The PSA for prostate cancer: does it detect cancer and save lives?

Let’s talk about prostate cancer. American men have a 16% chance of being diagnosed with it, though they have only a 3% chance of dying from it. Most prostate cancers grow very slowly, which means that you’re more likely to die WITH it than FROM it, according to Dr. David G. Williams.

The New York Times and the Washington Post have both reported that the PSA test is far from a definitive test for prostate cancer—in fact, it’s pretty useless. As I speak to prostate cancer patients, I am always struck by their fear of, and careful documentation of, widely swinging PSA numbers. And that’s how prostate cancer is diagnosed. We spend $3 billion annually testing PSA levels in men.

The PSA test measures how much prostate antigen a man has in his blood, which simply indicates inflammation level. However, any number of other causes, such as benign swelling (almost all men over 50 develop “benign prostatic hyperplasia”), Ibuprofen and other drugs, or infections, can elevate the PSA even though it is unrelated to cancer. But very few doctors point this out to patients, nor do most seem to be aware of the controversy.

Dr. Thomas Stamey of Stanford University is one of the original PSA promoters. In 2004 he stated, “PSA no longer has a relationship to prostate cancer. The PSA test is not relevant any more. You  might as well biopsy a man because he has blue eyes.” (Feel free to google Stamey and his comments and read many experts quoting him and discussing the PSA controversy.)

Stamey told Medscape Today’s Laurie Barclay, M.D.:  “About 20 years ago…we reported…there was a reasonable relationship between the blood PSA and the size of the…cancer. In fact, that relationship was approximately 50%, so it wasn’t even perfect 20 years ago when we first started using PSA to diagnose prostate cancer…in the last five years it’s now only 2%, so that’s negligible. That allows me to say that PSA today in the United States no longer has any relationship to the cancer except for 2% of men.” He states that a new cancer marker is needed.

The PSA test has been so ineffective in detecting prostate cancer, its inventor, Richard Ablin, has been speaking out against his own discovery for many years. Ablin is quoted in a March 2010 edition of The New York Times saying, “The [PSA] test is hardly more effective than a coin toss. As I’ve been trying to make clear for many years now, PSA testing can’t detect prostate cancer….The test’s popularity has led to a hugely expensive public health disaster.”

Biopsy or removal of the prostate not only causes incontinence and impotence, but also causes a dormant cancer to quickly spread.  I wonder how many men have undergone surgery and radiation for no better reason than a PSA score, even though IF they even had a cancer cluster in their prostate, they may have had no symptoms for decades.

Dr. David G. Williams, whose newsletter “Alternatives” I subscribed to for many years, feels that the PSA test is a travesty akin to mammograms for women, since it results in many “false positives” and may contribute to causing cancer rather than diagnosing it.

I have been meaning to write about this subject for quite some time. I do so now because I made a Canadian friend at Hippocrates, a 64-y.o. horse rancher named Craig, who was there to deal with his prostate cancer. The good news includes that there’s no chemotherapy prescribed for prostate cancer, so he wasn’t recovering from that nightmare as many are. Plus Craig has given up his beer and animal-flesh diet, in favor of green juices, sprouts, and plants. He has lost over 30 lbs. and feels great.

But I told Craig that there’s a lot of underreported controversy about the PSA that he puts so much stock in. He had no idea. This post is dedicated to him and I’ll send him the link.

Since these experts have stated in the New York Times and Washington Post that research shows little or no correlation between PSA and prostate cancer, just last month both papers also reported that new research shows PSA screening has not saved lives.

In 2009, The New England Journal of Medicine published findings from two studies that screening didn’t reduce the death rate in the U.S. In Europe, it was slightly reduced, but 48 men would need to be treated to save one life. That means 47 men become incontinent, impotent, or both, to save one.

Foods, herbs, and practices to decrease inflammation in the prostate and avoid cancer in that area include these ideas:

Saw palmetto, turmeric, lycopene-rich foods (watermelon, tomatoes, etc.), walnuts and pumpkin seeds, hot peppers, and lots of water. Be physically active, walk, rebound daily to move muscles and organs in the pelvic area and increase circulation. “Bicycle” in the air on your back.

And for the record, I do think a low PSA is a good thing. Inflammation is at the root of all disease. One possible corollary, however, should not be accepted: that a high PSA indicates cancer.