The prostate gamble

There are some things guys don’t want to talk about…

The goal of the Branko the Prostate Czech advertising campaign (no, really, you must check the website) is to try to use humor to get people to talk about prostate cancer.

But no humor was necessary to get people talking about a study late last week that said a fairly routine prostate test — the so-called PSA blood test — does little to save lives.

The problem, the study said, is the “cure” — invasive biopsies, for example — can be worse than the disease, in this case low-level threats to a man’s health that show up as cancer.

“I agree with some of the points they’re making,” Dr. Badrinath Konety, a urologist at the University of Minnesota, told MPR’s Lorna Benson. “But I also am not sure that the current state of the data that’s out there supports the strength of their recommendation.”

That put him a little at odds with Dr. Timothy Wilt, an internist and a professor at the University of Minnesota School of Medicine, who is also a member of the task force making the recommendations.

“What we know from the good medical science is that PSA testing does not reduce prostate cancer deaths or help a man live longer,” he told NPR’s Melissa Block.

Case closed? Hardly.

There’s always the story about the guy whose life was saved as a result of the test.

That’s Will Hubel’s story. The Langlois, Oregon man wrote us with it after Friday’s news.

At age 64, I’ve been pretty hit and miss about the PSA test. Last November my PSA went up from a below one to 4.6, but I had a negative digital exam and no inflammation. My MD recommended waiting a few months and repeating the test. By then I had moved to Oregon and through some confusion it took 3 months to get the results, which by then the PSA was 6.1.

I found a urologist, that spoke very down to earth like I would talk to someone. We decided to proceed with a biopsy, given my age etc. The biopsy showed stage 2 cancer in two masses, but probably still limited to my prostate.

I’ve decided, after talking to 3 doctors, a homeopath and an acupuncturist, and a few close friends, my wife, and wives of deceased friends, that I’ll have the surgery. Without the test, I wouldn’t have known I had cancer.

The description by Dr Tim Wilt was very much unlike what he describes. First there is really only one type of cancer found in the prostate. The cancer considered more aggressive is when it has spread outside the prostate. The men who are dying in my age group are the ones whose cancer has gone undetected.

Maybe the chances of harm from the test are higher than the chances of discovering something that can kill you. Both present a gamble that men have to make.

  • Carrie

    My dad was found to have prostate cancer through a PSA test. He started the tests at 55 because of a family history of prostate cancer. (His father died of it in his mid-70s). The PSA levels slowly elevated and it was found he did indeed have cancer at age 58. Because it was caught early, it hadn’t spread, they were able to remove it and he is cancer free now. I get that its a slow growing cancer but I think they should still recommend the test for younger men with family history at least. Certainly in my family’s case it was a good idea.