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Monday, August 5, 2013

The "Do Health Tests Really Help? Story

It was an ordinary day.  Headed to the urologist to have some blood drawn for my yearly PSA test.  This is the prostate-specific antigen test that will produce a number that will help my doctor determine if I have any warning signs of prostate cancer.  It is a test that many now think is unnecessary, but my doctor still recommends it every year.  I have been having the test since I was in my late 40s.  Those that don't favor the test feel that the PSA test is flawed and saves few lives and may turn many men into cancer patients because of all the chemo, radiation and surgery that that may eventually result from a doctor misinterpreted the final result number.  The American Cancer Society encourages men to talk with their doctors about the risks in getting the test.  It certainly is not a test that causes any physical harm, since all they do is draw a vial of blood.  When I have that done I must look away from the needle or I may need additional help to get off the floor.  Those that are against the test fear that insurance companies are paying for a test that may be useless.  My doctor does not agree.  He has used both my PSA test and a physical digital test to keep a watch on my prostate condition.  A few years ago I had such a high PSA number that he told me months later that had that been accurate, I would have been dead shortly afterwards.  Instead he read the number as showing I had inflammation of the prostate and treated it as such.  A urologist who works with the PSA numbers and is a skilled doctor will know how to handle PSA tests such as my test.  He now can compare my yearly tests to see my chances of really getting prostate cancer.  I read in a brochure that he gave me that about 45% of men in their 50s have shown signs of prostate cancer.  Pretty scary!  Then as I read on I read that just about every man will have evidence of prostate cancer if he lives long enough.  That's even more scary!  Another section of the brochure said that doctors usually recommend biopsies for men who have a PSA count over 4.  That has happened twice with me before my doctor realized that I had other reasons for the high numbers.  An enlarged prostate, inflammation of the prostate, several medicines in combination and even riding a bike can influence the number.  That is why my doctor treated me with medication after my high reading I mentioned.  Dr. Ian Thompson, who is the director of cancer therapy at the University of Texas, noted that the death rate from prostate cancer has dropped steadily since the PSA test was popularized in the early 90s. Others have shown that men with a number below 4 on the PSA test may still have prostate cancer.  There seem to be so many variables that it is tough for health specialists to determine what your PSA test number reveals.  They just have to get to know their patients and what their PSA test numbers have shown in the past.  Some doctors encourage PSA testing for people at high risk for the disease which includes African Americans and men with a family history of the disease.  For me, it seems I have peace of mind after talking with my doctor and knowing that my PSA test is within the limits that he thinks it should be.  You see, you must have trust and faith in your doctor to determine what he feels is best for you.  If you don't, it's time for a new doctor.  It was another extraordinary day in the life of an ordinary guy. 

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