Men’s Health: This One Test Might Save Your Life! 

Why would anyone not get a simple, painless cancer test? The prostate specific antigen (PSA) test is one reason deaths from prostate cancer plummeted in the 1990s. Yet today, doctors don’t always recommend PSA screening. Men often don’t get the test. 

Some believe that fewer men getting a PSA test explains the recent rise in metastatic prostate cancer – or cancer that has spread from its point of origin. Although there are good reasons to not get a PSA test, it’s important to understand the pros and cons before making a decision. Because getting a PSA test could save your life. Here’s why. 

All About Prostate Cancer

Most men don’t think about their prostate – until something goes wrong. Located below the bladder and just before the rectum at the back of the pelvis, this small, walnut-sized gland is responsible for adding fluid to semen and pushing it through your urethra. It often gets larger after men turn 40. Most issues involving the prostate aren’t dangerous, like inflammation and benign prostatic hyperplasia which causes the prostate to grow and even block the urethra. Unfortunately, prostate cancer rarely has symptoms until it’s advanced. That’s why the prostate specific antigen or PSA test is such a valuable tool. 

Protein-specific antigen is produced by your prostate. Elevated levels of this protein may indicate cancer. Discovering your PSA levels can be done from the comfort of your own home. Just go to Kyla and complete a short health quiz. This will help you identify the places where you can improve your health. It will also make it easy to choose at-home blood tests that are right for you. 

The Male Primary Care Panel, for example, offers not only the PSA test but also a lipid and comprehensive Metabolic Panel (CMP), along with tests for Thyroid-Stimulating Hormone (TSH), Hemoglobin A1c (HbA1c), cortisol, total testosterone and vitamin D. While other companies charge hundreds of dollars for similar tests, Kyla’s Male Primary Care Panel is just $99. The cost may even be covered by insurance. 

After selecting the test that’s right for you, you’ll receive the kit and instructions for sample collection in just a few days. Follow the instructions, collect a few drops of blood, and then return it to our labs at no cost. In a few days, you’ll not only learn your PSA levels, you’ll also get information on a variety of other things that could affect your health. Plus, you’ll be able to consult with a Kyla doctor who will offer personalized advice to improve or maintain your results. It’s not just about taking a test. It’s about making progress toward your health goals. With the Kyla app, you’ll be able to continuously track your progress with nutrition and lifestyle enhancements while setting goals, and taking daily actions.

Growing Risks from Prostate Cancer

Men are more likely to be diagnosed with prostate cancer than any other form of the disease other than skin cancer. Like that commonly occurring cancer, survival rates for prostate cancer are quite high. Some 97% of men are still alive five years after diagnosis. The two cancers have something else in common. Survival depends upon early detection. 

Here’s the scary part. Prostate cancer is also the second biggest cancer killer – killing more men than any other cancer other than lung. The fact that so many men are diagnosed with the condition is one reason for the high rate of death. Prostate cancer is also incredibly common – autopsies reveal some 30% of men over 55 have it. Most men diagnosed with prostate cancer will eventually die from other causes. As the U.S. population ages, it’s inevitable that more men will get prostate cancer. Despite this, increasingly doctors have shifted away from recommending a PSA screening. 

There’s a number of good reasons for not advocating the test. For one thing, higher than normal PSA levels can be caused by something other than cancer. This increases the risk of a false positive. The PSA test could also detect a very slow-growing cancer that doesn’t require treatment. Avoiding unnecessary treatment is a noble goal. It saves time and money – not to mention anxiety.  Yet there’s mounting evidence that the reduction in PSA screening has led to an increase in prostate cancer deaths.  

In 1999, prostate cancer was diagnosed in the U.S. at a rate of 169 per 100,000 men. Twenty years later, that number had plunged to 111 per 100,000 men. Yet despite that positive news, the overall number of cases in the U.S. climbed by over 40,000 in just five years – going from 182,806 new prostate cancer cases in 2014 to 224,733 new prostate cancer cases in 2019. 

While the aging population helps explain the growth, there’s more troubling news when it comes to advanced, metastatic prostate cancer. The hardest to treat form of the disease, this is when the cancer has spread. Over the past ten years, this has risen by 41% from 2010-2018 amongst men 45-74 and 43% for those over the age of 75. Many experts believe the reduction in screening is partly responsible for this shift. 

The downsides to PSA tests including increased anxiety and time-consuming treatments if the test shows elevated protein levels are why many U.S. doctors stopped advocating for the test. Plus, higher than normal PSA levels can be caused by infection or benign prostate enlargement. That’s why In 2012, an independent panel of health and medicine experts suggested that men stop having routine PSA screenings. Since then tests have declined, and rates of advanced prostate cancer have climbed. Concern that the reduction in testing is partly responsible, a European study looking at over 160,000 men between the ages of 55 to 69 concluded that the PSA test was beneficial. That’s because it showed the prostate cancer death rate decreased by 21 percent in men who were offered a PSA test every 4 years.

Getting the Test

Today many men don’t fit the parameters for testing. While the PSA test was once routinely given to men as they reached middle age, now it’s only given when there are other factors as well. Although the risk of getting prostate cancer increases after age 50 doctors usually only recommend a PSA screening when the other factors are included. Black men are more likely to develop prostate cancer (and they also have a higher fatality rate from the disease). You’re also in a higher risk category if a close family member was diagnosed with the disease before they turned 65. Some genetic mutations like BRCA1 and BRCA2 will also increase your risk. While these genes are often mentioned in connection with elevated breast cancer risk in women, they also increase the risk for prostate cancer in men. 

