By Dave Schafer
There was no rush for Al Dykes to see his doctor. At 54, Dykes was trim, drank in moderation, didn’t smoke, take medications, or eat much red meat, and had no health issues.
But it had been a few years since his last routine checkup, so he scheduled a well-man exam with his primary-care physician.
The test that measures the level of prostate-specific antigen in the blood showed he had 3.7 PSA per milliliter of blood, a point higher than it had been at his last exam.
It’s normal for men to have low levels of PSA in their blood, but prostate cancer can increase PSA levels.
Dykes’ father had died of prostate cancer at 83.
His doctor told him that he should probably see a urologist.
He didn’t need to do something right away. Prostate cancer is a slow-moving disease, and besides, it might not even be prostate cancer, Dykes thought. Dykes, a Public Works & Engineering assistant operations manager, meant to call a urologist, but it kept getting pushed aside by other priorities.
His wife, a nurse, never forgot. She kept prodding him, and in mid-August he saw a urologist. The digital exam was fine, but his PSA levels on this test, just six months after his last one, had jumped to 4.2. Anything above 4.0 is considered abnormal, according to the National Cancer Institute.
A few days after a biopsy, the doctor’s office called him to come in and discuss the test results.
“I had a sinking feeling,” he said. “It’s never good news when they want you to come in.”
He was right. Dykes had prostate cancer, his doctor said.
On Oct. 30, his prostate was removed. In early February, his PSA levels came back as undetectable.
“I’m now officially a cancer survivor,” he said.
It could have been 10 or 15 years before the prostate-cancer symptoms became apparent, Dykes said. By then, it could have been too late.
Because it was caught early, the cancer was contained in the prostate.
“Some of this stuff, these diseases, if you let it go to the point when you have symptoms, it may be too late,” Dykes said.
An ounce of prevention
That’s why getting your yearly general physical or well-man or well-woman exam is so important, said Dr. Alfreda Bell, a family-medicine physician with Kelsey-Seybold’s Houston Center clinic. Annual well-exams may seem like an unnecessary inconvenience, but they can make a huge difference in treating the disease.
A quarter of the hospital patients in a 2003 study had exhibited symptoms that, if diagnosed, could possibly have kept them out of the hospital, Bell said.
“Most people do not get their yearly exams, and it’s important for people to do that,” she said. “The sooner we can find a disease, the sooner we can treat it.”
Examining the exams
HMO Blue Texas’ HMO and PPO in-network members get one free physical or well-visit each year.
General physical exams look at the overall health of the patient: family history, vital signs, blood pressure, weight, pain, temperature, pulse and respiratory rate. Patients are screened for cholesterol, blood-sugar levels, and other problems based on predisposition. The doctor will also give the patient suggestions for maintaining a healthy lifestyle.
Patients should not eat anything for six hours before the exam, in case blood tests are ordered, Bell said.
“We want to examine patients head to toe,” she said. “We want to review whether they’ve had their immunizations. We want to identify things that are relevant, things that, in the next five or 10 years, or even in the next month, may cause problems.”
Well-man and well-women exams are physical exams that focus on the reproductive organs. At 50, men should start getting well-man exams that check the prostate and testicles and that answer concerns about sexual and reproductive health.
Men in the HMO Blue Texas HMO or PPO plans should get their general physical or well-man exam from their PCP.
Women age 18 or older, or younger if they are sexually active, should get well-woman exams that include mammograms, Pap smears and reproductive health. Women in the HMO or PPO plan can go to their PCP or gynecologist for their free yearly well-woman exam.
Still here today
Debra Vineski knows the value of annual exams; three times, routine exams detected a serious health problem.
During her annual physical in 2000, her PCP noticed her thyroid was enlarged. The lump was cancerous.
Vineski, an administrative assistant with the Controller’s Office, has been cancer-free since surgeons removed her thyroid.
A year later, during a well-woman exam, her gynecologist discovered fibroid tumors. Her doctor told her there were only two or three tumors, and that if they weren’t bothering her, she didn’t need to treat them.
Six years later, Vineski had surgery to remove them. The doctors found numerous tumors and endometriosis, a condition where tissue similar to the lining of the uterus is found elsewhere in the body.
In 2007, a routine visit to her oncologist uncovered a cerebral vascular attack and strokes. If left undetected, she could have suffered a fatal stroke or paralysis.
Because it was discovered early, her doctor treated it with drugs that are contolling her symptoms.
Highly trained professionals
Vineksi’s oncologist was alarmed by the symptoms she had written on her pre-exam form. She was having memory problems, she was fumbling her words, and words were getting mixed up when she tried to read them. Vineski didn’t think anything about the problems.
But her doctor sent her for an MRI, which revealed the cerebral vascular attack.
“It seems a bother to fill out that form each time,” she said. “But it might reveal something that means nothing to us but something to your doctor.
“Just filling out that form saved my life.”
Time for your checkup
At a physical exam, a nurse will ask questions to gauge your health.
Patients should plan for a physical exam to take 30 minutes to an hour, Bell said.
“Time is usually a factor for people who are working,” she said. “But if your company gives you time to come in, take advantage of it. That’s really a privilege.”
Vineski’s mother is a retiree who can’t get insurance because she had breast cancer within the past 10 years. She had to forego her well-woman exam last year.
“So many people don’t have free access to yearly exams,” Vineski said. “It’s important to take care of yourself. You’ve got these benefits. You should use them.”