Ben Stiller Reveals He Was Diagnosed With Prostate Cancer – BuzzFeed News


2. Quick
refresher: The prostate is a walnut-sized gland located under
the bladder that helps produce semen.

Quick refresher: The prostate is a walnut-sized gland located under the bladder that helps produce semen.

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Kocakayaali / Getty Images

The gland’s function is to produce seminal fluid, which helps
nourish and transport sperm as it leaves the body through
ejaculation. It tends to cause more issues (especially with
urination), as men age, and it’s checked during a routine
digital rectal exam, where a finger or instrument is inserted
in the anus to feel for abnormalities.

Prostate cancer is common — about 1 in 6 men will get it,
according to the
American Cancer Society.

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3. 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 School of Medicine, told BuzzFeed
Health.

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5. But the
PSA test remains controversial because there are conflicting
guidelines about who should get screened and whether it’s
even necessary at all.

But the PSA test remains controversial because there are conflicting guidelines about who should get screened and whether it's even necessary at all.

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“When you have three major agencies with different
recommendations then there really is no recommendation, it’s
more or less a big debate on medical costs, risks, and
screening benefits,” said Segal. Here are the guidelines
today:

Which one of these guidelines is best? That’s completely up
to the doctor. Stiller’s doctor decided to go against all of
them.

“The guidelines don’t replace a physician’s judgement, and
it’s up to the them to work with their patient and figure out
if a PSA test is the right call,” Dr. Darius Paduch,
urologist at Weill Cornell School of Medicine, told BuzzFeed
Health. The guidelines are also based on research up to 10 or
15 years old, he said, so they tend to actually be quite
outdated and don’t include the new screening technology.

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6. “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.

"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.

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Stiller, pictured here with his wife and daughter, was 46
years old and he had no family history, no demographic risk
factors, and no prostate cancer symptoms. According to
guidelines, he should have never gotten a PSA test.

“Stiller should be applauded for talking about this because
it’s men like him who get aggressive prostate cancer in their
40s who die from it, not the guys over 75,” said Paduch.

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7. 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 19th century, 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.

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8. 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.

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9. The
experts agree that Stiller’s story is an example of why men
should be more informed about prostate health.

The experts agree that Stiller's story is an example of why men should be more informed about prostate health.

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“Most of the time, the prostate is absolutely fine, so men
shouldn’t be afraid of having an exam or quick blood test
because it can save lives,” said Paduch.

So men — don’t forget to talk to your doctor about prostate
cancer and PSA tests! If you’re confused or worried about any
of this, talking to your doctor can help you understand your
risk and when you should get screened. Prostate issues are
not the easiest thing to talk about, but your doctor is ready
to listen and give you more information.

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