Men’s Health: Questioning the Necessity of Prostate Cancer Screenings

This article I'm posting as a  collaboration with and organization called The Sexual Wellness Center (for Adults over 50)

The article is copied word for word, but make sure you read my comments added at the bottom, as I always have my own opinion and spin things.

A PSA About PSAs: What You Need to Know About Prostate Cancer Screening (full article, word for word…….)

The PSA blood test is currently the best available screening test for prostate cancer. But PSA testing is very controversial. Should you get tested? That depends on your risk factors for prostate cancer and how you and your doctor feel about PSA testing.

Read on to learn more about your options. Prostate Cancer Basics The prostate is a walnut-size gland located deep in the male pelvis, below the bladder and above the rectum.

Prostate cancer is a major health issue for older men.

The National Cancer Institute projects 181,000 American men will get the disease, and 26,000 will die from it this year alone. For comparison, breast cancer develops in 247,000 women and kills 40,000 annually.

But unlike breast cancer, which can appear in women before age 40, very few men develop prostate cancer before 50: The average age at diagnosis is 66. Prostate cancer is unique. Unlike all other cancers, as men age prostate cancer becomes nearly inevitable.

In autopsies of men over age 85……

…… almost 100 percent show prostate cancer, but most of the tumors are indolent (relatively benign), slow growing, and pose no threat to men’s health or longevity. Doctors often say, “Some old men die from prostate cancer, but all old men die with it.”

Unfortunately, there’s no reliable way to distinguish indolent prostate cancers from life-threatening ones. If detected early, prostate cancer is very treatable. In fact, more than 90 percent of men survive at least five years after diagnosis, and most live much longer. Currently, PSA testing is the foundation of early detection.

How PSA Testing Works

PSA stands for prostate-specific antigen, a protein produced only by the gland. Since 1994, when the Food and Drug Administration approved PSA evaluation as a screening test for prostate cancer, physicians have typically ordered it as part of the battery of blood tests that accompany annual check-ups.

Most doctors order PSA tests when men turn 50, or earlier for men with family histories of the disease or for African-American men who are at greater risk. The same blood sample drawn to test for cholesterol can be used to gauge PSA. Tests are considered normal at PSA levels up to 4.0 nanograms of prostate-specific antigen per milliliter of blood (ng/mL). As PSA rises above 4.0, so too does the risk of cancer.

If a PSA reading is high……..

……. the next step is a prostate biopsy. This involves taking samples of prostate tissue and examining them under a microscope to see if any cells are cancerous. For prostate biopsies, urologists insert a probe into the man’s rectum. (The probe is about the size of a cherry, but feels larger.) It contains a spring-loaded hollow needle. The urologist presses a button that releases a needle into the gland and captures some tissue.

The doctor takes roughly a dozen or more samples. If the tissue shows cancer, the man is diagnosed with the disease. Why PSA Testing Is Controversial A good screening test reliably detects the target illness, and if the test indicates illness, treatment begins. Unfortunately, PSA testing meets neither of these two criteria.

PSA tests do not reliably detect prostate cancer.

Men with prostate cancer have PSAs below 4.0 (false negative), and high PSAs do not necessarily indicate cancer (false positive). There are several common non-cancer causes of elevated PSA including: 1) Sexual activity (partner or solo)     2) Age-related prostate enlargement      3) Infections (prostatitis or urinary tract infection) 4) Sitting for long periods (for example, long-haul truck drivers)

Because high PSAs cannot distinguish between cancer and other factors, many men—hundreds of thousands a year—wind up with unnecessary biopsies that are invasive, costly, and unpleasant. If biopsies find cancer, there’s no way to know if the disease is indolent or life-threatening.

But when doctors say, “You have prostate cancer,”…….

…….most men fear for their lives and opt for treatment even though the disease is often indolent and treatment is unnecessary.

There are two approaches to treating prostate cancer: surgical removal of the gland or radiation, either from a source outside the body in the form of an external beam or from radioactive pellets, known as seeds or brachytherapy, inserted into the gland. All treatments are equally effective, but they all cause side effects including persistent urinary incontinence and erectile dysfunction (ED).

Finally, many studies agree that PSA testing saves few lives.

In 731 men with early-stage prostate cancer, University of Minnesota researchers either removed the gland by way of radical prostatectomy or did nothing (watchful waiting). After 12 years, the treated men’s prostate cancer death rate was only 3 percent less than those who were not treated, a statistically insignificant difference.

Dutch researchers tested PSAs in 91,000 men regularly while 91,000 others were not tested. After nine years, the prostate cancer death rate was slightly lower in the tested group, but screening resulted in a great deal of over-diagnosis and over-treatment, with thousands of men suffering subsequent lifelong incontinence and ED.

Researchers with the National Cancer Institute……

…….recruited 76,685 men; half had regular PSA tests while half did not. After 10 years, the tested group was much more likely to be diagnosed with prostate cancer and treated for it, but the two groups’ prostate cancer death rates were identical.

