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PSA test


LannaGuy

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On 01/09/2017 at 5:45 PM, chiang mai said:

Almost any hospital clinic or lab will offer the PSA blood test but as said, the lab to test the sample needs to be accredited.

Accredited by whom?

Do the independent clinics display the accreditation prominently?

 

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2 minutes ago, Wandr said:

Accredited by whom?

Do the independent clinics display the accreditation prominently?

 

The results page provided by the lab will show an accreditation reference number, in the case of CMU it is 4126/55.

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1 hour ago, cheeryble said:

By all means have the test but be aware of this, issued by the main US policy makers after years of study and debate

https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/prostate-cancer-screening


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I just saw on the U.S. news about a week ago...the U.S. has reversed their opinion and has gone back to their original recommendation for men to get PSA tests regularly.

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7 minutes ago, simoh1490 said:

The results page provided by the lab will show an accreditation reference number, in the case of CMU it is 4126/55.

So I won't know beforehand if a lab is accredited?

If anyone knows a bit more about this accreditation then maybe I can look for it or even ask them.

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9 minutes ago, Wandr said:

Accredited by whom?

Do the independent clinics display the accreditation prominently?

 

Yes, they should be hanging on the wall when you first walk in. You can ask if you don't see them. But most of those small walk in clinics around the city are NOT accredited.

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Just now, Wandr said:

So I won't know beforehand if a lab is accredited?

If anyone knows a bit more about this accreditation then maybe I can look for it or even ask them.

Yes you will know since you will ask first. But avoid those small walk-in clinics. I've never seen one that is accredited.

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To be clear, it's not the clinic that needs to be accredited it's the lab itself. There is an accreditation symbol which I believe is a circle with a letter Q in the middle and a second one that has the letters "ilac MRA" across the middle, if you google the latter you'll see that's about the national standards council, standards and calibration..

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On 1/9/2017 at 8:17 AM, LannaGuy said:

 

 sounds good... a tad more specific please?  Hang Dong is a little large

Other side of Tesco on Hang Dong Road, opposite a big orange building.

Her clinic is on the corner of a soi opposite a Thai eatery.

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On 5/4/2017 at 4:13 PM, simoh1490 said:

To be clear, it's not the clinic that needs to be accredited it's the lab itself. There is an accreditation symbol which I believe is a circle with a letter Q in the middle and a second one that has the letters "ilac MRA" across the middle, if you google the latter you'll see that's about the national standards council, standards and calibration..

None of them would fake their status, would they?

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5 minutes ago, dcnx said:

None of them would fake their status, would they?

I don't know if they would or would not. But it's easy enough to ask for their accreditation number and see how they respond with supportive evidence or evasive replies. And now that you know what the format of that number is you you can see if it passes the sniff test! If none of that works you can check below and/or call for verification:

http://webdb.dmsc.moph.go.th/ifc_qa/dbqa/default.asp?iID=LEFIF

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I just saw on the U.S. news about a week ago...the U.S. has reversed their opinion and has gone back to their original recommendation for men to get PSA tests regularly.

 

Quite true Elektfified than u looked it up, it seems up to age 69 it's decide with yr physician, 70 onwards no PSA screening.

 

"So how useful is PSA screening? According to the New England Journal analysis, studies imply that 1 prostate cancer death is averted per 1,000 men screened several times each, and followed for 10 to 15 years.

 

I remember that lifetime mortality for Western men is 1 in 35 which given the worry and other possible downsides involved makes me personally wonder it its best to forget the whole thing and take ones chances (except I personally have enlarged prostate and a hint of incontinence so go along with it)

 

Wondering who announced this policy, as I note the USPSTF website remains thus far unchanged.

 

 

 

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Hubby and I wrestle with the "to test or not to test" PSA issue every time he has his annual (or more like every 14-16 months) health screening.  This is because both the size of his prostrate and his PSA number started to get larger about five years ago.  He had a biopsy a couple years ago and everything was OK, but having a biopsy carries risks and having a negative reading doesn't necessarily mean that someone is cancer-free.  It just means they didn't find any in their samples.  

