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Task force: PSA tests do more harm than good
May 21st, 2012
05:28 PM ET

Task force: PSA tests do more harm than good

The 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."

New story: Top American Cancer Society doctor weighs in on the announcement

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.


soundoff (437 Responses)
  1. Robert NunnallyM.D.

    As a physician, I feel that eliminating PSA's is almost criminal. Economics should not control practice
    This is just a sample of what is coming with Obama Care. 50 years ago we diagnosed prostate Ca
    with a digital rectal exam followed by a single needle biopsy. Positives were treated with castration or
    stilbesterol. This was very economical and sometimes effective. I have have prostate cancer for 5 yrs.
    Lesterboy

    May 21, 2012 at 22:27 | Report abuse | Reply
    • IggyDad

      Do you realize that not a single Federal health official is on these panels? These guidelines are not just about money, or even mostly about money. It's about all those men who go through unnecessary diagnostics procedures and surgery for no good reason. That's real risk, real pain, real stress. The balance is not just about money.

      May 21, 2012 at 22:45 | Report abuse |
    • Gronk

      sure, and now PSAs (and the resulting unnecessary followups and treatments) pay for your porsche, don't they?

      May 21, 2012 at 22:49 | Report abuse |
    • Paul

      There was no mention of health care costs. To quote: "the PSA exam and additional treatments that may follow, like radiation and surgery, result in far more harm than benefit." Doesn't the Hippocratic Oath say something like first do no harm? The article is saying that the use of the PSA test causes harm. Again, this is no mention of health care costs.

      May 21, 2012 at 22:53 | Report abuse |
    • Cynthia

      Great post! It is scary that these panel will decide whether or not people will receive a test. I am sure the wealthy will still have their own system tot avoid this though. However, with HMOs we are already there. They will hardly do anything anymore for a patient. It seems either way the U.S. goes economics will decide whether people live or die.

      May 21, 2012 at 22:58 | Report abuse |
    • C

      My father would have been dead at age 50 without this test.
      My father was one out of the thousand people it is saying benefits, and quite frankly if it helps save a life it should be done.

      May 21, 2012 at 23:02 | Report abuse |
    • N

      Paul is correct. The USPSTF is not allowed to consider costs when it makes recommendations. The task force uses a set of data (that it is very open about) to weigh the risks and benefits of any screening test, but health care economics is not part of that data. Ultimately, just as with routine mammography screening recommendations from a couple of years ago, the risks are often harder to objectively evaluate than the benefits since different people have different risk aversions when it comes to their health. So for the USPSTF, which is composed of a wide variety of physicians, nurses, and other health care professionals, their perception of the risks is different from the more monolithic group at the AUA. Frankly, everyone has the same intentions when it comes to screening guidelines: to provide the best possible guidelines that will ensure the best outcomes for patients. However, as one member of the USPSTF told me a couple of years ago, reasonable people will look at the same data and come to different conclusions. It's as simple as that.

      May 21, 2012 at 23:07 | Report abuse |
    • Bertha59

      My father was diagnosed with end stage prostrate cancer in 1991. He started hormonal treatment immediately. He died this year, 2012, from a stroke. Men should have the test for prostrate cancer as a matter of routine. My father lived 21 years after his diagnosis. All men/people should have routine exams so that they can get treatment to live longer. After all, we, as US citizens pay a lot to invest in research for treatments. That is why the Obama health care plan needs to be enforced.

      May 21, 2012 at 23:16 | Report abuse |
    • Gary

      Obama and his administration are gutting the health care system in this country. They are trying to save money by eliminating necessary exams for men and women. I don't see him cutting welfare or any of the social programs aimed at minorities. The sooner he is out of office the faster the economy will improve.

      May 21, 2012 at 23:19 | Report abuse |
    • KMB

      There is not one urologist, radiation oncologist, or medical oncologist on this panel.....THE physicians who treat these patients and care for this disease!!

      May 21, 2012 at 23:38 | Report abuse |
    • StevenC

      It's doctor's like you that are the reason most people don't trust docotrs. Far more concerned about your pocket book than what happens to a patient. Trying to twist things to suit you doesn't fool intelligent people. Other educated people can see right through you.

      May 21, 2012 at 23:39 | Report abuse |
    • mfx3

      What is it about you conservatives, always wanting to stick things in other men's butts?

      May 21, 2012 at 23:43 | Report abuse |
    • SBrunner

      I am not a doctor, I am not a man. I am in my early 60's and healthy so far. I am absolutely disgusted with this published news.
      Just like a was a year or so ago when it was published that women no longer need to do yearly mammograms or paps. Barack Obama, Obama Care Plan, New World Order= United States of America and the world are being set up by something and someone? All the conspiracy theories I am reading are looking more and more reality. God Bless all of those who are suffering or will come to suffer illness in the future. I believe absolutely nothing that we are being told anymore. Soon we will most likely be arrested by saying what I have just said.

      May 22, 2012 at 00:19 | Report abuse |
    • F2012

      What is your point, Robert? What we have now is bad, but was we had 50 years ago was even worse? Screening makes sense when the probability of benefit exceeds the probability of harm. This is not the case. Resorting to anecdotal evidence doesn't bolster your position at all, more like the opposite.

      May 22, 2012 at 00:34 | Report abuse |
    • rafael

      Doesn't sound like you practice evidence-based medicine. If I were a patient I would look elsewhere.

      May 22, 2012 at 00:38 | Report abuse |
    • Skipper

      You actually GRADUATED med school? I doubt it, given the stupidity of your comment. Eliminating the test may be a bad idea, but it has nothing to do with "Obamacare". You could have made an educated, lucid argument but, instead, you decided to make a lame political comment.

