PSA Test Gets the Finger

The US Preventive Services Task Force is at it again. It has not been
that long ago that they shook things up by toning down recommendations for
mammograms in women 40-50 years of age (See blog.) Now, after years of vigorous
campaigns to have men check their Prostate Specific Antigen, a marker for
potential prostate cancer, the USPSTF is saying that the costs or side effects
of all the therapies used to treat prostate cancer are not worth the marginal,
if any, benefits. They add that most men with prostate cancer are likely to die
of some other disease.

The Task Force recommendation that the PSA not be routinely offered to
men less than 75 years of age is vehemently opposed by the American Academy
of Urology. This is understandable. My guess is that, just like mammograms, a
significant number of doctors and patients will still choose to check the PSA.
I agree, but for slightly different reasons.
The USPSTF is correct in pointing out the horrendous statistics
associated with the treatment of an elevated PSA. Setting aside the monetary
costs, most men end of with impotence and incontinency problems. Some even die
of heart attacks due to the treatment. If checking the PSA does not involve a
sobering discussion about the potential problems from aggressive treatment,
then, I feel patients are not well served. The American Academy
of Urology agrees. It recommends that patients be given the option of doing
NOTHING for an elevated PSA.
In my opinion, the PSA may be checked after outlining ALL the options
available (surgery, chemotherapy, castration, etc.,) including a natural
approach which has been repeatedly shown to lower the PSA. So, many men will
likely choose to check the PSA. If elevated, they may become more driven and
motivated to eat more fruits and vegetables, eschew chemicals (xenoestrogens
like pesticides and plastics,) and supplement a few nutrients and herbs that
have been shown to be effective (Paw, paw, Curcumin, Saw palmetto, Pygeum
africanum, Anamu, Indole 3 Carbinol, Glutathione, etc.)
By the way, the finger test for the prostate also “got the finger.” I
didn’t hear anyone complain about that…