="https://www.nytimes.com/2010/03/10/opinion/10Ablin.html" target="_blank">https://www.nytimes.com/2010/03/10/opinion/10Ablin.html</a>). The only group the adheres to its use still is the AUA. There are too many false negatives and perhaps even worse, false positives, that make it unreliable certainly at best. Unnecessary biopsies are the result of false positives and biopsies are invasive and are accompanied by considerable risk. Passing a large stool the morning of the test (any massage of the prostate gland) can elevate PSA assays. Unfortunately, the ONCOblot was purchased by a Chinese company that has left the US market behind. BUT, a US company is working on a replacement that will use antibodies with a reflex to Western Blot that will end up being cheaper and easier to use. Meanwhile, we are studying the use of nagalase assays to evaluate for cancer presence, but nagalase can show positive with certain viruses too so while a negative test would be great and valuable, a positive nagalase would be inconclusive. At this point, I recommend a multi-parametric MRI of the prostate (at least it's feet first) which can show lesions typically as small as 5mm or even 3mm using a facililty that can process the slices in Holland. From there, depending upon size of any (IF any) lesion, and its location, you can decide whether to biopsy, watchfully wait, or "treat" with various non-surgical options. BTW, one assay, the PCA-3, can test specifically for a certain type of PCA, but it is not all inclusive. Lastly, most athletes will tell you that it takes about 10,000 practice swings to get proficient at something. The DRE (digital rectal exam) is considered the standard for prostate screening. Seriously? How many urologists, proctologists, or any doctors have performed DRE's 10,000 times?....</p></blockquote><p></p>
[QUOTE="Rand McClain DO, post: 111893, member: 90"] Hi Blackhawk, I am still not convinced that PSA is a valuable screening tool. Even the supposed inventor of the PSA test believes it should not be used as such ([url]https://www.nytimes.com/2010/03/10/opinion/10Ablin.html[/url]). The only group the adheres to its use still is the AUA. There are too many false negatives and perhaps even worse, false positives, that make it unreliable certainly at best. Unnecessary biopsies are the result of false positives and biopsies are invasive and are accompanied by considerable risk. Passing a large stool the morning of the test (any massage of the prostate gland) can elevate PSA assays. Unfortunately, the ONCOblot was purchased by a Chinese company that has left the US market behind. BUT, a US company is working on a replacement that will use antibodies with a reflex to Western Blot that will end up being cheaper and easier to use. Meanwhile, we are studying the use of nagalase assays to evaluate for cancer presence, but nagalase can show positive with certain viruses too so while a negative test would be great and valuable, a positive nagalase would be inconclusive. At this point, I recommend a multi-parametric MRI of the prostate (at least it's feet first) which can show lesions typically as small as 5mm or even 3mm using a facililty that can process the slices in Holland. From there, depending upon size of any (IF any) lesion, and its location, you can decide whether to biopsy, watchfully wait, or "treat" with various non-surgical options. BTW, one assay, the PCA-3, can test specifically for a certain type of PCA, but it is not all inclusive. Lastly, most athletes will tell you that it takes about 10,000 practice swings to get proficient at something. The DRE (digital rectal exam) is considered the standard for prostate screening. Seriously? How many urologists, proctologists, or any doctors have performed DRE's 10,000 times?.... [/QUOTE]
Insert quotes…
Verification
Post reply
Share this page
Facebook
Twitter
Reddit
Pinterest
Tumblr
WhatsApp
Email
Share
Link
Sponsors
Forums
Expert Interviews
Questions for Specific Doctors & Experts
Ask Dr Rand McClain
This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
By continuing to use this site, you are consenting to our use of cookies.
Accept
Learn more…
Top