Today on the show, my friend and fellow physician, Dr. Drew Pinsky, will reveal his personal battle with one of the most feared diagnoses out there: cancer. This past July, Dr. Drew underwent a radical robotic prostatectomy to remove prostate cancer that was on the verge of spreading. On my show, he shares the lessons we can take from his difficult experience, and shows us how listening to his loved ones, and not his intuition, saved his life.
Dr. Drew nearly missed catching his dangerous diagnosis. As many of us physicians do, Dr. Drew initially resisted going to see his doctor – after all, he was a doctor himself. Surely he would know if something were wrong, and for the most part, he felt fine. But thanks to persistent encouragement from his attentive wife, Susan, Dr. Drew finally took himself to get a physical.
As part of his physical, his doctor did some routine blood and urine testing, including a prostate specific antigen (PSA) test. PSA testing is very controversial, and national organizations that govern medical testing recommendations are divided on whether PSA should be routinely measured. An elevated value can mean anything from temporary or benign prostate disease to prostate cancer. Benign causes and slow-growing cancer are much more common than life-threatening, aggressive cancers that require immediate treatment.
Further workup following an elevated PSA can include invasive biopsies and procedures that may leave men with pain, urinary problems and sexual dysfunction – even if the results end up being benign. To minimize these potentially negative consequences, some doctors do not routinely screen their patients’ PSA levels, or only do so if patients are at elevated risk for prostate cancer. If you have questions about whether PSA screening is right for you, don’t hesitate to discuss the pros and cons with your doctor.
In Dr. Drew’s case, his doctor included a PSA, as well as a urinalysis. His PSA was somewhat (but not dramatically) elevated, and he had microscopic amounts of blood in his urine. But even though Dr. Drew’s father and uncle had had prostate cancer, he was still not very concerned. When a subsequent ultrasound showed enlargement of the prostate, however, Dr. Drew underwent a biopsy that yielded the result that he still didn’t expect. It was cancer.
After skin cancer, prostate cancer is the most common cancer in men and is more common than breast cancer in women. In fact, one out of every six men can expect to be diagnosed with prostate cancer during his lifetime, and the average age at diagnosis is 66. The American Cancer Society estimates that in 2013, about 238,590 men will be diagnosed, and 29,720 will die from prostate cancer.
The prostate is a walnut-sized gland that wraps around the male urethra. It lies behind the bladder and in front of the rectum, and normally functions to produce seminal fluid that nourishes and transports sperm and lubricates the urethra. Tumors growing on the prostate can sometimes be felt during a brief rectal exam, which is a common routine exam for middle-aged and older men.
Due to its location, prostate cancer may cause local symptoms as it grows, compressing the urethra and causing a hesitant urinary stream, dribbling, starting and stopping, or blockage of urinary flow. It can also cause blood in the urine or semen, back pain and erectile problems. In many cases, prostate cancer is so slow growing that it will not cause health problems over the course of a natural lifetime. But if it is an aggressive form of cancer, it may spread – commonly traveling to the bones, lymph nodes, lungs, liver or brain – and be deadly.
Since so many prostate cancers are slow growing, Dr. Drew and his doctor decided to monitor the cancer. Over the course of the year, he underwent two more biopsies, which showed that the tumor was still growing. Finally, with the support of his family, Dr. Drew underwent surgery in July to remove his prostate. Though the surgery was not easy for him, he is now cancer-free and back at work.
If caught early, prostate cancer is highly treatable, and a variety of both medical and surgical treatments are available. Though prostate resection or removal may have side effects, including sexual and urinary problems, many men recover completely. Too many people allow fear of cancer or discomfort (like a rectal exam or a biopsy) to keep them from getting the regular health surveillance they need. Others assume that they are fine unless something feels wrong. Dr. Drew’s experience goes to show that neither fear, nor a false sense of security, is a good reason to delay your checkup.
This is the secret that Dr. Drew’s wife knew. Our loved ones’ encouragement to seek regular care (which may sometimes sound like nagging) may be one reason why married cancer patients have a 20% lower risk of dying from their cancer, compared to unmarried patients. We can thank our friends and family not just for being a necessary support system, but for pushing us past our fear and hesitance and motivating us to take care of our health.