Opinion: Misperceptions about prostate cancer tests and PSA levels can put patients’ lives at risk – as one former teacher's story shows.
Ken Chadwick , accompanied by his wife Teri , recalls feeling angry when primary care physicians failed to diagnose him with prostrate cancer due to misperceptions about how to interpret prostate-specific antigen tests.With his retirement date approaching, St. Louis-area high school teacher Ken Chadwick decided to take advantage of his school’s health insurance while he still had it and obtain a number of routine medical exams and tests.
Two months later, surgery would reveal that Chadwick’s cancer, which had colonized 60% of his prostate gland, had also metastasized to nearby tissues, lymph nodes and bones. He had Stage 4 cancer, the most advanced. “It knocked my socks off a little,” said Chadwick, 63, recalling how he felt when he learned of the seriousness of his condition. “I’ve always been in pretty decent shape, and I eat pretty well. And, yeah, I probably was angry.
Most men with prostate cancer have a type that will never threaten their lives, with the only treatment needed being active lifetime monitoring of their PSA levels and other exams and tests.of cancer death among American men after lung cancer. One in eight men will be diagnosed with the disease at some point in their lives.
Not long after its debut, he said, PSA screening became commonplace among physicians and “what happened was there was a whole lot of over-diagnosis and over-treatment of minimally aggressive prostate cancer.” To lower the risk of over-diagnosing low-grade cancers that can be left alone, urologists now rely on more advanced tests — MRIs as well as a specialized blood test and also a new kind of fusion biopsy — on men with elevated PSAs to discern whether their cancer is intermediate or high-grade and likely in need of treatment.
But that wasn’t the case for Chadwick. He and his wife of 13 years, Teri Chadwick, a 58-year-old nonprofit executive, dealt with that grim fact the best they could. “The idea of him losing muscle mass, … I was just worried that he wouldn’t feel like himself, and that he would be freaked out by it,” she said.
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