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.

24 thoughts on “The PSA for prostate cancer: does it detect cancer and save lives?

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  1. A year and a half ago my stepdad had a PSA test done which indicated he was in danger of possibly having prostate cancer so his doctor recommended a biopsy. The biopsy showed up negative (great thing). However, it also opened my stepdad up to infection and he ended up in the hospital for a week with a superbug, getting pumped full of the strongest antibiotics. He found out after the fact how ineffective the PSA test even is and was extremely upset that he went through all of that. He wishes he had been more informed and says if a doctor ever tells him to get another test or biopsy he’ll decline and take his chances.

  2. A great article that served as a good refresher course and memory jogger for me. Do you have any demographics on the percentage of male fans of your site? Also, happy belated 45th birthday wishes. I spent my 45th in another century…

  3. Way to Goooo Robyn..

    About time all of this information is getting out to the public…Good Job…as we keep encouraging folks to become Self-Empowered with & in their Self…After all one lives in & with the body, mind, & spirit 24 hrs. a day…7 days a week….If they are here on Mother Earth..

    keep up the good work..& thank you

  4. I would be very careful when posting information saying that a PSA test does not detect prostate cancer. Technically, you’re correct. A PSA test does not detect prostate cancer, however, if the PSA number increasing over time it indicates that something could be wrong and there could be cancer. Thankfully, my Dad had an annual PSA screening which included his baseline numbers. A few years, maybe 10 years down the road his numbers were increasing and yes, he did have prostate cancer and it was caught very early. He received his treatment over 5 years ago and is very healthy, active and happy. We all have a choice to be proactive in all of our medical decisions. I know first hand that having a PSA test saved my Dad’s life. Please make sure you’re well informed when making medical decisions that could impact your life.

  5. Thanks for the information on the PSA test. My dad had prostate cancer so it is always there, lurking in the back of my mind. I try to eat healthy, exercise and am now a green smoothie fan. Thanks for all you do.

  6. Robyn, Thank you for this article. I will have my husband read it. I have been telling him for years not to let his doctor do a biopsy of his prostate. She keeps telling him his psa flucuates too much. She has even discussed having surgery with him. So far I’ve been able to get him to listen to me. Hopefully when he reads this, he’ll be more convinced.

  7. Robyn, I have enjoyed your website and musings for perhaps a year now. Just as a reference point, I am a 55 year old male who is in good physical condition and primarily a pescitarian (love salmon), but have no issues with a totally vegan lifestyle. Having walked the path you’re discussing, I would suggest that it’s highly misleading to state an opinion that is all one way or the other. You would be wise to look further in your research to doctors who are forward-thinking and look at the whole picture (I.e. Dr Charles Meyers @ American Institute for Diseases of the Prostate) rather than just one side or the other. Yes, there are many cases of misdiagnosis, but there are also many, like myself, that will testify that a simple PSA was the only indication that I had an aggressive and advanced cancer and I’m thankful that my PMD was paying attention. I’m also glad that I did NOT follow the path suggested by the first urologist I went to who also happened to be a surgeon. I could go on and on, but I will refrain. I would, however, highly suggest that you check out the doctor I mentioned above (especially his video blog here: particularly the seventh video from the top entitled “Prostate Cancer Screening”), and a book called Invasion of the Prostate Snatchers. Also, the AdMeTech Foundation (ttp:// which recently published a statement regarding this very subject, which seems to be becoming highly politicized: “However imperfect, the PSA test is the best tool men have today for early detection of prostate cancer which is critical for saving lives. Since its introduction in 1986, PSA screening has made a profound impact on prostate cancer care: According to the National Cancer Institute’s SEER database, over 90% of men are diagnosed with early disease and consequently, have 100% survival rate within 5 years of diagnosis (2). The overall 5 year sur- vival rate is 99.4% today compared to 75.8% in 1985 (2,3). However, when men are diagnosed with advanced, metastatic prostate cancer, 5 year survival rate remains as low as 28.7% (2). Even though curable when detected early, prostate cancer remains the second most lethal malignancy in men. African American men are 250% more likely to die.”

    Thank you for allowing me to respond. I would be glad to share more details of my personal experience with you and the knowledge I’ve gained.
    Best, Neil

    1. Mary, Neil, Cynthia, thanks for the lively dialogue. To be sure, PSA is certainly marking SOMETHING. ONE thing it might be indicating is prostate cancer. Not usually, though. Note that I did not say, never get a PSA screening, or ignore a high PSA—and note that I suggested we need more effective markers for diagnostic purposes. And, always, always expect vociferous voices to rebut, when $3 billion annually is at stake. Later this week I’ll post on a furor in the refined food industry, and count on a loud and well-worded counter-offensive from the sugar and refined-foods industries. A VERY high PSA certainly indicates that something is going on that could be cancer, and note that I studiously do NOT say that it should be ignored.

      That said, I leverage the direct quotes of experts operating in the data for the past 20 years, including those who originally championed PSA as a marker. It is them with whom you might want to take issue. My job is to call attention to the sacred cows. Mammography is a sacred cow and I’ve been taking some arrows for challenging it as a good annual practice for every woman 40 and older. I’m challenging the PSA obsession too because I think it’s an important issue that patients need to scratch below the surface before agreeing to being cut or radiated or both.

