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May 21st, 2012
05:28 PM ET
Task force: PSA tests do more harm than goodThe United States Preventive Services Task Force issued their final recommendation on the PSA prostate cancer-screening test Monday, recommending against routine PSA exams for men of any age. The task force says the PSA exam and additional treatments that may follow, like radiation and surgery, result in far more harm than benefit. Dr. Virginia Moyer, who sits on the task force, cited that only one out of every 1,000 men who are screened would actually benefit from the exam. Instead, most will have to deal with side effects from treatment that can range from incontinence and impotence, to stroke and death. “Your primary care physician shouldn’t routinely offer the exam," said Moyer. "But if a patient brings it up, that doctor has a responsibility to inform them of the potential harms and risk." However, the American Urological Association is not changing its stance on the PSA test. “We at the AUA still recommend the PSA, with its imperfections," said Dr. Chris Amling. "It’s the wrong thing to deny a man if he wants to have this test." Related: Value of mass prostate cancer screenings questioned The PSA test measures the amount of prostate-specific antigens in the blood. While the screening detects the presence of prostate cancer, it cannot make the distinction between aggressive, fast moving cancers, and the more common slow growing ones. “There is no other screening test for prostate cancer. It’s clear that the only way to cure prostate is to detect it early," Amling emphasized. Related story: Annual prostate cancer test doesn't save lives, study says According to the American Cancer Society, prostate cancer is the second deadliest cancer among men, and occurs most often in African-American. But survival rates also are very high. The American Cancer Society finds that 91% of all men with prostate cancer will live for 15 years beyond diagnosis. According to the National Cancer Institute, 70% of prostate cancer deaths occur after age 75. Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society supports the recommendation of the task force. “People need to realize that science hasn’t given us the answer," said Brawley. "In the past, when we don’t have a scientific answer, and we’ve guessed, we’ve hurt a lot of people." Related story: Who decides about screenings? The task force made its draft recommendation publicly available in October 2011, and reviewed nearly 3,000 comments before issuing its final recommendation.
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As a cancer biologist and young (diagnosed age 42) prostate cancer survivor myself, whose cancer was found by PSA testing, intuitively I feel this recommendation against testing is wrong.
More importantly, logically and scientifically, I also think this recommendation is wrong because it neglects the fact that a more intelligently crafted plan of PSA testing focusing first on younger men would save lives and reduce testing. PSA testing has also prevented men from presenting at diagnosis with extreme pain and troubles related to massive prostate tumors, an often-ignored fact.
What we need is not to stop PSA testing, but rather to adopt a better plan for it such as the one I outlined here on my lab's blog:
http://www.ipscell.com/2011/10/should-men-get-psa-tests-yes-but/
Paul Knoepfler, PhD
Associate Professor
UC Davis School of Medicine
the Obamacare rationing has begun.
Paul,
I read your recommendations and they seem reasonable. The one thing that I find about the PSA testing is that no one was able to tell me when PSA gave useful information. It would seem that the PSA test has been given for many years and it should be possible to give age specific outcomes based upon the PSA number. Millions of men have had PSA testing but no one seems to have made any attempt to assemble a data base of what PSA number means for a particular age.
For heart attacks, there exists a 10-year CVD Risk Calculator (Risk assessment tool) that gives a percentage for a 10 years in the future based upon a certain known risk factors. Information from the Framingham Heart Study was used to predict a person’s chance of having a heart attack in the next 10 years. I realize that the Risk Calculator is not perfect but it at least gives a person some information about their current heart attack risk. If a similar tool existed for PSA numbers, then doctors and patients could make an educated decision about their risk and treatment.
At the present time, a PSA > 4 is considered suspect and cause a man to go through a biopsy, x-rays and ultrasounds. Any time a person is exposed to x-rays, he has a small chance of the x-rays causing cancer. The same can be said for women who undergo mammograms. The diagnosis x-rays will cause some men and women to get cancer but no one tells patients that it will happen.
