Actor Ben Stiller made headlines last week when he said a PSA test saved his life. That’s a good thing, said Dr. Noah Allen, a urologist with St. Elizabeth Physicians.
With a couple of caveats.
Allen said exploring the merits of the PSA blood test used to detect prostate cancer is the best outcome from the announcement by Stiller.
But, Stiller’s “not a doctor, not a researcher,” said Allen. “He’s bringing the issue to the forefront. It makes people talk about it. That’s the positive,”
Prostate cancer is serious and complicated business:
- It’s the second leading cause of cancer deaths in American men.
- Most men diagnosed with the generally slow-developing cancer don’t die from it.
- It may not be treated at all. The patient and doctor may agree to monitor less-aggressive forms of the cancer.
A simple blood test measures the PSA, a protein produced by the prostate. A high PSA can indicate cancer or other problems including an enlarged prostate, infection in the prostate, or urine retention. To be clear, an elevated PSA is not a cancer diagnosis. But, it is one tool for the doctors.
A controversial decision a few years ago by the U.S. Preventive Services Task Force over whether the test promotes unnecessary biopsies or makes men anxious about the possibility of cancer means than many men are no longer routinely screened.
The controversy comes from one group, said Allen. Yet, there are four or five other groups that deal with prostate cancer, including the American Urological Association, that still recommend screening.
If a man has a family history of prostate cancer, especially a close relative including a father or brother, or is over 50, Allen recommends considering a PSA. Patients need to be educated on all risk factors as well as discuss the pros and cons of the test.
“You can’t look at one person’s experience and make a recommendation,” Allen said of Stiller.
The best place for men to start? A conversation with their primary care doctors about the test – its benefits and possible complications, said Allen.
