By Jerry Bembry
Richard Ablin, the man who discovered prostate-specific antigens—otherwise known as PSA and widely used to indicate potential prostate cancer—wrote in the New York Times two years ago that the disease comes in two forms: “the one that will kill you and the one that won’t.”
Having lost a brother and two uncles to prostate cancer, I have to assume I have the one that can kill me.
I learned of my cancer diagnosis only after a PSA test last year, the same test that the U.S. Preventative Services Task Force (USPSTF) this week recommended that doctors should no longer offer to healthy men for the detection of prostate cancer. The reason the USPSTF gives the tests a grade of “D”: PSA tests don’t save lives.
It’s my hope that the PSA test that I took last year helps to save my life. Over a two-year span my PSA more than doubled to 5.3. Levels above 4.0 are said to increase your risk of having cancer. That’s strike one.
Being an African-American male, I’m in a group that has the highest incidence of prostate cancer in the world. That’s strike two.
And having a first-degree family member with the disease (my brother, Joe, who died from complications of prostate cancer in 2010) places me at an even higher risk. Strike three.
Without a PSA test as an indicator, what were the chances of me learning I had prostate cancer?
What is the USPSTF saying to African-American men, who have mortality rates from prostate cancer more than double than that of white men (54.2 cases per 100,000 for African-American men, as opposed to 22.8 cases per 100,000 for white men)?
What exactly is the USPSTF saying to the 28,000 American men who die of prostate cancer each year?
Ablin stated in his New York Times op-ed piece that 30 million men have PSA tests each year, at a cost of $3 billion annually. And he spoke out against the test, describing it as a “profit-driven public health disaster.”
I would like Ablin and the members of the USPSTF who made this recommendation to tell me this: What’s the alternative? What is in place to tell me—a 49-year-old man with a cancer diagnosis that generally strikes men above age 65—that I am at risk? Can you provide me with the definitive test that tells me whether I have a cancer I can live with, or a cancer that can kill me?
Life with PSA testing helped me see my cancer in its progression, and allowed me a course of action. Life without PSA testing would have left me blindsided.
So, in light of this USPSTF recommendation, ask yourself these questions:
Do you really want to live without a PSA test, or suitable replacement?
Do you really want your life to come down to the equivalent of a roll of the dice?