On Tuesday, Ben Stiller spoke publicly for the first time about being diagnosed with prostate cancer in 2014.
Quick refresher: The prostate is a walnut-sized gland located under the bladder that helps produce semen.
Stiller, now 50, was diagnosed in July 2014 at age 48, two years after a blood test showed elevated levels of prostate-specific antigen (PSA).
Stiller wrote that when he was 46, his doctor gave him a "baseline PSA test," which is sometimes given to average or low-risk individuals.
The PSA test measures levels of prostate-specific antigen; anything over level 4 is suspicious, Dr. Robert Segal, medical testing expert and co-founder of LabFinder.com, told BuzzFeed Health. It's a screening tool to determine prostate cancer risk, not detect the cancer itself. After an abnormal PSA test, you'd usually go to a urologist, said Segal, who follows up with a rectal exam and MRI before they decide if you need a biopsy.
"It's sensitive but not specific, meaning it detects a high PSA but we don't know if that's from a fatal cancer, a low-grade cancer, or even just a benign inflammation or infection in the prostate," Dr. Harry Fisch, clinical professor at Weill Cornell Medicine and NewYork-Presbyterian, told BuzzFeed Health.
"The PSA test saved my life," Stiller wrote.
But the PSA test remains controversial because there are conflicting guidelines about who should get screened and whether it's even necessary at all.
"If my doctor had followed the guidelines, I would have never gotten tested at all, and not have known I had cancer until it was way too late to treat successfully," Stiller wrote.
However, many believe that the screening can lead to more anxiety and harm.
The risks and benefits of PSA screening have caused much debate in the medical world. Many researchers believe that the chance of a cancer misdiagnosis from a PSA screening and the cost of an unnecessary MRI and biopsy is enough reason to not use the test at all.
The history of prostate cancer screening is another issue, says Paduch, because prostate biopsies used to be over-performed in the mid 1900s, leaving many men who never even had cancer disfigured for life. However, the experts are quick to point out that a high PSA does not automatically lead to a biopsy, and that's up to the doctor's judgement.
The test itself is quick, simple, and low-cost.
Other doctors, such as Segal, argue that the PSA is always beneficial because because most prostate cancer cases are asymptomatic, so early detection key. "The PSA screening helps patients be more informed about their risks and helps doctors make better clinical decisions," said Segal. Scientists are trying to develop other simple tests, said Fisch, which they can use in addition to the PSA to get more accurate and specific results.
The simple blood test is usually covered by insurance and relatively low cost (under $60) out of pocket. You can find a lab here that does PSA testing and sends digital results, so you'll avoid a long and hectic doctor's appointment.
The experts agree that Stiller's story is an example of why men should be more informed about prostate health.
We're glad you're okay, Ben!
CORRECTION
Prostate biopsies used to be over-performed in the mid 1900s, leaving many men who never even had cancer disfigured for life. A previous version of this article misstated that biopsies were over-performed in the mid 19th century.