Prostate-Specific Antigen Test: Doing More Harm Than Good?

With new recommendations on PSA (Prostate-Specific Antigen) testing  for prostate cancer reaching the mainstream media yesterday, many men are wondering how this will affect them. What if they don't have their cancer caught early enough? What if they don't have cancer at all?

The PSA test, a cancer screening that began in the 1980’s, is effective in determining whether a patient has cancer or not. However, the test has been known to give false-positives and ,in addition to that, while the test determines the presence of cancer, it is not able to specify the type of cancer. According to the medical community, it is possible to live a long healthy life without treating certain cancers or putting your body at risk. There is both aggressive, fast-growing forms of cancer, and there are cancers that grow with the speed of a sloth. If a person has the sloth kind of prostate cancer, the probability that they will live a long healthy life and perish from some other ailment before the cancer grows enough to cause a problem is higher.

Many people get the “heebie-jeebies” from thinking about living their whole life with a cancerous tumor growing inside of them, slow-growing or not. However, the procedures following the PSA test are showing that in many cases the risks outweigh the benefits. In a study released on Monday, by the journal Annals of Internal Medicine, it is stated that evidence in the recent studies showed, "PSA-based screening can cause harms, including pain and complications from prostate biopsy and worry about test results."

Once a positive PSA test comes back, the patient has a biopsy done. If the biopsy yields a positive result, regardless of the type of cancer it is, most patients will opt for surgery or radiation under the direction of their doctor. Again, the Annals of Internal Medicine sees this as a hazardous problem stating:  "The more worrisome harms are related to treatment of prostate cancers found by screening when most of these cancers, if not found by screening, would have never caused problems for the patient." Essentially, the PSA test, while effective in determining whether or not a patient has cancer, does not differentiate between types. The concern here is that patients are allowing themselves to be susceptible to treatments that may be unnecessary, and may be for a cancer that will have little to no effect on their lives.

In a report from NBC Nightly News, it was stated that, "5-1000 men die from complications of prostate cancer surgery within 1 month of the procedure." The report also stated that, "20% - 30% of men receiving treatments end up impotent or with urinary or bowel difficulties, or with all three." Sexual dysfunction is also a common side effect from treatment.

While all of this may be controversial, as we are speaking about cancer and human mortality, it brings to mind something my college biology teacher said as we discussed Bio-film and other sorts of bacteria. He stated, "As humans, we hear 'bacteria' or 'germ' and what do we do? We get out our sanitizers and disinfectants; completely overreacting to something that occurs naturally in our daily lives and that isn't as evil as people think it is." I am in no way comparing bacteria to cancer, but it is an applicable thought. As humans we rationalize everything and do what we can to protect ourselves from death because we fear it. But at what point do medical procedures actually pose more harm than the problem we are trying to correct? This study raises that question.

Talk…Discuss…Research your options and determine the path you want to choose for testing and treatment. Men over the age of 50, as well as men over 45 of African descent are encouraged to start PSA testing. In the end, as the patient, it is up to you to make the best decision for yourself regarding testing and treatment options.