Joseph Wayne Singleton was 33 years old and felt fine when his wife asked him to schedule a more thorough physical than the annual exams he underwent to maintain his commercial driver's license. He agreed mainly to prove a point.
«My mentality was, 'OK, to make my wife happy, I'm going to do this and prove to her that I'm in perfect shape,'» the now 45-year-old musician from Opelousas, Louisiana, recalled in an interview.
What the exam revealed was anything but perfect. Although Singleton was too young for routine prostate cancer screening, his doctor decided to run a prostate-specific antigen blood test. The results came back with PSA levels that were, in his words, «through the roof.» A biopsy followed, and he was diagnosed with prostate cancer.
«It was totally unexpected,» Singleton said. «No symptoms.»
He was treated at MD Anderson Cancer Center in Houston, where doctors told him they had never seen prostate cancer in someone so young. After undergoing a prostatectomy to remove the prostate, Singleton said his age worked in his favor. «A couple of weeks after having the prostatectomy, I was back on airplanes flying across the country doing shows with my band,» he said. «It wasn't as bad as it possibly could have been.»
Reflecting on the experience, Singleton described it as a turning point. «By the grace of God, I'm here now,» he said. «It was quite an eye-opener. It made me question myself... a lot of 'why me?'» He added, «I'm still here after all those years, and there was definitely a purpose behind everything that happened.»
That purpose, he believes, is advocacy. «I came to the conclusion that because of the platform that I have, being a musician, that maybe it was meant for me to be an advocate,» he said. «I'm having people reach out to me from all across the country who are finding out about my story... and I think it's very important.»
Singleton is direct about what he believes the stakes are. «This could have turned out so much worse had I not gotten tested early,» he said. «I hate to think what could have happened.» His goal, he said, is simple: «If I could help prevent somebody else from going through what I might have gone through, worse than what I went through, that's the main goal.»
His message arrives amid an ongoing debate over when men should begin prostate cancer screening. Current guidelines do not recommend routine testing for men in their early 30s without symptoms or known risk factors. Robert Smith, senior vice president of cancer screening at the American Cancer Society, said most organizations agree that clinicians should discuss screening with men — emphasizing benefits, limitations and potential harms — rather than issue a blanket recommendation.
The recommended starting age remains contested. Some guidelines suggest 45, while others recommend 50 or 55 for average-risk men. Guidance on when to stop screening also varies, generally ranging from ages 69 to 75 or when life expectancy is less than 10 years. Screening frequency recommendations differ as well, from annual testing to every two to four years.
For men at higher risk, including Black men and those with a family history of cancer, guidelines call for more frequent screening beginning at ages 40 to 45. Smith noted that prostate cancer screening has long required weighing benefits against risks such as overdiagnosis, overtreatment and side effects including urinary incontinence and erectile dysfunction. But he said evidence now shows screening is more effective at reducing prostate cancer deaths than previously believed, and new strategies can help mitigate harms.
Smith described Singleton's case as concerning precisely because he was in his early 30s, had no symptoms and no known risk factors. Prostate cancer is uncommon in men younger than 40, so current guidelines would not have recommended screening in his situation.
Screening is intended for men without symptoms. Those who develop changes in urination, blood in the urine or semen, or persistent back or hip pain should see a doctor promptly. Smith said there is no guaranteed way to prevent prostate cancer, since its biggest risk factors — age, race and family history — cannot be changed. Research suggests a healthy lifestyle may help lower risk, including a healthy diet, maintaining a healthy weight, regular exercise, avoiding tobacco and limiting alcohol. «These are behaviors that not only reduce the risk of cancer, but also cardiovascular disease and diabetes,» Smith said.
For Singleton, the lesson is personal and urgent. He continues to share his story, hoping it prompts other men to have conversations with their doctors. «I'm still here after all those years,» he said, «and there was definitely a purpose behind everything that happened.»