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PSA Testing: Life Saver for Ben Stiller, Other Prostate Cancer Survivors

PSA Testing: Life Saver for Ben Stiller, Other Prostate Cancer Survivors

(Copyright AP)

By    |   Monday, 10 October 2016 02:35 PM

Comedic actor Ben Stiller went public this month with his battle with prostate cancer and has credited controversial PSA testing with saving his life.

In an interview on The Howard Stern show and in a first-person piece published on Medium.com, the "Zoolander" star disclosed that he was diagnosed with prostate cancer two years ago, but is currently cancer free — after undergoing robotic-assisted prostate surgery.

“I got diagnosed with prostate cancer Friday, June 13th, 2014,” he writes. “On September 17th of that year I got a test back telling me I was cancer free. The three months in between were a crazy roller coaster ride with which about 180,000 men a year in America can identify.”

Stiller credits early detection with his positive outcome.

“Taking the PSA test saved my life. Literally,” Stiller said. “That’s why I am writing this now. There has been a lot of controversy over the test in the last few years. Articles and op-eds on whether it is safe, studies that seem to be interpreted in many different ways, and debates about whether men should take it all. I am not offering a scientific point of view here, just a personal one, based on my experience.”

NYC doctor and medical testing expert, Dr. Robert Segal, tells Newsmax Health, Stiller’s experience spotlights the benefits of the PSA test, even though current federal health guidelines recommend against it for most men.

“Most men with prostate cancer are without symptoms, so screening is very important,” says Segal, a medical testing expert and founder of Labfinder.Com.

“Early detection [of prostate cancer] is key. Patients can get their tests done at nearby labs that are recommended by their physicians or to ensure quickly scheduling the test and ensuring it is covered by insurance.”

PSA testing has been controversial in some medical circles.

In 2012, the U.S. Preventative Services Task Force adopted a policy advising against routine PSA testing, based on the results of the so-called Prostate, Lung, Colorectal and Ovarian (PLCO) trial — a $400 million study sponsored by the National Cancer Institute.

For the study, men who received PSA testing were compared to those who did not.

Researchers concluded that there was effectively no difference in the death rate between the two groups and concluded PSA screening is ineffective.

But more recent research has suggested screening can help reduce the number of fatal cases of prostate cancer.

Earlier this year, a group of researchers from New York-Presbyterian and Weill Cornell Medicine reported in the New England Journal of Medicine that the latest studies contradict the task force’s recommendations — calling the 2012 PLCO study flawed — and argued that that the guidelines should be reviewed and reversed.

"We expect this article to have a profound impact on the debate over the value of PSA screening," said Dr. Jim Hu, director of the LeFrak Center for Robotic Surgery at New York-Presbyterian/Weill Cornell Medical Center and the Ronald Lynch Professor of Urologic Oncology at Weill Cornell Medicine.

"While there are risks of over-diagnosis and over-treatment associated with PSA testing, it can play an important role in preventing prostate cancer deaths as part of a personalized approach to cancer screening. We're going to have to reconsider this issue."
As a result, the federal task force has said it is reviewing its guidelines.

Prostate cancer is the second leading cause of cancer death among men and the most common form other than skin cancer.

PSA tests measure antigens in the blood that are linked to prostate cancer, as well as benign conditions such as prostatitis. Since the introduction of PSA screening in the early 1990s, the United States has experienced a 50 percent reduction in the prostate cancer mortality rate.

But PSA screening is not foolproof and doctors have expressed concerns that prostate cancer was being over-diagnosed and over-treated, posing the risk of serious side effects, such as incontinence and impotence.

In an interview with Newsmax Health, Segal says the PSAs indeed a life-saver. It’s also easy to perform, inexpensive, and usually covered by insurance.

“The cost for a PSA test is fairly low — about $40-60, which is traditionally paid by the insurance,” he says. “If blood levels of the antigen are high, men often get follow-up tests or a biopsy to check for signs of cancer in the prostate.”

Although prostate cancer often has no symptoms, men who experience the following should discuss PSA testing with their doctors, he advises:

• A frequent need to urinate, especially at night.
• Difficulty starting or stopping a stream of urine.
• Leaking of urine when laughing or coughing.
• Inability to urinate standing up.
• Painful or burning sensation during urination or ejaculation.
• Blood in urine or semen.
• Loss of weight and appetite, fatigue, nausea, or vomiting.

Stiller said he began having PSA tests in his mid-40s, even though he has no family history or prostate cancer, to establish a “baseline” to which future testing results could be compared.

“What I had —  and I’m healthy today because of it  —  was a thoughtful internist who felt like I was around the age to start checking my PSA level, and discussed it with me.” he writes.

“If he had waited, as the American Cancer Society recommends, until I was 50, I would not have known I had a growing tumor until two years after I got treated. If he had followed the [USPSTF] guidelines, I would have never gotten tested at all, and not have known I had cancer until it was way too late to treat successfully.”

When his PSA started rising several years ago, doctors confirmed Stiller’s cancer through an MRI and he underwent robotic-assisted laparoscopic radical prostatectomy.

“Due to a lot of skill and a little beneficence from some higher power, he got all the cancer,” Still says. “As of this writing I am two years cancer free and extremely grateful.

“I think men over the age of 40 should have the opportunity to discuss the test with their doctor and learn about it, so they can have the chance to be screened. After that an informed patient can make responsible choices as to how to proceed.”
 

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Ben Stiller has credited PSA testing with saving his life by catching his prostate cancer early. His case spotlights the benefits of the test, which federal health officials do not routinely recommend for most men. What you need to know about the pros, cons of PSA testing.
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