PSA Testing – Men Don’t Get It
The Below The Belt Challenge
Overall men are typically reluctant to visit a doctor. If and when they decide to show up for the “dreaded encounter” most resist the prostate cancer screen.
Two of the initial screenings done for prostate cancer are a PSA blood test and a rectal exam. Privately men admit that a rectal examination — using a doctor’s finger — is invasive, embarrassing and will go to extremes to avoid it. Physicians tell us that while a man may consent to a PSA blood screen, he will decline the rectal exam – despite the consequences.
The hullabaloo surrounding the accuracy of PSA testing and digital rectal examinations combined with the reluctance of visiting any doctor puts a lot of men off from scheduling an annual physical.
The story does not end there. The hesitancy has even deeper roots, specifically:
- How men view themselves, their masculinity and self-reliance.
- Treatments for prostate cancer can impact sexual function.
- Sex or lack thereof is a powerful motivator and can lead to avoiding treatment.
Men mistakenly believe if they receive a positive diagnosis and have surgery, they won’t be a man anymore because they might not be able to “get it up”. While this is clearly not the case today, it doesn’t take many stories to raise the fear of screening in the male population.
Lack of Awareness
In May of 2012, the United States Preventive Services Task Force, a volunteer group that suggests national treatment protocols, recommended against Prostate Specific Antigen (PSA) based screening for Prostate Cancer. The action was taken in an effort to reduce misdiagnosis and overtreatment.
USPSTF recently modified its position and now cautiously suggests testing may be beneficial for men over 55 years of age. Nevertheless, the decade long downplaying of the importance of early testing has played a significant role in decreasing the public’s awareness of this deadly disease.
What Can Be Done?
At the National Prostate Cancer Awareness Foundation, www.pcaaware.org we believe the answer to overcoming male resistance comes down to education and awareness. While 90% of women know the warning signs for breast cancer, fewer than 40% of men know or recognize the early warning signs for prostate cancer or BPH or prostatitis.
Fewer understand the importance of maintaining a lifelong commitment to heathy living and eating. It’s not about weight loss or developing those 6-pack ABs. Time and time again actuarial tables demonstrate that women tend to live longer than men. Why? On average, women are more aware of what they consume, are less prone to risky behaviors and ingest less alcohol than men. Women visit doctors on an average of 5 times a year vs. their male counterparts. Finally women speak up when they encounter medical issues. In sharp contrast, men often believe that silence is a cure when visiting their doctor.
A study from the National Cancer Institute has shown, that in spite of the criticism of PSA screening, over 1.3 million men were found to have prostate cancer by doing PSA screenings who otherwise would gone undetected. Early detection and treatment saves lives.
PSA screenings should intensively screen men at increased risk which includes African-American men, all men with relatively high PSA levels in their 40s and those men with a family history of the disease.
In response to the new recommendations by USPSTF, the National Comprehensive Cancer Network released a statement stating that PSA screening had “advantages and disadvantages” and that there are no right answers. A strong suggestion that each man should make an informed and knowledgeable decision about whether the test is best for them.