Can you stand ONE more comment about PSA and prostate cancer?

One last comment about PSA. We have people at both ends of the spectrum writing us. Some are furious that their loved one died of the treatment. Others are indignant that we don’t see what a wonderful gift the PSA test is for saving lives. I think this brief experience Dave R. wrote us is worth bringing front and center:

“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.”

Thank you for sharing that, Dave, and I’m sorry it happened to you. I know several people who have been tormented for years by Dept. of Family Services for not administering the drugs that pediatricians demanded their child take. When you go in for an ear infection, that simply isn’t an outcome you expect! I worried about that, myself, since I had a child with chronic ear infections but never gave her an antibiotic (I did get tubes in her ears, however), and I needed the pediatrician to work with me, and know that AB’s were not my remedy of choice. To that end, I had to change pediatricians.

I’m sure Dave never counted on getting a PSA resulting in his becoming “uninsurable” and being forced to work for only big companies.

More about PSA / prostate cancer / breast cancer debates

Any time we take on a sacred cow—like testing PSA for prostate cancer—we hear about it. We are certainly getting emails and backlash now. I anticipated that. Thank you to everyone responding. Let me reiterate that I honor anyone’s right to decide about the PSA or mammogram issue for themselves. I feel strongly that we should be educated about risks and benefits before we undergo harmful treatment or diagnostic procedures. To that end, I call attention to not just one or two, but quite a few experts and groups evaluating data and calling for a change in the way we deal with prostate and breast cancer.

Of course some people feel that a PSA test detected advanced cancer and thus saved their life—including Rudy Giuliani. But the U.S. Preventive Services Task Force says men should not get the PSA test because of so many who are consequently maimed and radiated unnecessarily. Read about it in the New York Times HERE.

And read a great interview on NPR here challenging the sacred-cow idea that “early detection is better.”

My opinion is that we need a new cancer marker for the prostate. And if we continue to monitor PSA, we need doctors to stop nearly automatically subjecting men to biopsies, surgery, and radiation for elevated (but lower) PSA numbers. We need more docs willing to work with patients on highly effective lifestyle changes as alternatives or at least complements to the surgical and radiation protocols.

The same task force reviewed the literature and recommended AGAINST women in their 40’s receiving annual mammograms, for similar reasons, one being that mammography finds cancer tumors that would never grow and become a problem in the woman’s lifetime. (I have mentioned here that a tennis opponent of mine had a mastectomy this past summer and was still home-bound 2 months later, having detected a STAGE ZERO tumor in a routine mammogram.) We also must consider that the radiation exposure cumulatively (and ironically) increases their risk of breast cancer, more in younger women than older women. Those with genetic markers for breast cancer are excluded from this advice. Read about it HERE.

I have been asked what I do. I state that here not to influence anyone else, who must be responsible for their own choices, of course, but simply to answer the question. This is not intended as medical advice.

I confess I have never had a mammogram and do not plan to, in the future. (My mother has never had one.) I choose a present and future without radiation. I feel confident in this decision mostly because my lifestyle is very disease preventive. I did have a thermographic scan a few months ago and will do that periodically. I have always worn a bra 16-18 hours a day and am changing that to about 8-16 hours  now.

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.