Monday, April 11, 2016

PSA Testing Anxiety

The Prostate Specific Antigen test commonly referred to as the PSA test, measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. Usually men with rising levels of PSA are asked to take a prostate biopsy. It's after the biopsy results are in that men are given the news whether or not they have prostate cancer. 

Once a man is diagnosed with prostate cancer, a yearly PSA test is usually required at least once a year for the rest of the his life. I don't know how many men go off the grid and skip their yearly testing. I do know this, I wanted to be and would have become one of the men who go off the grid and skip out on their yearly testing. I suspect doing this gives you the false confidence that your cancer will not return, To willingly take a PSA every year means you believe in the possibility of that your cancer could return. 

Even though I wanted to go off the grid, I couldn't. I'd been given a warning I found impossible to ignore. Though it happened many years ago, it's an incident I''ll never forget. A dear friend of mine was diagnosed with kidney cancer. They removed the cancerous kidney and he resumed his normal living. For the next few years he lived his life believing he was cured of cancer. No one told him to come in for yearly tests so he lived off the grid.

One day he developed severe back pain. He went to his doctor. He was placed on physical therapy. He went to PT for months without having any relief in his pain. Eventually he developed a severe case of night sweats. Once again he went for a physical exam.  His physician decided to run tests to determine whether or not his cancer returned.

Unfortunately for him, the return of his cancer went undetected for many years. By the time they discovered his cancer, it had spread so far he was given a few months to live. Within four months he died from cancer. I was furious. For years no one asked him to follow up or be checked for the return of cancer. When he suffered from back pain, he was wrongly prescribed physical therapy. He was near death before his doctors discovered his cancer returned.

There was a lesson in this for me and I burned it into my mind. The lesson was this: If I'm ever diagnosed with any form of cancer, I cannot go off the grid. I understood I could lose my life unnecessarily, by going off the grid, so  I made a promise to myself  if  I ever receive a diagnosis of cancer I would get regular checks whether or not they were recommended by my physician. I was sad and angry that my friend lost his life to cancer because no one told him to get checked on a regular basis. Perhaps he'd be alive today if the return of his cancer was discovered early on.

When I was first diagnosed with prostate cancer, without any effort on my part this lesson jumped of the file in my mind and read like a huge banner which said: YOUR LIFE DEPENDS UPON YOU NEVER GOING OFF THE GRID!

Within three years I was treating this like old New Years resolution. My wife would say it's time for your PSA test and I respond with the following question: "Would you mind if I skipped the test this year?" I don't know why I bothered asking, I knew the answer would be "NO!"

I had to ask myself a serious question. Why on earth would I want to avoid a test that could save my life?  I was surprised by the answer. Taking a PSA test year after year is a powerful and unpleasant reminder that our cancer could come back at any time. You'll never receive an all clear. The danger is never over.

 I don't like to be reminded my cancer could return. Six years after surgery, I'd like to believe I've beat prostate cancer once and for all and there's no possibility cancer will return. As I go for my next test, which is sometime next week, I'll have to wait with unpleasant uncertainty which could easily escalate to anxiety, until I receive the test results. During the entire time of waiting the following question will come to my mind MANY times a day: "Will this be the year prostate cancer returns?"

No matter what the results are, I'm grateful for the time I've spent cancer free. If I end up fighting disease once again at least I'll know early on, before it has an opportunity to spread. I remain one of the fortunate men diagnosed with prostate cancer. Early detection is an undeniable blessing both at the time of diagnosis, and in the time following treatment. So like it or not, I'll be getting my PSA tested year after year, for the rest of my life. If you have prostate cancer I hope you'll make the same commitment.

 Rick Redner and his wife Brenda are the author of I Left My Prostate In San Francisco-Where's Yours?

Rick has written more than one hundred blogs about prostate cancer.
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