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The man who discovered the PSA (Prostate-Specific Antigen) claims it’s inaccurate for cancer prevention and is being misused, and despite losing his own father to prostate cancer, refuses to have the test done himself.
Dr. Richard J. Ablin was among a group of 3 doctors who were the first to discover the PSA protein in 1970. They were looking for an immunological marker they could use to test for the recurrence of metastatic prostate cancer that had been treated with surgical removal of the prostate. What they found was the PSA, a protein present in both healthy and diseased prostate glands. Once the prostate had been removed, if this protein was present when tested, then they knew the cancer was recurring.
These pioneering scientists supported the use of the PSA test for the recurrence of metastatic prostate cancer, but opposed its use as a screening or detection tool for early prostate cancer, because it simply isn’t accurate for this. In both 1985 and 1993 meetings with the FDA, even doctors who supported the use of the PSA for prevention and screening of prostate cancer admitted it doesn’t detect cancer, and it has been shown in multiple studies to have a 78% false positive rate. Despite these facts, the FDA approved its use as a screening tool in 1994.
The approval of this test as a screening tool was a financial boom to urologists, who saw huge increases in their practice volume for evaluation of men with elevated PSA levels. The results, however, have been disappointing, as these original scientists predicted. Results are so erratic that, despite the cut-off level for normal being 4.0, a man with a PSA of 0.5 can have cancer, while a man with a PSA of 11.0 can be cancer-free.
The statistics show PSA is so unreliable, as an example, if you had an elevated PSA test in 2010 that lead to biopsy, cancer diagnosis and subsequent cancer treatment, there is a 1 in 50 chance that by 2020 or later, you will have been saved of dying from prostate cancer. But the dark side is you have a 49 in 50 chance that you were treated unnecessarily. As another example, if you PSA test 1000 men as a prostate cancer screening, and take another 1000 men and do nothing, 8 men out of each group will die of prostate cancer – the risk of dying from prostate cancer is the same, whether they chose PSA screening or not.
A man’s quality of life is dramatically affected by unnecessary prostate cancer treatments. Prostate cancer treatment leaves over 60 percent of men with long-term impotence and unable to have sexual intercourse, and over 40 percent of men with long-term urinary incontinence and having to wear a diaper at all times. All men are sterile and infertile after prostate cancer treatment, and if they choose to bank sperm, only 50% of those sperm will live, making fatherhood difficult, if not impossible.
Despite extensive PSA screening, prostate cancer is still the second leading cause of cancer death in men, with number one being lung cancer. Finally, after 20 years of its overuse, in 2013, The American Urological Association (AUA) came forward with the statement that the PSA should no longer be used routinely. The US Preventative Task Force (USPTF) also came forward with the same recommendation, yet these recommendations are largely being ignored. The motivations behind the continued use of the PSA are no doubt fear and greed.
In addition to being a killer, prostate cancer is the second most common cancer found in men, with number one being melanoma. To date, there is no screening test available that differentiates the aggressive form of prostate cancer from the more common, slow-growing, age-related form. Because of this, doctors feel justified in exposing their patients to the unnecessary risks associated with false positives and subsequent cancer treatment. PSA testing is also a moneymaker. Looking at statistics only from Medicare and the VA, over 3 billion dollars are spent yearly on PSA testing asymptomatic men. Compare this to the $300 million allotted to the National Cancer Institute for urological research, it seems financially we have our priorities backwards.
First things first – if your doctor insists on preventative prostate testing, ask for the Prostate Health Index (PHI), instead of the PSA. The PHI is a more sensitive version of the PSA, with 2 additional proteins included that seem to be cancer-specific. A 2015 study showed nearly 40 percent of the negative biopsies that had been done could have been avoided if the PHI had been done first.
Second, if your PSA or PHI is elevated, consider transrectal ultrasound imaging before a biopsy or other surgical intervention. This ultrasound does not carry the risk for infection that biopsy does, and creates an image of the gland that shows even small tumors or irregularities.
Last but not least, as they say, an ounce of prevention is worth a pound of cure. Be proactive and protect the health of your prostate.
Here are 5 ways you can protect your prostate health: