Actor Ben Stiller Reveals He Got Diagnosed With Prostate Cancer and Won, Now Advocate for Early PSA Testing
Almost five years since the U.S. Preventive Services Task Force made a controversial recommendation against prostate-specific antigen-based screening for prostate cancer, actor Ben Stiller jumped into that debate on Tuesday revealing how an early PSA test helped him beat a prostate cancer diagnosis two years ago.
"As my new, world-altering doctor spoke about cell cores and Gleason scores, probabilities of survival, incontinence and impotence, why surgery would be good and what kind would make the most sense, his voice literally faded out like every movie or TV show about a guy being told he had cancer … a classic Walter White moment, except I was me, and no one was filming anything at all," Stiller wrote in a post on Medium Tuesday, describing the moment he found out he had asymptomatic prostate cancer on June 13, 2014.
After appropriate research and a decision to surgically remove the cancer, Stiller, 50, says he was cancer free by Sept. 17 that same year. He strongly believes that if he hadn't gotten the PSA test early, he wouldn't have known about the cancer until it was too late. He is now advocating for the PSA test.
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"Taking the PSA test saved my life. Literally. That's why I am writing this now," he said.
After non-melanoma skin cancer, according to the Centers for Disease Control and Prevention, prostate cancer is the most common cancer among men in the United States. It is also one of the leading causes of cancer death among men of all races and Hispanic origin populations. In 2013, the most recent year for which statistics on the diseases are available, 176,450 men in the United States were diagnosed with prostate cancer and 27,681 of them died.
The PSA test, which is used to screen prostate cancer in men, has been the subject of much debate in recent years. PSA is a protein produced by cells of the prostate gland, according to the National Cancer Institute. The PSA test measures the level of PSA in a man's blood and the protein is often elevated in men with prostate cancer.
WARNING: Video contains an instance of coarse language.
The test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, the FDA approved the use of the PSA test in conjunction with a digital rectal exam to test asymptomatic men for prostate cancer.
In May 2012, however, the U.S. Preventive Services Task Force, an independent, volunteer panel of national experts in prevention and evidence-based medicine, released a report recommending against PSA testing for asymptomatic men after concluding that the risks of testing outweigh the benefits.
"Adequate evidence shows that nearly 90 percent of men with PSA-detected prostate cancer in the United States have early treatment with surgery, radiation, or androgen deprivation therapy. Adequate evidence shows that up to 5 in 1,000 men will die within one month of prostate cancer surgery and between 10 and 70 men will have serious complications but survive. Radiotherapy and surgery result in long-term adverse effects, including urinary incontinence and erectile dysfunction in at least 200 to 300 of 1,000 men treated with these therapies. Radiotherapy is also associated with bowel dysfunction," the USPSTF explained.
"Although the precise, long-term effect of PSA screening on prostate cancer–specific mortality remains uncertain, existing studies adequately demonstrate that the reduction in prostate cancer mortality after 10 to 14 years is, at most, very small, even for men in what seems to be the optimal age range of 55 to 69 years. There is no apparent reduction in all-cause mortality," the organization said in its final assessment.
"In contrast, the harms associated with the diagnosis and treatment of screen-detected cancer are common, occur early, often persist, and include a small but real risk for premature death. Many more men in a screened population will experience the harms of screening and treatment of screen-detected disease than will experience the benefit," the experts added.
The American Cancer Society, a nationwide, community-based voluntary health organization, also recommends against prostate cancer screening for men unless their health care providers tell them they are in the three categories below:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
- Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).
While admitting his advocacy for PSA testing is unscientific, Stiller said he decided to make a public statement because he did not have any of the risk factors highlighted by the American Cancer Society but decided to get early testing anyway which proved beneficial for him.
"There has been a lot of controversy over the test in the last few years. Articles and op-eds on whether it is safe, studies that seem to be interpreted in many different ways, and debates about whether men should take it all. I am not offering a scientific point of view here, just a personal one, based on my experience," Stiller wrote.
"The bottom line for me: I was lucky enough to have a doctor who gave me what they call a 'baseline' PSA test when I was about 46. I have no history of prostate cancer in my family and I am not in the high-risk group, being neither — to the best of my knowledge — of African or Scandinavian ancestry. I had no symptoms," he said.
The USPSTF has indicated that they are currently updating their recommendations on prostate cancer screening and Stiller believes just that admission alone should push men to carefully decide whether to do a PSA test or not.
"Five years after their initial recommendation to stop PSA testing, the USPSTF is presently, per their website, 'updating their recommendations.' I think men over the age of 40 should have the opportunity to discuss the test with their doctor and learn about it, so they can have the chance to be screened. After that an informed patient can make responsible choices as to how to proceed," Stiller wrote.
"I count my blessings that I had a doctor who presented me with these options. ... This is a complicated issue, and an evolving one. But in this imperfect world, I believe the best way to determine a course of action for the most treatable, yet deadly cancer, is to detect it early," he added.
