My advice to all of my male friends of a certain age
(probably 50+ years) is to get an annual PSA test. If I had not been getting
them, I would be writing this while dying of prostate cancer (and not know it
or I might be receiving palliative care) or I would already be dead. Typically
the symptoms of prostate cancer do not manifest until it is too late to do anything
about it.
It used to be that the high false positive rate of PSA
tests, and the consequent biopsy, were risky (incontinence or impotence or both),
and in too many cases unnecessary (either because there was no cancer or the
cancer was so slow-growing that you’d die from some other cause before the
cancer became deadly). I’m told that as a result of the false positives and the
ensuing risks, some physicians have been reluctant to recommend PSA tests.
It is my sense that diagnostic techniques have improved
markedly in recent years; before I had a biopsy, my urologist required an MRI,
and it was only after the MRI suggested strongly that there was cancer would he
conduct a biopsy. I’m also told that the biopsy procedure itself is more sophisticated
and the risks are much lower than they used to be.
Prostate cancer happens to about __ in __ males. It seems to me that anyone choosing
not to get a PSA test on a regular basis is putting his life at unnecessary
risk.
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