What is better in detecting psa: biopsy or scans

[Jif1]

Someone posted a recent research study questioning the best way for psa detection, saying that the psa was not the best indicator, but that a scan, perhaps PSMA was better.

Please let me know if you are aware of this study.

[Tall_Allen]

In what situation? Initial detection? Recurrent? Persistent after therapy? Newly diagnosed and metastatic? Deciding whether second-line therapies are needed? Deciding whether to change therapies?

[dhccpa]

Yes but docs use PSA regularly, scans very irregularly (some not at all).

[rscic in reply to dhccpa]

PSA is easy inexpensive with less chance of harm to the patient. Inexpensive is a key factor in making PSA testing common & which insurance will pay for. Unfortunately, many Doc's do not know how to read PSA and will only go by the normal readings range (less than 4 is "normal"). If one has a a PSA for years of 1.5 & now has a PSA of 3.2 there has been a doubling of the PSA and the reason needs to be figured out .... it could be benign or malignant. Many Doc's will say under 4 is OK and that will be the end of it. I have a friend who had a good Doc who did not ignore a jump in PSA even though it remained in the normal range & an early Prostate Cancer was found. This early finding made his cancer curable.

[dhccpa in reply to rscic]

What's the risk of scans? I've had a dozen the last three years. Plan to have quite a few more.

[rscic in reply to dhccpa]

ALMOST NOTHING is zero in medicine. Relative risk indicates PSA testing is the lowest risk of PSA vs PET vs Bone Scan vs PSMA. I do not know the comparison of PET vs Bone Scan vs PSMA ..... I am not sure there is public data on these, however, all risks are VERY low or the tests would not be approved. At some point one has to accept the evaluation of experts & though these evaluations may RARELY be wrong (European & FDA approval of Thalidomide is an example) your own evaluation of these is MORE LIKELY to be wrong as most people do not have the expertise to evaluate NOR the raw data to do so. For most people, spending time on trying to do things which enhance treatment (diet, nutrition, sleep, exercise, etc.) is a much more profitable pursuit vs trying to 2nd guess the experts.

Just an opinion.

[addicted2cycling in reply to dhccpa]

PSA test is cheap and easy.

PSA indicates an ISSUE EXISTS BUT IT DOESN"T GUARANTEE THAT PROSTATE CANCER IS CAUSING THE RISE. Scans, additional tests also indicate an issue BUT AS OF CURRENT MEDICAL TECHNOLOGY ONLY A BIOPSY WILL REVEAL the existence and GRADE of PCa .

p.s. >> better informed individuals please correct me if I'm wrong