Tag Archives: PSA test

A not-so-fond farewell to the PSA test

It’s one of the smartest moves ever made by a government panel — so naturally, they’re catching hell for it.

The U.S. Preventive Services Task Force has urged docs and patients to put the kibosh on the PSA test — because after some 2 million prostate surgeries and procedures based on that screening, the disease’s death rate has remained unchanged.

In other words, it’s crystal clear that those PSA tests haven’t saved lives. They’ve only increased the number of life-altering surgeries and other treatments that have left men battling side effects like incontinence, infection and sexual dysfunction.

And in the cruelest irony of all, some men have even died as a direct result of those prostate screenings and surgeries.

But I’m sure you’ve heard the noise by now: Instead of welcoming the Task Force’s long-overdue move toward common sense, there have been howls of protest.

Look closely, however, and you’ll see none of them are coming from objective scientists.

They’re coming from people with a stake in continued PSA testing.

The loudest cries are from the urologists and oncologists who’ve earned big money on prostate procedures over the years. In fact, as of this writing, the only major medical groups to come out against the new recommendations are urologists.

Even the American Cancer Society has remained silent — with some of its top officers admitting that PSA tests have led to the mass overtreatment of harmless prostate cancers.

“We didn’t start using this test because we had clinical trials that showed it worked — we started using it because it was around and we were told it saves lives,” Dr. Leonard Lichtenfeld, the organization’s deputy chief medical officer told PBS News. “There’s nothing to indicate that was true.”

But many of the men who’ve had a cancer detected by a PSA test — and treatments on those cancers — are convinced it saved their lives. They make up the other group protesting this, even though they have no way of knowing whether the treatment actually prevented their own death.

In fact, the numbers show the opposite: They almost certainly would have lived a long and healthy life never even knowing they had prostate cancer — and eventually, they would have died of something else.

It’s tough to believe that, especially if you’ve gone through the trauma of a prostate surgery and battled the side effects afterwards… but those numbers don’t lie.

And now, even the government is ready to admit it. The real question today is: Will your own doctor play along?

I’m not done with prostate cancer yet — keep reading for more on the vitamin that WON’T raise your risk.

Posted in House Calls, Topic 1.

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PSA tests don’t save lives

Another new study exposes the failed promise of the PSA test. Researchers have found that while these screenings may detect some cancers, they won’t actually make a difference when it comes to survival.

And that’s a failure by any definition.

Researchers analyzed data from six studies involving more than 387,000 patients who had been randomly assigned to either PSA tests or no screenings at all.

They found that while the PSA tests detected about 20 cancer cases for every 1,000 men screened, they didn’t make even the tiniest bit of difference when it came to predicting who would live and who would not, according to the study in BMJ.

“Therefore, the 20 patients (in 1,000) would be considered ‘overdiagnosed,’” lead researchers Dr. Philipp Dahm told the Reuters news agency.

I couldn’t have said it better myself.

That’s because these screenings often detect cancers that never would have harmed the patient, much less killed him. Some studies have even found that men with untreated low- grade tumors can live at least 20 years with them, and ultimately die of something else altogether.

But while these tests won’t increase your odds of survival… they will increase your odds of treatment, because men who flunk their PSAs are still routinely lined up for surgery and radiation–despite the fact that there’s no evidence these will increase survival rates, either.

And those treatments can do far more damage than that quiet little tumor ever would have, putting you at risk for permanent incontinence and erectile dysfunction.

But while even the mainstream comes around and starts to recognize the complete failure of the PSA test, some are still working to salvage it: Another new study finds that a single PSA test at the age of 60 might be able to predict your cancer risk.

Researchers tested for PSA levels in blood samples donated by 1,200 60-year-old Swedish men in 1982, then matched the results against the long-term medical records.

They found that those with the highest levels at 60 years old had the highest risk of death from prostate cancer by the age of 85… and those with the lowest levels had virtually no death risk.

But don’t sign up for that one-time test just yet, because even the men in this study with the highest levels of PSA still had a low death risk–less than 17 percent ultimately died of the disease, according to the study in BMJ.

And there’s still no evidence that treating even those men would have increased the survival rate.

So stop chanting the “early detection” mantra–stop worrying about cancers that won’t hurt you–and start enjoying life instead.

Posted in House Calls.

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November 2008

I’ve become more than a little embarrassed by my profession as patient after patient has shown up at my office with terrible and persistent pain that was ignored by other physicians.

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Posted in Newsletter.

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