I am 40 years old and in otherwise decent health. I try and exercise regularly, eat right, avoid excessive stress – all the things to help cope with lifestyle diseases like diabetes and high blood pressure, if and when they strike. The one ailment I often think about though, is cancer, because I (like most people) am not necessarily sure how to prevent it or deal with it.
Specifically I worry about prostate cancer. I have shared earlier that my father is a prostate cancer survivor. Apparently, this makes it more likely for me to have prostate cancer than other 40 year olds whose fathers may not have had the condition. Since the 1990s, when my father has been in treatment, we relied on a simple blood test called the Prostate Specific Antigen (PSA) to measure how aggressive the cancer was. The lower the PSA, the better is the control. Higher levels of PSA required urgent and aggressive treatment. Till recently, it was standard in the USA for all men over 40 to undergo a routine PSA screening annually.
Recent evidence questions the usefulness of the annual PSA testing. Apparently, higher levels of PSA do not necessarily mean an aggressive cancer. Or even if it does, aggressive treatments started due to high PSA may not necessarily benefit patients more than simpler, less aggressive treatments. Some authorities (including the USFDA) are now saying it does not make sense to do an annual PSA screening for men over 40.
What does it mean for me? Do I do an annual PSA? Worse still, if it is high, should I be concerned enough to undergo a biopsy? If there is a chance that treating the high PSA with simple measures is going to be as effective as aggressive treatments (my father underwent major surgery and over 17 years of chemical and hormonal drugs), should I subject myself to the aggressive treatments? How do I make a decision? As a patient (or in this case, a potential patient and with luck, never a patient), I want clarity and certainty in the choices available to me. The current situation provides me neither.
As a trained doctor (even though I don’t practice), I recognize that decision-making is not an exact science and may vary from patient to patient. A large amount of information needs to be processed to tailor a treatment course for a patient. Even then, the treatment may often be a choice between 2-3 options, all with their own pros and cons.
As an observer of healthcare trends, I feel responsible to help bridge the choices a doctor has to balance with the treatment certainty the patients seek. The only way to do this is to help improve the quality of conversations between doctors and patients. They need access to current and relevant information about their potential medical conditions. If patients can easily talk to medical experts and better understand their own conditions, we believe they can be well-informed partners in decision-making with their doctors. So like me, if you nurse concerns about your own health (or of a family member), irrespective of whether those concerns are past/ present/ future, real/ imagined, serious/ non-serious, urgent/ non-urgent, start having those conversations with healthcare experts today!
Aakash is a physician by training and worked in the pharmaceutical industry before embarking on an entrepreneurial journey with his wife Aditi in 2011. Mirai Health is their third baby and follows the birth of their two boys, Siddhant and Samin. Besides healthcare innovation, Aakash is passionate about running and sports.