Some men put off prostate screenings, fearing that an elevated PSA blood test will mean cancer, and they'll have to get treatment. But many men have another option for an elevated PSA it's called "active surveillance".
"I had a couple of family members who had gotten prostate cancer - my, at that time, my father-in-law, and then my uncle," said John Dallas Bowers.
Bowers said his uncle caught the cancer early and lived another 27 years. With that in mind, when his own PSA levels rose, Bowers went to Dr. David Chen of Fox Chase Cancer Center.
The first step is an MRI.
"He wanted to see if there are any areas of the prostate that sort of lit up and gave any indication of needed further observation. Some did, several did," he said.
After an MRI and a biopsy, Dr. Chen recommended "active surveillance" which is monitoring the prostate closely because any cancer cells the 79-year-old has are growing very slowly, just within the gland.
"It's safe, safe and appropriate to watch it and follow it and have it under observation and not treat it at all," said Dr. Chen. "Treating them is really probably going to cause them more problems than what the cancer itself would do left alone."
Bowers now gets PSA checks every six months at Fox Chase in East Norriton, Montgomery County.
"The next step might be another MRI. And depending on what that shows, it could lead to another biopsy," Bowers explained.
Dr. Chen said each man's care should be personalized, based on test results and risk factors such as a family history of prostate, breast, or ovarian cancer, their age, and their overall health.
"If somebody is being evaluated for prostate cancer, if you're found to have prostate cancer, to take a deep breath and take a pause, and not feel this pressure to have to run and do something," he said.
If treatment is needed, explore all the options radiation, chemotherapy, surgery. There's a lot of interest in a new approach called focal therapy.
"It may be effective to just treat one portion in one location that we can identify that's where their cancer is, and the rest of the prostate can be left alone," he said.
Bowers said he's at ease with "active surveillance" because Dr. Chen explained the whole process and gave him the choice. He urges other men to educate themselves and find a doctor who welcomes your questions.