Prostate Cancer Over-Diagnosed: Study

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Google: "The great American pseudo- epidemic of cancer of the prostate" and read the best article ever written on the subject from 1996. 1996!!! Everything in that article has only been reinforced by study after study since then. People in some other countries saw the PSA era for what it was a long time ago.
Follow that by Googling: "An elusive tumor in a man who has evidence of prostate cancer metastasis" the article is about imaging techniques but the interesting thing is the patient's case history: A radical prostatectomy 11 years ago, PSA only 3.0, Gleason only 6, he was told his "disease was organ-confined with no lymph nodes involved and now he's suffering from metastatic prostate cancer in his lung.
All of these latest studies followed men for 10 years. Metastasis of slow growing prostate tumors caused by all these unnecessary surgeries can take a long time to show up.
Follow that by Googling: "Robert Novak's battle with 4 cancers highlights importance of making informed treatment choices" OK ... this is all anecdotal but I've seen it happen too many times with friends and relatives and I'm saying that that Mr. Novak may have made a poor choice to battle prostate cancer to begin with. Did he die of primary brain cancer or metastatic prostate cancer? Only his doctor knows for sure. Did Paul Newman die of primary lung cancer or metastatic prostate cancer? Dominick Dunne just passed away. Cause of death: bladder cancer. Look a little closer and in one article it states that "he recovered from prostate cancer in 2003" -- whatever that means -- most probably that he recovered from the operation to remove his prostate. Only his doctor knows for sure. Causes of death are notoriously inaccurate -- and require rarely performed autopsies to validate -- these mis-classifications may be the the real source of the statistical reduction in deaths from pc since the introduction of PSA testing -- .
Google: "A biopsy can stimulate the inflammation that helps the cancer," and You can read about the guy who developed the theory that biopsies can cause inflammation that may lead to metastasis. Its highly technical but if you read it through to the end you'll get to the point (pun intended) in plain language:
"Of course, the primary culprit in all these cancers remains inflammation, which is looming ever larger as cancer's all around helpmate, potentially even when it comes to something as routine as a biopsy, a procedure long associated with cancer treatment."
This isn't wacko "alternative" medicine --this is cutting edge research at a reputable medical research institute.
Sometimes you see studies trying to knock "watchful waiting" by citing the number of participants who eventually decide to seek treatment. Other than the simple fact that its difficult for most people to live with a "cancer" diagnosis (however bogus that may be) ... it could also be because the "watchful" part consists of repeated biopsies every so often to monitor a cancer prog

Ed Dwulet of CA 2:47AM September 05, 2009

Screening, "early detection" and treatment of a "disease" that 100% of men will have if they live to be 100 is big business in this country. It has been commercialized by the widespread introduction and persistent use of an unproven test (PSA) to create a whole class of new "cancer" patients. The medical industrial complex's exploitation of prostate "cancer" fears rivals that of Bush's terrorism fear campaign. Fear sells ... and hospitals and doctors are getting rich pandering to it.
Choice is important in our for-profit medical system so at some of the all manner of equally unproven prostate cancer treatments are marketed like soft drinks to these newly created pseudo-patients (who are often encouraged to choose their own poison)... each has their own profit-driven advocates within the system. But its more likely that if your doctor happened to invest in DaVinci machine he would end up convincing you that it was the best thing since sliced bread. Or if your doctor is a partner in a proton radiation facility, Its likely you'll end up there -- and on and on. All the treatments are debilitating in one way or another and they ruin many men's lives.
As is obvious from some of the comments here, the dumbed-down US population cannot comprehend the even the simple statistics behind the latest studies on screening. At best ... somewhere between 20 and 48 men have to be treated to save one! And yet here we have the usual plethora of testimonials about how someone's particular PSA test and someone's particular treatment saved their particular life. Informed consent, though sadly lacking with respect to PSA testing and cancer treatment in this country, if it were offered, still requires a certain minimum level of intelligence and education. Most men walking around without their prostates and calling themselves "cancer survivors" are statistical survivors of our medical system, not of a disease that would have killed them. One 60 year old friend I had who was being railroaded into a radical prostatectomy was told: "have this operation and there's a 96% chance that you'll be around in 10 years." But what he wasn't told was that there was a 95% chance he would survive 10 years if he did nothing!
In a different world, what all men will get if they live long enough, and will die with rather than from, would be called "Age-related prostate degeneration" (how about ARPD) -- something that has no relation at all to the real aggressive prostate cancer that kills relatively few -- and for which, as of today, there is no scientifically proven screen or test or cure.

Ed Dwulet of CA 2:45AM September 05, 2009

I am an African-American Male over 40 years of age and my family physician have always recommended a PSA during my annual physicals. My most recently annual physical, the results of the PSA's reading was 5.0. During my previous physicals these readings were 4.0,4.2 and 4.7. As recommended by my physician I have seen a specialist and he cannot tell me what this means and have scheduled a biopsy for 9/2/09 to see if it is only an enlarged prostate or something else. My concern that I am a healthy person, who exercises daily and eat healthy foods,etc. I will go through with the biopsy tomorrow and await the results. I also have notified the specialist who's performing the biopsy, that it is my decision even though the biopsy results are not known, I will not have any surgery and radiation treatments that will lead to erectile disfunction, etc. Any recommendations and/or comments that you can provide?