      May 22, 2012 at 00:43 | Report abuse |
    • James

      My Doctor does not test for PSA. By luck I got a condition that looked like a problem in the bladder and he gave me a PSA test that showed an elevated PSA. He sent me to a Urologist who found that I had an aggessive prostate cancer of the prostate that had protuded out of the sac. This is called advanced local prostate cancer. It had only spread slightly to the surrounding tissue. Any more delay in the diagnosis and I would have been finished. I live in Australia where they have the proverbial Death Panel approach to medical care. I did receive a death sentence, the only question is when it will be carried out.

      May 22, 2012 at 01:03 | Report abuse |
    • Gibberwocky

      Where in the article does it say that PSAs will be banned? All it says is that they are recommending that men don't get them. If you want the test, by all means, go for it.

      May 22, 2012 at 01:32 | Report abuse |
    • iminim

      For years evidence based medicine has called into question the widespread use of the PSA as a screening test. This new recommendation is not a surprise. Of course the PSA has led to diagnosis & treatment in some men whose lives had been saved, otherwise it would not have been in use so long. But the sad truth is that it is used mainly because nothing more reliable has come along, not because the PSA is a great test. There are many men who didn't have their cancer diagnosed early enough because the PSA test failed them. There are others who have undergone needless aggressive & life altering treatment because of the inadequacies of the PSA. It is time to campaign for a better test. Proving and admitting the inadequacies of the PSA is the first step in that process.

      May 22, 2012 at 03:40 | Report abuse |
  2. Bill

    This is OBAMA care at its finest–get used to it America. Obama care presupposes that you are going to die anyway, so why spend the money on something that may not save your life. Obama considers you expendable and the money could be better utilized for more welfare or unemployment checks. Obama care will ration this and other health care all in the name of saving money. Obama wants everyone to share in the pain, that is why he says to all older Americans: do your part-die.

    I am now cancer free for 2 years because of a PSA test at age 63! I had radiation seed implants. I had no symptoms, but the PSA was high and the autopsy was positive.

    May 21, 2012 at 22:27 | Report abuse | Reply
    • CB

      You really need to inform yourself about what "Obama Care" is. It is insurance reform. It is not government run healthcare. PS-how's that Medicare working out for ya? The Affordable Care Act will keep your insurance company from kicking you off because you did have prostate cancer. The report on the efficacy of the PSA test has nothing to do with "Obama Care". Educate yourself-although that might be difficult since your autopsy results were positive.

      May 21, 2012 at 22:44 | Report abuse |
    • Gronk

      the autopsy was positive, huh? well, condolences on your death, and congratulations on figuring out how to post from beyond the grave.

      May 21, 2012 at 22:47 | Report abuse |
    • Herb

      That pretty well sums it up ... except that because the PSA is a restricted test the medicos will raise the price up to some astronomical level ... that you have to pay on your own. Repeal Obama Care. Its not just the money its your health

      May 21, 2012 at 22:52 | Report abuse |
    • Paul

      See my comment to the previous post. There is no mention of money in the article. This recommendation is based on the harm done to men who take the test routinely.

      May 21, 2012 at 22:56 | Report abuse |
    • Jake

      Autopsy implies that you died. the PSA test does not make money for the doctor ordering it. But it does save a few lives. If you really believe that 20% against getting it are acceptable odds, then all the data supporting the use of antihypertensive drugs and drugs to lower cholesterol , are also uselss. Evidence based medicine should be the goal, not epidemiological data that is confusing to the casual observer.

      May 21, 2012 at 23:14 | Report abuse |
    • joep199

      The autopsy was positive? I think you mean biopsy.

      May 21, 2012 at 23:44 | Report abuse |
    • neal

      An autopsy is a self-administrated biopsy.

      May 22, 2012 at 03:19 | Report abuse |
  3. Allen O. Cottle, M.D.

    We really need a test which will determine the aggressiveness of prostate CA. The Gleason Score is the best to date, but could be improved upon. Stage 4 prostate CA is a horrible disease. In my practice, I have had many of those patients commit suicide rather than continue living with the agonizing pain which is not controlled by conventional terminal care. This conclusion to stop screening with the PSA smacks of an attempt to save money. 11 years ago, I had a Stage 1 Gleason 6 CA treated by radioactive seeds. My PSA's have been zero since that time.

    May 21, 2012 at 22:28 | Report abuse | Reply
    • terry

      Certainly a thoughtful and reasonable post. Thank you !!

      May 21, 2012 at 22:36 | Report abuse |
  4. c s

    For what it is worth read this web site about prostate cancer: http://www.nhprostatecancer.org/FAQ.html

    One of the interesting pieces of information is:
    "What are the odds that the PSA test might save my life?
    Let’s say that your PSA test led to a biopsy that revealed you have prostate cancer. And you chose to be treated for that cancer. Having this treatment provides a one in 50 chance that 10 years later, you will have been spared death from a cancer that would otherwise have killed you.

    What’s the chance that my treatment was not necessary?
    The figures above mean there is a 49 in 50 chance that you will have been treated unnecessarily. And that it was not necessary that you suffered the after-effects of the treatment. "

    There are no good answers. You can die from prostate cancer and still have a low PSA. In one large study, prostate cancer was diagnosed in 15.2 percent of men with a PSA level at or below 4.0 ng/mL see:
    Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per milliliter. New England Journal of Medicine 2004; 350(22):2239–2246.