I agree with Dr. Knoepfler and the medical professionals with the URA. What's needed is better education about this disease, and more adaptive treatment regimes. To suggest that men not be screened for this deadly disease is beyond belief. It reads like a strategy one would find in a feminist book on men's health. Perhaps the same strategy should be adopted with regard to screening for breast cancer as well. After all, mammograms don't always reliably discern the difference more aggressive and slower growing forms of breast cancer. Whay say Dr. Moyer?
Dear Dr. Knoepfler,
I'm sorry to hear about your experience with prostate cancer and glad to hear you are doing better.
Thus far, the largest randomized prospective trials have not shown reduced overall mortality, and in one, prostate cancer-specific mortality itself was not reduced. Could you please propose what specific screening intervention you would implement in order to create a "more intelligently crafted plan of PSA testing"? The proposal you make of screening at a younger age would increase the number screened, not decrease it. I agree with your point in your blog that if PSAs were screened only in patients that "led to detection of a high-grade" cancer, then it would be 100% effective–sadly, nobody knows what the characteristics of those patients are (at least, they haven't published them).
This is not intended to take away from the very true fact that there will always be people whose lives were saved from screening. However, that does not mean that a screen is appropriate. In theory, we could biopsy every male above 45 for parotid acinar cell carcinoma (a very rare cancer) by taking an invasive biopsy and we would certainly find cancer and save lives–there is unfortunately the other side of the coin–morbidity and mortality due to screening huge numbers of people, a very prudent clinical reason for not performing a test (Hippocratic oath: "First do no harm") .
-HP
Guest...you do realize that this mandate does not impact cost...Medicare will still pay for screening. This data and controversy regarding PSA screening has been around for years, long before Obama took office. Agenda much?
Hypertrophic...exactly. Too many unnecessary prostatectomies for low-grade malignancy and BPH that do not impact mortality yet have potentially devastating morbidity. In theory, an inexpensive test with good sensitivity sounds like a reasonable screening tool, but this particular test is simply too non-specific to be routinely utilized. This data has been around for a long time and has nothing whatsoever to do with "Obamacare". That's just hyperbolic propaganda without any evidence to support that argument.
I was diagnosed, twice, with prostrate cancer based on PSA; the first time I was told it was aggressive and I elected for advanced radiation therapy (cyber knife) and, for 3 years my PSA was normal but, then, began to climb ( out of 350 men who elected this treatment, I was one of three for whom the PSA began to climb) and following biopsy, I was once again diagnosed with the disease. I went through the process, again, of figuring out what procedure to elect to combat the diagnosis and I elected surgery; the problem is that once you have undergone intensive radiation, surgical removal of the prostrate is like trying to completely remove melted cheese from a piece of bread of a grilled cheese sandwich. Well, I was fortunate to have the insurance and find a physician to do exactly that (Memorial Sloan Kettering New York) and I have been PSA "0" and cancer free for some time but, the surgery left complications with healing from prior radiation and I had to undergo many surgeries to remove scar tissue that virtually shut down my ability to urinate; several in an emergency room under intense pain. I, also, was left urinary incontinent and home bound, as a result, for almost 18 months and, due to surgeries during this time, couldn't lift anything over 20 pounds. Needless to say, I wasn't very social during this time and having a catheter 24 hours did, in fact while limiting mobility, offer relief. I, now, have gone almost 18 months with a PSA of 0.00 and have an artificial implant (thank god) which allows me to leave my home with confidence. I thank god for the PSA test and know without it, I would not be spilling my life experience here. What kills me now, is that my older brother just had a PSA of 17..... we talk alot... and now I talk alot to my son and my brother talks alot to his sons... Is a PSA test worth it? For me I'm glad to be breathing and for my brother.. I hope it will be equally beneficial.
A PSA test saved my life. The cancer was caught early. Sounds like the insurance company's paid for this study.
