Actually it may make sense if the only test available is unreliable. If, say, the only test available is some old guy mumbling over a bag of chicken bones, then he throws them up in the air and depending on how they fall you get your prostate removed or bombarded by radiation ... leading to impotence, incontinence, etc. then that may not be a test you want to pay for, either personally or as a large expenditure of health care/tax dollars.

Last year I had a high PSA. Had the biopsy (that was fun, let me tell you). No cancer detected but enlarged prostate. Urologist wants me to take expensive drug that "may cause impotence in some men" ... "just to be safe" (my symptoms are otherwise manageable.

So am would I be wise to avoid the drug and any additional treatment based on a test that really didn't tell me anything of value or should I agree to treatment for something I may not have that may cause significant changes in my life?

Maybe I will never know what the correct decision was even in hindsight. There is a lot of emotion around this topic and not a huge amound of clear, non-politicized data one way or another.

My father had MULTIPLE needle biopsies in his prostate because of high PSA levels. The first one was only one needle, then they went to 2, then 4, then 8, then 16 and then 32. They NEVER found a single cancer cell. My father told them that if they continued (the next planned needle biopsy was for 64!!!) he would no longer have any risk for prostate cancer since they would eventually remove the entire prostate gland via biopsy. I don't know if they have him on a medication today for his enlarged prostate, but he doesn't have prostate cancer even though his PSA levels continue to be high. Now ... he DID develop parathyroid cancer and had the parathyroid glands removed, but those are a little too far away from the prostate gland so the needle biopsies of his prostate didn't detect that.

Medical science continues to advance. Tests and treatments that once were ROUTINE are no longer. When's the last time someone bled a patient to balance the humours in their body? I guarantee you that when they stopped the practice of bleeding patients that some were horrified and predicted that many more people would die if it was stopped. My point is that if it is a faulty test, then maybe it shouldn't be THE test that urologists use to determine a risk of prostate cancer. Maybe it should be used more sparingly - like when there's actually SYMPTOMS (like increased frequency of urination, impotence, inability to completely empty the bladder etc) instead of being a blanket test that happens when a man reaches the age of XX. Maybe there needs to be a new test developed that more accurately predicts or detects ACTUAL cancer.

Due to an elevated PSA test, I endured [2] two biopsies....each hitting me with 12 needles in a row, and each biopsy of 12, separated by about 2 weeks, as I recall.

Although not traumatic as far at the discomfort was concerned [each shot got progressively worse], the pain was totally gone before I paid my bill for the procedure each day. Of the 24 biopsy needles, only [1] one on the 2nd procedure showed an abnormality.... cancer cells, and to day, I owe my life to that PSA test....and that was about 15 yrs ago.

If it's the "only game in town", why not continue it! You've got nothing to loose, and everything to gain...or at least, that's my humble opinion. I'm almost 70, and I may actually see my daughter get married next year, and who knows......I may even be a grand dad within the next few years, and all of that is because I took the PSA test. Damn good return, huh? :o)

Remember the doctors also OWN the test labs they send you to. If no tests are done they stand to lose MILLIONS every year. I had the test at 50 and it will be the last one I ever take!

PSA is actually good measurement in looking for prostate cancer. It must be combined with other information, however. One factor that must be managed is simply choosing what constitutes a high enough level to warrant biopsy. Here, a difficult choice must be made. For many years, that level was 4 ng/dl. At this cutoff, if the patients' number is lower, then approximately 86% of those people WILL NOT have cancer, but if it is higher, approximately 20%-50% of people WILL have prostate cancer. That is why doctors choose to biopsy. There may not be cancer, in fact your odds may even be less than 50%, but I think you would be more angry with your doctor if he told you that you only had 40% chance of having a deadly cancer but it's not worth taking the time to biopsy.

Now, what happens if you raise the value to 10ng/dl? At this value, you can only be 38% sure that you don't have cancer, not too effect as a screening tool. However, if you are over 10, then you are at greater than a 67% chance of having cancer, possibly even up to 84%. There will be fewer people getting biopsied for no reason, but there will be a lot more that walk out of the office that have cancer but don't find out about it.

