An Okotoks cancer survivor urges all men to see their doctors annually and never take their good health for granted.
Merlin MacNaughton, 59, has been cancer-free for eight years. If it wasn’t for his annual physical check-up and prostate-specific antigen (PSA) test conducted by his doctor each year, his cancer may not have been detected on time.
“I was getting yearly physical check-ups and Dr. Ansell would always do a PSA test,” said MacNaughton. “About three or four years into getting my regular check-ups, the test showed that my PSA numbers had gone up.”
An internal exam was inconclusive, so MacNaughton was referred to the Calgary Prostate Cancer Centre. A biopsy confirmed he had cancer in the prostate.
It was still contained in the prostate and was not considered aggressive, so he was provided with several treatment options to consider. He decided to have his prostate removed.
“There can be complications with that procedure, but Dr. Donnelly did an incredible job and I’m cancer-free and have had minimal side effects from having my prostate removed,” said MacNaughton.
Annual follow-up appointments confirm he has been cancer-free since 2008, he said.
Men tend not to take their health into consideration on a regular basis, said MacNaughton, which can lead to issues and diagnoses being missed. Being symptom-free, he was surprised to learn he may have cancer.
“I was quite shocked when I found out,” said MacNaughton. “I think most men, me included, think they’re bulletproof.”
MacNaughton said he is grateful for his wife, who insisted on his annual check-ups, and for his family doctor, who believes in running the PSA test despite recent claims the blood test is unnecessary.
He said he does not understand why there has been controversy about the PSA test, as it is not invasive and provides a good indicator if there is an issue.
“People say it causes undue stress for people who may not have cancer or have aggressive cancer, but I’d rather know than not know it’s a possibility and find out too late,” said MacNaughton.
There is no other testing ability other than the internal test, he said, which in his case did not reveal anything unusual. It was the PSA test alone that alerted his doctor to a possible issue and resulted in a biopsy, he said.
MacNaughton said he has known several men who did not have check-ups or avoided the PSA test for several years and by the time prostate cancer was discovered it was already in advanced stages.
“Until they come up with something else, I will go for a blood test every year, no problem,” he said.
Pam Heard, executive director of the Calgary Prostate Cancer Centre, at the Rockyview General Hospital, said the clinic strives to educate men to the importance of regular check-ups and PSA tests to detect cancer in its earliest stage.
The clinic recommends men have their first PSA test at age 40, or earlier if there is family history of prostate cancer, to determine a baseline PSA level. Fluctuations of the PSA level may be an indicator of cancer.
“There has been a lot of talk about how the PSA tests are unnecessary, but it is so misleading,” said Heard. “It’s the only test we have for prostate cancer.”
The main concern among men and some health professionals is a number of negative or false-positive results that come from biopsies after elevated PSA levels are found, she said.
Even some family doctors will not have PSA testing done during annual check-ups, which Heard finds surprising because organizations like the Canadian Urological Association and the American Urological Association, and Prostate Cancer Canada all recommend having the test done at age 40.
“We are all interested in early detection,” she said. “Prostate cancer is 99 per cent curable if detected early.”
While Heard admits the PSA test is not perfect, she believes it is an important first step for all men.
If the PSA level reads high after a check-up, a patient is referred to an urologist by his family doctor, she said. After biopsies and testing, a diagnosis can be made confidently.
In cases of low-grade cancer, PSA levels are monitored annually, and if there is an increase further testing will be conducted to see whether the cancer has advanced, she said.
“The side effects of treatment can be bad and recovery can be difficult, so we only want to treat those cases that are aggressive,” said Heard. “There is still no way to identify without a biopsy which cancers are aggressive or not.”
Surgery and radiation treatments are proceeded with as last-case scenarios, she said.
The Prostate Cancer Centre runs a program called the “man Van,” which is a mobile unit that travels through urban and rural centres to educate men, administer PSA tests and spread awareness of the importance of early detection, she said.
Men can visit the Man Van to have a PSA test done, and receive results within 48 hours, she said. Man Van clinic times can be found online, and the next scheduled clinic is Nov. 20 at Chinook Centre.
“There are 2,400 men diagnosed with prostate cancer every year and of those, 400 men die from the cancer and should never have died,” said Heard. “It’s such a tragedy, because it is curable if detected.”
Prostate cancer is not linked to diet or lifestyle, she said, but remains the number-one cause of death in Canada for men.
For more information about the Calgary Prostate Cancer Centre, the Man Van and the PSA test, visit www.prostatecancercentre.ca.