Based on these studies and others, the U.S. Preventive Services Task Force (USPSTF), an influential expert panel that advises the Department of Health and Human Services on screening tests, estimated that…… {continued}

……for every 1,000 men over 55 who get regular PSAs for a decade
(which totals 10,000 PSA tests):

* At most, one prostate cancer death would be prevented
* 100 to 120 men would have false-positive results leading to biopsies
* About one-third of those who were biopsied would experience bothersome side effects
* 110 men would be diagnosed with prostate cancer, and many would suffer ED and incontinence

As a result of these findings, the USPSTF recommended against routine PSA testing…….

…….. asserting that the financial and human costs outweigh the benefits. The American Urological Association, a big promoter of PSA testing, initially argued against the decision but has since softened its position, saying PSA testing should depend on men’s “values and preferences.”

Of course, most men just do what their doctors recommend, and most doctors continue to order annual PSA testing, fearing lawsuits for failure to diagnose cancer..

Since the USPSTF recommendation against routine PSA testing……..

…….. two things have happened: rates of PSA testing have declined a little and treatment of diagnosed prostate cancer has shifted dramatically away from surgery or radiation to watchful waiting, with treatment only if the cancer spreads beyond the gland.

Five years ago, the vast majority of men diagnosed with prostate cancer opted for treatment. Today, almost half choose watchful waiting. Back in 1970, researcher Richard Ablin, Ph.D., discovered the prostate-specific antigen.

Ablin [the inventor of the PSA Test] has become an outspoken critic of PSA testing.

He himself does not get tested, saying that the costs outweigh the benefits. His book, The Great Prostate Hoax calls PSA testing “a disaster.” What’s a Man To Do? When you talk to your doctor, review your risk status. If you’re not African-American and have no family history, ask if PSA testing is prudent for you.

Think about what your doctor says, then decide for yourself. San Francisco health and sexuality journalist Michael Castleman writes the “All About Sex: blog on PsychologyToday.com and publishes GreatSexGuidance.com where he provides free answers to sex questions from people of all ages and erotic inclinations.

My comments on the subject

Since people always write back and ask my opinions, I'll jump the gun and state them below……

My Opinion on "Seeing Your Doctor……"

Not saying there are not good doctors out there, I think we have the best crisis care in the world, like if I broke my wrist playing basketball. Every man has to make his choice, but I'm not the biggest fan of that phrase "See your doctor". Why? Because in general terms, doctors have a vested financial interest in their recommendations and treatments, so I don't think you can get a biased answer. (that been totally document and exposed as pertains to, as an example, Doctors profiting from Chemotherapy drugs). It's an apparent "conundrum", which I had to address by taking control of my prostate health, specifically my nutrition for prostate health, and from what I learned, I'm not overly concerned about Prostate cancer, though extensively aware of it (can't help but be aware being and African American, though youthful, male in my 50's). If you trust your doctor, fine, but I still think you have to consider the Profit Motive, but that's my opinion. The issue I have is there are documented natural solutions to Prostate Health, and my belief is that it would be impossible for the medical industry to reveal them to us (along with solutions for all cancers and major diseases) without going out of business. The main purpose of any organization is to sustain itself. So, because those natural healing realities are kept from us, I would never expect a doctor to offer me a real solution that Nature seems to abundantly provide (I think it is illegal for them to give natural cures anyway).

My Opinion on Being African American amd Prostate Cancer Vulnerabilities.

A bold statement coming, but I'm not thinking twice about it. Why? Because I've thought about it so much in the past, had so many fears, and from that, proceeded to do the research necessary for my own well being. I think the point missed with African males is that  we are out of our natural habitat, that being warm sunny African climate, and thus are not getting the healing Vitamin D from the sun, primarily because of darker asking blocking Vitamin D in Northerly Climates (though note the Massai tribe in Kenya, Africa had one of the highest average Vitamin D scores of any culture in the world, about 45.5, though they are very dark skinned, but they are cattle herders in the Equatorial sun all day long). Also, we're ignorant to healing nutrients (like cancer fighting Vitamin B17/Nitrilosides) found in native African foods like cassava (or cancer fighting fighting, B17 Rich foods available in the USA like Apricot Seeds). Once you come into certain particulars of African American biochemistry, you can conquer the fear and ignorance of this issue. Sure, there is some risk of any disease, but I can get hit by a falling scaffold, or choke on a fish bone, but I've put in the work to do what necessary to address this issue for myself. Thus, I don't see my personal circumstances as having me in any assumed high risk category. I would never expect to get this information from a doctor, because they are [arguably]  exploiting these vulnerabilities in African American health for profit, but I think every segment of the American public is being exploited for profit by the medical industry. African Americans are at a specific disadvantage, however, because African American biochemistry is not compatible with Western medicine

My comment on my so called "Prostate Test I take every evening….."

Want to say as a closing interesting statement, I drink a half can to a can of coconut water every night before bed, just cause it quenches my thirst, and at age 55, perhaps for the last few years, I never have to get up to go to the bathroom at night to urinate.

(I can't even remember when was the last time I got up at night to go to the bathroom).

~stay healthy~

 

Core of article [less my comments] taken word for word from an article presented to me by "The Sexual Wellness Center"

Other interesting reads, for men and women, from the Sexual Wellness Center (for Adults over 50) Website

Anyone curious about the history of Black NHL Hockey Players, go here

 

you might also like……

 

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