PSA testing on seniors

We Often Consider at What Age a Man Should Consider PSA Screening, But We Rarely Ask When Do Individuals Stop?

I just had an interesting conversation with an individual who asked me at what age do most men start thinking about NOT having an annual PSA test? To be honest, I didn’t have an immediate answer. It’s a complicated question and I am, to be honest, stumped. Age is certainly a factor as is the reality that there exist 24 types of prostate cancer that range from indolent to very aggressive.

We frequently read about suggested guildelines for PSA screening. I personally like the AUA recommendation that suggests a man should talk to to his doctor about a first screening to establish a baseline when he enters his 40s. From there, based on a man’s general state of health and family history, he can decide on a screening approach that is right for him.  But in the almost twelve months that I have been writing this blog and the years that I have been meeting fellow patients, I can’t remember a discussion that addresses the other end of the spectrum. I would think that a vibrant, active 78-year-old man with a form that appears to be aggressive would be grateful to have the data and take some sort of action. Of course, a man of the same age could be pleased to live out his life with little or no intervention if his numbers indicated a slower growing form of cancer that he could quite possibly live with.  But, how many give up, for whatever reason, wanting to know at all?

So, I have to ask four questions:

1.) Are there men out there in their 70s and 80s who choose to no longer have annual PSA screenings and why?

2.) Are there men out there in their 70s and 80s who insist on annual PSA screenings?

3.) Are there men in this age group who have been screened and diagnosed with cancer?

4.) If you were given a diagnosis of cancer in your 70s or 80s, what course of treatment did you decide upon?

Thank you to anyone and everyone who can provide some insight.