    May 21, 2012 at 22:32 | Report abuse | Reply
  5. ss

    My dad (70) had a PSA test done in the hospital 2months ago while there for gallbladder surgery....he had missed his routine PSA test the year before but the year before that it was normal. The doctors were shocked to see his PSA reading was 189!!! (this is absolutely no exaggeration, I wish it were.) So from 2years previous a reading of 4 up to 189. the doctor called in a urologist to do the "digital exam"(finger) and the urologist said everything felt normal and his prostate did not feel enlarged or abnormal. The main surgeon insisted my dad follow up with another PSA and digital exam after a week of healing from his gallbladder surgery. Again, the PSA was just as high and digital exam...nothing. He was then sent for an MRI and a nuclear MRI which showed the prostate cancer cells had metastasized up throughout his spine. The good news, it hadn't yet penetrated the bone due to early detection. The biopsy revealed aggressive cancer with 70% of the prostate having cancer. SO...that being said and what we are going through, I absolutely tell every man I meet to insist on a PSA test and not rely on the digital exam. My brother is 46 and I have asked him to get his PSA checked as well. Incidentally, my dad was otherwise very healthy but was suffering from what seemed to be gallbladder problems. For now he is doing hormone therapy and injections to strengthen his bones to keep the cells from penetrating the bone. He follows up next week to see if his PSA has lowered since starting therapy. I am so thankful to that doctor in the hospital that decided to just do a PSA test. So BS to the study above, I really am starting to wonder if indeed the government feels there are too many people and it's time to let some go. Why else cut all the preventative care? It isn't like we don't pay out the @ss for all our care anyway.

    May 21, 2012 at 22:34 | Report abuse | Reply
    • joep199

      The American Cancer Society, which is not part of the government, supports the results of the study.

      May 21, 2012 at 23:47 | Report abuse |
    • ss

      My feeling is that until one of these people on the panel or one of the important reps either from government or the Cancer Society have to go through this...it is of no importance. I guarantee you, if someone like Brad Pitt came forward and endorsed the PSA testing and how it saved his life....everyone would be on board. Us little people don't have much say. Sucks.

      May 22, 2012 at 07:28 | Report abuse |
  6. terry

    The person posting under name "Voice of Reason" seems to be more interested in insulting someone and impressing everyone with his/her supposed intelligance than anything else.

    May 21, 2012 at 22:35 | Report abuse | Reply
    • Voice of Reason

      It would be good to learn to spell

      May 21, 2012 at 22:41 | Report abuse |
    • terry

      See what I mean ?

      May 21, 2012 at 22:48 | Report abuse |
  7. edvhou812

    Yes! I never have to ever worry about some dude having to stick his hand up my butt! 😀

    May 21, 2012 at 22:35 | Report abuse | Reply
    • Paul

      not entirely true.

      May 21, 2012 at 22:37 | Report abuse |
    • Bob Brown

      You should get a digital prostate exam AT LEAST every time you get a PSA. Over about age 50, you should get the digital exam annually. Your family doctor should do this as part of your routine health exam.

      May 21, 2012 at 23:15 | Report abuse |
  8. Paul

    Ok, it's the prostate biopsy that starts costing money, then the other treatments. Of course if you eliminate tests you will save this money, but you may also live to regret this decision. When the cancer spreads to your bones, you will wish you had gotten rid of the cancer before you started your death struggle.

    May 21, 2012 at 22:35 | Report abuse | Reply
  9. The TRUTH

    So this is OBAMACARE ... we told you!! They are changing all the rules and preventative tests because they DON'T care and don't want to spend money on YOUR health. But they will waste a cool million sending the 9th Circuit Court on a trip to Hawaii!!! WASTEFUL GOVERNMENT, waste waste waste

    http://blogs.ajc.com/jamie-dupree-washington-insider/2012/05/21/judges-defend-hawaii-conference/?cxntfid=blogs_jamie_dupree_washington_insider

    May 21, 2012 at 22:40 | Report abuse | Reply
    • mchambers_64

      This was initiated in 2006 via research and sampling. Get your facts right, The Truth.

      May 21, 2012 at 22:46 | Report abuse |
    • Jake

      Obamacare is not the problem It is the third party payor system. If you do not want Obamacare, there are options. You can buy your own health insurance or get it from your workplace. why should the third party be involved? the cost of medical care is ridiculous because the person getting the "care" does not pay for it out of pocket. This is the only developed country without national health care plans for all of its citizens. Obamacare is woefully inadequate. What Obama should have gone for was a two tier system. Basic care for all and optional health insurance for direct pay for those who choose to pay for it themselves. The cost of defensive medicine is the real culprit for the inability of ordinary people to pay for their own care. First, the people need to understand that illness is seldom someone else fault and if they are unhappy and do not have the ability to pay for care out of pocket, they should not be allowed to litigate against anyone except the Government.

      May 21, 2012 at 23:26 | Report abuse |
  10. mchambers_64

    This, in a nut nutshell, is population control.

    May 21, 2012 at 22:41 | Report abuse | Reply
  11. Martin

    I am 56. My father died from prostate cancer. Seven years ago a rising PSA resulted in a biopsy, which showed Gleason 6. The urologist recommended immediate surgery. I elected watchful waiting instead and seven years later, my PSA is about the same. One could argue PSA testing provided no benefit to me. I disagree.

    The real disconnect here is that the government says that many men needlessly "suffer" from unnecessary surgery/treatment and side effects. I know several men in my "category" who elected for surgery or other treatment. While one could dispute that the treatment actually helped them (it is impossible to prove for example that surgery saved a life), I don't know anyone who had the treatment complain about the result. Instead, as here, most such men appear to be confident in the belief that the treatment saved their life. If so, where is the harm that the government sees in the test?

    I am confident that I chose the best course for myself. I see no reason to discontinue the use of the PSA test, cheap as it is.

    May 21, 2012 at 22:45 | Report abuse | Reply
    • ss

      I'm so sorry to hear that Martin. I don't know what my dad's Gleason was rated ( I will ask him) Unless there is something my parents aren't telling me, they say the doctor seems very optimistic and that it seems it was caught early even though it's aggressive. I am hopeful that your 3-5 years extends way beyond their predictions. I have heard that many people live longer than the doctors estimated. Good luck Martin. Btw, my dad did have a broken rib, from what, we aren't sure, he doesn't remember hurting himself but the pain was excruciating. Best of luck to you Martin. I hope our voices on here will somehow, make a difference.

