Alternative Cancer Therapies | Natural Health Blog

Date: 05/11/2010    Written by: Jon Barron

PSA Testing – Too Much of A Bad Thing

PSA Testing for Prostate Cancer

When the inventor of the primary screening test for prostate cancer calls it a "hugely expensive public health disaster," you'd think doctors might take the hint. If only! Instead, the medical profession acts like an enabling spouse, and the pharmaceutical industry plays the role of the neighborhood bar. There may be too much dignity to be lost for the medical profession and too much profit to be given up by big Pharma to allow them to make the changes that the reality of prostate cancer screening requires. 

In a recent Op Ed column for the New York Times, Dr. Richard Ablin, the discoverer of PSA (prostate-specific antigen, an enzyme made by the prostate), says the annual bill for PSA screening in the U.S. is $3 billion, even though the test "is hardly more effective than a coin toss." According to Ablin, the test does not detect the presence of prostate cancer. It merely shows how much prostate antigen a man has in his blood. "Infections, over-the-counter drugs like ibuprofen, and benign swelling of the prostate can all elevate a man's P.S.A. levels, but none of these factors signals cancer. Men with low readings might still harbor dangerous cancers, while those with high readings might be completely healthy," he says.

In fact, Dr. Ablin points out the test got approved by the FDA after a study came out showing that it could detect a mere 3.8 percent of prostate cancers, "which was a better rate than the standard method, a digital rectal exam." One might think a psychic reader having a good day could do a lot better than 3.8 percent!

But the problem extends beyond the questionable accuracy of the test. There's also the fact that even when it does detect prostate cancers, in many cases, that finding makes not one whit of difference. In 2008, the United States Preventive Services Task Force (USPSTF) recommended that screening for men over 75 years old be discontinued. The task force found that most prostate tumors are slow growing, and that's particularly true for older men. Men of that age will almost certainly die of other causes before their prostate tumor kills them or even before they experience symptoms, even without treatment. In fact, studies show that up to 44 percent of all identified cases of prostate cancer have been found at a point where the disease won't affect life expectancy. And yet one out of every three men older than 75 gets screened for prostate cancer, and if diagnosed, those men typically get shuttled through a series of treatments that can be debilitating and painful and completely unnecessary.

But even for younger men, the value of the test is questionable. According to a study published in the New England Journal of Medicine in August of 2009 by the Department of Veterans Affairs, "[u]sing the most optimistic assumption about the benefit of screening -- that the entire decline in prostate cancer mortality observed during [the study] period (1986-2005) is attributable to this additional diagnosis -- we estimated that, for each man who experienced the presumed benefit, more than 20 had to be diagnosed with prostate cancer." In other words, 20 men received treatments like radiation and surgery, but only one of them lived longer because of it. The study concludes that this has led to the diagnosis of prostate cancer in over one million additional men, and "most of this excess incidence must represent over diagnosis." A similar European study of 182,000 men found that while screening did lead to a slight decline in death rates, 48 men had to be treated to prevent one death. And the author of yet another similar study, Dr. Gilbert Welch of Dartmouth University, said, "For every man who avoids a prostate cancer death due to PSA screening, about 50 men have to be treated unnecessarily -- and a third of these men will have serious problems with treatment." These problems include impotence, incontinence, breast enlargement, and rectal bleeding.

The American Cancer Society has started backing off its insistence that every man needs the test even if he's older than Albus Dumbledore. In its revised guidelines, it cites a study of 76,600 men that found that annual PSA and rectal exam screenings made no difference in cancer deaths at 10-year follow-ups. But still, the new recommendations remain wishy-washy. They basically suggest that men over 50 in good health should talk to their doctors about whether the testing makes sense -- and guess what they're going to recommend? Meanwhile, the American Urological Association still suggests regular screenings.

According to Dr. Ablin, the test still gets performed on over 30 million men annually, and the fact that pharmaceutical companies keep pushing the tests helps keep the screening momentum up. While he concedes that in some cases, testing makes sense -- where there's a family history of the disease, for instance, he also concludes, "I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster. The medical community must confront reality and stop the inappropriate use of PSA screening. Doing so would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments."

Of course it's interesting that the medical community assumes that diagnosis absolutely indicates the usual treatments will follow, but that's a subject for another time. Given the inaccuracy of the tests and the likelihood that those with a positive diagnosis will fall prey to the typical radiation/surgery routines, it seems obvious that prevention and clean living make a lot more sense.

And finally, if your doctor insists on a PSA test, and if you always do what your doctor tells you, then at least press him/her for the updated PSA test, the Prostate Health Index. The Index test measures blood levels of three different types of PSA. Combined with annual biopsies, or tissue samples, it was about 70% accurate in singling out the aggressive tumors in a small study. Oh, I almost forgot to mention, although it's now used in Europe, it's still waiting for FDA approval in the U.S.

:hc

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Comments

  •  
    Submitted by joe on
    May 31, 2010 - 1:51pm

    so, what are you recommending for someone in their 60's?...no screening, just wait for cancer symptoms or get lucky?