      Is it not compelling that 48 men have to have their prostate removed and impair or destroy their sex life and put them in the bathroom every 20-30 minutes for the rest of their lives, due to a faulty-at-best marker?

  8. One other cause of flutuations in PSA levels is sexual intercourse….your levels rise(!) after sex. Some doctors forget to tell their patients to abstain at least 2 days prior to the test.

    1. PSA rises after sex….if that’s true, then a rising score (bad thing) is linked to a GOOD thing for the prostate (sexual intercourse). Interesting.

  9. Well it saved my husbands life when at 48 he had 3 done in a short time (because it was elevated) to make sure they weren’t false positives and was referred to a great urologist who tested him again and suggested a biopsy which did reveal cancer in 4 out of 12 spots. His father and uncle both had prostate cancer and all three had different treatments. My husband had surgery and the nerves were spared because it had had been caught relatively early. I am not saying that certain dietary modifications would have not delayed or prevented this, but I am glad he had the test, since as it was, his life was spared with no adverse long term effects (aside from the first few months). I have heard controversy regarding PSA screenings, but I really don’t appreciate this posting, especially with people commenting that they were discouraging their husbands from having biopsies after elevated PSAs. My husband had no symptoms prior to, being that he was so young and some of the other ratings, it showed it was moderately aggressive and when prostate cancer has metastasized it is not easy to treat. I have been following your blog for years, but this is just not intelligent

    1. Tammy, tomorrow I will post more experts, more credible sources, and more research about how problematic the mass radiation and surgeries are, based on PSA. Not saying your experience, which I value and do not judge, isn’t accurate….just saying this is a very important issue for people to consider more thoughtfully.

  10. Yes, everyone does need to do their research, but if they don’t know they have an elevated PSA, and they are awaiting symptoms, they may ignore a deadly disease, as many people do die from this.

  11. I have to disagree. A PSA test can be a very useful and helpful tool in early detection, and early detection saves lives. No doubt, there is risk in any medical procedure, but the question is not whether ANYONE is harmed, the question is whether the benfits outweigh the costs. To say that no one is being saved, is simply not true, and is really quite irresponsible.

  12. I strongly encourage you to reconsider the title of this post, which is simply and dangerously incorrect. Even the Task Force did not make the assertion that the PSA “detects nothing”. It detected my asymptomatic aggressive prostate cancer. By the time a man experiences symptoms from prostate cancer it has very likely spread. Experts disagree with the Task Force recommendations (others have posted links here) but your post goes beyond even those tragically misguided recommendations. PLEASE at least change the title.

  13. did anybody read that the man who created this says it does not work !

    my oldest uncle went in for a check up and was told his levels were high, surgery followed with the Dr. saying it was a success and they got everything , well 9 months later the cancer which most likely would have stayed dormant spread through his body and he was dead in less than a year of living in a diaper from the damaged this operation caused ! and at the time i had read a article by Dr. Micheal Colgan who used to write articles in various muscle magazines that i used to read and he stated that prostate cancer is one of the most slow growing cancers there is and most men will die with it than from it and the main reasons Drs. push for these operations is that they were getting paid on average 180,000 dollars per surgery

    and this was 20years ago when i read this and later watched my that was in good health waste away to 100LBS and we found him dead in his apartment . i also worked with a man in his early 50’s that had the surgery done and he was trying to get me to go get tested and i pointed out to him that before the surgery he was a healthy looking man but now looked 10 to 15 years older in bad health and i would pass on it ! and as far as black men go i am a black male and my personal feelings is that something is wrong when one group of men are the norm for getting a certain disease ! and i a right to have a conspiracy theory about it seeing that my own government injected syphilis into black men without them knowing to test its effects !

    1. Richard, yes, what the government was doing to African Americans in the 1950’s is unconscionable. I read a book about the African American woman from whom they took cancer cells without her consent, to grow and sell them for research. Now there are truckloads of her cells all over the world being used in hundreds of ways, and her family lives in financial deprivation and never been compensated for what was done to her at Johns Hopkins.

  14. Thanks for the article. I went in for a routine physical a couple of years ago (I’m a scout leader and needed one for summer camp). My doctor suggested that I should have a PSA test. I said fine. My PSA count was moderately high for my age and I was referred to a specialist. The specialist confirmed the readings and suggested a biopsy. I procrastinated the biopsy for a year and then finally went in for the procedure. It was not only uncomfortable, but painful. My doctor said that the biopsy was negative and told me that in his opinion, I will never have prostate cancer. In fact, he has never had a patient with a negative biopsy ever get prostate cancer. This should be the end of a moderate to good story, but now I am considered uninsurable unless I’m included on a big companies heath plan. Just because I had a moderately high PSA test! I wouldn’t advise anyone to get a PSA test. I’ve heard too many other horror stories.

  15. This response is for Richard regarding the “$180,000 ” the doctor’s are being paid for prostate cancer surgery I have to question this strongly since my husband had a very reputable urologist who did his residency at the Mayo Clinic and our insurance company paid him between $3000 and $4000 for a successful nerve sparing surgery done 7 years ago. Not likely.

  16. So how do you detect prostate cancer? Medicine is a reactive and not a proactive profession with so called experts having an agenda that is slanted to their particular option. That is why it is called Piled High Deeper! If you have an elevated PSA – better check it out and get more than one option and see what treatments are available. That is what I’m doing.

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