Ed Walker is 102 years old. I met him by chance on a steep hill in Lunenburg, Nova Scotia – not long after my husband blurted, “I hope you’ve got good brakes on that scooter!” Ed pulled up next to us (to demonstrate his brakes) and jubilantly announced his age, along with his suspected reason for it: “I have prostate cancer but chose to leave it alone.”
I chuckled to myself, thinking that he was probably right about his longevity-hospital avoidance connection.
Of course, the diagnosis and treatment of prostate cancer is being hotly debated these days. While no one likes the idea of leaving cancer untreated, slow-growing prostate cancer may be less of a threat to men at a certain age than the treatment required to cure it. And that’s a difficult truth to accept – especially for Americans.
My fellow blog contributors have noted the disconnect between scientific evidence and clinical practice in regards to prostate cancer. According to a recent study in the New England Journal of Medicine, PSA (a screening test for prostate cancer) testing has not made a difference in overall longevity. Urologists still favor testing (the American Urological Association guidelines recommend initiating PSA testing for all men starting at age 40) while family medicine physicians don’t usually recommend it. Is there a conflict of interest driving this difference in recommendation? Perhaps – though I suspect it has more to do with a surgical mentality (to cut is to cure!) than a conscious decision to protect one’s income. If you think there’s a shortage of urologic procedures to go around, then I’d recommend you simply consider the increasing age of the US population. It’s not as if the prostate gland is the only thing that needs work “down there.”
Perhaps Americans can take some cues from their elderly neighbors to the north – and try to accept that doing something is not always better than “doing nothing.” In the case of some prostate cancers, it’s cheaper, safer, and a lot less painful.
Just ask Ed Walker.