That was definitively shown by a 2004 study of 2,950 men who were followed for 7 years as part of the Prostate Cancer Prevention Trial.
These men never had a PSA level above 4, or an abnormal digital rectal exam, for the entire length of the study.
(Stage III cancers have begun to break out of the prostate; stage IV cancers have invaded nearby tissue and bone.) That has resulted in a steadily declining death rate of 4 percent a year since 1994.
The declining mortality has generally been attributed to the widespread use — starting in the 1990s — of a simple test for the prostate-specific antigen, or PSA.
He sat there grinning apologetically as he held up one gloved and well-lubricated index finger and asked me to bend over a chair.
Then he stuck his finger up my ass and pushed on my prostate like it was a doorbell on Halloween night. I put it off repeatedly until the night, months later, when I met the person I later called, only half jokingly, the Angel on the Train.
That's what those running-to-the-men's-room commercials for Flomax are all about.
My internist did that for me in the summer of 2007, as part of a regular physical. The results showed mildly troubling cholesterol — but a very troubling PSA number.
Now, almost 2 years later, I'm not going to say, "Thank god they caught it in time... Blah blah blah blah." No, what I'm thinking is more along the lines of: I want my prostate back. The size of a golf ball, it's tucked away under your bladder, biding its time until you and your reproductive system decide to emit the sacred seed.
This long bomb triumphantly delivers your DNA into the end zone. But around the time in your life when you start to think more about your 401(k) than foreplay, your prostate starts to misfire.
About 10 minutes later, after I'd recovered, he gave me a scrip for an antibiotic and told me to come back at the end of the summer so he could retest my PSA. I was sitting in the dining car having chicken a la Amtrak with my wife and son when suddenly a disheveled old man tottered up the aisle carrying a little plastic bag full of pills. Then I started talking to him, and before I knew it we were comparing prostates.
The steward swung him around and plopped him into the booth with us. My wife ratted me out: "He had a high PSA reading," she said, waving her fork in my direction.