 

But, in my Lanna Care Net activity, I've seen about a dozen men go through end-of-life due to prostate cancer and it is the one of the worst forms death I've seen.  The cancer spread into bones, usually the pelvis and spine, crippling the victim and creating a huge burden for his family or caregivers.  The victim is bedridden well before death comes.  

 

Most people would like to die at home, but it's difficult with this disease.  They become a dead weight in the bed, difficult for their family to bathe, move about, keep from getting bedsores.  They really should be in a hospital-type bed, tended by people with proper equipment.  Sadly, the man is unable to assist his family in moving himself.

 

That's because the cancer has invaded important bones, and the pain is intense.  Also, it doesn't take very many days of constant bed-rest before someone's muscles wither.  Pain control at home is very difficult.  Someone must keep an ongoing relationship with a doctor, someone willing to prescribe oral morphine for home use.  Doctors here will prescribe only to people they know and only if there is someone responsible at home to monitor and administer.  At some point that ceases to work or someone is unable to take the medicine by mouth.  There is no way to have nurses visit and administer morphine by IV here.  There are no patient-controlled pain medicine pumps here.  

 

The best alternative for someone dying of prostrate cancer is to spend their final weeks at McKean Rehabilitation Center, a skilled nursing facility with some nice private rooms at a reasonable price.  Your loved one could come and stay with you there.  Vivo Bene Village in Doi Saket has also helped people with more money to spend through the end-of-life and their entire family would be welcome in their upscale surroundings.  These facilities have the equipment, nurses and knowledge to take care of a dying man's body, keeping him as pain-free as possible, clean and comfortable, permitting his family to focus on being with him during his final weeks and not expending all their energy caring for him.

 

I've gone on a little to long, but this is a subject close to me.  Many of the men I've watch die were under age 70.  Some actually "caught" their cancer in early stages with a PSA test and decided to do nothing, but most hadn't.  The "cure" for prostrate cancer is daunting and can be expensive to someone living pension-check-to-pension-check, which is why the men who caught it early decided to "do nothing".  But, there is less invasive action, like taking drugs to suppress hormones production and slow down the cancer, etc.  

 

Options like this make me push Hubby to have a PSA test with each health screening and then retest three months later just to make sure the number isn't rising significantly.  I'll continue to push him after he gets in his 70s, until it's obvious he's going to die from something else within a 2-3 years.  At this time, though, he's very healthy, except for the need to take longer when he pees.  It's probably that enlarged prostate.  

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You make a good point Nancy though with al the years the USPSTF took to make their consultation, study, and recommendation it may well be they made it in full consideration and in spite of the painful exit of the unlucky ones. All I can say is well done to you for being available for those you've helped, marvelous.

 

The other thing I've considered in my own little study of prostate cancer is this: we know that the majority of cases diagnosed as histologically cancerous are so low grade that the powers that be have considered not calling it cancer, but I wonder about the aggressive cases timeline. What I mean is, is the once per annum PSA test just an arbitrary figure? "Once per annum'" sounds like it

I would like to think that it was a time taken such that given the speed of progression most cases would be caught in time.

But if with aggressive cases the average period of no return is say four months then an annual check up would be of little use.

Anybody have that information?

 

 

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I would as a prostate cancer sufferer ,and having had a PSA of 12 ,with a Gleason score of 8, indicating aggressive cancer, say PSA screening is absolutely critical.
But also critical , is to detox the body and boost the immune system.
Just doing 'watchful waiting' without immune support is wasting valuable time.
Critical to catch this early,whilst in the 'capsule'.
For sure the only way to check the cancer , and rate it's aggressiveness , is a biopsy.
Sadly very few treatments ,leave men without unsavory side effects.
Those interested 'Google Cyberknife'.
Again caught early, without the need for large doses of radiation, this can leave the body functioning 100%.


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Whilst a PSA test in itself is not conclusive.
The fact of the matter is; with prostate cancer , there are no symptoms ,until it is way too late.
So a PSA tracking up ,indicates there could well be an issue! Yes biopsy is not pleasant, and has risks.
But they can be minimized, another option is an MRI, but this won't give a 'Gleason' score.


