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    There’s something about PSA: Ben Stiller fights the good fight

     


    Henry Rosevear, MD

    UT Blogger Profile

    Dr. Rosevear is a urologist in community practice in Colorado Springs, CO.

     

    As a freshman at Dartmouth, I read numerous poems by Robert Frost, one of Dartmouth's most famous sons (class of 1896, 102 years before me for those who are curious). My conclusion? About one-third of what he wrote should be required reading (my personal favorite is "The Road Not Taken"), but about a third should probably have been sent back by his editor for significant revisions.

    More from Dr. Rosevear - Clinical pathways: A roadmap to medical success

    I think Ben Stiller's cinematic work can be similarly summarized. "There’s Something About Mary" and "Meet the Parents" are simply hilarious, whereas "Little Fockers" (a sequel to "Meet the Parents") was not worth the $1.39 I paid Redbox to rent the movie.

    With that in mind, I approached Stiller's blog about his experience with prostate cancer with some trepidation. My take-away? Read it, print it out, and post it in your office.

    In summary, at the age of 46, Stiller received a baseline PSA that was elevated. It was repeated a few times on a 6-month interval by his primary care doctor who eventually referred him to a urologist. The urologist performed a rectal exam and ordered an MRI before performing a biopsy. This led to the unfortunate discovery of Gleason Score 3+4 disease.

    I say “unfortunate,” as I do not wish cancer on any man, but as Stiller pointed out in his blog, the discovery itself was incredibly fortuitous. Fortuitous because if his doctor had followed the USPSTF recommendations, as most doctors do, Stiller’s cancer would only have presented itself in 5 to 10 years when Stiller developed symptoms of metastatic disease.

    Related - The return of prostate cancer: A step backward

    After telling his survival story, Stiller goes on to talk a little about the controversy surrounding PSA and then asks the question: “But without this PSA test itself, or any screening procedure at all, how are doctors going to detect asymptomatic cases like mine, before the cancer has spread and metastasized throughout one’s body rendering it incurable?”

    Good question.

    He continues: “Or what about the men who are most at risk, those of African ancestry, and men who have a history of prostate cancer in their family?”

    Another good question.

    He concludes by suggesting that, “I think men over the age of 40 should have the opportunity to discuss the test with their doctor and learn about it, so they can have the chance to be screened. After that, an informed patient can make responsible choices as to how to proceed.” Tough statement to argue with.

    Next: It's been a long time since I've read a more condescending statement from a doctor

    Henry Rosevear, MD
    Dr. Rosevear, a member of the Urology Times Clinical Practice Board, is in private practice at Pikes Peak Urology, Colorado Springs, CO.

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