Sperling Prostate Center

3 Reasons Men Risk Missing Prostate Cancer

When was your last annual physical? If it was less than 12 months ago, skip the rest of this blog. However, if it was more than a year ago—and you don’t have an upcoming appointment on the books— ask yourself why you’re avoiding going to the doctor. Maybe it’s one of the following three reasons:

  1. You get your health information from the internet and social media – who needs a doctor?
  2. You think you’re healthier than the average man.
  3. You’re worried that an underlying health problem will be detected—for example, a PSA blood test picks up prostate cancer.

Skipping an annual checkup risks missing prostate cancer (PCa), which almost always has no symptoms in its early stages. Yet that’s when it’s most likely to be cured. I’ll come back to this shortly.

In 2022, a large Florida health group, Orlando Health, commissioned The Harris Poll to conduct a national survey regarding men’s doctor visits. The survey found that 38% of men get their medical information from social media—call me old-fashioned, but how is that trustworthy clinical advice for an individual’s personal situation? And the majority of respondents (65%) saw themselves as healthier than everyone else. What kind of logic is that, the majority thinking they’re healthier than… the majority?

As for detecting an underlying condition, here’s what a board certified surgeon Cedrek McFadden said in an interview for Today:

… finding “problems before they become problems” is the main reason to go to the doctor once a year, McFadden stressed. “To find the elevated blood sugars before the diagnosis of diabetes, to find the high cholesterol before the heart attack — prevention is easier and cheaper than a cure.”

This brings me back to prostate cancer. The key to preventing PCa is lifestyle habits. There is ample published evidence that diet, exercise, stress management and avoiding exposure to known carcinogens has preventive value, even for men with a family history of cancer. Although there are no guarantees against cancer, overall wellness is proven to protect against cancer and other chronic diseases.

On the other hand, an annual physical that includes a PSA blood test is essential for detecting suspicion of PCa. Notice that I didn’t say “detecting PCa” but rather “detecting suspicion.” That’s because the PSA blood test is not specific. It could be picking a number of other conditions such as infection, BPH, or external stimulation like riding a bike or masturbating within 24 hours of the blood draw. However, a lot of doctors who see a higher-than-normal PSA result automatically send the patient for a needle biopsy. This is unfortunate, because there’s a noninvasive way to tell if cancer is present or not: a scan using multiparametric MRI (mpMRI). In fact, studies show it can avoid unnecessary biopsies altogether.

Knowing there’s an intermediate step between a blood draw and a prostate biopsy takes the fear factor out of an annual doctor visit—at least when it comes to PCa. An mpMRI is very specific for the presence of PCa. If imaging detects a tumor, it also gives important information regarding its size, shape, location and most importantly, its danger level.

In turn, if the scan results warrant a biopsy, at our Center we offer real-time, MRI-targeted biopsy that uses fewer needles but yields the most accurate results. It provides all the diagnostic information necessary to develop a customized treatment plan for each patient. For qualified patients, the plan can include Active Surveillance or a focal treatment to avoid the side effect risks of surgery or radiation.

Thus, while a PSA blood test does not prevent PCa, when used in conjunction with mpMRI it CAN prevent over-treatment with its possible urinary and sexual aftereffects. To put it another way, avoiding a doctor visit actually raises the chances for diagnosing PCa at a later stage, when aggressive treatment is necessary. In such cases, ignorance is not bliss. Not knowing you might be walking around with PCa is a setup for greater anxiety and unhappiness than any routine checkup will ever offer.

When it comes to PCa, an ounce of prevention (i.e., annual checkup) is worth a pound of overtreatment. To paraphrase Hamlet, get thee to an annual doctor visit.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

 

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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