Bill McElroy considers himself an “extremely lucky” man.
He knows many people wouldn’t see him in that light, especially since he’s about to undergo surgery to remove a cancerous prostate gland.
Rather than sit at home, relax and wait for his scheduled operation Wednesday (April 15) at Victoria General Hospital, the fit 69-year-old Langford resident rounded off a brisk walk this week with a stop at the Gazette office to talk openly about his situation.
McElroy calls himself lucky, because if he hadn’t made a firm request of a walk-in clinic doctor a little over a year ago, the chain of events that led to his diagnosis might never have begun.
“If I hadn’t asked for that PSA test …” he says. “It just so happened I had the more aggressive, fast-growing type of prostate cancer.”
Unlucky enough to have had his family doctor retire five years ago, leaving him without a regular physician, McElroy was left with having to rely on walk-in clinics for his health care.
Like many men, especially those as generally healthy as he is, he says, he’s not one to go to the doctor for just anything.
But when it comes to health scenarios that need regular monitoring, walk-in clinics often lack the continuity needed, he adds. “You never know who you’re going to get the next time you go in.”
Prostate specific antigen (PSA) test orders, not unlike mammograms for women, generally require the patient to have a regular doctor to send the results to. McElroy was fortunate that in his situation, the results were secured by the clinic which ordered the PSA test initially, and they let him know they needed to see him.
His baseline PSA serum concentration reading wasn’t off the chart at first, slightly higher than what is considered normal, McElroy says. Having been referred to a urologist by the clinic doctor, however, he saw increasingly higher numbers in subsequent testing.
McElroy, the studious board chair and treasurer of the Pacific Centre Family Services Association in Colwood and longtime board volunteer around Greater Victoria, read a lot on the topic and researched possible options for people in his situation. In consultation with specialists, he chose to go with complete removal of his prostate gland.
At the end of the day, he’s glad he took action when he did, but he questions the long-term prognosis for health care when thousands of people in Greater Victoria don’t have a regular doctor.
“I’m not angry, but I hoped this use of walk-in clinics would be a stopgap measure,” he says. “What happens in the long run if someone has undetected breast cancer or prostate cancer?”
Their chances of survival go down dramatically, says Leanne Kopp, executive director of The Prostate Centre in Victoria.
“If caught early, (treatment of) prostate cancer has a 90- to 95-per-cent chance of success,” she says.
Kopp agrees with McElroy that middle-aged and older men, especially those using walk-in clinics, need to become advocates for themselves for prostate health.
“As doctors retire, (family) practices are much more difficult to get into,” she says. “In terms of something like a PSA test, where you need to follow that number from year to year, that’s when men tend to fall between the cracks. What’s important is creating that baseline.”
The PSA test has been the subject of controversy of late. Critics argue that many men with elevated PSA serum readings, including some for whom slow-growing prostate cancer would not pose a higher-than-average health risk, are being recommended for more invasive testing, such as biopsies, that carry a risk of further health problems.
Despite the “needle-in-the-haystack” bad press, Kopp insists that the PSA test “is really right now the best screening tool for prostate cancer. Until something comes out that can be a better screening tool for men, this is the best way (to detect cancer early).”
McElroy says that since he started letting people know about his situation, he’s heard a number of related stories.
“One today concerns an older man who hadn’t had a prostate exam for years,” he says. “Like me, he had no pain or symptoms, so never thought about it. Apparently, when they did a PSA, he scored over 600 (a “normal” reading is in the 4.0 to 6.0 range). After an exam, he was told it was really too late to do anything, because the cancer had spread throughout his body. Another point for early detection.”
To find out more about PSA testing and its benefits and risks, visit theprostatecentre.org or talk to a physician.