The “enigma that just won’t go away” has come up again. In late May, 2026, I published an article with that title implying that “the enigma” was still on the minds of American men. The “enigma” referred to here is testing for Prostate Specific Antigen, PSA, the blood test purported to screen for prostate cancer, after age 70. The equally enigmatic United States Preventive Services Task Force (USPSTF) has stuck by its guns and continued to maintain that PSA testing after age 70 is not cost effective.
I personally think that is bad advice. In today’s health care world, many men who reach age 70 are just getting started. How many 70+ or 80+ men do you know who still play golf, pickleball, or ride their bicycle? These men are as physically capable as they were ten years earlier. They could be looking at another 10, 15, or even 20 years more life expectancy. And unless some unexpected catastrophe happens, their lifestyle will remain active. These men aren’t ready for the bone pile just yet.
Many argue that they are testing for a disease that may not affect them negatively for many years, and they probably will die from something else before prostate cancer causes problems. I say, “Phooey!” to that. I’d much rather know if I have prostate cancer because it can be monitored and treated when and if necessary. That’s much more preferable to me than suddenly learning I have Stage IV cancer when I could have been doing something about it along the way. And it’s the improved quality of life men in their 70’s and 80’s have nowadays that makes me have that opinion. It’s like saying you’ve reached the age of expendability, and even though I can ride my bike 30 miles, my age says I’m not worthy of treatment.
Then there’s the surgeons’ credo: “A chance to cut is a chance to cure,” A lot of people, like those representing the USPSTF, are all worried about PSA testing bringing about unnecessary surgeries that leave patients impotent and incontinent. If an 80+ year old man is facing prostate cancer surgery, this is the time for honesty and wisdom from the surgeon to direct the patient properly. The surgeons’ credo has to be ignored here, and the surgeon needs put himself in the patient’s shoes and advise honestly. Unfortunately, this is an unrealistic dream. You have to have the right surgeon for that to happen, but it’s possible.
As I said before, I would like to know where I stand. I don’t want to be the scenario that was Joe Biden! Either he has an uncharacteristically aggressive form of prostate cancer or he has been grossly mismanaged.
Another factor is getting past your doctor’s personal bias regarding PSA testing after age 70 or 80. He may stubbornly refuse to order the test. If he does you have the option to go to a lab you can order your own tests, or change doctors to one within a more agreeable stance.
I think I’ve stated my position on this issue. Seventy is just a number. It’s not the first step on “The Stairway to Heaven.” There’s a “Long and Winding Road,” ahead so you must “Let it Be.”
Reference: “Ask the Doc.” The Boca Beacon Summer 2026.
PSA Testing: The Enigma That Won’t Go Away. DrGOpines.com 2026 May 26.
