The end of the PSA test?
It's been a long time coming, but the PSA test used to screen men for prostate cancer is finally on the outs.
The U.S. Preventive Services Task Force has formally given a "D" to the PSA test. It's the lowest possible grade the guideline-writing agency issues, and it means the risks of the test outweigh the benefits.
Naturally, there's been a lot of screaming from some doctors who want to keep using it, along with the men who believe the test led to a prostate surgery that saved their lives.
In reality, the studies are remarkably consistent -- so consistent that I don't get why this new recommendation is controversial.
Fact of the matter is that the PSA test has an incredibly high rate of false positives -- as high as 80 percent. That might be tolerable if it saved lives the other 20 percent of the time, but it doesn't.
Instead, it often leads to treatments such as surgery that can come with serious long-term risks like incontinence and impotence -- and studies have shown that most of these men would have survived even without those life-ruining treatments.
That's because prostate tumors grow so slowly you'll almost certainly live with them -- not die because of them.
This isn't just a maverick opinion from the land of alternative health. It's the reason the very mainstream USPSTF is abandoning the test, the reason many mainstream doctors stopped using it long ago, and the reason even the man whose discovery led to the test -- Dr. Richard Ablin -- now regrets it.
I don't think the PSA needs to be abandoned completely, as it may be of some use in men with a high risk of the disease -- such as men with a strong family history of prostate cancer. It can also be used to monitor men on testosterone therapy.
But even then, it's just one tool in the toolbox and needs to be used alongside other better tools, such as the digital rectal exam and prostate ultrasound.
If prostate cancer is diagnosed, many older men can safely take what's called the "watch and wait" approach, although I've never cared for the phrase. It sounds a little like "watch and do nothing," and that's exactly what you shouldn't do.
Instead, work with a holistic doctor on getting the nutrition your body needs to slow, stop, and even reverse the growth of your prostate tumor. This used to be considered an "alternative" approach -- but thanks to the Task Force's decision, it's quickly moving into the mainstream.
If you or a loved one has been diagnosed with prostate problems, consider getting help at my clinic.