James Solomon of CA 11:38AM September 01, 2009

As my PSA climbed to 8 1/2 & 9, my primary care doc sent me to a urologist. A 12 needle biopsy was negative. Six months later, an 18 needle biopsy also proved negative. I was taking Flomax at the time because of trouble urinating. When I felt the Flomax was not doing anything for the urination problem, my urologist suggested a TURP (roto rooter). When that was done and the removed tissue sent to pathology, it was discovered that I had cancer of the prostrate to the tune of Gleason 8. I underwent robotic surgery to have it removed last year and my last PSA was undectable!
My point is, don't pay attention to all the BULLS_IT from the media, the government and the "Reliable Sources". Get a PSA starting at 40 (it's only a blood test), a DRE and if necessary a biopsy. It may save your life.

A. Johnston of CO 10:03AM September 01, 2009

Family history led me to start PSA screening prior to age 40. At 50, my numbers started climbing. The clincher was the biopsy, which revealed an aggressive (Gleason 4/3) cancer in the left lobe. Surgery was successful. The PSA is like a prolonged fever - an indicator which suggests further testing is warranted. The needle biopsy is the key, the PSA is the warning.

Ed Magowan of FL 9:46AM September 01, 2009

In my view just another scam to drum up business, 1st by scare tactics, then by treating unfound symptoms for the sake of "better be safe than sorry".
But hey, its only money right, as long as you have enough of it and if you have insurance so much the better.
Just keep milking the insurance companies and that will surely continue to drive up prices in health care costs, wouldn't you think?

AK Nicol of WA 9:38AM September 01, 2009

My brother is in his mid-50s and is dying from prostate cancer that was diagnosed too late and had already spread to his spine. It was detected by the simple PSA test that this article suggests is leading to "over-diagnosis." I wish my brother had been "over-diagnosed" a few years earlier so I would have more time left to spend with him, so that he could have been saved by an early treatment or surgery like so many other men who have survived prostate cancer to live long, healthy lives.
Everyone should think long and hard about the entire healthcare debate and suggestions that there are too many tests being done, that it's too expensive and that we can't possibly provide such tests for the uninsured. Think about which of your relatives you would be willing to sacrifice - a brother, a father, a son - in the name of greater efficiency or the irrational fear-mongering over any type of public or co-op health insurance that could cover things like PSA tests before a disease goes too far and ends up costing tens of thousands in hospital costs and the human tragedy of premature deaths in a family.
The old adage that an ounce of prevention is worth a pound of cure rings true. If we really want to reduce the financial and human costs of a healthcare system engineered by MBAs and money managers instead of doctors, healthcare workers and patients (that's all of us) we need to support prevention and that means screening for life threatening diseases.

A Concerned Brother of FL 9:22AM September 01, 2009

I also had a low psa for several years. A new family doctor gave me a DRE and "did not like the way it felt". Even though she could not feel a tumor, she sent me to a Urologist. The Urologist recommended a biopsy. It came back positive 1 in 12. With a Gleason Score of 3+3, 6. After much study, I elected to have the prostate removed by Robotic surgery in Houston. The cancer was contained in capsule with no margins. I have no side effects from the surgery except that my urine stream is as it was in my youth, and I sleep all night without getting up. My PSA is undetectable one year post op. I maybe one of "unnecessary" treatments, but you will not convince me that my surgery was not necessary. Dr. Brian Miles of Houston performed my surgery in June of 2008.

Herb Stark of TX 9:14AM September 01, 2009

i help and continue to help men with prostate cancer for many many yrs- and have found that the use of so-called conventional treatments or very damaging--surgery causes an array of problems--mental issues-blood clotting-urinating on themselves=hormone injections--lupron-zoladex and casodex-(same old dog and pony) drugs-causes massive bone loss and many other issues--it does nothing for the tumor-radiation and chemo- what joke--hifu another joke--within 17-36 months over 90% of these men that have used these medical treatments, the cancer has returned within this time frame-it is like you can set your watch by it--i have also found that with men dignosed with a gleason 7 or under- if they do nothing to address the prostate cancer issue-they will very likley die of something other than prostate cancer-and that most men dignosed and use the conventional treatments-there gleason will increase almost immedaley after starting on conventional treatments-please do not rush into anything quickly-concerning prostate cancer--most of it is very slow growing--remmeber if you are dignosed with prostate cancer by your urologist--you have just become a nail and he/she has a hammer--www.nutrition2000info.com
hormone therepy

larry pope 7:57AM September 01, 2009

What levels of PSA should be a concern for people who have had radical surgery and yearly follow-up PSA testing. Should chemical shots be required, at what PSA level and for how long.

Edward A. Brominski of PA 6:30AM September 01, 2009