The following op-ed is written by Ken Rechtin, a Newport city commissioner. This op-ed previously was published in 2021 and re-posted in 2022.
Prostate Cancer Awareness month is September 2021.
Every cancer gets a month. And every cancer gets a ribbon. What’s the ribbon all about? Is it just a participation trophy?
Now, every cancer gets a color too. (What’s that all about!? It’s not as though every disease deserves their own color! There are not enough colors in a rainbow for that!) We prostate owners (or ex-owners) really don’t want a ribbon when this finger is better.
Anyway, prostate cancer owns blue (not to be confused with BIG BLUE).
And college football season begins NOW. Foam fingers will be elevated at every stadium in the country. Seeing those #1 fan fingers is an appropriate reminder for us!
A little-known fact is that prostate cancer is the most frequently diagnosed cancer in men and is a leading cause of cancer death in men, second only to lung cancer.
Unlike the breast exam which women perform monthly, the DRE (digital rectal exam, no relationship with my last name) is NOT, and I repeat, NOT a self-exam! It’s recommended to see a physician for a digital rectal exam, as they have experience feeling prostates for lumps or enlarged prostate.
The next test is a simple blood test called a PSA (Prostate Specific Antigen). Again, do NOT draw your own blood for this test. Ask for one of these tests from your primary care provider every year!
PSA screening has profoundly changed the natural history of prostate cancer in the United States. From 1992 – 2014, there was a 75% decrease in the percentage of men diagnosed with metastases and 53% decrease in the prostate cancer mortality rate. The Cancer Intervention and Surveillance Modeling Network (CISNET) estimated that 45% – 70% of the mortality decrease is directly attributable to PSA screening.
So, you ask: “Ken, this is all fine and good, but why is this important to you?”
Well, here’s the story:
In the summer of 2019, at my annual visit with my primary care provider, she performed the annual anal DRE (digital rectal exam) and the annual PSA.
The PSA was elevated and another test three months later showed it was elevated even further! This test is not like a quiz in school, getting a higher number is not the goal!
Next was the visit to a highly recommended urologist during which he scheduled a prostate biopsy. (If you must know the details of a prostate biopsy, please give me a call.)
2019 November 8th, I wrote to our children to let them know:
“I’ll get to the point of this post quickly….I have prostate cancer…..the Gleason Score is 4+5=9 (you guys can Google that and learn all about it.)….I will get a CT and a bone scan to determine whether it has spread and on the 20th of this month after the results of the tests are done your mother and I will meet with Doctor Urologist to determine treatment.”
A Gleason Score of 9 is bad news folks!
Then there was a bone scan and CT scans to see if the cancer had spread.
All these tests were negative!
2019 November 20th, again writing to my kids:
“Your mother and I met with Doctor Urologist this morning.
All the tests indicate that there is no spread of the cancer outside of the prostate.
The prostate removal will be scheduled for some time in December.
Afterwards, my PSA will be monitored to assure that there is no growth or spread. If no additional concern in PSA levels, there will be no need for additional treatment!”
2019 December 20th was a sad day, my prostate and I were separated permanently. Results were less than enthusiastically received. The cancer (like Elvis) had left the prostate (building). It had metastasized to the lymph nodes in the area. BAD NEWS!
2020 May 11th, Another communication with the kids:
“So….this morning I had a visit with Dr. Urologist, the guy that robbed me of my prostate. Prior to this visit I had another PSA test last week. The results of that test were that my PSA went from .06 in February to .07 last week.
Dr. Urologist said that this is good and bad. Good in that the increase is small. Bad in that there is an increase. He will order a PET scan (DO NOT bring you dog or cat to this test!) to see if the prostate cancer can be identified in a specific spot. He will also refer me to a radiation oncologist. Typical “salvage” radiation lasts about six weeks with very minimal side effects (so they say).”
During 2020 June and July, I endured what Dr. Radiation Oncologist recommended. It was radiation treatment of five days a week for seven weeks. I think that they told a little white lie when they said that there were minimal side effects from this radiation.
After radiation was completed, we waited six months before another PSA. At this point ANY detectable level of PSA means that the cancer is BACK!
2021 February 4th I wrote to the kids:
“GOOD NEWS……GOOD NEWS…….GOOD NEWS
Visited the Urology Surgeon on Monday. My PSA, which is an indicator of prostate cancer, is BELOW 0.04. This means that the cancer is either nonexistent or undetectable.
I go to see the Radiation Oncologist in 6 months for another PSA check….”
2021 August 13th My most recent email to the kids:
“Every 6 months I will have my PSA checked. PSA stands for prostate specific antigen. Presence of a detectable amount of PSA, which is only produced by the prostate (which was removed 18 months ago) would indicate that the prostate cancer is present.
I am happy to report that the most recent test indicated no detectable level of PSA.
Break out the booze!
This is probably MUCH more information than you want or need to know!”
So, the moral of this story?
I am here today because of the physical, the annual anal exam called the DRE and the PSA. This is not to throw shade on the folks responsible for keeping me on this earth. A boatload of excellent physicians, technicians and other health care providers are responsible as well.
So, what should you do? Awareness is everything!
Men ages 45 to 49 should have a baseline PSA test.
If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.
If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.
If you are here on this earth today because of a DRE and a PSA, share your story with others! Don’t be embarrassed to talk about it! Hold your foam finger high!