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Home > Archive > Prostate > October 2004 > Re: PSA predicts BHP, not much else >>personal experience and comments
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Re: PSA predicts BHP, not much else >>personal experience and comments
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| Len:
Makes sense.
Kind of like the old Type I vs. Type II Errors in statistics!
Mel
"Leonard Evens" <len@math.northwestern.edu> wrote in message
news:j5KdnTr4YbsUkv3cRVn-tQ@comcast.com...
> MB wrote:
>
> All these numbers are arbitrary. If you set it at a higher level, a
> greater percentage of cancers will be found on biopsy, but more will be
> missed. If you set it lower, fewer cancers will be missed, but the
> "yield" in cancers from biopsies will be lower, which means more
> unnecessary biopsies. Doctors have to choose some cutoff. The original
> was 4.0, but that was later changed to age adjusted cutoffs starting at
> 2.5 for younger men and rising to 4.0. But now some doctors think that
> they should use 2.5 for all men. It does seem more important to place
> emphasis on the rate of increase of PSA rather than on any cutoff, but if
> it gets too high, your doctor may still think a biopsy is warranted.
> There is always an art to medicine in addition to (uncertain) science. A
> doctor may have a feeling based on everything he knows about you that he
> should order an biopsy in your case where he wouldn't in another case. I
> think almost every urologist will want to do a biopsy in a man under 70-75
> if the PSA gets much over 4. But they may be willing to tolerate higher
> values in older men. For men past 80 they probably won't do PSA testing
> at all, and some may drop testing even for men in their 70s.
>
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