      May 21, 2012 at 23:15 | Report abuse |
    • ss

      Sorry Martin, I see I posted the above post to the wrong person....I will repost to the appropriate gentleman below.

      May 22, 2012 at 07:22 | Report abuse |
  12. Bob808

    Three years ago at age 47, I had a good physical, everything normal with a low-normal PSA. My doctor said not to bother with another checkup until I was 50. I followed his advice, and 4months ago my PSA measured 33. After a biopsy, my gleason score was 8, leading to staging tests (CAT scan, bone scan) which indicated the cancer had metastized to my spine, ribs, and pelvic and abdominal lymph nodes. In the comforting words of my Urologist, a "game changer". Now I find myself on androgen deprivation therapy (testosterone blockade) and bone strengtheners so my ribs and spine don't break too easily. It's working for now (last PSA was 0.68), but their best guess estimate of my life expectancy is 3 to 5 years. 3 to 5 years. I think that if I had been having routine PSA screening every year, this would have been caught a lot earlier in it's progression, and I wouldn't be dealing with 3 to 5 years, my wife wouldn't be dealing with 3 to 5 years, and my kids would still have Daddy around for a long time. Hopefully that happens anyway, I try to stay positive, but when some advisory panel says yearly PSA testing is unnecessary, I have to call BS. Get tested, guys.

    May 21, 2012 at 22:51 | Report abuse | Reply
    • Lisa101

      Bob,Sorry to hear about your diagnosis. My prayers are with you and your family.

      May 21, 2012 at 23:23 | Report abuse |
    • Jim Naples Florida

      I'm with you brother and god speed and luck to you and your family; our family's thoughts and prayers are with you. Please forgive the fools... after all it seems we have become an America of "what's in it for me?" and I, I, I, Me, Me, Me ... who gives a crap about a "barn raising" and looking out for your neighbor.. what's in it for me?

      May 21, 2012 at 23:34 | Report abuse |
    • hollistergrant

      Prostate cancer spread into my husband's spine, pelvis, and ribs, but he lived 13 years after that (and passed away from a medical error in treatment, not the illness). Don't measure your life by anybody else's timetable. Live every day to the fullest, enjoy your family, drink water, and walk outside in the sunlight and fresh air every day - walking is one of the best things you can do for yourself (it jumpstarts your immune system). Best wishes to you.

      May 22, 2012 at 02:32 | Report abuse |
    • ss

      Hi Bob, I accidentally posted this under the wrong post to the wrong person, it was intended for you.
      I don't know what my dad's Gleason was rated ( I will ask him) Unless there is something my parents aren't telling me, they say the doctor seems very optimistic and that it seems it was caught early even though it's aggressive. I am hopeful that your 3-5 years extends way beyond their predictions. I have heard that many people live longer than the doctors estimated. Good luck Martin. Btw, my dad did have a broken rib, from what, we aren't sure, he doesn't remember hurting himself but the pain was excruciating. Best of luck to you Martin. I hope our voices on here will somehow, make a difference.

      May 22, 2012 at 07:23 | Report abuse |
    • ss

      I know, I know, forgot to edit my message to you instead of Martin....It was your post I read and my words are meant for you Bob. I apologize for all my errors. =( But the message is the same Bob, I'm hoping you will live a long, healthy life for you and your wife to enjoy. Best of luck.

      May 22, 2012 at 07:25 | Report abuse |
  13. Stan

    How can detection be a bad thing? What is needed is a treatment that kills the cancer but doesn't cause side effects. I just saw a very promising company at the AUA meeting called Lazure Scientific. They have a treatment that has been tested extensively pre clinically that shows excellent efficacy without side effects at all. Without the PSA test solutions such as Lazure's wouldn't be utilized until it was too late.

    May 21, 2012 at 23:03 | Report abuse | Reply
  14. Don

    It seems to me that it is not the test which is often the problem, it's the treatment. If you take away the test, you remove the option for treatment. Why do this? Should women stop having mammograms because often the cure for breast cancer is really tough? I think I am voting for Romney.

    May 21, 2012 at 23:08 | Report abuse | Reply
    • rafael

      That is about the most ill-informed and non-sensical conclusion I have read yet. Congratulations.

      May 22, 2012 at 00:43 | Report abuse |
  15. DEIN

    Several comments above are wondering what the possible harm of a simple blood test is. It's not the blood test itself that is the problem. The issue is that a lot of people are being treated for a cancer that perhaps would not have caused any real problems for them, and they would never have known about, all because they got the test. This can have very serious consequences, ranging from side effects that are more of an irritation all the way to death. There are many comments above stating that the PSA saved their life. My question is, how do you know? Once you make the decision to treat, you don't really have the benefit of knowing how things would have turned out without treatment.

    May 21, 2012 at 23:11 | Report abuse | Reply
    • ss

      That's not a good enough reason to avoid testing. What needs to be done is improve treatment options after definitive results have been established. They are ruling out a screening, which is ridiculous. That is the argument here, based on the headline. Dumping the testing is not the answer. Perhaps the treatments should be evaluated. Once the cancer has spread from the prostate to other areas of the body, that is where the real problem begins. Many men have been successfully treated with hormone therapy....the other treatments, well, I don't know much about at this point in time.

