PSA stands for “prostate-specific antigen.” The prostate is a walnut-sized gland essential to male urinary and reproductive activities but with a tendency to go cancerous.
Two disclaimers: Every man here has a prostate, and none of the women. I ask the indulgence of the ladies on the basis that most of you know some male about whom you care.
Secondly, I am not a doctor or a scientist. All the medical information is from Google, mostly from the National Institutes of Health or American Cancer Society. Don’t rely on this without doing your own research and talking with your own doctor!
That said, about one in nine men will be diagnosed with prostate cancer during his lifetime and one in 41 men in the U.S. will die from it. One study of men age 70 to 79 who died of other causes found undetected prostate cancer in 36 percent of whites and 51 percent of African Americans. If caught early, treatment yields a high survival rate: a 96 percent, 15-year relative survival rate.
How do you detect prostate cancer? The PSA test — just a blood draw — generally accompanied by a DRE, or digital rectal exam, which is undignified but brief. (Men, do not complain about DRE to your lady friend; she might tell you what's in a gynecological exam, and that, my friends, is a discussion you will lose.)
Jim told me he’d never heard of the PSA test. By the time his cancer was detected, it was too late. His process of dying took about two years and whenever he got a public voice — such as once when he was interviewed over a Seahawks game — he made sure to recommend the test.
It would seem to be a no-brainer. It’s not a huge expense, and while the DRE is a pain (you know where), so is cancer — so what the heck.
BUT there is a controversy. Studies do not indicate that early detection of prostate cancer changes overall life outcome looking at the whole population. How can this be? It is so counterintuitive!
- Part of the issue is the problem of false positives. Screening is not magic. With a false positive, you think you have the cancer when you don’t [so] you would undergo the risk of seriously negative urinary or reproductive issues for nothing.
- If you get a positive test, you have to decide whether to treat. Remember that 30 to 70 percent? You may be in a place in life where something else is going to kill you before prostate cancer, so why do the treatment? Why even take the test?
As for me, I am only in my 60s and in good enough health that I need to plan for another 30 years of life. There is time for prostate cancer to kill me, so I went looking for it: I got the test.
Due to your age and other factors, your analysis may differ from mine. You have to live with the consequences, so you have to make the informed choice. I cannot ask you to get the test. I will not ask you not to get the test.
I am asking you, today, to calendar a talk with your doctor about the PSA test. Talk with him or her about your own personal risk factors. You’re thinking “Good idea. I’ll get to it later.” That’s what I would say if I were sitting in your chair. Life is busy, I have a job and a family and I’ll get to it later.
Gentlemen: For Jim, later came before he knew. The reasons for waiting — family and friends — are the reasons to go now. Calendar a time to talk to your doctor. Put your plan on your calendar right as soon as we’re done here.
Jim did not have the opportunity to put this on his calendar because he didn’t know about the test, but thanks to him, we know.
He left so much behind — family, friends, work, a big red truck named Clifford. Let’s not do the same.