The plural of anecdote is not data
A PSA saved my father's life too. Now he has been cancer free for 4 years!
A friend of mine had a sudden rise in PSA one year from the usual 2.5 to 6.5, with NO symptoms, otherwise perfectly healthy. The Dr. retested 6 months later, and it was 19. If he did nothing he would be dead in a year. In spite of surgery, it is the aggressive kind and has spread, but at least he is still alive two and a half years later. This man is in his 60s. How dare you say his life isn't worth saving? If you don't like this test, invent a better one, but don't throw out the only gauge you have.
The prostate cancer death # in 1997 was 42000
The prostate cancer death # in 2007 was 29000
The population increased yet the number of deaths went down. Why? PSA screening and better treatment. Let's sit down with our patients and be reasonable, but not take edicts from the government who does not want to pay for this disease.
Never mind the years of promoting early detection as the best way to increase the chances of survival. It won't be long before they declare it's futile to even treat cancer once detected since the survival rates aren't all that great.
In my case I had just turned 50 when I went for a routine exam. My doctor was fresh out of residency and included the PSA test as part of the standard battery of blood tests. The level was 4.0, not alarmingly high but considered above norma, and I had no symptoms, but he wanted me to see a urologist anyway. I had a biopsy (THAT was fun) and the results were a Gleason of 6 IIRC. That doctor sent me to another urologist who specializes in the daVinci procedure at Mass General. So last March I had the operation and the next morning he told me that he was pretty sure he got it all and that he was able to keep the nerves intact to preserve function, so to speak. Bottom line is, I fared better than all of the other men that I know personally who have had prostate cancer, because it was caught early, I was young and healthy enough to have the operation, and my doctors were really good. I have very little in the way of side effects and I am pretty happy to have this out of the way. As an engineer and science-oriented person I felt that it was important to rely on the expertise of my doctors and the available data to make an informed decision about my treatment. No, they are not always right, and yes the test is not absolute, but as "Gigi" said don't throw out the only gauge you have.
exactly the same for me
My dad DIED FROM PROSTATE CANCER in March 2010. He had no symptoms. By the time his quack doctor suggested doing a screening PSA it had already metastasized to his bones (all the way up to his skull) and his lymph nodes. He died a horribly painful death and to suggest no screening for a curable cancer is asinine.
I feel these studies are so biased in terms of cost that they are denying people the right to save their own lives. Fine if insurance companies don't want to pay for them but stop making this about the cost. What does a blood test cost? A couple hundred dollars at most? Surely men can spend that to make sure that they live to see their kids grow up or their grandkids grow up. My wife had a colonoscopy that found a pre-cancerous polyp. She's 35. If she'd waited until 50 who knows how bad it would have been. But you read these articles saying it's a waste for doctors to do these types of tests with younger patients. My kids would disagree. Pay out of pocket if you have it but what's more important than your life?
At age 78 I was told I should skip this year, as my PSA test over the years was below 4. However, it had been steadily increasing from 0.5. In the summer of my 79th year, I was having an incontinence problem. My primary physician recommended that I see a Urologist. A PSA test of 42 and DRE suggested I have a biopsy. The result: Stage 4 cancer and a Gleason score of 9. The cancer had metastasized to several areas of my skeleton. I am now 83, and have been on Lupron, and lately also Zytiga. I'm still not able to get a reliable estimate of my possible longevity, which I can understand. I'm also aware that I am living longer than expected. Altho I feel fine, I have lost considerable strength and stamina. That may be due in part to the therapy. However, I feel that if I hadn't skipped that one year, I'd be in far better shape today, with better prospects for living to a ripe old age. And no, I'm not a doddering old man. I was still quite active and doing all the physical chores I had always done. GET THE TEST!
