Wellness April 11, 2024

OJ Simpson dies after prostate cancer diagnosis: What to know about PSA screening

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O.J. Simpson died at 76 following a diagnosis of prostate cancer, which is the second-leading cause of cancer deaths according to the American Cancer Association.

In May 2023, Simpson posted a video on X, then known as Twitter, revealing that he had recently "caught cancer" and "had to do the whole chemo thing." He added, "It looks like I beat it." Simpson didn't specify the nature of the cancer at the time.

In February, it was revealed Simpson was getting chemo for prostate cancer treatment.

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O.J. Simpson at the Expo Center Edison in Edison, N.J., March 31, 2006.

Like many cancers, early detection is key. Prostate cancer can be screened for with a blood test called Prostate-Specific Antigen (PSA). The goal of screening is to catch cancer before symptoms present and can be done during medical check-ups.

The good news is for most, prostate cancer does not have to be life-threatening.

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"A man who gets prostate cancer even if they have high risk, they are usually treatable," said Dr. Vipul Patel, Medical Director of the Global Robotics Institute, Executive Director of the Society for Robotic Surgery, and the Founder of the International Prostate Cancer Foundation.

But the PSA screening test isn't perfect, and right now, screening is not recommended for everyone. The United States Preventive Services Task Force (USPSTF), which helps establish standards for screening tests, says the decision to screen people aged 55-69 for prostate cancer should be a choice between the individual and their healthcare provider.

"PSA is not the perfect test to diagnose prostate cancer, but it is the simplest test we actually have available...PSA was picking up a lot of men who had prostate cancer, but it was also picking up patients who didn't have prostate cancer," said Patel.

After a high PSA is detected, a doctor may call for a biopsy. However, there are risks of complications such as infection or bleeding. He notes that hopefully as screening technology improves with tools like MRI and other blood tests, the unnecessary harm will also decrease.

When making the decision of when to screen someone for prostate cancer, clinicians also consider the risk of someone developing prostate cancer. Some groups, including Black Americans, have a higher risk. Black men and women are more likely to die from prostate, uterine and breast cancer compared to other races, according to recent data from the American Cancer Society.

Some providers choose to pursue testing as early as 40 in those of high risk, which include those with "any family history of prostate cancer, specifically, if there's a first degree relative, so a father or brother, that has a history or a diagnosis of prostate cancer…or men that are of African American descent," said Dr. Seixas-Mikelus who specializes in Urologic Oncology and Robotic Surgery at The Urology Clinic in Sumter, South Carolina.

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Notably, the USPSTF does not recommend screening over the age of 70. "As men age, prostates get larger, and in general PSAs can rise just based on age," said Patel.

Additionally, while screening is designed to detect and treat aggressive prostate cancer, not all identified prostate cancer will require treatment, especially as they age.

"Prostate cancer, in the majority of the instances, is often a very slow growing, potentially non-lethal cancer. And so as men get older, the value of screening becomes less and less…what is the risk of dying of prostate cancer versus what is the risk from some of these other medical problems?" said Dr. Manish Vira, System Chief of Urology at Northwell Health Cancer Institute.

However, recommendations for screening do not apply if a patient develops symptoms.

"If a patient comes in with urinary symptoms, blood in the urine, pelvic pain... Now, we're not talking about screening, we're talking about diagnostic evaluation," said Vira.

The USPSTF is currently reviewing the guidelines for prostate cancer screening and recommendations may change in the next few years.

"We care deeply about ensuring that men have the best information available to them….science and medicine are constantly advancing, so we are committed to updating our recommendations on a regular basis. We began updating our recommendation on screening for prostate cancer in late 2023 and are working to move it through our rigorous recommendation development process efficiently," said Dr. John Wong, Vice-Chair of the Task Force.

Dr. Camry Kelly, DO is a member of the ABC Medical News Unit and is Chief Resident at Mayo Clinic Family Medicine Residency Program in Rochester, Minnesota.

Dr. Ashley Yoo, MD is a member of the ABC Medical News Unit and an Internal Medicine Resident at George Washington University Hospital in Washington, D.C.