September 10, 2012
Dr. Dudley Atkinson, a urologist, merits applause for protesting against the report issued by U.S. Preventive Services Task Force, negative to PSA testing. Let us take his thesis further.
The report is an unfortunate collection of errors of judgment released by an institution of scientists. Its credibility and respect are self-destroyed, to-wit:
The PSA test measures the amount of PSA (prostate-specific antigen) the prostate leaks into a man’s blood. A small amount of blood is extracted from the man and analyzed, without additional urine sample. The result suggests a healthy prostate (“undetectable” less than 0.1mg/ml) or that something inside the gland is not behaving and requires further attention (more than 0.3-0.5 or as high as 2,000). The test is prostate-specific, not designed as cancer-specific. It does not measure the existence or nonexistence of cancer. It does not make the man healthier or sicker or cause death. It shows the amount of PSA in the blood.
From suggesting that testing may cause cancer and death, to recommending physicians not to test due to the “known risk of harms,” to affirming that “cancer would not have grown” if not for PSA testing, or confessing proudly that the task force panel included nurses, gynecologists, pediatricians — but “not urologists,” the report inspires scientific absurdity and lack of credibility — not an intelligent model for physicians and men.
True: the PSA test, as most others, is not perfect. But it is the best to measure prostate initial misbehavior and used all over the world. It was discovered by a team of scientists directed by Dr. T. Ming Chu in 1978, approved for diagnosis in 1980. While researching for my book, Prostate Cancer is Curable, Dr. Chu never insinuated in our conversations and correspondence that his test was perfect; he rather emphasized his expectation that another scientist would announce at any time the discovery of a replacing better test. None did, so far.
Statistics show that the PSA test, by flagging an anomaly in the prostate, contributed to a decrease of incidents of metastatic disease by 75 percent and of death rate by 25 percent. I interviewed personally over 100 patients diagnosed with prostate cancer; 100 percent declared strongly in favor of testing.
The report also undermines the efforts of most urologists and of thousands of us who by means of books, articles, lectures and supporting groups such as Man-to-Man, the American Cancer Society’s attempt to encourage a mental attitude among men (some full of machismo) to being tested and actively concerned about their own health. Eloquently, 85 percent of first appointments with an urologist are made by a woman (wife, partner, daughter), not by the man, horrified of “being touched” by the physician.
Santiago Vilas, Ph.D.