      May 21, 2012 at 23:19 | Report abuse |
    • DEIN

      What the researchers are saying is that more men are being harmed by doing the testing than are benefitting from it. There is no simple answer. Clearly there are individuals who benefit from PSA testing, but on a population basis there are several large studies which show that the death rate from prostate cancer is about the same in men who get the PSA as it is in those that don't. Combine that with the potential harm, and it isn't as simple as blowing this recommendation off as some government conspiracy. I believe it deserves some more research.

      May 21, 2012 at 23:31 | Report abuse |
  16. Jim Naples Florida

    WHO ARE THE IDIOTS ON THIS "PANEL"? WHO PAYS THEM? ARE THERE ANY HISTORIES OF PRIOR EMPLOYMENT OR OTHER ASSOCIATION WITH THE HEALTH INSURANCE INDUSTRY? WHO DO THEY TRULY REPRESENT?

    May 21, 2012 at 23:29 | Report abuse | Reply
  17. arguenot

    Well, first obamacare wanted to do away with mammograms, now PSA tests. Oh yes, this forced health care being rammed down our throats is the magic bullet….bullet being the operative word. And this is just a panel, can you imagine what will happen if we are forced into the mess of a health care solution. No "death boards"? Really? No limitations on care? Really? And the government will reach right into your bank account to swipe the money whether you want this mess or not.
    If you voted for obama in the prior election to prove you were not a racist, please vote for ANYONE else, to prove you are not an idiot!

    May 21, 2012 at 23:32 | Report abuse | Reply
    • Maya

      How exactly can you complain about more medical care being shoved down your throat, as well as the opinion of a board which is recommending LESS care? Pick one. Either you want all the expensive testing, or you don't.

      May 22, 2012 at 02:47 | Report abuse |
  18. Hypertrophic Prostatectomy

    Can't believe the doctors on this comment board are using their anecdotes to prove points. People-Evidence-based medicine!! Look at the literature!! The data is equivocal at best!! Cite me one study when you try to prove something, or at least tell me what's wrong with the studies so that I know why you aren't citing it. Don't just type M.D. at the end of your name and try to convince me you're right–that's called coercion.

    May 21, 2012 at 23:38 | Report abuse | Reply
    • Bob Brown

      Yo! Cite us one study. ... Oh, wait... you haven't taken a position.

      May 22, 2012 at 00:29 | Report abuse |
  19. Joe, MD

    It's part of the government's plan to cut costs. In this case they have targeted prostate cancer. In another month it will be another disease or cancer. It should be noted that they excluded urologists from the decision-making boards regarding prostate cancer, when they are the ones that know the most about the disease. I had prostate cancer, and had no symptoms. A routine PSA test was 4.0, and it remained at this level for six months, and suddenly jumped up to 9.0. With this type result there was cancer present, the trick was to find it by a biopsy. As the cancer had not spread throughout my prostate it took several biopsy visits before a positive one was obtained. It was a Gleason 9, which was a very aggressive cancer. If I had not had the PSA test these cancer cells would have invaded the nearby rectum and bladder and spine, and caused tremendous pain and suffering before I died the government way. As it turned out, I selected radioactive seeding and after 6 years my PSA is steady at 0.14 and I am symptom free. Never let them take your PSA test away from you.

    May 21, 2012 at 23:44 | Report abuse | Reply
    • Maya

      Can you read, Mr. Fake MD? This task force is not part of the government. All I ever hear from you whackjobs is the government this, and the government that. Sure, the government is screwed up, but people who do nothing but blame the government for all of society's problems and their own problems are only trying to avoid having to take any responsibility or having to think critically.

      May 22, 2012 at 02:50 | Report abuse |
  20. B.

    @Gary You are a dick! Supplying healthcare to the majority has nothing to do with depletion of other social services. Get a degree in economics and you'll be able to do better than Bush math.

    May 21, 2012 at 23:48 | Report abuse | Reply
  21. TexDoc

    Story you won't see on CNN:
    An investigation was underway Saturday into the death of a baby who was born in a hospital waiting room in England's East Midlands region.

    Steven Yorke and his partner Sara Proud went to Leicester Royal Infirmary on Sunday night when Proud realized she was in labor.

    When they arrived, they were told to wait in a side room with other expectant parents.

    May 21, 2012 at 23:49 | Report abuse | Reply
  22. Jack

    Did they say they were banning the PSA test? Allegedly it is cheap, so what's stopping anyone?

    May 21, 2012 at 23:51 | Report abuse | Reply
    • Bob Brown

      As near as I can tell, about $100. And insurance companies will use the report to decide that the PSA test is "non-covered." So, those who can afford to pay will get the test and those who depend upon insurance will not.

      May 22, 2012 at 00:31 | Report abuse |
  23. Robert

    I'm age 49, and the VA gave me a routine PSA test last fall, which showed higher than normal levels. Biopsy showed I had cancer in 9 of 12 samples taken. The doctor said at my young age it probably would have taken my life. Two weeks ago I had 62 radioactive seeds implanted, and I'm told I will never have to worry about prostate cancer ever again. Was it worth the minor impediment to my urinary and sexual functions? Who knows. I'm not an expert. I have to take their word for it. My doctor thinks it is a good thing.

    May 21, 2012 at 23:52 | Report abuse | Reply
    • Arnie K

      I had 165 radioactive Iodine seeds implanted in my prostate over 14 years ago at age 49. I remain cancer free. So, have no regrets.

      May 22, 2012 at 01:02 | Report abuse |
  24. 66Biker

    So let me get this strait here... They're saying that you should not have a PSA test done, which is nothing more than a blood test, because it would do more harm than good? I'm Diabetic and by that kind of reasoning I shouldn't have A1c tests done, because they would do more harm than good. I'm sorry folks, but that is completely stupid. That ranks right up there with insurance plans not wanting to pay for Test Strips and Lancets for diabetics.

