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  Nostalgia ain't what it used to be

Tuesday, 25 September, 2018
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Time for Round Two

Date: 15 October, 2011

By: Chief

Imager, ah crap, here we go again.

Well, just what in the world am I writing about? Prostate cancer screening tests of course. These:

tests — known as the PSA (Prostate Specific Antigen) test and the Digital Rectal Exam. But[t] the biggie right now is the PSA test. Does it do any good or is it just a way to flush more of your hard earned money down the medical expenses pipeline?

According to the U.S. Preventive Services Task Force the PSA test is an utter waste of your time and, naturally, your money. Quoting SF Gate:

"The draft recommendations, which were posted Friday by the U.S. Preventive Services Task Force, were based on studies that suggest routine PSA screenings do not save lives but tend to lead to unnecessary tests, treatments and complications such as impotence and incontinence.

[. . .]

"In a statement accompanying Friday's draft recommendation, the task force said studies indicate PSA screening leads to 'substantial overdiagnosis' of the disease. The group gave the screening test a 'D' rating, meaning it found 'moderate or high certainty that the service has no benefit or that the harms outweigh the benefits' and discouraged its use."

And that my friends is an absolute fact.

About the PSA test

Back in February, 2010 I wrote a two part story about useless medical tests and examinations. I included the PSA test for a very good reason. It is worthless. That was in part two of the story.

Why is the PSA test worthless? Simple — it is inaccurate for one thing. For another — there is no safe number pertaining to a man not having prostate cancer. Quoting the British Medical Journal:

"At present the one certainty about PSA testing is that it causes harm."

Well no joke there Sherlock. Imagine that.

Indeed our very own American Cancer Society has stated the benefits of the PSA test are, at best, dubious. Dr. Otis Brawley, Chief Medical Officer for the American Cancer Society, wrote an enormous editorial specifically about prostate cancer detection and testing (you can read the entire thing here). Quoting the American Cancer Society Prostate Cancer Q and A page:

"Prostate cancer is a major killer. We are truly handicapped by the fact that screening and many of the commonly used treatments have not been proven to save lives. All the major professional organizations in the US, Canada, and Europe recognize that screening has not been shown to save lives (emphasis added).

"It is difficult to comprehend, but there are prostate cancers that are confined to the prostate and never destined to metastasize (spread to other parts of the body). Screening diagnoses a large number of men who would never be bothered by the disease. In one clinical trial, more than 12% of average risk men were diagnosed through screening over 7 years. This group of men is estimated to have a lifetime risk of death of less than 4%. This study suggests that 2 out every 3 men in this study did not need to be diagnosed nor treated. While this study suggests that the proportion of men in the overall population who are diagnosed with cancers that do not need therapy is as high as 67% of men with localized disease, others estimate it to be as low as 30%. We have very poor ways of predicting who needs treatment because their prostate cancer might kill them, and who does not need therapy because their tumor is of no threat to them."

As far as I am concerned that pretty much tells me the PSA test is dead ... but not yet buried. And because it is not buried, it is really beginning to stink.

Urologists

Naturally there must be at least one group that is crying foul. Why lo and behold it is the American Urological Society (along with most professional urologists). Quoting SF Gate:

"The American Urological Society immediately criticized the proposed change, arguing that discouraging PSAs will do more harm than good. The American Cancer Society, which urges men to decide for themselves, did not release a statement, and the Prostate Cancer Foundation in Santa Monica said it would respond to the recommendation Monday."

I can fully understand the urologists concern. The PSA test is a cash cow for them. If more and more men decide against getting a PSA test that leads to less and less income from the:

All of that and possibly more just to try and determine — if — you do have some sort of prostate cancer.

I have had exactly two PSA tests. The first one about two years ago. The results were my "number" was "a little high." That led to a Digital rectal exam. Never again. At the end of the examination, my healer (he's much better than a mere doctor) pronounced my prostate "normal." The second and last PSA test was a few months ago. The results were quite different from the first. The "number" had gone down some. As I wrote earlier — there is no safe (free from cancer) number. Period. So how do you like them apples? A useless test without a doubt.

No more PSA or Digital Rectal Exams for me. And you know what? I'm happier that way.

Epilogue

We the People need to know the facts about a medical test before we allow the doc to perform it. Quoting CNN:

"The task force concluded: 'The vast majority of men who are treated do not have prostate cancer death prevented or lives extended from that treatment, but are subjected to significant harms'."

Neither my wife nor I allow our healer to just order whatever test he feels is necessary. Not a chance. We want to know what the specific test is for and why he thinks we need it. The number of tests the lab does on us are very, very few. Under a half a dozen.

Remember you are in charge. You tell the doc what they are allowed to do. The damn doctors think we work for them. Not a chance.

They work for us.

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