WARNING: What is being described is graphic but also vital for life-saving male health, especially for those men age 50 or older and particularly for those of us on the other side of 60.
The cell phone call had disturbed the pleasure of an afternoon’s worth of crappie fishing.
I hate when that happens, too.
But this call was important and the telephone number appearing on my cell phone’s screen appeared vaguely familiar.
In general terms the conversation started with “Hello, Jeff, this is Doctor Wolkoff. Your PSA numbers haven’t gone down very much.”
If that wasn’t disturbing enough what followed certainly qualified as a personal earth-shattering moment.
“You need a prostate biopsy,” the good doctor Lawrence Wolkoff said with a soberness that I may have misread more than I should have.
Following Wolkoff’s address and after speaking with his assistant, we set May 14 as the date for the biopsy.
Ever since I had turned 50 some 12 years ago I have insisted on what I call my “old man’s physical.” That has included both a physical as well as a prostate-specific antigen (PSA) blood test.
I’ve always been a touch paranoid about being invaded by prostate cancer in spite of the fact that I do not fall within the most-likely-to-get categories.
Those markers include: Black men get prostate cancer much more than do male members of other racial or ethnic groups; a family history of the disease; being age 65 or older; and a couple of other medically technical points that I’ve found to be complicated enough so as to blur my brain cells.
But the raw statistics and the stark realities demand that any guy over age 50 should get tested; annually, too.
And the older one becomes the more red-line the need for this testing becomes as well.
After all, the National Cancer Institute notes that annually about 242,000 American men are diagnosed with prostate cancer. And the male-only disease will steal the lives of around 30,000 men.
That figure is only about 10,000 less than the number of women who will die of breast cancer, by the way.
(As an aside, and a point that I’ve always been upset about, the federal government allocates just under $700 million annually for breast cancer research but no more than $390 million for prostate cancer research. It’s a matter of the squeaky wheel getting the most government grease, with the nations’ men having allowed those gears to rust barrel-tight.)
Still, when my family doctor - Mike Baranauskas - saw that my PSA numbers demonstrated a fairly good spike in elevation it was time to reassign me to the care on an urologist.
In this case, Dr. Lawrence Wolkoff.
Wolkoff was good about his business when he sat me down in his examining room. He noted that on daily basis he sees any number of men demonstrating the same PSA measurement parameters.
Just to be on the safe side, however, Wolkoff performed what has sometimes become a Hollywood slapstick joke about the male anatomy.
He put on a pair of Latex gloves and with what I assume to be one of his trigger fingers, penetrated my rectum and then approached and began feeling the prostate gland, one of a man’s pretty-important reproductive organs.
The prostate gland is typically described as being like a walnut in size and surrounding the urethra, the tube in which urine flows.
What is being sought is a judgement call by the doctor as to his evaluation of the prostate’s size, its hardness, whether any lumps exist and a host of other factors.
As explained by Wolkoff and other scientists, if the prostate is too large it puts a headlock around the urethra tube. That belt-tightening then arrests the flow of urine from the bladder to the penis.
This is the physical portion of a man’s two-part prostate health examination
Guys, the entire process takes under maybe 10 or 15 seconds. Take it from a pain wuss, while the pressure is mildly uncomfortable it is hardly painful.
Next up is the PSA blood test. This test requires a visit to what is called a “phlebotomist,” the medical term for the vampire who draws the blood required for laboratory analysis
Once the lab results are reviewed a report is given to the requesting physician. Those results are often made available within a couple of working days.
Yeah, I know all about the PSA controversy; whether the test is reliable, does it cause more harm that good, does it upset patients more than is necessary, are there false-positives, should men in their 70s and 80s even bother getting the test, blah-blah-blah; I’ve read them all .
I also know that some studies suggest that one-half of all men in their mid-70s or older likely have prostate cancer. And that such men often die of something else long before normally a slow-developing prostate cancer does its dirty work.
Fact is, I’m not in my 70s, let alone my 80s. And I hasten to remind everyone, I’m pretty much paranoid about prostate cancer, either of the jack-rabbit-quick kind or else the creeping-at-a-snail-pace variety.
So I’ve shoved aside any thoughts of macho manhood and have undertaken the yearly ritual of an examination of my prostate.
Yep, including the one where a physician pokes around where the sun doesn’t shine, so to speak.
I even once allowed a female doctor to perform the task.
My belief is that of the James T. Kirk-character famously played by William Shatner in one of the “Star Trek” movies: “The first order of business is survival.”
Would that more men my age shout “amen” to that pithy piece of logic.
Yet when it comes to logic and one’s health, a woman has it all over a man.
As one female editor here at The News-Herald put it: “Once you give birth you stop being embarrassed.”
Men - many men, anyway - just don’t get it. They often shun a frontal thought about their health in general and their prostate health in particular.
It’s not what men want to talk about in their man caves when their discussion is more focused on things like ERA’s, passing statistics and who is the Cavalier’s best free-throw artist.
Neither will you hear even a whisper of the word “prostate” in a deer camp, my hometown.
Rather, there it’s all guy-speak regarding MOAs, illuminated reticles, bullet drop and the controversy about issuing too many doe tags.
That’s okay for those situations, I guess, though a brutally frank look at the subject is so important that it can literally be a life-saver.
After all, the survival rate for prostate cancer victims is high; no, make that, very high.
But ONLY if the affected male overcomes his squeamish pride and junior high giggles and makes the effort to save himself a whale lot more in the way of pain, grief, and assured death by waiting until it is too late.
I’m not looking forward to the biopsy procedure - and I’ll cover that subject next - but I am trusting that my rigorous commitment to having my prostate examined each and every year for more than a decade is going to pay a living dividend.
- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn
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