An ounce of prevention worth a pound of cure

Ask Mike Gracz about the Rotary Health Fair and he’ll tell you it and the comprehensive blood analysis offered through the fair saved his life.

“I hardly even knew I was getting a PSA (prostate-specific antigen) test, but it was at the health fair and I just checked the box,” said Gracz, who was 39 at the time he had the screening done in 2000. “I’d always heard about the health fair and thought it was a good idea to get the blood work done.”

Results from the PSA test were high, so Gracz’s doctor recommended a follow-up test, another test, a biopsy, and finally, at age 40, Gracz underwent surgery for prostate cancer.

“It’s 11 years in February that I’ll be cancer free,” said Gracz. “And I’m getting another blood test at this health fair.”

For years, Boyd Walker of Homer took advantage of the Rotary Health Fair as a way to monitor his PSA.

“I slowly noticed it started to increase, which was a tip-off that something could have been wrong,” said Walker, who, after more screenings and a biopsy was diagnosed with prostate cancer and in July underwent a radical prostatectomy. “I’m four months out. There’s is a recovery period, no question about it, but I’m doing fine.” 

Walker credits the Rotary Health Fair for his and others’ health.

“Just off the top of my head, I can think of five people in Rotary who found out they’ve had cancer at the Rotary Health Fair,” said Walker.

Phil North of Kenai, a friend of Gracz, has had a very different experience.

In 2005, at the age of 48, North had a physical that included a PSA test.

“(The doctor) told me my cholesterol was maybe high, but basically didn’t say much of anything,” said North. “I went away from it not thinking there was anything I needed to do.”

In March 2010, North had another physical done by a different doctor and was told his PSA was “pretty high.” A follow-up PSA two months later showed an even higher score and his doctor referred him to a urologist.

“While all this was unfolding, I looked through my medical records and saw the 2005 results and it was elevated then, but I hadn’t heard anything about it,” said North, who was eventually diagnosed with prostate cancer and underwent surgery.

He has made some significant lifestyle adjustments as a result, eliminating sugar and animal products, switching to a plant-based whole food diet and exercising every day. Had he been told about the elevated PSA in 2005, he would have made those changes sooner.

“Basically, I wasn’t given an opportunity to do anything because (that doctor) didn’t say, ‘This could mean you have cancer.’ I’m resentful that I wasn’t given the chance to do anything about it,” said North.

Now, North said his health is “not so good. As it turns out, the surgery wasn’t fully effective. I still have a PSA reading where I shouldn’t, so it’s quite likely I have some small remnant of cancer.”

North’s doctors have recommended another biopsy, which he is planning to have done, and he has monthly PSA tests. After the last one, he got a note from the doctors saying there was no change so he could wait until December or January to repeat it.

Earlier this year the U.S. Preventive Services Task Force issued a recommendation that PSA tests offer “very small potential benefit and significant potential harms.” 

The task force encouraged clinicians to take that into consideration and not screen patients with a PSA test unless the individual being screened understands what is known about the screening and makes a personal decision “that even a small possibility of benefit outweighs the known risk of harms.”

Wesley Turner, M.D., a urologist at Providence Hospital’s Cancer Center in Anchorage, pointed out that a PSA test is not a specific test for cancer.

“If someone has an infection, the PSA can be elevated,” he said. 

The potential risks of a PSA test, according to information provided by the Mayo Clinic, are the choices made based on the results, including a biopsy.

“The risks are bleeding and infection, the biggest of those an infection,” said Turner. “But with our clinical decision-making, I can hone it down and not do unnecessary biopsies.”

Turner said he takes the same stance as the American Urological Association, that the task force’s advice is not appropriate.

“The AUA is outraged and believes that the task force is doing men a great disservice by disparaging what is now the only widely available test for prostate cancer, a potentially devastating disease,” the AUA says on its website.

Turner, who meets with Homer patients once a month through South Peninsula Hospital’s specialty clinic, said, “If you get a PSA that’s slightly abnormal, talk to your primary care physician. All of them in Homer are great physicians. They can have a conversation with you and say it’s OK to watch it or refer you to a urologist.”

Speaking from personal experience, Walker said, “Get it checked. The health fair is a good way to do that.”

Gracz agreed.

“The most important thing is to find out,” he said.

McKibben Jackinsky can be reached at