A PSA test alerted me to possible cancer

PSA test

While in my sixties my family doctor routinely ordered a PSA test along with my usual annual blood panels. At age 74 I'd had none for several years and during a regular checkup, I asked if I shouldn't be doing a PSA test. His reply was that protocol was not to do routine PSA testing after a man reaches 70 years of age. The reasoning behind that is apparently that "prostate cancer is slow growing" and something else is likely to kill you before cancer does. I found that a bit shocking and I responded, well I WANT a PSA test! No problem he said. All you had to do was ask. I honestly was flabbergasted.

Pre-test symptoms

I'd had problems voiding my bladder for several years and was on Tamsulosin to help with that. The cause was assumed to be BPH. It helped for a while, however over time the Tamsulosin was becoming less and less effective for me.

PSA results

My most recent PSA result at age 69 had been 2.1, very normal for a man that age. When results came back at age 74 it had already jumped to 9.98! I was immediately referred to a urologist for further evaluation. By the time I had yet another PSA test ordered by the urologist it had risen to 14.49, a roughly 50% increase in only two months! That's when the fear set in. This must be something fairly aggressive I thought. An MRI found a Grade V anomaly in the left anterior prostate and an MRI-guided transrectal biopsy was scheduled.

Biopsy Results and Treatment

A fifteen-core sample resulted in a Gleason score of 4+3=7, Intermediate, Unfavorable. Fortunately, CT and bone scans found no evidence of regional or distant metastases. Ultimately I underwent four months of Firmagon ADT with adjuvant IMRT treatments. Upon completion of treatments, my radiation oncologist flatly assured me "You will NOT die of prostate cancer!" I had some major cardiac side effects from the ADT that required cardiac ablation, but so far side effects of radiation have been minimal eighteen months out. My most recent PSA at a one-year follow-up was 0.299.

Importance of the PSA test

The bottom line is the PSA test I insisted on having is what alerted me to what could have developed into metastatic disease before I even knew I had a problem. I belong to a support group of men with prostate cancer and their loved ones and caregivers. Many of them have advanced metastatic disease and must put up with life-altering side effects of the treatments to try and hold their cancer at bay to eke out a few more months or years of life. The really sad part is they might have been able to avoid it if only they had detected it in time. I would rather chance a false positive than continue unaware until it's too late!