If you're a man - or if you care about men, then you must be following the current controversy over whether men should be regularly screened for rising PSA levels. The US Preventive Services Task Force, whose membership can be found here and which notably has no urologists on it, has recommended that healthy men no longer receive the blood test that measures the prostate specific antigen.
Last night, I had the chance to talk with Dr. Patrick Walsh, who is among the handful of most famous urologists in the world, and whose book, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, is the go-to resource for any man with prostate cancer. Read up here for Dr. Walsh's contributions to prostate cancer detection and the perfection of nerve-sparing surgical techniques that have vastly improved outcomes for men undergoing prostatectomies.
We first met Dr. Walsh two-and-a-half years ago when my husband was diagnosed with Stage 2A prostate cancer, found as a result of a suddenly rising PSA. Thanks to our friend, Dr. Tom Lamont, who introduced us to Dr. Walsh (they both have served on the editorial board of New England Journal of Medicine), we were able to get detailed advice from Dr. Walsh at that time. (Yes, for those of you following our family's saga, my husband had prostate cancer a year before he was diagnosed with pancreatic cancer.) Just as one tiny example of Dr. Walsh's influence: Dr. Andrew Wagner, the urologist at Beth Israel Deaconess Hospital in Boston who operated on my husband, was trained in Dr. Walsh's lab.
But I'd never met Dr. Walsh face-to-face until last night and so was very pleased to be able to talk to him at a gala this weekend honoring Dr. Lamont's 40 years of contributions to medicine. That tribute deserves a post of its own but suffice to say when 280 people show up from around the world to honor a single doctor, then you know that person has had quite an effect on medicine, in Tom Lamont's case the field of gastroenterology. I am extremely lucky to count Tom and his wife Emily Lamont as among my closest friends.
I digress. As soon as I saw Dr. Walsh last night, I asked him his opinion about the PSA controversy. He was unequivocal. Men should continue to have their PSAs monitored. Here's what he said: "29,000 American men's lives were saved this year because they had their PSAs monitored." He's a urologist. He's been treating prostate cancer for decades. He's now retired so has no vested personal interest in bringing more people into his own practice.
And so, men friends, before you cavalierly forego having your PSA checked, listen to what someone who's been working in the field for his entire career has to say. We don't have any data on how much research the panel saying to skip PSA tests actually did, how detailed the data was that they were looking at, how statistically accurate it was, how trained they were to make their evaluation, and what other factors might have been influencing their decisions.
Having just endured a family member's death from another, albeit incurable, cancer, this is not trivial stuff. As yet another doctor friend told us when my husband was considering whether to have his prostate removed, "You don't want to die from prostate cancer." It's a very difficult cancer to endure. Especially when it's preventable.
