en Stiller has been treated for prostate cancer, he revealed on “The Howard Stern Show” Tuesday, after his doctors diagnosed him in June 2014. He is now cancer-free, and he credits his health to a controversial screening test that has divided experts because of its potential for overtreating slow-growing tumors.
“Taking the PSA test saved my life,” Stiller wrote in a blog post on Medium Tuesday.
The PSA test detects an enzyme, prostate specific antigen, that is released by prostate cells. Elevated levels of PSA could indicate cancer. In many cases, though, the cancers would progress so slowly that it would not threaten a man’s health or life.
“The problem is, PSA tests find a whole lot of prostate cancers that will never kill people,” urological surgeon Dr. Peter Albertsen of the University of Connecticut Health Center told STAT last year. The treatment — biopsy, surgery, and chemotherapy — could end up hurting patients more than the cancer itself, some experts say. It could also lead to side effects like incontinence and impotence that decrease quality of life.
In 2008, the US Preventive Services Task Force, a team of experts gathered by the federal government, recommended against PSA testing for men 75 years and older. In 2012, it recommended against the test for all men. The American Cancer Society, however, recommends routine screening starting at age 50.
Stiller wrote that his doctor tested his baseline PSA levels when he was 46. Stiller said that because his doctor went against guidelines, he was able to receive the diagnosis earlier. “If he had followed the US Preventive Services Task Force 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,” he wrote.
After Stiller’s initial PSA test, his doctor continued to check his PSA levels every six months and watched them rise for a year and a half. Then, Stiller was sent to a urologist for a physical exam, then for an MRI, and then for biopsy that confirmed the growth was a moderately aggressive cancer. Stiller’s consultations with multiple doctors convinced him to go forward with surgery to remove the cancer.
Since 2012, studies have shown that prostate cancer diagnoses have decreased. Many viewed this as a positive change, but a 2015 editorial in the Journal of the American Medical Association worried that fewer PSA tests would lead to more men dying from prostate cancer.
Stiller said that the controversy around PSA testing lies in the doctor’s interpretation of the data and recommendations, rather than the blood test itself. “I think men over the age of 40 should have the opportunity to discuss the test with their doctor and learn about it, so they can have the chance to be screened,” he wrote. “After that an informed patient can make responsible choices as to how to proceed.”