Please forgive me for writing about this again. There has a been a lot of discussion recently about the effectives and wiseness of giving men PSA tests. I often say that I had PSA disease. From the time I was 50 (15 years ago), I had been getting regular PSA test as was the recommendation at the time. It was the view then that at PSA of under 4 was good but PSA’s above 4 were of potential concern. This was a pretty simple minded way to look at things. There are many factors that influence PSA such as weight, infections and just ones nature. My PSA was 4.1. My doctor suggested we wait a year and see what happen. We did it again a year later and my PSA was 4.3. She then suggested I have a biopsy. So I went to a urologist. He said to me there was a 25% chance that they would find cancer. I was pretty sensitive to the issue of Prostate Cancer since Andy Grove with whom I had a lot of contact at Intel had been treated a year earlier for Prostate Cancer and wrote an cover article in Fortune that got a lot of attention. With one chance in four that I would have cancer , it seemed smart to find out. I had the biopsy (not a lot of fun) and waited for the results. The doctor scheduled the appointment for the end of a day. I did not think much about that at the time but later realized that was so he could spend some more time with me when he told me that I had indeed had Prostate Cancer and had a Gleason score of 6 (3+3). I won’t go into what the Gleason score is. You can read about it here. My score was not very high. That combined with my rather low PSA score of 4.3 meant that I had about an 80% chance that my cancer was confined to my prostate and had not spread. So like most urologist at the time, he recommend that I have my prosate removed. The idea was that if the cancer had not escaped from the prostate and you removed the prostate that you could not die of prostate cancer. I think the same logic is applied to breast cancer and ovaries (in women with high risk). Of course, I might have some side effect like not being able to have an erection (I was a single man or 51 years), urinary or even worse elimination problems. There were alternatives and I choose the same method as Andy Grove. I had a combination of internal (seed) and external beam radiation. The side effects are better in general and definitely in my case. What we now know (and maybe we knew then) was that most men who have Prostate Cancer do not die of it. They die with it. We also believe that there are many kinds of Prostate Cancer and the most are not life threatening. What should have been done in my case. We should have just do what is called watch and wait. We should have checked the PSA every year or even every six months to monitor the rate of increase. We might have done a biopsy ever year or two. I think there is a good chance that now at the age of 65, I would still have had my prostate. PSA tests are cheap. I understand that they only cost about nine dollars to perform (of course the labs charge more for them). It is important to monitor the PSA. If you have a PSA of lets say 10 and a Gleason score of 8 or more, you need to do something. But Urologist make a lot of money by taking out Prostates and they will play to the uncertain. I often have contact with men that have recently been diagnosed with Prostate Cancer. In cases similar to mine I suggest that they wait. Sadly none have.