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Pros and Cons of the PSA Test
Here’s what you need to know before you agree to get a PSA test.
Prostate-specific antigen, or PSA, is a protein produced by both normal and malignant cells of the prostate. Itโs widely recognized as a reliable diagnostic tool in detecting prostate cancer. But thereโs a problem with PSA blood testing. Several, in fact.
For one, thousands of men are told they have abnormally high PSA readings. These men are told to wait three to six months to be re-tested. A lot of the time, the second test comes back within normal ranges. But imagine waiting six months, paralyzed by the fear you have prostate cancer.
You may be too young to worry about the PSA test, but sooner or later, a doctor will advise you to get one. Here are some things to consider.
Is the PSA Test Worth It?
According to an assessment by the US Preventative Services Task Force:
- If 1,000 men ages 55 to 69 get tested regularly for 10 to 15 years, 240 of them will test high enough for PSA that they require a biopsy.
- One hundred of these men will get bad news from the lab.
- Eighty of them will require surgery or radiation, and 60 will suffer side effects from this treatment, including incontinence and impotence.
- Only one to two prostate cancer deaths will be prevented.
Additional data from the task force concluded that youโre 120-240 times more likely to be misdiagnosed because of a positive PSA test and 40-80 times more likely to get unnecessary surgery or radiation than you are to have your life saved.
As bad as these findings were, it was kinder to PSA tests than another analysis done by the Cochrane Group, a group that provides impartial assessments of medical procedures. They carried out a meta-analysis of five major PSA test studies. The combined data showed โno significant reduction in prostate cancer-specific and overall mortality.โ
The report added:
โHarms associated with PSA-based screening and subsequent diagnostic evaluations are frequent and moderate in severity. Common major harms include over-diagnosis and overtreatment, including infection, blood loss requiring transfusion, pneumonia, erectile dysfunction, and incontinence.โ
A Profit-Driven Disaster?
Even the guy who discovered PSA, pathologist Richard J. Ablin, called it a โprofit-driven public health disasterโ because it led to approximately 30 million American men being tested every year at a cost of at least three billion dollars.
Weโre not dissuading someone from getting the test. If youโre closing in on your 50s or older, or have a family history of prostate cancer, think about getting your PSA tested. After all, the test has saved some lives. However, itโs not foolproof and it comes with its own list of serious drawbacks, including potential severe emotional stress, often for nothing.
Keep Your Prostate Healthy Now
To alleviate some worries, start giving your prostate some love. (No, not like that.)
Two of the best things for your prostate are lycopene and punicalagin compounds from pomegranates. Itโs difficult to get a prostate-supporting amount of these things in whole foods, however, so take the supplement route. P-Well (Buy at Amazon) contains 30 mg of lycopene and 180 mg of punicalagin from pomegranate whole fruit extract. Both help keep your PSA levels in check.
As a bonus, a healthy prostate equates to having healthy erections. So even if youโre not worried about prostate health yet, you probably want to keep everything else down there performing optimally.
References
- Horgan J. Why I Wonโt Get a PSA Test for Prostate Cancer. Scientific American, June 14, 2017.
- Ablin R, MD. The Great Prostate Mistake. The New York Times, March 9th, 2010.
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