When the evidence says no to PSA testing
Unreliable PSA-based screening for prostate cancer exposes men only to great danger. I know you feel like you’ve been hit over the head and that your world is about to end since getting a prostate cancer diagnosis.
But let’s hold up. The good news is that most prostate cancers will not kill you and you are much more likely to be robbed of health during this prostate cancer testing and treatment deception than having your life “saved”. In fact, to hammer home this point, the five year survival for “prostate cancer” is estimated to be 100 percent, the 10 year survival is estimated at about 98 percent while the 15 year survival is estimated to be about 96 percent REGARDLESS of the type of treatment. Even more stunning is the revelation that NO treatment has a similar 10-year survival to someone who did have treatment.
Since there’s NO emergency to act on your diagnosis, let’s take a good look at how you got to this point. Especially, is there objective evidence to support the current so-called standard prostate cancer testing and detection program?
Are the “standard” prostate cancer detection steps reliable? NO, they are not.
- Urinary symptoms – these are very common in men as they get older because enlargement changes in the prostate can restrict urinary flow. Urinary symptoms are not usually caused by an underlying cancer.
- Prostate exam or DRE (digital rectal examination) – this unreliable test has the same accuracy as a coin-toss. Every doctor feels something different and despite being flawed some doctors want to perform this exam every six months.
- The PSA (prostate-specific antigen) test is falsely labelled as specific.
It is NOT specific for prostate cancer.
- The PSA test is highly unreliable and associated with a false positive rate of 78 percent.
- The PSA limits of 0-4 ng/ml being “normal” are arbitrary and FALSE.
- The PSA is frequently “elevated” in unimportant conditions.
- The PSA can be artificially raised or lowered by several processes without an underlying cancer being present.
- It’s NOT any prostate cancer that can kill – it’s only the 15 percent or so of high-grade cancers that can kill.
- Since high-grade prostate cancers often make little or no PSA these potentially deadly cancers are commonly missed.
- The PSA is unable to distinguish killer-cancers from non-deadly cancers.
- The PSA test FAILS to save significant numbers of lives. In their study “Mortality Results from a Randomized Prostate-Cancer Screening Trial” (linked below) urologists concluded that “PSA-based screening results in a small or no reduction in prostate cancer specific mortality.” That is, despite the PSA test the annual U.S. death rate from high-grade prostate cancer remains at about 30,000. Furthermore, the 10-year survival rate is about the same whether the cancer was detected and treated or not treated.
- Alternative biomarkers such as PSA derivatives (like the percent free PSA), PCa3, “score” tests and genome tests are not foolproof – the PTEN test is an immunohistochemistry assay that tries to determine the aggressiveness of cancer cells found on a biopsy specimen. Even the few urine tests for prostate cancer detection lack significant specificity for identifying those with only the few potentially deadly high-grade prostate cancers.
- Also be aware that the business of healthcare knows how to DECEIVE and make money off your concerns. Just like drug manufacturers are clever at creating drug shortages and producing fraudulent generic drugs for profiteering, laboratories and imaging centers are not above generating abnormal blood tests or imaging reports to create doubt and encourage repeat studies for big profits.
- The ultrasound-guided 12-core prostate needle biopsy can’t “see” cancer but samples blindly and randomly only about 0.1 percent of the prostate gland. Not only is this test uncomfortable (despite local anesthetic) but it carries a significant risk for sepsis (by going through the rectum), rectal bleeding, erection issues and depression. Shockingly, the grossly unscientific 0.1 percent hit-or-miss biopsy means that there is zero knowledge about what is going on in the 99.9 percent rest of the prostate.
By now you will realize that your highly unreliable urinary symptoms, prostate exam and undependable PSA test lead commonly to a very risky prostate biopsy that samples only about 0.1 percent of the prostate. A “standard practice” that injures countless men and helps few if any simply cannot be supported by the feeble medical excuse that the PSA test “is the best we have”.
Why is PSA testing and PSA-based screening bad for your health?
- Because, the few important potentially deadly high-grade prostate cancers commonly make little or no PSA and won’t be detected.
- Because, the PSA is elevated mostly in simple prostate enlargement and in those with low-grade prostate cancers that don’t need detection or treatment since they are not life-threatening.
- Because, the USPSTF (United States Preventive Services Task Force) has determined already that the harms of PSA testing outweigh its possible benefits.
- Because, the PSA screening test is highly unreliable and causes untold numbers of men to undergo risky and unnecessary testing and treatment.
- Because, 30 million PSA tests are ordered annually in the U.S. with little or no impact on the annual U.S. death rate of 30,000 from high-grade prostate cancer.
- Because, PSA testing fails to meet the criteria for an effective screening test and is not lifesaving.
- Because, PSA-based screening wastes billions of precious healthcare dollars.
Why was this highly unreliable PSA test unleashed on a hopeful healthcare public?
Because, through slick external corporate pressure the PSA test for prostate cancer was given an approval for use “as an aid in the early detection in men 50 years or older” by the FDA in August 1994. As a consequence of this foolish approval the prostate cancer industry was handed a golden opportunity to market a terrifying cancer label and scare men towards worthless but money-making PSA testing.
The PSA is a fraudulent screening test that offers zero protection against dying from high-grade prostate cancer. Fueled by greed, orchestrated deception and scare-tactics this licensed medical error serves only to exploit the vulnerable with false hope and false promises. Fortunately, the sick money-making prescription that ruins countless lives and created a public health disaster has a quick remedy. The PSA’s misguided FDA approval can be easily rescinded.
Horan, A., “The Big Scare. The Business of Prostate Cancer”
Ablin, R., and Piana R., “The Great Prostate Hoax”
Barrett, S., and Jarvis, W., “The Health Robbers”
Eban, K., “Bottle Of Lies”
Coming soon – Part 2 ……….. The unreliable prostate biopsy
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Your body, your rules
Bert Vorstman BSc, MD, MS, FAAP, FRACS, FACS