    It's kind of like not changing the oil in your car. Sure it will be fine for awhile. But after a few years that oil is going to get nasty. It may not do it for a long time, but sooner or later it WILL ruin your engine. If you don't do regular maintenance on your car it will eventually die. And guess what? The same principle applies to your Body! If you don't take care of yourself, you WILL die prematurely too.

    May 21, 2012 at 23:53 | Report abuse | Reply
  25. SmokeScreen

    So let's see... this test "only" helps 1 out of 1000 men. About 330 million US population, say roughly half men, 115 million, say 40% of them fall into the category of men who should potentially be screened, that's 23 million men... "only" benefiting 1 out of 1000 would be 23,000 people helped. That's a lot of loved ones saved. I don't think the PSA test itself is harmful, as some people are saying here, I think it's some of the potential treatments administered as a result of the test that's of concern. I'm just hoping insurance companies don't stop covering this test because of this report. That would be criminal.

    May 21, 2012 at 23:53 | Report abuse | Reply
    • joep199

      The test itself is not harmful. However, the study indicates that the number of people who are harmed (incontinence, impotence, infection, etc.) by the treatment (radiation therapy, surgery, etc.) administered in response to the test exceeds the number who are helped by it.

      May 22, 2012 at 00:00 | Report abuse |
    • 66Biker

      We know that's what the article says, joep199. But if you see a Doctor that is qualified and not some borderline quack, I doubt that you would have to worry about that. My Doctor has me take that blood test every year, and IF it ever shows any need to be tested further, then we do more tests. And then IF it's warranted, we may discuss treatment options. But whatever those may be, it's up to me to make a decision regarding treatment. Not to mention, my Doctor always tells me "Don't take my word alone on anything serious. Get a second opinion before making a decision."

      May 22, 2012 at 00:31 | Report abuse |
  26. joep199

    I wonder how many of the "M.D.'s" posting here actually are doctors, and how many of those who relate the horrible anecdotes about prostate cancer have actually experienced what they're writing about. Just from reading the posts, it seems like there are more people interested in using this as just one more way to promote their political bias than there are interested in really understanding the science behind this study. The study was NOT done or promoted by the government, and it has NOTHING to do with the Affordable Health Care Act, but not many of the posters here seem to have taken the time to look up that very pertinent point.

    May 21, 2012 at 23:55 | Report abuse | Reply
    • Bob Brown

      I wonder how much of what joep posts is the truth.

      May 22, 2012 at 00:33 | Report abuse |
  27. Paradox6

    Who needs death panels if these Obama appointees are going to try to shape policy and medical thought so no one gets the tests until they are symptomatic. What a pile of baloney. A PSA test is usually an extra vial of blood taken with routine blood work.The test doesn't cause anything to happen, it simply tells you there is a potential problem. It does not commit anyone to do anything.

    This is the first time I have ever heard anyone suggest that less information is better. Ignorance is bliss?. This is really an obscene way to ration care. How many PSA tests have caught prostate cancers at an early stage, resulted in prompt and less invasive treatment and obtained cures. This is a step back to the stone age,

    May 21, 2012 at 23:56 | Report abuse | Reply
    • joep199

      This was NOT a government run program. Check the facts before you make yourself look ignorant.

      May 22, 2012 at 00:01 | Report abuse |
    • Bob Brown

      Joe is right that it's not "government run." It is, however, government FUNDED. "He who has the gold gets to make the rules."

      May 22, 2012 at 00:08 | Report abuse |
  28. B.

    @DEIN So, by your logic, have no testing for anything so you will never have to know the name of the disease of which you will die. A dozen of my friends and family members, male and female, at 50 tested for colon and breast cancer. Three were positive for colon cancer, one Stage 4, one Stage 3. No one died. Four were found to have breast cancer. One had metastacized to her brain, she died after 3 years of serious treatment, and the rest have successfully been treated. No test, 7 dead people. With testing, 1 person dead. Testing is KEY!

    May 22, 2012 at 00:01 | Report abuse | Reply
    • DEIN

      You can not extrapolate the findings from prostate cancer research to other cancers. Colon cancer screening, for example, has been clearly shown to reduce death rates from colon cancer. And these are not my conclusions, but come from a panel of experts interpreting findings from large scientific studies. Interestingly, I know of no other industrialized country where the PSA is routinely recommended.

      May 22, 2012 at 00:12 | Report abuse |
  29. Bob Brown

    I'm not a doctor, I'm an old guy who pays attention to his health. There are several physicians posting here, and I hope they'll correct me if I'm wrong.

    My understanding is that prostate cancer WILL kill you if untreated and if something else doesn't kill you first. For slow-growing prostate cancers, something else is likely to kill you first, and so radical treatment is generally not necessary. Instead, we old guys do what the docs call watchful waiting.

    On the other tentacle, aggressive prostate cancer will kill you quickly and painfully. Unhappily, it appears from the article that it is hard to tell the difference. One can compute a "Gleason score" after examining tissue removed through a needle biopsy. The description of a needle biopsy suggests it is neither cheap nor comfortable. And, the prognosis from the Gleason score can be wrong.

    Given the Gleason score, doctor and patient decide what to do next. That can range from radical surgery to "check again in a year."

    So, gents, with a PSA you get a chance to talk to your doctor. Three of you out of ten with an elevated PSA have cancer, which may or may not kill you, depending on how many years you have left and how aggressive the cancer is. The other seven don't, and further testing is a waste of pain and money. If your PSA is normal, 89 of 90 of you do not have cancer, but one of you does, and the PSA lied. You might die of prostate cancer, but probably not because something else will like;y kill you first.

    I want the test. If I have an elevated PSA, my doctor and I will make a decision about what comes next.

