As a prostate cancer survivor whose primary care physician missed my cancer for the better part of six years, I object to the position that PSA doesn’t matter.
Like the vast majority of men, I was “stupid” where my healthcare was concerned. I never asked for a copy of my blood work or questioned the results of my tests. After all, we treat our doctors like gods.
After I was diagnosed, and endured the usual battle with my insurance carrier over the issue of a pre-existing condition, I retrieved years’ worth of blood work results—and there it was staring me in the face. My PSA had been steadily increasing over several years. The results showed that my testosterone levels had been low; consequently my doctor was routinely giving me hormone injections.
Successful medical care is a partnership between patient and doctor. Had I obtained my blood tests sooner and asked why certain numbers had changed, then perhaps my doctor might have caught my cancer earlier. But most primary care physicians do not fully understand how to use PSA testing and wind up ordering biopsies, afraid of the attorney waiting in the wings.
Thomas Stamey, MD, considered to be the father of PSA testing, said that it is not the results of a single test but the trend of those results that is critical. The secret to the successful treatment of any cancer is early diagnosis. PSA testing is merely a tool, and when paired with a digital rectal exam, it can support a wait-and-watch approach so that biopsies or other tests are ordered only when warranted.
There is no valid reason to eliminate PSA screening as part of the general blood work-up during a routine physical exam. PSA screen can be done at a nominal cost. I would hope that a physician would place more value on a man’s life than on the cost of a test.