Dr. Virginia Moyer is a PEDIATRICIAN, not a cancer specialist. What a slap in the face for men, having a woman who doesn't even specialize in cancer tell them that they don't recommend the simple blood test. Virginia, I think you should be denied mammograms, since you will probably die of something else, rather than the cancer. What a moron.
Vote this idiot out!
You are so right! This is Obamacare. Women are no longer supposed to get mammograms until they are in their 50's and now this. My father was saved by a PSA test. The sad thing is that those of us who can afford to pay for these tests on our own will continue to do so. Those who cannot afford to will not so ultimately, Obamacare hurts those who can least afford to pay. The Democrats need to wake up and take a look at what this guy is doing. VOTE HIM OUT!!
LOL ....... again men get pushed under the bus. .......... Do you remember the hugh and when the same recommendations were made regarding mammograms.
Typical US. If it does not happen to a woman ... involve special accommodations / treatment ....... it does not warrant any societal action
Sadly, that's pretty much the way it works. If you are male, just deal with it. If you are female, how can we help you?
I agree. I find that men are treated poorly in all aspects of the medical field compared to women.
As a woman, I am offended by your suggestion that somehow we get special treatment by the medical community. Perhaps we are more involved in our health, or speak up more to get what we need (including getting the same Task Force to go back on the whole no-mammogram-until-50 agenda). Men need to speak up as strongly as women do when it comes to these important issues. Look up the history of breast cancer awareness and what women had to do in order to get law changes. Women's sufferage, indeed. Get off the couch and do something about it. Whining never changed anything. to get involved, please go to http://www.fightingprostatecancer.com
"Where ignorance is bliss"..."Real knowledge is to know the extent of one's ignorance."..."Ignorance, the root and stem of all evil."
Shall I continue?
This has to be one of the most asinine reports I have ever read in my 41 years on this planet.
How would this task force respond when I tell them that last year, at the age of 40, I was diagnosed with prostate cancer? I do not even have my past history. My baseline and 1st (!) test was high above norms. A simple PSA test does no harm!!! Ignorance does! Let me repeat, a simple PSA test does no harm. Well informed people should use this as a great example and reason for further discussion with their health care providers. That is exactly what I did. Now at the age of 41 I am cancer free, after having robotic prostatectomy surgery in December. Thank G-d the cancer was confined. What would the brilliant minds of this task force say to my wife and family in 5, 10, 15 years had I not had this simple blood test? How would they explain my death was avoidable? How would they explain a simple blood test could have alleviated all their sorrow? (Granted I'm being a bit biased there).
Bottom line – and please understand, which I hope you will, and forgive my bluntness – these folks need their heads examined. Perhaps an ostrich is happy with their head in the sand, I'm not!
At age 68 my PSA went from 4.2 where it had been for years to 10+. Biopsy confirmed small tumour. My urologist insisted that patient and wife meet him for an an hour long interview to review the options and their various consequences. My family generally lives into their late 80s. It was likely that the cancer would kill me prematurely. On that basis we decided on Radical Protatectomy. Today I am continent with a PSA of 0 and a normal life expectancy.
I believe my case to be a model of how this should be handled. Discontinuing routine PSA tests is not the answer. They provide an opportunity to evaluate the options should the need arise
Welcome to obamacare... did you really think things wouldn't be cut back by panels? First it starts with the recommendations against... then it will be followed with insurance not paying for anything not recommended...
Welcome to Obama Care!
Think the USPSTF isn't part of the health care panels that will "curb" health care expense in the future by determing that wellness care has no discernible benefits and thus allow insurance companies to deny coverage? Time to get your head our of your ass....
Trying to explain that screening is not a good idea is very hard to non scientific consumers. People don't see the cost in pain and suffering (and deaths) from false positives. Trust the science. Screening after 75 is a really really bad idea. Before 75 it should be between the patient and their doctor understanding risks and benefits. No one in my family has died from cancer in over 4 generations. I wouldn't recommend early screening for me or my son.
