What If the “N of One” Is Me?

I am a 54-year old academic, family doctor. Last May, after the US Preventive Services Task Force issued a draft recommendation that physicians talk with patients about PSA (prostate-specific antigen) testing at age 55, I was updating my clerkship presentation about preventive screening. At the time, I was experiencing some palpitations (sensations of an abnormal heart beat), so I decided to check my TSH (thyroid stimulating hormone) and CBC (complete blood count).  

Not having checked my PSA since age 48 (it was 0.9 then), I decided, on a whim, to add a PSA to my blood tests. It came back 10.8, which means there was a possibility of cancer.

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