The test is not so much flawed, it is a useful tool. I don't think it should be discarded, but doctors need to combine this tool with other factors when considering sending a patient to biopsy.

I got my statistics from a couple different scientific research papers. One titled "Prostate-specific antigen testing accuracy in community practice" and another "Four no more - The 'PSA cutoff era' is over".

I've said it before and I'm saying it again...FUND DIAGNOSTIC RESEARCH

Early detection and prevention is the KEY to improving overall health of the population and will effectively reduce health care costs. No need to waste a trillion dollars on insurance overhauls. Put that money where it is needed.

The U.S. Preventive Services Task Force, the same group that recommended doctors scale back on mammograms for women, is thinking of recommending against use of the prostate-specific antigen or PSA test.

During the debate over Obamacare, this group came out with it's stance on mammograms. Because of the outrage the administration came out and said that this group did not have any influence on recommendations for health care procedures. It took CNN discovering the group in the thousands of pages of Obamacare to uncover that this group actually sets policy on procedures. For the most part the left said nothing since this was pushed by Obama.

Grunt, you're an idiot. Doctors don't own the test labs they send you to. Period.

Med Student - quite a bedside manner you're cultivating there bud. Yes, grunt is wrong but for all you know he might just be a misinformed genius. No need to be insulting. I hope you don't intend to come into my hospital and treat the nurses that work for me that way.

I think what everyone is forgetting here is that IF you get a positive result from the PSA test, it is still YOUR CHOICE whether or not to do a biopsy, have surgery or take medications. This Board is taking away your choice as how to proceed and that's not right. And HELLO....no urologist or oncologist on the board? Give me a break! It's not about doctors getting rich - it's about insurance companies and their shareholders getting rich, as we all die from preventable/treatable diseases.

The PSA blood test costs the insurance company about $10; it's the possible biopsy and treatements costs which the insurance companies want to avoid paying for.

If you did some research, you would learn that majority of Race for the Cure and other events are privately funded through donations and citizens, the majority being women, who have gotten involved to get the message out and organize these events.

So I suggest if you feel so left out, get off your duff and start organizing the male population raising funds and arranging events.

I'm also going to point out a fact that with regard to heart attacks - when men present themselves they receive testing and treatment almost with no questions asked. Women - the medical field has been proven to ignore the symptoms women present with and send them home with a script that does nothing. They may have well given us M&M's. I know and researched it -- having presented twice and ignored. The doctor no longer has a medical profession due to getting organized with others and kicking him to the curb.

So I don't listen well to the 'victim' tones you post as the media and medical field have been a driving force to inform men over the last number of years to be tested. If you didn't listen - your problem. There are massive amounts in the 'male' medical issues.

I find it in a way odd to listen to the 'paid talking medical heads' this morning spouting so quickly that testing not needing to be done. One in fact who has spewed for years to get tested, in fact admitted he hadn't been himself. It does expose that these tests are more driven in media by 'corporate pharm/medical' paid talking heads. Women have taken the responsibility for themselves - it's your's as a male to do the same. Majority of male population don't pay attention or get involved. That's on them then. Not my job to battle with my sig other to get tested, go to dr, etc. He's an adult

First of all, in case you missed it, the same Board has already modified their mammogram recommendations to say that we don't need them as much as previously recommended. Secondly, are you seriously going to sit there and complain about how women are given preferential treatment?! I'm not even going to start with ALL of the ways this is a man's world and how many issues that women face would not be issues if men had to face them too. Do you have any idea how many years it has taken women organizing together and marching on Washington to get any funding or recognition for breast cancer research? How many men did it take to get prostate cancer the attention it has gotten so far? I can tell you...just one: Lance Armstrong and within months, everyone had a yellow bracelet. And have you considered that possibly one of the reasons prostate cancer is less survivable than breast cancer is because men are less likely to be tested than women are to get mammograms? (Not that I'm blaming you there - just trying to be objective about reasons for survivability). There must be some women out there who can back me up as to how hard it is to get your man to go to the doctor for anything much less a prostate exam?

