Wednesday, June 20, 2012

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…

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