Prostate Cancer 2016: Ben Stiller Diagnosis Spotlights PSA Tests, Treatments
Noted comedy legend Ben Stiller, 50, revealed this week that he was diagnosed with and successfully treated for prostate cancer in 2014 — and he says it’s all thanks to a now-controversial screening test.
After initially disclosing his diagnosis on The Howard Stern Show earlier this Tuesday, Stiller released a more extensive post on Medium discussing his brief battle with the disease. According to the post, Stiller was diagnosed with prostate cancer in mid-June of 2014. Soon after, he underwent a minimally invasive procedure to remove the cancer called a robotic assisted laparoscopic radical prostatectomy. Later that September, a test confirmed he was cancer-free, and he’s been in remission ever since. Stiller added, however, that he only become aware of the cancer because he was given a prostate specific antigen (PSA) test on the advice of his doctor two years earlier.
“Taking the PSA test saved my life. Literally. That’s why I am writing this now,” he wrote.
As Stiller noted, there’s been a fierce debate over the PSA test and other forms of prostate cancer screening. In 2008, the U.S. Preventive Services Task Force (USPSTF) issued a far-reaching recommendation advising that men over the age of 75 no longer receive the test, which measures the level of a substance released from the prostate that’s oftentimes higher in men who have prostate cancer. In 2012, the agency went even further, recommending that no men with an average risk of prostate cancer get a PSA test, a recommendation that Stiller noted would have likely left him unaware of his cancer if his doctor had followed it.
“I have no history of prostate cancer in my family and I am not in the high-risk group, being neither — to the best of my knowledge — of African or Scandinavian ancestry. I had no symptoms,” he wrote.
Stiller does discuss the USPSTF’s rationale for their decision. Evidence has shown that the PSA test isn’t as reliable or useful as it first appears. False positives are commonplace, particularly among men Stiller’s age, and even when the test is perfectly accurate, the very nature of prostate cancer complicates things further. The majority of cases progress slowly, if at all, are very rare before age 50, and even when untreated, are rarely fatal. So while a PSA test may catch a case early, it’s still tricky to figure out whether this early detection outweighs the added stress and even harm inflicted upon people being unnecessarily treated (Stiller’s case was considered a “mid-range aggressive cancer,” according to tests he was given).
Stiller acknowledges these points, taking pains to present his case for expanded screening as one side of a legitimate debate. One recent study he cites, however — showing that advanced cases of prostate cancer have become more prevalent in the wake of the USPSTF recommendations — has been criticized by other experts for its flawed conclusions. Still, with the USPSTF set to update its screening guidelines in the near future, Stiller hopes that his perspective can provide important context.
“This is a complicated issue, and an evolving one,” he wrote towards the end. “But in this imperfect world, I believe the best way to determine a course of action for the most treatable, yet deadly cancer, is to detect it early.”