MEN: THE PSA TEST COULD SAVE YOUR LIFE

Editor's Note: A retired Cape Girardeau businessman and prostate cancer survivor, Cliff Rudesill is a vocal advocate of PSA tests. This is his first-person story of why he feels the screenings are essential for men.

You have cancer.

Those three words are probably the most dreaded in our society. If my doctor was trying to get my attention, he succeeded. Yes, I had prostate cancer. This was early 1997.

The story really goes back to 1992 when my doctor started including PSA (Prostate Specific Antigen) tests into my regular checkup. It is a simple blood test to see if you have, or are heading towards an elevated PSA level. An elevated level indicates possible prostate cancer and that further testing is needed.

Presently, the PSA is the most accepted test to alert a man to the possibility of prostate cancer. A digital rectal exam is not completely adequate. It is impossible to examine all surfaces, and the interior of the prostate gland. If you wait until you have symptoms of these dreaded disease, it is normally too late for successful treatment.

I realize some doctors are not completely sold on PSA tests, but until something better comes along for early diagnosis, PSA is much better than doing nothing.

If you catch prostate cancer early, before it gets out of the prostate gland, the cure rate of prostate gland removal is excellent.

If you have a doctor who does not believe in PSA tests, I personally would get a second opinion and find a doctor who does. It's your life at stake, not the non-believing doctor's. Bet you 1,000 to one, he hasn't had prostate cancer.

Facts prove PSA testing saves lives by alerting the early, curable stages of prostate cancer. All it takes is a simple blood test that could save your life.

My tests each year had followed this trend: "1.7, 2.2, 2.53, 3.25, 3.33," and then the trigger of passing the dreaded number "4." January 1997's test came back "4.3." For years, passing "4" was the level where further tests were suggested.

Researchers at Washington University biopsied 332 men with PSAs between "2.6" and "4." Surprisingly, they found that 22 percent of these men already had prostate cancer. It's true some had PSA levels higher than "4" and still did not have prostate cancer. The point is it's good to know you don't as well as finding out you do.

After I hit 4.3, my doctor suggested other tests. The first, performed in the doctor's office was an ultra-sound. It came back negative all clear no sign of cancer. So far so good.

My doctor felt the only way to really know if I had cancer was to take a series of biopsies. This is how Arnold Palmer, the world famous golfer, found his prostate cancer. It wasn't too unpleasant an experience; just some internal twinges. Then it was back to his office in a few days for the results. That's when my wife and I got those dreaded words.

You have prostate cancer.

Now what? The doctor suggested a bone scan/MRI to try and determine if the cancer had spread. This was done at the hospital without pain. Then it was home again to wait a few days for the results.

It was good news. The cancer had not spread to the bones.

I had always heard that prostate cancer was "slow growing." But I found out in discussion that isn't always true.

Biopsies reveal more than just "yes or no." They reveal where in the prostate the cancer is located and if it is fast, slow or moderate growing. Mine was moderate growing.

Between all these tests, I made phone calls to learn more about what my options were, what others had done and what their results were in meeting the threat of prostate cancer.

I found out that 43,000 women died each year from breast cancer. It had heard a lot about that from TV, newspapers and magazines.

Women talked and were doing things to keep breast cancer in the public eye, and had been able to get $200 million a year from the government dedicated to finding cures and treatment.

I also found out that many men choose not to talk about or seek early diagnosis of prostate cancer. The result: 40,000 men die each year from prostate cancer. Yet, because of men not being willing to discuss prostate cancer or keep the disease in front of the public in TV, newspapers, magazines, only $20 million a year from the government is spent on prostate cancer research, treatment, cures, etc.

I don't fault the ladies. Quite the opposite. I fault the men. Men need to communicate.

Men should spread the word and set up a program of getting their PSA checked each six to 12 months, depending on age. Look for an upward trend in the numbers. If it keeps going up, get to a specialist on prostate cancer for biopsies.

I found out there were a variety of possible treatment alternatives including surgery, radiation and laser probes.

But the only sure cure, if it had not spread from the prostate, was to get it out. Other treatments strive for control.

My urologist said my age, 72, could be negative in considering surgery. Was I physically up to surgery? My gastroenterologist said he didn't feel I should consider radiation because of my history with colitis. It is difficult, if not impossible, to restrict radiation rays to just the prostate gland. If they penetrated organs near the prostate, they could cause other serious complications. Probes still weren't considered truly tested.

Friends and doctors who had complete prostate removal felt it was the surest way to get rid of the complete cancer. The question: Had my cancer penetrated the wall of the prostate and spread to lymph glands or any other adjoining organ.

My doctor set up an appointment for me at Barnes-Jewish Hospital, a teaching hospital aligned with St. Louis University. These were the people who helped originate the PSA test and specialize in prostate surgery. My new doctor insisted on additional tests to ensure good physical condition and to make sure the cancer had not spread outside the prostate.

All the tests came out well and surgery was set. The operation went smoothly with no surprises. The tests paid off.

The operation spares the nerves underlying the prostate, which generally results in fewer impotence and urinary problems than conventional prostate surgery. At the time, my doctor and his partner had performed over 3,700 of these operations. By now, I'm sure the number is over 5,000. This is the same operation that Joe Torre, former St. Louis Cardinal, and now New York Yankees baseball manager received about a year ago.

Prostate cancer is the second largest killer of men, behind heart disease. It's puzzling to me that many men won't take the time to get a simple blood test that could save their lives.

Above all, do not let your doctor tell you "your test is normal." Insist on the number, and keep a list of your test results by date. Then you and your doctor will know exactly how each result compares with the previous test. A study by researchers at Washington University School of Medicine in St. Louis call for prostate biopsies for men in the PSA range of 2.5 and up.

Men over 40 should be tested every year and every 6 months over 50.

Now I get my PSA checked every 6 months 4 times in two years. They are handled by my family doctor, J.P. Downey also a cancer survivor. They have come back less than .02, which means the cancer has not come back, nor has it spread elsewhere.

African American men, for some unknown reason, are three times more likely to get prostate cancer than Caucasian men. It is generally agreed that if prostate cancer runs in your family, you are at a greater risk.

The cost for a PSA test is very small. The cost for not getting PSA tests could be larger than you would like to pay: Your life.