Michael Richard's Secret Prostate Cancer Diagnosis Explained

Although the world may know him as Cosmo Kramer, Jerry Seinfeld's quirky neighbor on "Seinfeld," his name is actually Michael Richards. He's also, as we now know, a cancer survivor. 

In May, Richards sat down with People to promote his upcoming memoir, "Entrances and Exits," where he revealed how close he came to death. "I thought, 'Well, this is my time. I'm ready to go,'" he told People of his stage 1 prostate cancer diagnosis in 2018. "But then my son came to mind just a few seconds later and I heard myself saying, 'I've got a 9-year-old and I'd like to be around for him. Is there any way I can get a little more life going?'" As he told the magazine, there was no time for radiotherapy or similar treatments. Instead, the whole prostate needed to be removed, or he would have been gone in a matter of months. Richards' cancer, like most prostate cancers, was discovered when his doctor found high prostate-specific antigen (PSA) levels in his blood. The following biopsy showed that, although it was stage 1, ""It had to be contained quickly," Richards told People. "I had to go for the full surgery." 

According to the American Cancer Society, prostate cancer is the second most common cancer in men (skin cancer being first) and it's the second-leading cause of cancer-related deaths among men. Because of this, if you have a prostate, it's important to start getting regular prostate exams at age 55, per John Hopkins Medicine. It's also paramount that you educate yourself about prostate cancer in general.

For the most part, prostate cancer rarely has symptoms, and if there are signs, they tend to be sneaky. While blood in the urine should absolutely have you running to the doctor to be examined, the other signs like fatigue, bone pain, and high blood pressure don't exactly scream cancer. That's why, as John Hopkins Medicine suggests, people with prostates should start getting those prostates examined at the age of 55. If prostate cancer runs in your family, especially your immediate family, then you want to start getting prostate exams at 40.

Contrary to what we see in the media, a prostate exam and diagnosis doesn't involve a finger in the butt. According to a 2024 study in the British Journal of General Practice, "digital rectal examination is not a useful screening test for prostate cancer." Instead, prostate cancer is diagnosed via a blood test. If the blood shows an unusually high level of prostate-specific antigen (PSA), then the doctor will request a biopsy. During the biopsy, a small amount of prostate tissue is extracted so it can be analyzed for the presence of cancer cells, per the Mayo Clinic. Depending on what's found, you'll either have to go straight to surgery, as Michael Richards did, or begin treatment options. Luckily, in most cases, prostate cancer grows slowly, according to the American Cancer Society.

Although Michael Richards needed his entire prostate removed, which is usually the case when surgery is involved since the prostate is only the size of a walnut, some diagnoses don't need any treatment at all. According to a 2022 study in Informed Health, low-risk prostate cancer, meaning the cancer is localized and is growing either very slowly (low-risk progression) or not at all, doesn't warrant any treatment. If the prostate cancer is intermediate-risk, meaning the cancer is confined to the prostate, treatments may range from "active surveillance to partial gland ablation, radical prostatectomy, and various radiotherapy methods," per a 2020 study in European Urology Oncology. High-risk or very high-risk prostate cancer, in which the tumor has spread past the parameters of the prostate, is treated with a combination of radiotherapy (RT) and androgen deprivation therapy (ADT) or, if necessary, surgery (via a 2021 study in Cancers).

What's important to realize when it comes to prostate cancer is that stages and risks don't always coincide, as was the case with Richards. He was diagnosed with stage 1, but needed surgery immediately. Only a medical professional can decide the best option for you. And they can only do that if you stay on top of your prostate exams.