How is a harmless blood test harmful? You must not be very bright. If you have a test done every year and the value stays at a certain level, and then one year jumps dramatically, wouldn't you think something was wrong? Wouldn't you want to get it checked out? I feel sorry for you patients. Doctors really do think they are GOD.
My father was diagnosed with prostate cancer in his 70's based on a PSA. The treatment killed him. I wish he had never had this test. He would have lived longer and had a better quality of life.
What is all this stuff about risks, death, etc from a simple and cheap BLOOD TEST ? If it comes back as normal then fine, If it comes back high, then decide if biopsy is needed or not. Biopsy is NOT painful if you are put to sleep for it. If biopsy comes back negative then fine. If biopsy comes back as cancer, then take the necessary steps. To tell patients just forget having any tests is nuts just because of the expense.
Well, it seems that the replies to this comment made the point rather nicely.
A blood test isn't "harmless". Setting aside the admittedly small risk of any procedure, including venipuncture, one then must ask what do you do with the result?
If a test has poor sensitivity or specificity, what comes next if it is abnormal? Do you ignore it? Do you follow it along with follow up blood work (also flawed in the same manner)? Or do you pursue further testing and procedures?
What the laymen fail to grasp is that just because one, or five, or fifty men are diagnosed with prostate cancer by further testing, that doesn't mean that they were "saved". Can you demonstrate that they would have died in the absence of treatment? How? Even if you could (which is impossible), does that offset the much greater number of men suffering significant morbidity from the diagnostic and treatment regimen? What is the individual and societal cost of doing this?
This isn't about a political agenda; I am very conservative. It is about how medicine has chosen to explain itself to the public for years. Treatment is not always better. Most physicians will not pursue the same aggressive regimens that they recommend to their patients.
The United States Preventive Task Force? Who in the wide world of sports are these people?? And how could some statement from them hold water?
Oh wait...I know how it can...because we are only a year away from Obamacare. The government wants to cover a little as possible.
First...they said...women don't need as many breast exams....then they said...women don't need as many pap smears...now they say...men don't need as many colon screenings.
Keep it up. By the time Obamacare becomes law...they won't have to cover anything.
Thanks ObamaCare... and people thought the "death panels" were just a made up political thing. This is another step toward rationing medicine and reducing care. Cheaper for the govt by increasing the death rate, since they won't be detecting illnesses and therefore won't be paying for expensive treatments that SAVE LIVES.
I was 58 when diagnosed with prostate cancer. Not mentioned in the posts is that I had high frequency ultra sound (HIFU). This is not yet FDA approved but is an exceptional treatment for this disease in a properly diagnosed patient. The side effects are minimal when compared to all other treatment modalities. And yes, a patient when diagnosed with cancer does not how aggressive the cancer is but HIFU tilts the scale in favor of this treatment for all ages.
Horrible decision for this government! PSA is for screening, and then the investigation begins. It saved my life 8 years ago. Plus, there are treatments like Proton Radiation that has NONE of the side-effects of surgery. This is the direction that this foolish doctor should be looking at!
I will sue my doctor if he misses prostate cancer
Incorrect treatment based on test results should never be a reason not to test. If the treatment is ofter incorrect fix it, but don't omit the test because of that. This is a relatively cheap test so the test cost is not the reason to omit it.
Government propaganda. Pure and simple. Thanks Pravda...er...CNN!
As a survivor of prostate cancer, I respectfully disagree. I may have been that 1 in 1000 cited above, but I much prefer being alive to being dead, especially since the usual form of fatality involves spread to the bones and a VERY painful death. My therapy wasn't much fun, but I still find being alive fascinating every day.
Why are people posting "Welcome to Obamacare"? This has nothing to do with Obama's health plan. I wish people wouldn't make this a political argument, its clearly the business side of medicine requesting this. The paragraph below is taken directly from the USPSTF site.
