There is no substitute for PSA testing when a man reaches 40 years old. Knowing his PSA level at that stage in a man’s life and beyond is MANDATORY along with the digital exam for early detection and treatment.
Based on my primary care team’s prostate assessment in January 2022, I considered myself in the clear, but after several months of medication, my urine flow had not improved and was compounded by constipation. My wife and my best friend encouraged me to return to the VA in August. After feeling my distended stomach, my doctor immediately sent me to the emergency room.
The ER doctor wasted no time and inserted a Foley catheter. “Will it hurt?” I asked. He just raised his eyebrows. I spent three days in the hospital while the medical team drained 4 gallons of urine from my bladder. “You’ve experienced kidney failure,” the on-call urologist explained, but after three days and proper hydration and medication, my kidneys returned to normal. Clearly, this is not something to monkey around with. I left the hospital with an appointment to see a urologist, and with a catheter that I would bear for six weeks.
PSA: the first order of business
The first order of business was a PSA test. The PSA test is a blood test used primarily to screen for prostate cancer, and measures the amount of prostate-specific antigen (PSA) in your blood. Normal PSA is 0-4; mine was off the charts as they say, at 415. We immediately scheduled surgery for September, and it would include a biopsy.
My research suggests that virtually all men will experience prostate cancer. Many will never know they have it. However, the sooner it is detected, the more treatable it is. That is the mistake I made; I avoided the digital exam and the PSA test until the cancer had reached – in the words of my urologist – “an incurable stage.” Those were his exact words when he reported the biopsy results over the phone.
Why did I avoid the digital exam?
- I considered it invasive.
- I considered it embarrassing. Swallow your pride.
- I felt my feeble efforts to maintain prostate health with saw palmetto sufficient. It’s clearly not.
I had a long chat with a very good friend in St. Louis several weeks ago. He called to tell me that a mutual friend had died after battling prostate cancer for 15 years. When I told him I had prostate cancer, he surprisingly responded, “Me, too.” He is a dozen years my junior. His high PSA is 6.1 and the staff at the Mayo clinic has prescribed nothing beyond regular, close, and frequent monitoring of his PSA. They will act when his personal situation warrants it.
I suspect had I had a PSA test when I was 60, I wouldn’t be in the ‘incurable’ situation I am in now. To be clear, when I say ‘incurable,’ my doctors tell me I am ‘buying time’ with aggressive treatment like chemotherapy to battle aggressive cancer, aggressive because it has metastasized into the bones. When I asked how much time, I’m told five years. I smile. Five years is enough time for me to do those things I have yet to do. In truth, God only knows.
Encourage the 40+ year old men in your life to begin annual PSA testing and a digital exam with their primary care physicians. There is no reason to fear the digital exam. It is a bit uncomfortable but only lasts a few seconds. Early detection can make prostate cancer easily treatable with great success.
One of my daughters-in-law gifted me a copy of Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer. I STRONGLY ENCOURAGE every person with a male in their lives to read this book. A 20-year-old can learn how to approach his father and grandfather. This book contains everything you need to know about dealing with prostate cancer, and it is likely to put you at ease with your personal situation, even if it is an advanced stage