Prostate cancer is the most common type of cancer in the United States and is the second-most common cause of cancer deaths American men after lung cancer. The National Cancer Institute says about one in five men will be diagnosed with prostate cancer at some point in their lives.
So why do so many men avoid getting screened? One local doctor says part of it may be the fear of losing control.
Mike Saunders, 63, says he lived in denial.
"I don't like coming every two months to have blood tests but you know that's what I have to do," he said.
The tests are to make sure Saunder's prostate cancer doesn't return. He used to think he was invincible. But seven years ago, his brother convinced him to get screened because it runs in the family.
"I denied that I had prostate cancer. It wasn't going to happen to me," he said.
Despite removing his prostate, Saunders is still not out of the woods. Urologist Dr. Herb Ruckle, Chair of the Department of Urology at Loma Linda University Medical Center, keeps a close eye on his disease.
"Active surveillance means that you periodically query the cancer to see if its growing or becoming more aggressive or becoming a threat," Ruckle said.
"Had I done it earlier maybe I would have been in a better position right now. I'm convinced of that," Saunders said.
Many men like Saunders avoid the PSA test because they're confused about it.
Over the decades, PSA screening has led to more tests, more anxiety and treatment in men who may have not needed it because their tumors were slow growing. But, screening also finds those with life-threatening aggressive tumors. Given this spectrum, Ruckle said doctors today are much more methodical in their approach.
"What you're trying to do with prostate cancer treatment is trying to make a man's life longer and better," Ruckle said.
The most current guidelines from the American Urological Association recommends men start PSA screening at age 55 and continue up to age 69. For high risk men, experts recommend an earlier start.
"High risk men which would mean first degree relatives, African American ancestry," Ruckle said, "Would be prudent to start screening or at least have a first PSA at age 40."
And just because you get screened doesn't mean you have to have more tests. Ruckle said even during treatment, men must remember they're in control.
"Shared decision making is really important," Ruckle said.
Saunders and his doctor are partners in his care. Their message? Knowledge is power.
Saunders said, "To live in denial and avoid the consequences, avoid the process of getting checked is just stupid."
Why do some men avoid prostate cancer screening? Local doctor says men fear losing control
CIRCLE OF HEALTH