I am happy you are O.K. My dad died for prostate cancer. I try to do the PSA measure every year, but actually I did just one. I am 45 years old, so...

I hope to meet you in Berlin PR Summit. I am an applicant. It seems that I am near of one of the 50 seats, but It´s not sure.

If I go in the end I´ll bring my sport shoes for a run.

All the best, Benito Castro, from Sevilla, Spain

Mr. Edelman,
In reading “The Scimitar”, I can relate completely to the apprehension that you felt as a result of the “medical situation” and the time involved in waiting for the results.
Thanks for being open, honest and for sharing your Humanness in this situation. I believe that you have helped others through your action. I am glad that you are well.

Best regards,
Rob D.

Richard,

I too am glad you are OK.

But now, let me give the exact opposite side of the story. A story that is so different than yours that I hope it will be read by hundreds of men who read your blog and interpreted it, perhaps fatally, the wrong way.

I am 50 years old and in terrific health, or at least I thought I was. I worked out six days a week and boasted regularly about my extreme low-fat diet. I had no history of prostate cancer in my family.

I went to the doctor in mid-July for a respitory infection. After looking at my chart, this very-alert physician said, "you know, you're 50 years old. You need to get a PSA test." Only a year before, this same doctor had performed a digital
rectal exam and found no reason for concern.

You can guess the rest of the story. My PSA test came back 5.2 (only 1.2 points above normal), and I was sent to a urologist for a biopsy. Three days later, I received a call from the urologist's office that went like this:

"Can you be at the office at 5 p.m.? And the doctor would like you to bring a relative."

Of the 14 tissue samples collected during my biopsy, ALL came back positive. My cancer was a T2b, my Gleason score--7.

For those of your readers not familiar with the terminology, my results put me in the aggressive cancer category, just barely inside the circle they call "early stage."

Were it not for that respitory infection, and the subsequent PSA test, I would almost certainly face a terminal diagnosis six months to a year hence.

The PSA test may have saved my life. Since receiving my diagnosis, I have talked to a dozen men who discovered their cancer at the ages of 42 to 45 through a serendipitous PSA test. Those men have successfully received treatment and are leading full lives BECAUSE of the PSA test.

Needless to say, I am infuriated beyond words when I read medical literature that debates whether men should get a PSA test before 50---or at all.

Now I know you are not advocating that. In fact, you wrote the opposite. But anyone reading your post without a discerning eye might not pick up on the nuances.

Yes, we need a better prostate screening test. And yes, there are many false positives associated with the PSA--though the American Cancer Society reports a 25 percent chance of cancer for men with PSA tests between 4 and 10.
That's a one in four chance--not as wildly improbable as you suggest.

But I would rather undergo the slight discomfort of a needle biopsy and be certain of my condition than rail against the PSA test.

I learned about this blog from my editor David Murray while sitting at the Henry Ford hospital in Detroit. Tomorrow, I undergo radical prostectomy to remove my cancer.

If it is successful, I will live to see my three young girls grow up.

And I will have only the PSA test to thank for it.

Thanks for raising this issue, and for your male readers over 40 (my opinion): Go get your PSA test NOW.

It will no doubt come back normal, but your doctor will thank you for giving him a baseline number to compare future tests against.

Mark Ragan
CEO
Ragan Communications
CHICAGO

I'm glad you're healthy - I hope your message about getting regular "manograms" gets out. Mark's story scares me - I hope the surgery was successful. I'm forwarding this to my husband right now.

Dear Richard,
I relate to your story as a daughter and not as a woman who has spent many years working in the healthcare communications industry. This summer, my father called to tell me that his PSA levels were high and that he was going for a biopsy. He called me not only because I am his eldest child but also because he felt sure that my 8 years of experience in oncology communications and my work on prostate cancer treatments would allow me to help him understand the disease, treatment options, risk benefit ratios, all the things I had spent years understanding. He thought wrong as I burst into tears and contemplated, for the very first time, the mortality of my parents. I managed to pull myself together but after that experience I think he was a little shell shocked. When my mother asked if he was now going to tell my siblings, he said "yes, I'll send them an email!" He imagined that if a seasoned professional who knows all about the prognosis of disease caught early, the many men over the age of 70 who die of something other than prostate cancer but with evidence of the disease, the number of patients who are not even treated, blah blah blah, could fall apart, how would the "lay people" in his family react?

Luckily he is fine and his brachytherapy has gone well but this incident has really hit home for me in a way unlike anything else in my many years of being part of the industry. After years of working with patients, their healthcare providers, advocacy groups and the entire "therapeutic alliance" I now have a profound and practical insight into the communication issues and the emotions that are inextricably linked in healthcare and will use my new insight as a signpost in my thinking about how brands, companies, stakeholders relate to patients and their families and caregivers. Thanks for sharing your story and for encouraging your audience to get tested...even if it is somewhat unreliable. Let's hope it is not too long until the manogram is a reality.