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15 hours ago, NancyL said:

Hubby and I wrestle with the "to test or not to test" PSA issue every time he has his annual (or more like every 14-16 months) health screening.  This is because both the size of his prostrate and his PSA number started to get larger about five years ago.  He had a biopsy a couple years ago and everything was OK, but having a biopsy carries risks and having a negative reading doesn't necessarily mean that someone is cancer-free.  It just means they didn't find any in their samples.  

 

But, in my Lanna Care Net activity, I've seen about a dozen men go through end-of-life due to prostate cancer and it is the one of the worst forms death I've seen.  The cancer spread into bones, usually the pelvis and spine, crippling the victim and creating a huge burden for his family or caregivers.  The victim is bedridden well before death comes.  

 

Most people would like to die at home, but it's difficult with this disease.  They become a dead weight in the bed, difficult for their family to bathe, move about, keep from getting bedsores.  They really should be in a hospital-type bed, tended by people with proper equipment.  Sadly, the man is unable to assist his family in moving himself.

 

That's because the cancer has invaded important bones, and the pain is intense.  Also, it doesn't take very many days of constant bed-rest before someone's muscles wither.  Pain control at home is very difficult.  Someone must keep an ongoing relationship with a doctor, someone willing to prescribe oral morphine for home use.  Doctors here will prescribe only to people they know and only if there is someone responsible at home to monitor and administer.  At some point that ceases to work or someone is unable to take the medicine by mouth.  There is no way to have nurses visit and administer morphine by IV here.  There are no patient-controlled pain medicine pumps here.  

 

The best alternative for someone dying of prostrate cancer is to spend their final weeks at McKean Rehabilitation Center, a skilled nursing facility with some nice private rooms at a reasonable price.  Your loved one could come and stay with you there.  Vivo Bene Village in Doi Saket has also helped people with more money to spend through the end-of-life and their entire family would be welcome in their upscale surroundings.  These facilities have the equipment, nurses and knowledge to take care of a dying man's body, keeping him as pain-free as possible, clean and comfortable, permitting his family to focus on being with him during his final weeks and not expending all their energy caring for him.

 

I've gone on a little to long, but this is a subject close to me.  Many of the men I've watch die were under age 70.  Some actually "caught" their cancer in early stages with a PSA test and decided to do nothing, but most hadn't.  The "cure" for prostrate cancer is daunting and can be expensive to someone living pension-check-to-pension-check, which is why the men who caught it early decided to "do nothing".  But, there is less invasive action, like taking drugs to suppress hormones production and slow down the cancer, etc.  

 

Options like this make me push Hubby to have a PSA test with each health screening and then retest three months later just to make sure the number isn't rising significantly.  I'll continue to push him after he gets in his 70s, until it's obvious he's going to die from something else within a 2-3 years.  At this time, though, he's very healthy, except for the need to take longer when he pees.  It's probably that enlarged prostate.  

Great post full of info thank you. Another friend of mine has an enlarged prostate here and could not pee at all. Went to Bangkok Hospital and had to wear a catheter for around 8 weeks with it being taken out, to test, and put back again. He was convinced it was cancer and went back to UK. To cut a long story short he had the biopsy etc. and it turned out negative!  to this day none of the Doctors can explain why his prostate was so enlarged only cut down alcohol and cut out caffeine. 

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5 hours ago, LannaGuy said:

Great post full of info thank you. Another friend of mine has an enlarged prostate here and could not pee at all. Went to Bangkok Hospital and had to wear a catheter for around 8 weeks with it being taken out, to test, and put back again. He was convinced it was cancer and went back to UK. To cut a long story short he had the biopsy etc. and it turned out negative!  to this day none of the Doctors can explain why his prostate was so enlarged only cut down alcohol and cut out caffeine. 

Your friend had benign prostatic hyperplasia.  According to Dr. Wiki about 50% of men some evidence of it by age 50 and 75% by age 80.  It is correlated with the use of alcohol and caffeine and some studies suggest it's also correlated with consumption of high amounts of protein.  It's really a very common condition in older men who live a western lifestyle.

 

https://en.wikipedia.org/wiki/Benign_prostatic_hyperplasia

 

 

 

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