The USPSTF is an independent panel of non-Federal experts in prevention and evidence-based medicine and is composed of primary care providers (such as internists, pediatricians, family physicians, gynecologists/obstetricians, nurses, and health behavior specialists).
Of course, like all medical review boards / associations they are supported by the Health care industry, the insurance and health tech companies. Has anyone tracked their stock performance over the past 10 years! You all getting the real picture now.
Who do you think Obamacare when it goes into effect will listen to? Funny how after 30 years of telling us one thing...all of the sudden right before Obamacare becomes law...they change their mind.
Hmmmmmm....sounds a little interesting to me.
This data has been around for some time, long before Obama took office. Routine DRE and PSA testing has not been routinely recommended for several years based on the fact that DRE is a horribly non-sensitive exam and PSA is a non-specific test. The argument (and the data) have long supported the argument that routine testing results in more unnecessary biopsies and resultant prostatectomies with potentially very unpleasant morbidity than actual reductions in mortality. I am not sure I support this argument and still offer to my patients that PSA testing is efficacious (especially if one looks at trends with PSA instead of an isolated value) and does so with the knowledge of the potential adverse ramifications. This is nothing new and nothing whatsoever to do with Obama. Let go of the agenda.
The war on men has begun.
Just crawl back home and die. We have to make this Obama are work somehow.
Holy crap go and look at the other recommendations that this "task force" has made since Obama got in office and ObamaCare is being shoved upon us.
http://www.uspreventiveservicestaskforce.org/recommendations.htm
Look at the items from 2010 and newer... pretty much every update is against preventive screening for a whole variety of cancers!
Yes, its a massive conspiracy. Obama wants everyone to die of cancer. That way there will be nobody left to control! Oh, wait...
It's just a simple blood test. Why would they recommend against it? This article makes it seem like the test itself is a big deal. Ludicrous.
This is horrible advice. My wonderful husband died in 2009. I miss him every day of my life. He was diagnosed with prostate cancer in the mid-1990s, after sklpping the PSA test for several years. The cancer spread to his bones, but he still lived 13 years with the disease (he hiked outdoors every single day, one reason he did so well). Chemo took his life, not the disease. Who the hell are these people who devalue life and say to do away from the only diagnostic test for prostate cancer?
How about we keep the PSA test and get rid of the finger up the butt? I could do without that.
The local hospital has free yearly prostate screening. Blood as well as a rectal exam. When I asked the urologist how important the rectal was as compared to the blood test, he said the rectal caught 20% more enlarged or questionable prostates.I was checked at normal despite having frequent nightly urination. 5 -6 times.
THE Flowmax drug seems to help but shuts down sexual performance. TURP's are surgeries of the past, stints are in.
A psa test is a simple blood test. I do not understand the complications mentioned above. I've had two psa testsand it's a good thing I asked for the second test after a year because my psa was up somewhat (4.75) and a subsequent dre found a hard spot on my prostate which later proved to indicate a 6-12 malignancy through a biopsy and a gleason score of 7. I chose Da Vinci operation and my urologist said it was "close." I hope she got it all. Future psa tests will tell the tale. Psa is good but don't neglect getting a physical exam of your prostate as well..
So, where the HELL is all that risk and harm with a PSA test that this article talks about ? It is just a blood test!! Risks and harm ???? What risk and harm ??????
What you people don't understand is: the majority of abnormal PSA's don't indicate cancer. Therefore the majority undergo further invasion painful testing for no benefit. They have psychological worry about the potential cancer diagnosis, etc. You can't base screening guidelines on N of 1 studies.
We would cure many more cases of lung cancer if we started screening with chest CT scans at 20 yo, but then we would have no money to afford healthcare. People may not want to puts finances in mind when talking about healthcare, but it needs to be done
And what YOU don't understand is to mind your own business. If YOU don't want the test, then be my quest and don't have it !! Or is it that you are a womaqn ? If so, then let me say further to kiss my a__ !