    For those who've been honking about cost, you're about half right. Although cost was not allowed to be considered in the decision process, insurance companies CAN consider the recommendation in deciding whether to pay for the PSA test. If you're like me and want the test, start saving pennies today. As near as I can tell, it'll cost you about $100. And I'd really love to blame this on President Obama, but I can't figure out how to do it. He gets a pass this time, OK?

    May 22, 2012 at 00:02 | Report abuse | Reply
  30. B.

    @Sanity The supposed "war on men" has decades to go before it catches up to the perpetual "war on women," so I wouldn"t hold my breath waiting on equality.

    May 22, 2012 at 00:05 | Report abuse | Reply
  31. B.

    @Steve "...it reads like a strategy one would find in a feminist book on men’s health." WHEN did being feminist mean being against mens health? Never! You should name the book or remove your hugely ignorance post.

    May 22, 2012 at 00:14 | Report abuse | Reply
  32. ironwolf56

    If it was a women's health issue it would be an automatic thumbs up; but men's health issues aren't worth any votes so...

    May 22, 2012 at 00:14 | Report abuse | Reply
    • Michael R.

      What if this "recommendation" affected women? I agree, we would NEVER hear the end of it...an outcry of "what are they trying to do to us"? Wasn't there a total outrage a few years back over the American Cancer Society's suggestions of altering mammography guidelines? Where is the men's healthcare advocay in America?

      May 22, 2012 at 00:59 | Report abuse |
  33. dat

    Typical Obama politics. If you want to live, elect someone else for pete's sake!

    May 22, 2012 at 00:18 | Report abuse | Reply
  34. Humanist999

    The PSA test saved my father’s life.

    My dad had prostate problems in his 50’s – 20 years ago; the doctor, at the time, told my father again and again, visit after visit, that it was age, it was muscular, blah, blah, blah. It was not until over a year after symptoms that my mom saw an article about something new called a PSA exam. My dad demanded one from his doctor – and low and behold, an initial PSA test, a tissue sample, and following tests confirmed he had aggressive cancer; so aggressive, we thought we would lose my father due to the doctor’s inaction.

    It’s been 20 years and dad is cancer free. Cancer surgery and follow up chemo-therapy saved his life.

    Gentleman, don’t let anyone tell you differently. If you’re feeling as though you are having a problem – do something about it. Your action may save your life.

    May 22, 2012 at 00:24 | Report abuse | Reply
  35. B.

    @DIEN I can extrapolate any damned statistic I want because this is a blog and you are just one person with an opinion. I disagree with the topic conclusion. I believe testing is useful if it catches even one person's cancer. If this panel is made up of Ph.D.s, then I have an even better belief in my opinion, as I, too, have a Ph.D and a separate M.D. My experience is that testing is a positive proactive decision.

    May 22, 2012 at 00:27 | Report abuse | Reply
    • DEIN

      Clearly you are a person who makes decisions based on scientific evidence and rational thought rather than opinion and emotion. Oh, never mind.

      May 22, 2012 at 00:36 | Report abuse |
  36. Humanist999

    Thanks W. Bush… yet another latent gift. As if our economy in the toilet was not enough.

    May 22, 2012 at 00:28 | Report abuse | Reply
    • Bob Brown

      This is relevant how?

      Oh, wait... you're just being nasty about the Obama Economy.

      May 22, 2012 at 00:36 | Report abuse |
  37. B.

    @Bertha So good to hear that your father enjoyed 21 years after diagnosis. Some will say this must have been a slow growing cancer, but what they assume is not necessarily fact. End stage says it all. Your father was a smart man, obviously.

    May 22, 2012 at 00:32 | Report abuse | Reply
  38. Ed

    This recommendation is nuts. The tests are not harmful, only the often overly aggressive treatment that gets pushed on many men when they score positive on the test. Change the recommended response to the test...a positive test means you get closely monitored, a negative test means you have another year of no worries.

    May 22, 2012 at 00:35 | Report abuse | Reply
    • DEIN

      Actually, many times men who are told they have cancer decide they want aggressive treatment even when they are told it would be an option to monitor closely. For many men it is hard emotionally to live with a diagnosis of cancer and not be aggressive. Don't be so quick to blame the doctors.

      May 22, 2012 at 00:39 | Report abuse |
  39. uncleray33

    the test is cheap, and painless, and should NOT be eliminated.....what YOU and your doc decide on the results is important...my PSA was a little over 6 in 2004 at age 71..biopsy proved cancer..hormone therapy for 6 months, then I decided on radioactive seeding (100 seeds)...painless..went home same day...PSA is checked every 6 months, and has been at less than .01 since 2005...am 79 now..no urinary problems..I drink, smoke, play golf, and YES..sex...I only take ONE pill daily to control cholesterol......take the test, guys

    May 22, 2012 at 00:42 | Report abuse | Reply
  40. Arnie K

    Without PSA testing, there is no way to detect curable cancers before they become lethal. I am a 14-year survivor of prostate cancer who remains disease-free because PSA testing detected my cancer while still curable. I hate to think where I'd be now if I had not been diagnosed and treated early. While PSA testing is imperfect, it remains the only way to determine whether men may have prostate cancer. Advising against this simple blood test is irresponsible. Many men will die because they will never know that they had prostate cancer. The disease has no symptoms until it is too late.

    May 22, 2012 at 00:52 | Report abuse | Reply
  41. uncleray33

    the biopsy is no fun...my urologist took 8 samples from each side of the prostate....it's a very sharp,quick, pinching feeling, and there was no pain afterwards..I even drove my own samples to the lab....

    May 22, 2012 at 00:55 | Report abuse | Reply
    • Barry

      I had two biopsies; one six point twelve years ago (that was somewhat uncomfortable but certainly tolerable) and one 12 point two years ago. At the start of the biopsy two years ago the urologist injected lidocaine prior to taking the tissue samples. There was then zero discomfort when the twelve tissue samples were harvested. If done correctly the risk is minimal and it is essentially a non-event. In my opinion any man that finds an excuse for not having a yearly PSA and/or avoids a biopsy is either being a first class wimp or just does not care to avoid dying from prostate cancer.

