Healthy men shouldn’t get routine prostate cancer screenings, says updated advice from a government panel that found the PSA blood tests do more harm than good.
Despite strenuous protests from urologists, the U.S. Preventive Services Task Force is sticking by a contentious proposal it made last fall. A final guideline published Monday says there’s little if any evidence that PSA testing saves lives — while too many men suffer impotence, incontinence, heart attacks, and occasionally even death from treatment of tiny tumors that never would have killed them.
The guideline isn’t a mandate. The task force stresses that men who want a PSA test still can get one, but only after the doctor explains the uncertainties. That’s in part because the panel found PSA testing hasn’t been studied adequately in black men and those with prostate cancer in the family, who are at highest risk of the disease.
The Obama administration said Monday that Medicare will continue to pay for PSA screenings, a simple blood test. Other insurers tend to follow Medicare’s lead.
“The guideline isn’t a mandate.”
It will become one under Obamacare.
Absolutely, Gamecock. This is nothing more than a cost saving move both in the testing phase and the early treatment phase.
Apparently, they don’t want to treat prostate cancer until it has metastasized outside the prostate which, by the way, is very difficult and expensive.
True, prostate cancer in a man in his mid-70′s probably shouldn’t be treated because the man will probably die of something other than the cancer. However, an otherwise healthy man in his 50′s diagnosed with prostate cancer found with PSA and biopsy (like me) potentially has many years of life expectancy if the cancer is found early and treated.
But Obamacare will eventually take the treatment choice away from the patient and doctor because of rationing.
Don, this same issue was brought up by the BJM concerning mammograms. The issue is the number of benign tumors that are found and heavily treated. Chemotherapy, Radiotherapy, and surgery all have their downfalls. and risks, and most are very hazardous to your health. Routine testing is actually best suited for finding slow-growing non-invasive tumors. The deadly ones are the fast-growers that expand from nothing to untreatable between screenings.
Treatment kills three times more guys as the cancer itself. Hardly good news. Another scary thing, and this was news a number of months back, the PSA test is highly prone to false positives — its value was already in question. Thus we have to wonder how many died from treatment that didn’t have cancer.
But at least they’ll still pay for the test, hooray. That’s $10 for the test and $180 for seeing the Dr. for 8 minutes. The test gets the patient back in through the front door and starts the billing clock. That’s another way they make money — billing/overbilling for Dr. visits.
Not long ago I was seeing a Dr. once a month for a while for a certain condition. He never spent much time with me, simply re-filled the month-at-a-time prescription and billed by the half-hour. I got a peek at his schedule and saw that he was doing eight half-hours per hour. Nice.
The first step to healthcare rationing is for the government to declare that a test that was previously considered very important for prevention and/or early detection of disease is no longer important.
The junk was that the prostate specific antigen (PSA) test was ever endorsed in the first place. It has no known relationship to genuine life-risk, has a history of false positive bias and has caused a great deal more harm than possible good. Good riddance to this one.
Betcha can’t cite evidence of anyone ever being harmed by the test.
Mismanagement of the results is certainly possible, but that’s not the test’s fault.
Here’s a professional counter to your argument as well:
http://emedicine.medscape.com/article/457394-overview
The PSA test is not a test for cancer per se. It is a test for elevated prostate specific antigens, which can indicate cancer but generally indicates there’s something not right with the prostate that should be investigated. When a PSA test comes back positive, a competent urologist will order a percent free PSA test which can provide a better indication as to whether an infection or other non-cancer cause is driving a high PSA. This can help to avoid an unnecessary biopsy.
I can understand a reasoned argument for eliminating the test for men in late life as most prostate cancers (PC) that emerge in old age are non-aggressive. However, there are several variants of PC that can strike when a man is in his 40′s or 50′s that are aggressive and deadly.
There was a history of PC in my family so I started having the PSA test done annually at the age of 40. Had I not been vigilant to have a PSA test done every year, I would likely be dead by now. I was diagnosed with PC in my early 50′s and underwent a nerve sparing radical prostatectomy (RP) using Da Vinci robotic surgery. Post surgery, I had no lasting issues which are commonly attributable to RP. Life is good and I believe the PSA tests saved my life.
I strongly believe that if you have a history of PC in your family, annual PSA tests starting at the age of 40 should be done. If there is no history then one might be less vigilant about having the test.