On Feb. 15, I joined about 165,000 other men in the country who are diagnosed with prostate cancer.
Thankfully, my family physician had ordered a PSA test this year as part of my annual physical examination, and my urologist followed up with a biopsy.
I hadn’t received the PSA screening since 2012, and although I had annual prostate digital exams, my doctors hadn’t detected any abnormalities.
The U.S. Preventive Services Task Force, an independent panel of experts, recommended that doctors stop ordering the PSA test in 2011.
This volunteer group of national experts in prevention and evidence-based medicine found that routine prostate-specific antigen testing was causing too many patients to receive unnecessary prostate biopsies and treatment.
By 2017, with fewer men being detected with early-stage prostate cancer and with the rise in advance prostate cancer incidences, the task force determined that men ages 55 to 69 should make an individual decision about the PSA screening with their clinician, but men over 70 should not be tested.
However, the recommendation to exclude older men from the PSA screening was not universally accepted.
“There is increasing evidence that this age-based approach is significantly flawed,” said Patrick Walsh, an internationally renowned professor of urology at Johns Hopkins School of Medicine, who co-authored a recent study on high-risk prostate cancer in older men.
According to the John Hopkins investigators, men age 75 and older account for 48 percent of metastatic cancers and 53 percent of the deaths from prostate cancer. Without PSA testing, cancer can go undetected, limiting treatment options.
My father, who is 93, was successfully treated for prostate cancer at age 78.
After receiving my pathology report, my urologist ordered the Polaris genetic test, which is used to predict disease-specific mortality in prostate cancer patients using the biopsy specimens. There are similar genetic tests for breast cancer.
My disease was classified as an intermediate-grade prostate cancer, with many lifesaving treatment options.
According to the Prostate Cancer Foundation, you need to do your due diligence and seek second and third opinions prior to accepting treatment. Finding a higher-volume, experienced and successful radiation oncologist or prostate surgeon will take time and patience.
The foundation has a free downloadable resource guide at www.pcf.org on diagnosis, treatment, side effects and risk factors for patients and families.
Certain factors affect the treatment options for prostate cancer, including age, health problems, expected side effects of treatment and past treatment for the disease, according to the National Cancer Institute. Some men are perfect candidates for surgery; others might do better with radiation or waiting for treatment and monitoring the disease progression.
Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About 6 in 10 cases of prostate cancer are found in men older than 65. Prostate cancer occurs more often in African-American men and less often in Asian-American and Hispanic men than in non-Hispanic whites or in those with a family history of prostate cancer, according to the American Cancer Society.
The Americans with Disabilities Act prohibits discrimination against people who have cancer and cancer survivors. The determination of whether someone has a disability is made on a case-by-case basis, yet given its inherent nature, cancer will almost always be found to substantially limit a major life activity and meet the ADA definition of disability, according to the Equal Employment Opportunity Commission.
Andy Winnegar has spent his career in rehabilitation and is based in Santa Fe as a training associate for the Southwest ADA Center. He can be reached at firstname.lastname@example.org.
Free PSA testing
The Prostate Cancer Support Association of New Mexico is sponsoring free PSA testing for men. To receive this blood test, visit the organization’s office at 2533 Virginia St. NE, Suite C, in Albuquerque to pick up a voucher. The office is open from 10 a.m. to 2 p.m. Monday through Thursday; call 505-254-7784.
On the web
• Download the Prostate Cancer Foundation’s free resource guide at www.pcf.org.