  •  
    Submitted by jonbarron on
    June 1, 2010 - 4:29am

    Joe:

    Your question assumes that PSA testing actually is somewhat accurate and not harmful. Pretty clearly, the studies show it's neither. Therefore screening provides minimal benefit and significant potential harm. Essentially, then, it's primary benefit is that it helps men feel like they've done something proactive. Keep in mind that the odds are 50:1 against your receiving benefit from the test versus unnecessary treatment. If you're in the group of one whose life was save, you would say, ""That's the best thing I ever did."" If, on the other hand, you're in the group of 50 that received unnecessary treatment (and particularly the group of 16 that was significantly harmed by that treatment), you'd probably say, ""Not so much!"" In the end, getting tested, at least up until age 75, is ultimately a personal choice.

    Jon

  •  
    Submitted by Kevin on
    June 3, 2010 - 1:22pm

    Some problem occured and my mail disappeared, so I will start again.
    As a naturopath who has worked with many cases of prostate problems, including prostate cancer, and as I have done a lot of research into the PSA hypothesis, I would like to add some information that may be of interest.
    1) The Prostate Specific Antigen is an antigen that is specific to anything except the prostate. That is to say, the PSA is not and cannot be manufactured in or by the prostate gland. This is a provable fact demonstrated by:-
    a) Women produce PSA in breast milk, and as women do not have a prostate gland it would be impossible to attribute the PSA to a prostate.
    b) Men who have had surgery and the whole prostate has been removed still produce PSA many years (possibly for the rest of their lives) after the surgery took place.
    These two facts prove the PSA and prostate are not connected.
    What is connected is the PSA and infection / immunity levels in body. Every male with a high PSA has a viral or fungal infection.
    Breast milk serves two purposes. 1) to provide nutrients, and 2) to provide immunity.
    So these are two sources linking PSA and infection/immunity.
    The million dollar question is, ¨Why don´t women with viral / fungal infections show PSA in the blood?¨
    Hence the reason for my ongoing research. I have theories but they are not for this post.
    So where is the PSA produced?
    All my research to date shows that the PSA is produced in either the adrenal glands or the liver. These organs appear in both males and females and so would explain why PSA appears in males without a prostate and in female breast milk.
    If males want a high PSA number to appear on a blood test then ejaculate before the test (up to 2 days before) and the PSA number will be high.
    If males want a low PSA number to appear on a blood test then take the herb Saw Palmetto.
    If males want the PSA number to be zero, or close to it, then work on the immune systemn and elimate all infection. A blood test will show neutrophils and lymphocytes (2 different white blood cells). When their numbers are 70% and 20% then the PSA is zero or close to it. When those numbers are say 60% and 30% then the PSA numbers will be high because these numbers represent viral / fungal infections.
    I hope this helps somebody.

    Kevin
    Morocco

  •  
    Submitted by Peter Brooks on
    June 1, 2010 - 5:03am

    HI ,,I live in England,,,7 years ago because of a slight rise in my psa levels and family history of prostate cancer I was advised to have a biopsy performed,, which came back negative.
    I was then to be put on the ""watch and wait "" register,
    2 years later I was again advised to have a further biopsy performed, this one was to take 13 samples at the same time..The day after the biopsy i went into toxic shock,,(scepticaemia)..after 3 emergency admissions into hospital over a week , the scepticaemia was killed off,,,along with the good stuff in my body,,I was put onto Gentimycin intravaeniously which the consultant called ""Bleaching"".It certainly did,,It eraicated everything in my body..
    This caused me so many problems after,,a very depleted immune system,,which lead to various emotional and physical problems even to this day..The results from this biopsy also came back ""negative""..Ironic isnt it,,it was actually the consequences of the biopsy which very nearly took my life,,,
    While I was in hospital wth the drip of ""Bleaching"" in my arm,, I well remember another consultant while doing his rounds telling me "" the best thing I could do
    would be to have it out now""( meaning my prostate),,He himself was about to have a prostectomy done that very week,,
    Five years later I am still having regular psa tests done ,,but nothing on earth would ever persuade me to have another biopsy done,, I have since looked into the tests done and the way its undertaken ,,and often think what could have been,,had i taken the advice of a consultant surgeon that day,,
    I am slowly getting back to some sort of health,,although it has had a very profound effect on my life ,,it has taken a lot of work ( and acidophilus) to get my immune system back to anything like reasonable,,
    I would urge anyone in this position to really seek a second ,,or even third opinion before going ahead with any radical surgery,,please look at all the options,,I wish all reading this a long and happy life,, Peter

  •  
    Submitted by Guest on
    February 28, 2011 - 10:42pm

    PSA or the prostate specific antigen is presently world-renowned and turned out to be the foundation of the chief screening means employed for prostate cancer that annually causes tens of thousand fatalities in the whole world. Psa Tests for healthy males has lead to several of them, especially in the United States where unsanctioned nationwide screening program exists, being left unnecessarily distraught, aggravated, infertile and incontinent. But, regrettably in spite of several more prostate cancers being identified there is no such therapy meriting this detection.

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