Lifestyle choices play an outsized role in both the risk of developing prostate cancer and in successfully managing the condition following a positive diagnosis. A diet high in animal fat, excessive alcohol use and/ or a body mass index over 25 are all factors. Even if you aren’t in a high risk category, getting a PSA test may still be important. That was the experience of actor Ben Stiller. 

“I was lucky enough to have a doctor who gave me what they call a “baseline” PSA test when I was about 46,” Stiller wrote in Medium. “I have no history of prostate cancer in my family and I am not in the high-risk group…I had no symptoms. What I had — and I’m healthy today because of it — was a thoughtful internist who felt like I was around the age to start checking my PSA level, and discussed it with me.

“If he had waited, as the American Cancer Society recommends, until I was 50, I would not have known I had a growing tumor until two years after I got treated. If he had followed the US Preventive Services Task Force guidelines, I would have never gotten tested at all, and not have known I had cancer until it was way too late to treat successfully.”

Stiller opted for surgery following an MRI and a biopsy that validated his PSA test results. The cancer was successfully removed and today he is cancer free. He remains dumbfounded that so many recommend against getting the test. 

Often called a “quiet cancer” because it can lay dormant for decades, prostate cancer is notoriously slow growing. That doesn’t mean it should be ignored, nor is the cancer benign. Still, having a positive PSA diagnosis doesn’t mean immediately getting surgery or radiation. An increasingly popular third option is available for most men. It’s called active surveillance, and a landmark study showed that it can be as safe as the more familiar treatments. 

Twenty-five years ago, the University of Oxford began tracking over 2,500 men (out of a sample of over 82,000) between 50 and 69 years of age who were diagnosed with localized prostate cancer following a PSA test. The study participants were randomly enrolled in one of three treatment options: surgery, radiation, or active surveillance. 

After 15 years, 97% of the men diagnosed with prostate cancer were still alive. While 45 men did die from prostate cancer, other causes claimed the lives of over 350 of them. Even more surprising, deaths among prostate cancer patients were evenly distributed among the active-surveillance, surgery, and radiation groups. Although the men among the active surveillance group were more likely to get metastatic prostate cancer, in 2023 updated information from the study revealed that despite the cancer’s growth men in the active surveillance group were no more likely to die (although many of the men in this group did opt for surgery or radiation.) 

The secret to long term survival following a positive PSA screening is the same secret we all have. Eat healthy foods, including a plant-based diet rich in fiber, whole grains, and lean protein. Exercise regularly and reduce stress. Most importantly, work with a trusted healthcare professional. 

At Kyla, you’ll be able to gain insights into your health through AI analytics and advanced testing. This means you can see exactly how your lifestyle affects your body. You’ll be able to track vital health indicators like primary care and hormone levels while using the Kyla app to conveniently monitor your data. By using Kyla’s resources, you’ll not only extend your lifespan but your healthspan as well. Healthspan is the years of healthy, disease-free life that you have ahead of you. 

A long healthspan is possible whether or not your PSA levels are elevated. In fact, you may someday be able to extend your lifespan more than one year for every year you are alive. It’s called longevity escape velocity and it’s a future Kyla is striving toward. Learn more about your healthy future today, by downloading the Kyla app and discovering how to take control of your health. 

Sources:

1. “Prostate,” Cleveland Clinic. August 9, 2022. https://my.clevelandclinic.org/health/body/23965-prostate
2. Key, Alyson Powell. “What’s Behind the Rise in Advanced Prostate Cancer?” WebMD. September 08, 2023.https://www.webmd.com/prostate-cancer/advanced-prostate-cancer-rise
3. “U.S. Cancer Statistics Prostate Cancer Stat Bite,” Centers for Disease Control and Prevention. U.S. Cancer Statistics Prostate Cancer Stat Bite. U.S. Department of Health and Human Services; 2024. https://www.cdc.gov/united-states-cancer-statistics/publications/prostate-cancer-stat-bite.html
4. “Prostate cancer screening: Should you get a PSA test?” Mayo Clinic. November 3, 2022. https://www.mayoclinic.org/tests-procedures/psa-test/in-depth/prostate-cancer/art-20048087
5. Ashley, Robert., MD. “Ask the Doctors – Do I really need a PSA test?” UCLA Health. https://www.uclahealth.org/news/article/ask-the-doctors-do-i-really-need-a-psa-test
6. Stiller, Ben. “The Prostate Cancer Test That Saved My Life,” Medium.October 4, 2016. https://medium.com/cancer-moonshot/the-prostate-cancer-test-that-saved-my-life-613feb3f7c00
7. Hamdy, Freddie C. F.R.C.S.(Urol.), et al. “Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer,” The New England Journal of Medicine. April 27, 2023. https://www.nejm.org/doi/full/10.1056/NEJMoa2214122

Beck, Melinda. “With Early Prostate Cancer, Forgoing Treatment Makes No Difference,” The Wall Street Journal. September 14, 2016. https://www.wsj.com/articles/new-study-could-reassure-prostate-cancer-patients-1473887066