Alarm, because the information I read was inaccurate, at best misleading, and likely to lead to an increase in advanced prostate cancer at a time when a large number of baby boomer men will be entering the 50 to 70 age range - a time period where the risk of prostate cancer increases dramatically.
Horror, because my husband, George, was diagnosed in July 2009 with an advanced, aggressive prostate cancer because his doctor was practicing the kind of medicine advocated in this article, and it didn't have to happen.
George is 63 years old and we’ve been together 28 years and have a lovely 26-year-old daughter.
We are entering a wonderful time in our lives that comes with maturity, a perspective on life, and a time period where we are thoroughly enjoying each other's company with the expectation of many, many years ahead of us. Now, the love of my life and I are in the throes of a diagnosis of advanced prostate cancer.
None of this had to happen.
With PSA testing and a digital rectal exam (DRE), prostate cancer can be detected early and treated successfully.
My husband has had an annual physical exam each year from his primary care physician. But his first PSA wasn’t until 2006, and it was 0.8; his digital rectal exam was normal.
His doctor talked him out of having a PSA test in 2007 and 2008 but performed a DRE in these two years, which he said was normal.
In January of 2009, his next test, George’s PSA was 16 but went unnoticed by his doctor. In April, my husband saw his doctor again prior to having knee replacement surgery, and again, the PSA report went unnoticed. In June, my husband returned, and his doctor noticed the abnormal lab report and ordered another blood test, which came back with a PSA of 30.
George was referred to a urologist who observed an asymmetrical nodule on DRE and made an appointment for a biopsy the following week. The pathologist's report was a Gleason score of 9. Fortunately, the bone scan was negative but there is still a question of lymph node involvement. Of the eight doctors we consulted, none recommended surgery and all recommended that treatment begin right away with hormone therapy, which he has started.
Next week we meet with doctors to discuss radiation treatment – though I am still searching high and low for all the possible answers and treatments available to make sure that George gets the best treatment possible.
What stands out is the question: If both an accurate DRE and a PSA were done each year, would the cancer have progressed as far as it has? Or would we have had a chance for a cure?
I wanted to know about the cancer as soon possible and have the option to choose treatment which had the chance of a cure. I fear for the future of my husband and myself
In the end, reading the New York Times article could not have been more horrifying. I fear for all the men and doctors it might influence.
*Martha E. Shenton, Ph.D. is Professor, Department of Psychiatry and Radiology Director, Psychiatry Neuroimaging Laboratory, Department of Psychiatry, and Psychiatry and Behavioral Science Imaging, Department of Radiology, Brigham and Women's Hospital, and Director Clinical Neuroscience Division, Laboratory of Neuroscience, VA Boston Healthcare System and Harvard Medical School