Wait and see with a PSA
You might think the PSA test is the be-all-and-end-all in the world of mainstream medicine.
That’s misguided thinking.
A study came out recently that supports exactly what I’ve been saying all along. The amount of PSA (prostate-specific antigen) that is found in the blood at the time of prostate-cancer diagnosis doesn’t adequately predict lethal prostate cancer.
The researchers looked at PSA levels in 267 men from Sweden, Iceland, and Finland who had been diagnosed with early, localized prostate cancer over a 10-year period. They wanted to analyze the rate of change of PSA levels over the course of the study. PSA levels were recorded for two years following the diagnosis, and then a wait-and-see approach was taken with no further treatment. (But they were watched for further disease progression, just in case.)
By the end of the study, 34 of the patients had died from prostate cancer, and 18 had developed prostate cancer that had metastasized, but they were still alive.
The researchers concluded that there was a correlation between early PSA levels and the rate of change with the development of lethal prostate cancer but that the levels were not accurate enough to outright predict lethal cancer.
The PSA has actually been a pretty lousy predictor of prostate cancer. I touched on this in the January 2006 issue of my newsletter, Health Revelations, but it bears repeating. The overall mortality rate from prostate cancer has dropped only about 6 percent to 8 percent since PSA testing first began about 15 years ago. Meanwhile, the number of cancer diagnoses has more than doubled, resulting in a great deal of unnecessary treatment, cost, and suffering for many men.
The fact that you have prostate cancer does not necessarily mean it will kill you. Most men die of something else well before the prostate cancer ever gets to that point, because most prostate cancers are slow growing. Men with just localized prostate cancer that is untreated have a long-term survival rate that is high. But the sad fact is that many men are put through unnecessary treatment when the wait-and-see approach would make more sense.
Unnecessary treatment via an invasive surgery can cause life-altering side effects, such as incontinence and impotence. Make sure your doctor takes his time in discussing how to treat your particular situation.
Medicine should be personally tailored to the patient—it’s just not one-size-fits-all, and don’t let anyone tell you anything different.