No..Psa is an inexpensive test. better to take it as one indicator of problems arising. Then get a digital rectal exam. I'll take a somewhat painful prostate biopsy over terminal cancer any day.
What do you the the 90% that have normal biopsies and suffered physically and mentally for nothing?
A biopsy is NOT painful as you are put to sleep for it. Tell that doctor that you insist to be put to sleep for the test. If he or she argues, find ANOTHER doctor!!
Terry you an idiot. You are the same one that complains when they raise your insurance rates yearly to cover general anesthesia for a minor procedure. You would also be the same one to sue the anesthesiologist if you had a complication from general anesthesia even though it has known risks
Reply to "Voice of Reason" Oh, talk mean to me some more, feel excited now, do you ?
Since I'm a prostate cancer survivor, and I've had...along the way...a biopsy, let's clear up all these lies.
A prostate biopsy is NOT painful. Yup, you get a device inserted, and that's never much fun, but it's NOT painful. The collection of the sections feels a bit like being snapped with a rubber band. It might sting slightly, but it's not painful. It might be embarrassing, or even "icky" for some people, but medicine is like that sometimes. I had no anesthetic or anything else, and didn't "suffer" at all, beyond waiting for the results. Yeah, it's no fun finding out your Gleason score is a 7, but it's better than not knowing. I was presented with all the options, and made a choice. I'm happy with my choice, and...even more than that, I'm happy I'm still alive. At least for now, I'm not facing that really ugly, painful death that goes with the disease if if progresses.
Yup, I'd love to see a test that can predict how fast a specific cancer will spread. Still, I'll take alive over dead every time.
Insurance companies no longer want to pay for this test; but they need a reason to reject payment. You will probably see, in the very near future, insurance carriers no longer covering this procedure based on recent "finding" in the medical field.
Andy (above) may be correct, but you can't necessarily rule out Obama-Care. National insurance will not want to cover it either.
Health insurance companies do not have your best interests in mind. It's all about profit and bottom line.
The panels have existed for more than 50 years. They try to take a scientific based approach to determine where testing is doing more harm than good. If you look at the numbers you'll find Prostate Cancer kills a LOT of people every year. What the details tell you is that in more than half the cases it's not the Cancer that kills but the treatment for the cancer. In addition they've done studies looking at life expectancy of treatment versus non-treatment and what they've found is that the test is causing people to get treatments that have a higher chance of killing them than the cancer does. So the panel has recommended that routine (un-symptomatic) testing be stopped so people that won't die of the cancer stop getting treatments that might kill them. Maybe there is a better approach that involves routine PSA testing along with some very detailed patient evaluations but that goes beyond panel recommendations. This is panel is simply trying to make sure medicine isn't making things worse. At the least the recommendations will cause revised medicine. Regardless though this has not a thing to do with ObamaCare if for the only reason that it hasn't even been implemented yet and won't until 2016.
First the mammogram now the PSA; the death panels get to work early. I personally know six women and five men who would be dead except for the tests that saved them; tests that experts now say are not needed.
I find it ironic that everyone in this country complains about the high cost of healthcare, then whines about stuff like the PSA test. Yeah, I suppose health outcomes would be better if you got every screening test under the sun every year for life. But that's part of what's driving up healthcare costs. Its simple: either put more money into healthcare or you have to make cuts to keep it affordable.
The test is only a blood analysis. Not very costly. The costs is incurred when the PSA count goes above 4 and doctors recommend remedial action.
this is gov getting in your business, test results are always better than no test results. The action is determined by the doctor and not the gov/insurance clan. so, ObamaCare with continue to attack testing as a way to cut costs. Bad news for our health.
Correction!!! The action is determined by the the patient with a doctor's recommendations. A doctor doesn't get to decide anything, the patient does !!
GOOD! now I can get my wife to stop nagging me
it affects her health too!
Or you could have just told her to shut up !!!
