Before all you men think that the PSA test is useless, I'd like to tell you my story.


I don't know about Richard J. Ablin's statistics; all I know is the PSA test saved my life. 


Back in November 2006, I went to my doctor's clinic because of a sinus infection.  My regular doctor wasn't there that day, so I saw another.  He noted that I had never had a PSA test and had not recently had my cholesterol levels checked.  He asked if I would agree to having them tested; I said OK.


My cholesterol levels were great.  The PSA, however, was 6.9, with anything over 4 being suspicious.  My urologist said that the only way to positively determine if there was cancer was from a biopsy.  Richard Ablin does men a great disservice by calling prostate biopsies "painful."  This is total BS.  I assume he never had one.  I am a baby when it comes to pain, but my biopsy was not bad at all. The urologist floods the area with anaesthetic; there were some occasional twinges during the procedure, but it was completely tolerable, even for me.


The biopsy showed cancer, which of course was a great shock.  Carmen and I did a lot of praying.  In considering all the treatments, I selected the fairly new surgery that utilizes the DaVinci robot.  My urologist and his partner (it takes two to do the robotic surgery) had performed over 400 such surgeries and had outstanding results.  The robotic surgery is much less invasive and recovery time is significantly reduced.  I was skiing 6 weeks after the surgery in February 2007.


Although the biopsy showed only low to medium grade cancer, the pathological results of the removed prostate showed some of the highest grade cancer, which meant it was ready to spread.  Mine was encapsulated, however, so there was no spreading.  All my PSA levels since have been undetectable.


Ablin says only men with a family history of prostate cancer should have regular PSA tests.  There is no history of it in my family, so, according to Ablin, I should never have been tested.


He also quotes statistics that say there is only a 3 percent chance of dying from prostate cancer.  Well, my father-in-law died from it at age 62.  If only the PSA test were available back then.


I consider the sinus infection - that led me to a new doctor and the PSA test - was a miracle in an unusual disguise.  If my Doctor had followed Ablin's advice, I would never have had that test, and I would probably now be going through treatment for a high-grade cancer that had escaped the prostate, or maybe dead.


I thank God for the PSA test.  Wouldn't you?


Ted Trampe




> Date: Wed, 10 Mar 2010 10:25:31 -0600
> From: jellings@me.umn.edu
> To: wine@thebarn.com
> Subject: [wine] off topic, for men of a certain age - Prostate Mistake
>
> FYI,
>
>
> March 10, 2010
> Op-Ed Contributor
> The Great Prostate Mistake
> By RICHARD J. ABLIN
>
> Tucson
>
> EACH year some 30 million American men undergo testing for prostate-specific antigen, an enzyme made by the prostate. Approved by the Food and Drug Administration in 1994, the P.S.A. test is the most commonly used tool for detecting prostate cancer.
>
> The test.s popularity has led to a hugely expensive public health disaster. It.s an issue I am painfully familiar with . I discovered P.S.A. in 1970. As Congress searches for ways to cut costs in our health care system, a significant savings could come from changing the way the antigen is used to screen for prostate cancer.
>
> Americans spend an enormous amount testing for prostate cancer. The annual bill for P.S.A. screening is at least $3 billion, with much of it paid for by Medicare and the Veterans Administration.
>
> Prostate cancer may get a lot of press, but consider the numbers: American men have a 16 percent lifetime chance of receiving a diagnosis of prostate cancer, but only a 3 percent chance of dying from it. That.s because the majority of prostate cancers grow slowly. In other words, men lucky enough to reach old age are much more likely to die with prostate cancer than to die of it.
>
> Even then, the test is hardly more effective than a coin toss. As I.ve been trying to make clear for many years now, P.S.A. testing can.t detect prostate cancer and, more important, it can.t distinguish between the two types of prostate cancer . the one that will kill you and the one that won.t.
>
> Instead, the test simply reveals how much of the prostate antigen a man has in his blood. Infections, over-the-counter drugs like ibuprofen, and benign swelling of the prostate can all elevate a man.s P.S.A. levels, but none of these factors signals cancer. Men with low readings might still harbor dangerous cancers, while those with high readings might be completely healthy.
>
> In approving the procedure, the Food and Drug Administration relied heavily on a study that showed testing could detect 3.8 percent of prostate cancers, which was a better rate than the standard method, a digital rectal exam.
>
> Still, 3.8 percent is a small number. Nevertheless, especially in the early days of screening, men with a reading over four nanograms per milliliter were sent for painful prostate biopsies. If the biopsy showed any signs of cancer, the patient was almost always pushed into surgery, intensive radiation or other damaging treatments.
>
> The medical community is slowly turning against P.S.A. screening. Last year, The New England Journal of Medicine published results from the two largest studies of the screening procedure, one in Europe and one in the United States. The results from the American study show that over a period of 7 to 10 years, screening did not reduce the death rate in men 55 and over.
>
> The European study showed a small decline in death rates, but also found that 48 men would need to be treated to save one life. That.s 47 men who, in all likelihood, can no longer function sexually or stay out of the bathroom for long.
>
> Numerous early screening proponents, including Thomas Stamey, a well-known Stanford University urologist, have come out against routine testing; last month, the American Cancer Society urged more caution in using the test. The American College of Preventive Medicine also concluded that there was insufficient evidence to recommend routine screening.
>
> So why is it still used? Because drug companies continue peddling the tests and advocacy groups push .prostate cancer awareness. by encouraging men to get screened. Shamefully, the American Urological Association still recommends screening, while the National Cancer Institute is vague on the issue, stating that the evidence is unclear.
>
> The federal panel empowered to evaluate cancer screening tests, the Preventive Services Task Force, recently recommended against P.S.A. screening for men aged 75 or older. But the group has still not made a recommendation either way for younger men.
>
> Prostate-specific antigen testing does have a place. After treatment for prostate cancer, for instance, a rapidly rising score indicates a return of the disease. And men with a family history of prostate cancer should probably get tested regularly. If their score starts skyrocketing, it could mean cancer.
>
> But these uses are limited. Testing should absolutely not be deployed to screen the entire population of men over the age of 50, the outcome pushed by those who stand to profit.
>
> I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster. The medical community must confront reality and stop the inappropriate use of P.S.A. screening. Doing so would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments.
>
> Richard J. Ablin is a research professor of immunobiology and pathology at the University of Arizona College of Medicine and the president of the Robert Benjamin Ablin Foundation for Cancer Research.
>
>
>
>
> --
> ------------------------------
> * Dr. James Ellingson, jellings@me.umn.edu *
> * University of Minnesota, mobile : 651/645-0753 *
> * Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
>
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