      May 22, 2012 at 01:59 | Report abuse |
  42. NickD2

    Prostate cancer will kill you. It usually has no symptoms until it is had spread beyond control. the only way to defend against it is to detect it early.

    This is nothing to do with national health care and everything to do with insurance comapnies wanting to not pay for tests that save thousands of lives a year.p

    If we will not proterct men from prostate cancer then we should not lrotect women from breast cancer. Try that and see how much noise gets made.

    May 22, 2012 at 01:01 | Report abuse | Reply
  43. W. Keller

    Yep, cut that sucker out – who needs another damn test anyway. Of course, I'd be dead by now – but other than that the test is of little use.

    May 22, 2012 at 01:21 | Report abuse | Reply
  44. jetty

    Dr. Virginia Moyer, a woman, recommends that men do not need a PSA test. Yet feminists scream when male doctors talk about "women's health". Liberal hypocrisy at its finest.

    May 22, 2012 at 01:31 | Report abuse | Reply
  45. Greg Naylor

    Reblogged this on GREG'S LEGACY.

    May 22, 2012 at 01:33 | Report abuse | Reply
  46. Jim McDonald

    Can you say 'death panels?'
    Another day, another obama lie.

    May 22, 2012 at 01:48 | Report abuse | Reply
  47. Barry

    I find recommendations such as these very offensive. The decision to have a PSA test and the action to take as a result of the test clearly belongs to the patient, not the physician and certainly not a Federal panel. As a 67 year old male I want to have regular (at least yearly) PSA test data since it is a forgone conclusion all men will get prostate cancer, the question is just when. Also, PSA is the only prostate screening test now readily available, albeit imperfect. I also want to take a conservative approach and, if in doubt, biopsy, even if that means a biopsy every few years. I had a biopsy two years ago and it was essentially a non event. The decision to accept the minimal risks associated with a biopsy are mine and mine alone, not the medical communities. If the biopsy is positive, I will have my prostate removed (no seeds and certainly not "watchful waiting") and I will not have someone else deciding for me how I should play the odds relative to my remaining life expectancy and the time for which the prostate cancer to begin to degrade the quality of my life or kill me. Again, listen up medical community, this is certainly not your decision.

    May 22, 2012 at 01:51 | Report abuse | Reply
  48. John Lane

    This is nothing to do with obamacare. This is a careful analysis of the cost vs. benefit of this test. The costs include surgery that often isn't needed, causing impotence and other problems, as the report says, and providing a great deal of the income of doctors in this specialty. The same thinking led to the caution on the mammogram. But neither the PSA nor the mammogram is banned, or was recommended to be banned, but rather, to be used more judiciously. If you have the money to get the test, no one is stopping you. But treatment for slow-growing prostate cancers might be unwise. Didn't they find that beyond a certain age, most men have such cancers? It's a tough problem, but at some point you have to examine the cost and harm to the patient versus the benefit. Consider: many of us have an annual physical and blood work. Why not have it on a quarterly or monthly basis? Maybe they might catch some ailment sooner. But we don't do that because cost/benefit wise, it doesn't pay.

    May 22, 2012 at 02:19 | Report abuse | Reply
    • Barry

      John Lane, the cost of the PSA test or any "unnecessary" procedures that result is a small price to pay for helping me assure, to the best technology allows, a longer high quality life span. I made a decision a long time ago for myself that will be to have my prostate removed by either an open prostatectomy or the DiVinci robot if I am ever diagnosed with prostate cancer. I will definitely not wimp out with something stupid (at least for me) like watchful waiting or seeds if I am in otherwise good health with no other life threatening issue. These are decisions I made for myself. They are most certainly not the right decision for everyone but you come across in your post as if you know whats best for everyone. That is exactly why I think there is such a strong emotional content to most of these posts because the medical community is telling individuals like myself what is best for them. What is best for me, as long as I have a high quality of life, is to take the most conservative approach available to maintain that high quality of life. With respect to risk attendant to this conservatism, it is my judgement call, not yours, a Federal Panel, the urologists, etc. Why do I give a Sh== about cost-benefit (assuming the cost is a relatively small risk associated with medical procedures such as a biopsy) if my goal is to use a very imperfect technology to assure I maintain a high quality of life?

      May 22, 2012 at 02:37 | Report abuse |
    • John Lane

      Fine, that's your decision. I specifically said "if you have the money no one is stopping you from having the test."

      But Wikipedia says this: "The PSA test increases cancer detection but does not decrease mortality.[5] Moreover, prostate test screening is controversial at the moment and may lead to unnecessary, even harmful, consequences in some patients.[6]

      If the PSA does not decrease mortality, and often leads to "unnecessary, even harmful, consequences," then I can see why this panel reached this conclusion.

      May 22, 2012 at 02:58 | Report abuse |
    • John Lane

      "stroke and death" are among the possible harmful consequences that may result from PSA findings.

      May 22, 2012 at 03:09 | Report abuse |
  49. Pablo

    This is not a law. but rather a recommendation based on careful analysis of statistics. The doctor and the patient can still follow any course they choose. The panel is simply recommending that physicians not pursue the test as routine as data show the followup treatment to positive test results, frequently caused more harm than good. This is a medical issue that has been debated for a number of years and has nothing to do with Obama.

    May 22, 2012 at 03:07 | Report abuse | Reply
  50. John Lane

    "stroke and death" are among the "harmful consequences that may result from PSA findings.

    May 22, 2012 at 03:08 | Report abuse | Reply
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