I am about to turn 71 and have so far, knock wood, dodged the Big C, cancer. This assumes that all the screening tests that I have done have been accurate. (A grad school roommate of mine was not so lucky. He had a “clean’ colonoscopy that missed his cancer. It killed him. Irony alert: his professional specialty was health economics.)
So far this year I have been screened for four types of cancer. I celebrated the new year with a colonoscopy. I have a family history of colon cancer so I’ve been having them every few years since I was in my early 40s. The gastroenterologist found and removed some noncancerous polyps. So far so good. See you in 2029, doctor.
I go to the dentist twice per year. He does a thorough visual screening for oral cancer. He looks in my mouth every which way and so far he’s only seen normal tissue. Smile when you say that, mister.
During my youth I routinely had bad sunburns owing to my heritage from the British Islands. Between running and bicycling I have spent thousands of hours under the sun since I turned 22. My skin is a cosmetic disaster. I go to a dermatologist twice a year for skin screenings. My most recent visit resulted in a biopsy. The tissue was noncancerous. Just to be careful, the doctor froze the bejesus out of the tissue near the biopsy site.
Next week I go for my sixth prostate cancer screening blood test. This involves measuring the amount of prostate specific antigen (PSA) in my blood. During a routine test in 2024 at my primary care doctor’s office, my PSA measured above 4 ng/ml which is indicative of a non-zero probability of prostate cancer for people in my age cohort (60 to 70) with a family history of prostate cancer. My doctor sent me to a urologist who has ordered four subsequent PSA tests and an MRI.
The MRI showed that I have an enlarged prostate (not unusual for old men) and no sign of cancer. An enlarged prostate tends to secrete more PSA into the blood. This alone could cause a high, but innocuous PSA level.
PSA levels also increase with age. Having just turned 70, I have entered a new PSA cohort. My threshold for concern is now 6 instead of 4. Being old has its advantages, I suppose.
Doctors hate when their patients introduce some random wisdom from the Internet. As it turns out, I heard from multiple sources online that bicycling can cause a rise in PSA levels. It seems the pressure of the saddle of a conventional bike on the perineum in turn causes pressure on the prostate gland leading to the prostate secreting abnormally high amounts of PSA.
In August 2025, I repeated one PSA test after having taken a couple of days off the bike. There was no change in my PSA level. (A friend of mine did the same and his PSA fell. As they say in med school, your mileage may vary.)
In February of this year, however, I had a more promising result. The weather was bad that I rode recumbent bikes indoors for about a week before the test. Low and behold my PSA level of nearly 6 in November fell to nearly 4. I felt young again.
In anticipation of my PSA test next week, I have been riding my recumbent exclusively for the last few weeks. I am hoping that Big Nellie is just what the doctor ordered.
A Few Spokes Shy of a Wheel 