Obama does not need a PSA test because he has no need for his prostate.
after that opening game throw-out, I doubt that Obama has a prostate or testicles
Well, VIRGINIA, just don't think to much of you saying that MEN shoudn't have this test – a simple blood test. Thank you very much, but I will listen to my male doctor on this issue, if you please. Where is all that risk and harm you talk about when it is just a BLOOD TEST.
Terry,
If you received an education past first grade you would understand things like logic, statistics, etc. Until then go back in your worm hole
And you can rely upon stats for YOUR life if you want, I don't. Funny how you gamble so well with the lives of others.
Until you start paying for ALL your healthcare costs out of pocket, shut the f–k up
And just how do you know what I pay for, Mr. Smarty pants?
So when is some male law student gonna be sitting in front of Congress talking about the "war on men" and how we should pay for his condoms?
Condoms are OTC and cheap, its a minor issue.
Pelosi is in favor with this because she does not have a prostste (or does she)
A friend of mine was diagnosed with this test at age 40. He would be dead now if it were not for the early diagnoses. The death squads are now in full force. God help us!
yo are correct
hey
Here's the deal. You have to die of something. Most men with prostate cancer will not die from the disease (neoplasia). If you really want to go through testing, the imperfect PSA as described above, and treatment (whose litany of horrible side effects are not well enumerated in the article) so be it.
Ask your (should be male in this case, for honesty's sake) physician if they would go through whatever treatment regimen they propose if you are diagnosed with prostate CA. I'll bet a dollar not many of them would.
Next, talk to a "survivor" of chemo, radiation, or surgery. See if they are happier with the diapers and impotence than they would be with mild urinary hesitancy/retention and the small chance of dying of their condition.
Of course urologists come out against this. It's their bread and butter. Someone just saw their paychecks shrink.
Sometimes the treatment is worse than the disease. The article hints at "number needed to treat". How many people need to be treated for a condition for it to be considered worthwhile?
Just because you can screen (imperfectly) for a condition doesn't mean you should.
For those who are interested, look up the sensitivity, specificity, false positives and false negatives of PSA screenings, then decide if you want one.
Choose life..take the test. If aggressive cancer, get rid of it asap
Exactly more men will die with prostate cancer than of prostate cancer. We decided in the 70's screening for lung cancer was a good idea only to discover it caused more harm than good. I guess you need to be rational to understand this argument though
"Next, talk to a "survivor" of chemo, radiation, or surgery. See if they are happier with the diapers and impotence than they would be with mild urinary hesitancy/retention and the small chance of dying of their condition."
To Luca Brasi, you don't know what you are talking about. Live through the agony of a tumor in your bones and then tell me you wouldn't want treatment. You've never faced this or you wouldn't write what you said.
This recommendation is nothing but rationing of care as a result of the nationalized medicine design. It will not be covered because a pediatrician without a prostate, appointed by the liberals to the USPSTF, says the test does more harm than good. This lady is misleading the public by implying that anyone with an elevated PSA reading will be rushed to treatment without confirmatory tests. Read the actuall cases of people whose life has been saved by the test. What a shameful, unprofessional behavior. But I bet members of congress and others in the government and the labor unions will have a plan that does cover it.
The PSA test is not needed unless you are the one who has prostate cancer.
Utter nonsense.Since I was 63 I have had PSA readings every 6 months commencing April 2003, 3.0, October 2003, 6.2, April 2008,12.40 and I then had a biopsy. Had previous Lyphoma cancer 28 years ago so surgical removal was out of the question, so I was declared a walking dead man. Reading in April, 2012 was 17.4. Cancer specialist recommendations were no medication of any kind unless it hits 23.0, and we will think about it then. I am now 74. Maintenance and vigilence is absolutely manadatory and this finding is blatantly against the ongoing welfare of men's health. Ok guys, lets start a movement ( No PUN intended)!!
Men need a blue ribbon campaign similar to the pink ribbon for women's breast.