SO SHOULD A MAN DO A PSA?

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As a physician I like to do blood work, it’s a window in to what’s going on inside the body. Lab work can lead to effective treatment in returning health or maintaining health. But then it depends on the tools the physician uses. If the tools are toxic or dangerous then maybe it’s better not to know what’s going on inside the body, it least that’s what the latest task force of independent scientists concluded.

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For instance if your doctors is going to use drugs that make your liver sick because he finds your cholesterol elevated then maybe it’s best he doesn’t know your cholesterol isĀ  high. Test study after study indicates drugs for cholesterol not only don’t work (save lives), but they lead to other health problems and shorten a person’s life. That’s a similar finding with the PSA test. Because of the damage to men’s health and the lack of extending life from all the expensive and dangerous procedures that are done once a positive PSA is found this task force recommends not doing routine PSA’s.

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Sure the urologists are screaming bloody murder but then this finding will substantially reduce their income.

So should a man in his 40s do a PSA? Here’s what the task force says: Oct. 7, 2011 — Men should just say “no” to prostate cancer screening with the common PSA blood test, according to draft guidelines from the U.S. Preventive Services Task Force.

About a third of men over age 40, and about half of men age 65 to 79, get regular blood tests for prostate specific antigen, or PSA.

Rising PSA levels are an early sign of prostate cancer, but the test gives a false cancer signal up to 80% of the time. Moreover, not all PSA-detected prostate cancers are dangerous.

“The common perception that PSA-based early detection of prostate cancer saves lives is simply not supported by the scientific evidence,” task force co-vice chair Michael L. LeFevre, MD, MSPH, professor of family and community medicine at the University of Missouri, tells WebMD.

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“In the American Cancer Society’s 2010 guidelines, we said we were uncertain: The evidence is not convincing that PSA testing works,” Lichtenfeld tells WebMD. “We feel the task force came to a reasonable conclusion.”

Just as women once were told that hormone replacement therapy would prevent heart disease — until scientific studies showed that it did not — Lichtenfeld says current evidence strongly suggests that doctors were wrong to tell men that PSA testing would protect them from dying from prostate cancer.

“Men need to know the truth,” Lichtenfeld says. “We have gone through 20 years where we have had strong voices telling us PSA testing works. So there is a huge component of men who believe PSA testing has saved their lives. Now, when we say it wasn’t necessarily so, that becomes a difficult conversation.”

The idea of PSA screening is that it will detect early prostate cancers that can be cured. But clinical trials fail to show that PSA screening cuts prostate-cancer death rates.

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“At this point we have had over 370,000 men enrolled in clinical trials, and we still do not see a significant benefit,” LeFevre says. “If there is a benefit, it is very small. That is different from zero benefit, but the true benefit is somewhere between small and none.”

The harm from a PSA test is that a positive test leads to a biopsy . Biopsy can detect prostate cancer — but that’s where troubles begin.

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“The major problem is that most of the cancers we detect do not need to be treated, but we do not know which ones do need to be treated,” LeFevre says. “And these treatments do have significant harms.”

Etzioni argues that the Gleason score — a scale used to evaluate prostate cancer severity — tells doctors which cancers should be treated and which should not. But Lichtenfeld agrees with LeFevre that “we do not have a test to tell which cancers are indolent and which are aggressive.”

Once they learn they have a prostate cancer, most U.S. men want treatment. And LeFevre notes that treatment carries very real risks. “I’m not going to criticize men who believe that their lives have been saved by this test,” because that’s what doctors have told them, Lichtenfeld said. “If you’re sitting there and you wet your pants three times a day, you’ve got to believe it’s worth it, that it saved your life.”

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Many men who agree to a PSA test do not understand what it is. Some common misconceptions:

PSA is just a measure of inflammation, and it can be elevated for many reasons besides cancer: normal enlargement of the prostate with age, an infection, even recent sex, a strenuous bike ride or horseback riding.

A recent Johns Hopkins University study found surprisingly high rates of hospitalization after prostate biopsies and a 12-fold greater risk of death in those who develop infections.

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About 90 percent of prostate cancers found through screening are early-stage. Most will grow so slowly they will never threaten a man’s life, but there’s no good way to tell which ones will. Research suggests that tumors causing symptoms are more likely to warrant treatment than those that are not. Also, finding aggressive prostate tumors early may not affect how lethal they prove to be; the PSA test may just let men learn of them sooner than they otherwise would.

For every 1,000 men who undergo prostate-cancer surgery, five die within a month. Another 10 to 70 men will have complications of surgery. And 200 to 300 of these men will go on to have long-term urinary incontinence, impotence, or both.

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“The net result is that doctors and patients and families are going to have to have very careful conversations with their doctors that really emphasize what the scientific evidence shows,” Lichtenfeld says. “And that is not overwhelmingly in favor of PSA testing.”So the question is should you have a PSA? What if you had a positive PSA would you run and have a dangerous and ineffective treatments done simply because you’re scared? This study, which if you read it carefully, had over 370,000 men. It is a massive study. You would be surprised how small studies there are that release new dangerous drugs on the market or medical surgical procedures that have not been studied fully as this has.

If you have a Chiropractic Physician to do the PSA and follow his recommendations then that would be a completely different story. Working with nutrition and diet and lifestyle to improve your immune system and target the prostate with nutrients that have been shown to improve function makes a lot of sense. This is the best cancer to have. I know that sounds strange to your ears but if you read the study carefully you will realize the vast majority of man with prostate cancer outlive the cancer. Cancer studies show that nutrients from vegetables can stop the progression of cancer at every stage. Do you think improving your diet might help prostate cancer? What about restoring nerve function in your body? The nervous system regulates and controls the immune system, the hormonal system and directly influences the health of prostate. What do you think the effects of improving the nerve supply through chiropractic adjustments would have on your prostate?

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Getting a PSA is a personal decision. The studies indicate that if you are having symptoms related to prostate than getting a PSA might be indicated, it’s just what you do with those results once you get them.

Study after study indicates conservative healthcare is the most intelligent approach. You’re not going to be left impotent, incontinent or worse with chiropractic and natural healthcare. The choice is yours. You can follow the crowd or you can follow wisdom.