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James Conroy’s wife, Jenny, encouraged him to start having annual medical exams after he had been skipping them. It then became part of his yearly routine.
At the first of the year, he would call his primary care doctor and ask, “What day do you want me there?” Usually, the answer was sometime in February for his annual exam.
Conroy isn’t one to go to the doctor for every little scrape, he said, but he does get that head-to-toe check once a year. Those checks have helped him control his blood pressure and cholesterol and even revealed a heart attack he didn’t realized he had suffered a couple of years ago.
This year, the annual exam might have saved his life.
His primary care doctor took blood as he always does and noticed Conroy’s prostate-specific antigen, or PSA, level was elevated to 12.4 (4 and under is considered to be a normal range). In case it might be an infection, Conroy took a 10-day course of antibiotics and then retested. It was 16.4.
“It indicated everything we needed to know,” he said.
Conroy, 67, who lives in Bandera, had a biopsy that revealed he had an aggressive form of prostate cancer. He’d had no symptoms, but he did have a family history of prostate cancer through his father.
He was told by a urologist, “this is going to get you if you don’t do something about it,” he said. “We can do something about it, and if we do, you have a great chance to come out unscathed,” he was told.
Surgery at St. David’s Medical Center in Austin at the end of May removed his prostate and 20 surrounding lymph nodes.
Conroy is now considered cancer-free, but he will continue to get PSA tests and be monitored to make sure nothing new develops.
“I’m a firm believer in the well-check,” he said. “We missed a bullet on that one.”
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Well-checks and regular screenings
Centers for Disease Control and Prevention data show that in 2015, men went to doctors about a third less than women.
Women regularly receive female-specific cancer screenings such as Pap smears and mammograms, although those guidelines have changed as far as what year to start and whether to do them annually.
Male-specific cancer screenings have been more nuanced. Even PSA isn’t always done, depending on a man’s risk factors, including age and family history, and symptoms. A digital rectal exam also can help monitor the prostate.
“Checking PSA is not always the right approach,” said Dr. Kyle Keyes, a urologist at Texas Oncology in Austin. “There are many things that can cause an elevated PSA.”
Those include an enlarged prostate for reasons other than cancer.
Keyes said while it takes about 1,000 men ages 55 to 70 to be checked for PSA to prevent one of them from dying, checking PSA should be done for the right person in the right situation — a family history of prostate cancer and other risk factors.
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What to look for in male cancers
Prostate cancer is the most common cancer in men, aside from skin cancer. Most prostate cancers are found in men 65 or older, and African American men have the highest rates, followed by Hispanics, white non-Hispanics and Asians.
The American Cancer Society recommends that most men begin talking with their doctors about their risk factors for prostate cancer and screenings at age 50. African Americans and men whose father or brother had prostate cancer should begin that discussion at 45. Men who have more than one first-degree relative (father or brother) with prostate cancer should talk about screening at 40.
Bladder cancer and kidney cancers are more common in men than women, and prostate cancer, bladder cancer and kidney cancers can all have some of the same symptoms, including changes in urination; blood in the urine; pain in the back, hips or ribs; sexual difficulties; and weakness or numbness in the legs. Bladder and kidney cancer symptoms also include weight loss and fatigue.
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The other cancer that is male-centric like prostate is testicular cancer, but unlike prostate cancer, it mainly affects younger men, usually ages 15 to 40, and is fast-growing and noticeable. “In general, it just really feels like a bag of rocks down there,” Keyes said.
Because of that, it has high cure rates, he said, compared with some of the other cancers that are stealthier until they are very advanced.
If men are experiencing any of these changes or symptoms, Keyes encourages them to go to their primary care doctor for an exam and bloodwork.
“Primary care is a wonderful first step,” he said. “Then if something funny is going on,” it’s a trip to a urologist.
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Keyes also encourages men and women not to ignore other universal cancers such as colon cancer. They should get a colonoscopy beginning at age 45, sooner with a family history, and avoid skin cancer by wearing sunscreen and doing annual skin checks.
Men also can do these healthful things to reduce their cancer risks:
- Talk to family members about their health histories, including which cancers they had and at what age they were diagnosed.
- Don’t smoke, or stop smoking, including e-cigarettes.
- Get to a healthy weight and maintain it.
- Get regular physical activity.
- Adopt healthful eating patterns that rely on fruits, vegetables and whole grains, and limit processed foods and red meat.
- Limit alcohol use to no more than two drinks a day.
And don’t wait to see a doctor if something doesn’t feel right. Timing matters when it comes to how far the cancer has spread and its treatability.
“Any unexpected pains that are not going away probably should be investigated,” he said.
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