Final Answer: Forget PSA Tests

May 22, 2012 7:36 am 6 comments

After years of sidling up to the conclusion, the U.S. Preventive Services Task Force has finally come out and said what the evidence has long shown: PSA tests do more harm than good. The New York Times reports that the lastest study of the pros and cons of PSA tests shows that at best, one man in every 1,000 given the P.S.A. test may avoid death as a result of the screening, while another man for every 3,000 tested will die prematurely as a result of complications from prostate cancer treatment and dozens more will be seriously harmed. The task force found that up to 43 men per 1,000 tested will be damaged in some way. Thirty to 40 men will develop incontinence or erectile dysfunction, or both, as a result of treatment. Two more men will have a serious cardiovascular event, like a heart attack, and one man will develop a life-threatening blood clot in his legs or lungs. Read more in the New York Times.

6 Comments

  • This Preventative Services Task Force is a health care rationing entity established under Obamacare. Its sole function is to find ways to lower costs, aka rationing care. The UK has had a similar agency for years which has caused treatment for prostate cancer and other cancers which mainly affect older people to be reduced to the point where the UK’s death rate for these cancers is over twice in the US.
    So look at the larger picture when seeing stories like this…

  • Please stop reporting that the PSA test does harm. The test is only a blood sample. Subsequent treatment may cause harm but not the test. Why not focus on whether or not additional treatment is needed?

  • This is why we don’t want government making these decisions. It may not be “worth it” to a government panel looking at the big picture, but it sure is worth it to the individual patient who could die if not screened. Healthcare is a PERSONAL choice, not a governmental one. Keep government out of healthcare!!!

    • It is far less likely “the government” is telling your doctor what he can and can’t do…..more likely by far to be your health insurance company. (an RN)

  • Correct, partly, on the statements above. That is: the article confused me (an RN) because the PSA itself is a simple blood test. THEN, if the result of the test shows numbers higher than expected, the patient and physician (who should be a urologist up to date on this complex situation) decide if treatement–surgical procedure–is needed. Earlier studies showed men with prostate tumors were usually elderly, as stated above…but also that they were far more likely to die to various age related problems or just “old age” before the Prostate tumor would be large enough to lead to death. That is why the “always gotta do something immediately” attitude, which is a common mindset here is not always the right thing to do. The older a man is, and the more other health problems he has, the more risk there is by adding surgery. It is a matter of risk/benefit ratio….adding the usual risks of any surgery may be riskier than the problem itself. Remember, getting in your car is most dangerous thing you do daily!
    The other thing, which may confuse people, is that many older men develop an enlarged prostate with age, which can lead to difficulty urinating, weak stream of urine, and other noticeable problems. This is almost always not cancer or a cancerous tumor. The procedure to open up the urinary channel, sort of a roto-rooter thing and seldom requires actual surgery, but rather a procedure. Even very elderly men can have this done, generally safely, usually done under spinal anesthetic not general anesthesia (which is the riskiest part of any surgery usually) and more if a patient has other health issues/ poor lifestyle involved. Its usually a quick procedure, the body is entered via the urethra (urine outlet) so its not actually surgery in the sense of an incision being needed. For someone suffering with pain and discomfort, up many times in the night to urinate, or urinates with difficulty, and perhaps has a fear of cancer, GO to a board certified urologist who is the type of physician who treats all these problems. Almost always you’ll be reassured after some basic tests are done–and even if more than a simple procedure is needed the earlier it’s treated the better.

  • @Manny: thank you, thank you, thank you. These “news” stories are often abbreviated to the point of being misleading. And, I personally do not want to be 1 of the 1000 that dies because I did not get the test. So I want the test, and if my PSA goes from 1.7 to 8, and the guy does the digital exam and tells me my prostrate feels like a lump of coal, I want to talk to someone one pronto. More information is always better.

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