Preview of Your Coming Attractions

When I retired after 40 years of writing columns for the San Jose Mercury News, I figured I'd said about all I could say. Wrong. I've realized that at age 76, I'm about 10 years older than the oldest baby boomers, who are now turning 66. My very average body has had a lot of experiences in those 10 years. I've learned a lot that could be helpful to people just starting on that same path -- what to do, what to avoid, what to keep an eye on.. Consider me your canary-in-the-coalmine for the boomer generation. Tune in regularly for the heads-up advice.

Monday, November 7, 2011

Testing 1-2-3

     It’s a darn good thing that we’re old enough to learn patience. If we weren’t, the constant, conflicting health recommendations from experts would drive us nuts.
     I’m thinking here about the recent guideline controversies regarding pap smears and PSA tests. I can’t speak from direct personal experience regarding pap smears. Their frequency has been called into question by people who fear we’re being over-tested and, as a result, made overly anxious. I just tend to think that I’d want as much information as possible about possible threats to my health.
     I can speak directly about the PSA tests that screen for prostate cancer, though. As readers of this blog know, I’ve had the tests. I’ve had prostate cancer. I don’t have it any more because I got treatment. You can figure that I take this a little personally. But please don’t discount what I’m about to say because of my perceived bias or conflict-of-interest. Use that patience thing.
     The U.S. Preventive Services Task Force says it’s no longer recommending routine PSA tests for seemingly healthy men. It isn’t entirely clear, the task force says, whether the test leads to life-saving treatment. Many prostate cancers are extremely slow-growing. Something else may kill you first. Biopsies to determine if a guy actually has prostate cancer are medical procedures, and any medical procedure carries risks. Spikes in PSA readings can be caused by common things: a vigorous bike ride, an infection, recent sexual activity. And there’s that over-testing concern.
     Here’s my take: Don’t test seemingly healthy men? Prostate cancer exhibits no symptoms until it’s further along than you’d like. Prostate cancers can be slow growing? What if they’re not? What if they’re aggressive enough cause a spike in your PSA test? What if sex caused the spike in your reading? Ask for another blood test and stay out of the bedroom beforehand.
     And those over-testing concerns? It sure beats over-dying at the other end of that scale.


  1. I agree. PSAs (Public Service Announcements) should always be tested -- especially for three things. To make sure they're public. To make sure they're service. And to make sure they're announcements.

  2. Just never get yours biopsied. No telling what you'd find.