‘Friends’ Actor James Michael Tyler Speaks Out on The Importance of Early Prostate Cancer Detection

After being diagnosed with prostate cancer in 2018, ‘Friends’ actor James Michael Tyler emphasizes the importance of early detection. Learn more about prostate cancer screening options.
‘Friends’ Actor James Michael Tyler Speaks Out on The Importance of Early Prostate Cancer Detection

James Michael Tyler’s Prostate Cancer Diagnosis

James Michael Tyler, who is best known for his role as the coffee shop manager, Gunther on the sitcom “Friends,” was diagnosed with prostate cancer in September of 2018. In an interview with NBC’s Today Show, James said that he was diagnosed with advanced prostate cancer before it spread to his bones. The illness was initially caught during an annual checkup.

James recalls, "I was 56 years old at the time, and they screen for PSA, which is prostate-specific antigen. That came back at an extraordinarily high number ... So, I knew immediately when I went online and I saw the results of my blood test and blood work that there was obviously something quite wrong there.”

Like many, James put off doctor’s office visits during the pandemic, noting, "I missed going in for a test, which was not a good thing. So the cancer decided to mutate at the time of the pandemic, and so it's progressed."

Currently, James Michael Tyler is undergoing chemotherapy treatments, and emphasizes the importance of how screening and early diagnosis can lead to better prognoses for others.

"There are other options available to men if they catch it before me," Tyler told NBC Today. "Next time you go in for just a basic exam or your yearly checkup, please ask your doctor for a PSA test. It's easily detectable."

What Exactly is Prostate Cancer?

Prostate cancer – the malignant growth of cells in the male prostate gland – affects approximately 11.6% of men during their lifetime.i  It is one of the most common forms of cancer among men and is typically slow-growing. In the U.S., an estimated 248,530 new cases of prostate cancer are identified per yearii, with a 5-year survival rate of 97.5%. Survival rate decreases with aggressiveness of the disease.iii

Currently, there are about 3.1 million prostate cancer survivors in the United States.iv  Early detection is key to survivability. The earlier prostate cancer is found and treated, the more probable a patient will remain free of the disease. Early detection can lead to better outcomes; however, for some men, one of the most common detection methods — prostate biopsy — may offer more risk than benefit.

PSA Testing and Biopsies

Prostate-specific antigen (PSA) testing is widely used as a screening tool for prostate cancer. There are some important things to note about PSA testing:

PSA is not a cancer-specific marker. As such, there are considerations regarding PSA testing:

  • PSA concentrations are not definitive evidence for the presence or absence of prostate cancer
  • Elevated PSA may not indicate cancer
  • PSA is also present in non-cancerous conditions, such as benign prostatic hyperplasia
  • PSA levels are affected by acute and chronic prostatitis, as well as by physical trauma and inflammation

PSA testing accuracy has been difficult because men with typical tPSA values will not undergo biopsy unless their digital rectal exam (DRE) is abnormal. The work-up bias tends to overestimate the sensitivity and underestimate the specificity of the test.v,vi

Typically, as PSA levels increase, so does the probability of detecting cancer.

PSA (Hybritech Calibration) PSA (WHO Calibration) Probability of Cancer
0-2 ng/mL 0-1.6 ng/mL 1%
2-4 ng/mL 1.6-3.1 ng/mL 15%
4-10 ng/mL 3.1-7.8 ng/mL 25%
> 10 ng/mL > 7.8 ng/mL > 50%

However, only about 25% of patients whose PSA levels are between 4-10 ng/mL have a subsequent positive biopsy.vii,viii With biopsies being invasive procedures that may leave patients vulnerable to a number of risks, many healthcare professionals are focused on reducing biopsy-related compilations.

The Need for phi

Prostate Health Index (phi) is a simple blood test that provides better prostate cancer detection to reduce negative biopsies. The FDA-approved test is ordered under particular circumstances, such as when a patient’s PSA is in the 4-10 ng/mL range, and it combines PSA, free PSA and p2PSA tests.

Prostate Health Index results are based on a score that provides information on the probability of finding prostate cancer and providing confidence in biopsy decisions. Because phi analysis improves specificity for prostate cancer, it fills the diagnostic gap between PSA screening and a prostate biopsy.

Want to learn more about prostate cancer and phi?

i. National Cancer Institute (NCI). Cancer of the Prostate - Cancer Stat Facts. SEER. https://seer.cancer.gov/statfacts/html/prost.html. Accessed 24 Jul. 2019.

ii. Cancer of the Prostate - Cancer Stat Facts. (2020). National Cancer Institute: SEER. https://seer.cancer.gov/statfacts/html/prost.html

iii. National Cancer Institute (NCI). Cancer of the Prostate - Cancer Stat Facts. SEER. https://seer.cancer.gov/statfacts/html/prost.html. Accessed 24 Jul. 2019.

iv. National Cancer Institute (NCI). Cancer of the Prostate - Cancer Stat Facts. SEER. https://seer.cancer.gov/statfacts/html/prost.html. Accessed 24 Jul. 2019.

v. White J, Shenoy BV, Tutrone RF et. al. “Clinical Utility of the Prostate Health Index (phi) for Biopsy Decision Management in a Large Group Urology Practice Setting.” Prostate Cancer Prostatic Dis, vol. 21, 2018, pp. 78–84.

vi. Tosoian JJ, Druskin SC, Andreas D et. al. “Use of the Prostate Health Index for Detection of Prostate Cancer Results from a Large Academic Practice,” Prostate Cancer Prostatic Dis, vol. 20, no. 2, 2017, 2013, pp. 228–233.

vii. National Cancer Institute (NCI). Cancer of the Prostate - Cancer Stat Facts. SEER. https://seer.cancer.gov/statfacts/html/prost.html. Accessed 24 Jul. 2019.

viii. Draisma G, Etzioni R, Tsodikov A et. al. “Lead Time and Overdiagnosis in Prostate-specific Antigen Screening, Importance of Methods and Context.” J Natl Cancer Inst, vol. 1101, no. 6, 2009, pp. 374–383.

Editorial Team
Editorial Team
The Beckman Coulter editorial team brings you timely news and resources focused on elevating clinical laboratory performance and advancing patient care.

Related Articles

Avoiding Disruptions in Laboratory Workflow During Challenging Times

Avoiding Disruptions in Laboratory Workflow During Challenging Times

Today’s laboratories face many disruptions in workflow that delay patient care. Learn how automated urinalysis solutions can free-up time consuming bottlenecks.
‘Friends’ Actor James Michael Tyler Speaks Out on The Importance of Early Prostate Cancer Detection

‘Friends’ Actor James Michael Tyler Speaks Out on The Importance of Early Prostate Cancer Detection

After being diagnosed with prostate cancer in 2018, ‘Friends’ actor James Michael Tyler emphasizes the importance of early detection. Learn more about prostate cancer screening options.
Making an Impact Together

Making an Impact Together

Join us this month as our colleagues talk about experiencing one of our core values, The Best Team Wins, and two shared experiences that bond us together, Realize Your Potential and Make a Real Difference. From Asia, Europe, the Middle East and the U.S., our colleagues are finding satisfaction and happiness in working together to achieve results.