By Kay Quinn, St. Louis Post-Dispatch, October 16, 2006

You''re used to seeing him in local television ads. But these days, Dave Sinclair is talking about more than cars and trucks as he walks the lots of his five dealerships.

He is encouraging all men older than 50 to get screened for prostate cancer.

"If you''re not watchful, you''re stupid," Sinclair says. "I''m like everybody else - I want to go to heaven, but I don''t want to die to get there and I don''t want to do it now."

At 78, Sinclair is talking tough about a subject many men would rather avoid. After years of getting annual blood tests that track prostate-specific antigen, better known as PSA, he was diagnosed and treated for prostate cancer three years ago. He has also watched two close friends die from the disease.

These experiences motivated him to act. Sinclair is convinced that regular PSA tests saved his life, so later this month he will sponsor free PSA screenings at three of his dealerships. He is hoping that men who have avoided the test will change their habits.

"If you don''t, you die a horrible death," Sinclair says. "And I''ve seen the horrible death several times."

PSA screenings are recommended annually for all men older than 50, says Dr. Gerald Andriole, chief of urology at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. Men with a family history of prostate cancer should begin getting annual PSA tests at 40.

Andriole says the test isn''t perfect, but he recommends that men get the test along with a digital rectal exam.

Interpreting the results of PSA tests has changed in the past decade. Ten years ago, doctors recommended prostate biopsies for men with PSA readings over four. Recently, that number was scaled back to 2.5. But Andriole says that today, doctors will typically recommend biopsies in men whose PSA readings show a steady rise over the course of a year.

"PSA has many good attributes, but it has a few bad ones," Andriole says. "Part of the problem with PSA is that it often results in us finding cancer in men who may not actually go on to die of it."

In other words, according to the National Cancer Institute''s website, the PSA test sometimes identifies tumors that are growing so slowly that they probably aren''t life-threatening.

Andriole believes advances in the technology used to perform prostate biopsies should help doctors better determine which cancers need aggressive treatment. That information, when combined with a man''s age, life expectancy, family history and PSA results, is used to help doctors recommend treatment options and predict disease outcomes.

Sinclair hopes his story will motivate more men to be screened regularly for cancer.

"I don''t worry about it," Sinclair says. "I''m watchful, but I don''t worry."