We sure could use a little good news today... It's a simple blood test!

Anne Murray once recorded a song titled "A Little Good News."
"We sure could use a little good news today..."

Good news with PSA test

I got my good news this morning when my latest blood test results were posted on the patient portal. If I wasn't on blood thinner I'd celebrate with a glass of wine! Under the circumstances, I'll just have to make do with sparkling water. The reading from my Monday morning blood draw came in virtually the same as the last one taken when I visited my family doctor in February. February’s result was 0.28 ng/ml and this one came in at 0.27 ng/ml. That's down from 14.49 before the biopsy, months of preparation, and finally, a treatment that I completed in May of 2021.

Last December’s reading had been 0.275 ng/ml. It appears now almost two years out from completion of radiation and ADT my PSA has stabilized and probably will not drop much further. Three consecutive readings that are virtually identical seem to indicate I’m stable and home free for now. It will never fall to zero as long as I still have a prostate, but as long as it remains stable and does not begin a rising trend I believe I can breathe easy on that score, at least for the near future.

Asking for a PSA test

During a routine office visit in early 2020 my doctor was explaining the blood tests he was going to order for me. They included the usual metabolic panel, A1C (I'm diabetic), CBC, and so on. I had not had a PSA test for several years, and I had been having trouble voiding for quite some time. At age 74 I finally spoke up and asked, "Shouldn't we be doing a PSA test as well?"

He was quick to explain that Medicare protocol had been updated to recommend men of age 70 and over should NOT be routinely tested for prostate cancer. He went on to enumerate the supposed justifications for the change in policy that had been handed down from the policy-making experts on high. Reasons included the possibility of unwarranted treatment, the stress imposed upon patients who find out they have cancer, etc., etc. (Is it better to remain ignorant and unaware?)

"Well, I WANT a PSA test!" I insisted.

"No problem," he said. "All you had to do was ask."

My last previous PSA at age 69 had been 2.1. When the nurse called to tell me my current test had come back at 9.98, she sounded very sympathetic, almost apologetic on the phone. "I'm sorry to give you this news. We'll need to set you up for a consultation with a urologist as soon as possible."

Diagnosed with promising prognosis

Two months later a follow-up PSA test with my urologist showed a rapid rise in PSA to 14.49! That alarmed me. Medicare ended up paying for that simple, cheap blood test. Fortunately, we caught my Grade 3, Gleason 4+3=7, Intermediate, Unfavorable Stage cancer while it was still fully encapsulated and potentially curable.

I seem to have dodged a bullet. (Knock on wood!) My “good fortune” was thanks only to my insistence on a PSA test at age 74. It’s a simple inexpensive blood test I otherwise would not have gotten based on the medical protocol of the day. I have often pondered the question, "What if I had not spoken up at that particular time?”

What if I had just let it slide? What if I had not said “Damn the protocol! I WANT a PSA test!” Where would I be now if I had not insisted on being tested? Would I be paying the ultimate price for a policy I had no idea had been implemented in the system? I had been relying on my doctor to tell me when I needed this or that test. After all, he’s the doctor, right?

PSA testing earlier

I wonder how many men are out there who are 70 years and older with incurable Stage IV disease that might have avoided it if only they had been tested sooner? Sure, the protocol of not testing men over the age of 70 resulted in a lower rate of prostate cancer being reported. On the surface of it, that’s a big plus!

Not treating early-stage disease probably did initially save money for the system and perhaps saved some percentage of men with low-risk diseases the potentially horrible side effects of unnecessary treatment. I’m sure the policymakers were patting themselves on the back. “Look at what we’ve accomplished!” But then whoops!! Oh my gosh, who would have foreseen the new policy would result in a significant rise in the incidence of late-stage, incurable disease?

I was fortunate

I was fortunate, but it angers me when I think of others who have not been as lucky as I am. If the protocol was about saving money for the Medicare system, it was/is a policy that’s penny-wise and dollar stupid! I’m sure in the long run it will have been a very costly mistake in terms of dollars spent. Much more tragic than that is the human cost in terms of shortened longevity and degraded quality of life for so many.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The ProstateCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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