Lauretta,

This is a man's world? Please tell me how this is true. I would like to know.

When we have a test that actually gives an indication of what cancers are truly going to be deadly vs. those who will likely not kill during a man's lifetime then we will be able to provide a test that avoids the potentially life changing side effects of possibly unneeded treatment and doesn't waste limited health care dollars that might also be spent for something else with proven benefit.

A lot of the current emotion of this debate assumes an unlimited budget to perform any test or procedure that anyone (or their doctor) wants. In the real world, that is not the case. If we spend money on "this" then we will have less money to spend on "that", just like in a household budget. So, we better be sure that what we choose to spend on our money on really provides benifit.

That's a pretty stupid and insensative remark. Cross your fingers you aren't one of those.

If you were referring to the original comment from Eli, I think he was suggesting that the recommendations from this panel might be coming from the idea that the government would choose to not fund the test and let people die rather than spend the money to treat them. (Death Panel stuff.) I give him credit that he was not suggesting that course of action.

Thank you for recognizing my point, Brad. :-) The Government has incentive to deny or encourage people not to get tests.

December 2003 I had my prostate removed. I was 53 at the time. My PSA had been slowly rising for 5 years. My doctor did the digital exam and found a spot on my prostate that should not have been there. At that time I had a 10 stick test and found that I did have cancer and that the cancer was still contained in my prostate. Four months later I had it removed. Every 3 years I get a PSA test to make sure that I am still clean. My last reading was .007.

I'm sure glad I had the PSA test, and I think the 28,000 who die each year will increase considerably with this horrible cancer.

Brad, while I understand your reasoning, which does make sense to a degree, there is the -> but what if it turns out that, I AM the cancer paitent. As I wrote in my opinion before I saw your response posted. This test, as in many others for other diseases, is only a part of what needs to be done in the course of making a diagnosis. Like a rattle under the hood of your car, better to find just a loose piece that needs to be tightened down, than to let it go only to have your engine blow up. The PSA test is not the be all end all, to be sure.

Ah, yes, let's roll out the "death panels" nonsense. I see you crossed out the "not hurting the patient" comment. Not possible that there might be a rational school of thought that the test just might not be providing good value for the money spent and could be leading to unnecessary treatment with significant side effects for those treated. Odd that those from the party that distrusts big government and decries government waste would not at least consider that wide application of this test may actually be a waste of health care dollars in an era where health care is an increasing percentage of personal and governmental expenditures.

Doing away with the test for male prostate cancer without something better to replace it is not wise.

Oh, and "death panels", you said it I didn't.

You do realize that a PSA blood test costs about $10 ?

The insurace companys have used "death panels" for decades. Fool.

I DO pay through my company provided health care premium and co-pays. It is vital part of my benefit package. Obama Care will take the decision to include such tests away from the company providing Health Care to its workers and put the decision in the hands of committees who have no credible medical representation in the area being considered. Now that certainly IS change, but not exactly the hope an educated and informed individual would choose.

grunt.......... I already pay about $1500/month for health insurance and you want me to pay for testing out of my own pocket as well? The PSA blood test costs about $10; it's the biopsy and surgery that will cost a lot more. It's the health insurance industry that wants to discourage the PSA testing in order that they won't have to pay for biopsies and surgeries. There is no Obama Health care panel.

Hang in there. I had my prostate 8 years ago . Same story as yours. Half the erection problem is due to your cardio conditioning. take this opportunity to get in shape and thing will be ok even without viagra. Take care and good luck. PS I am 69 and would BS you.

Never take one opinion. I had to change doctors. Also go to the best they cost the same as the worst doctor. I finally ended up in Sweedish in Seattle.. Doctor Lilly. A read expert and he knows how to give a biopsy without pain....

Actually, Jack, the answer to your question is the Gleason number. If you have a positive biopsy they also grade your cancer. A Gleason number of 6 or below is not aggressive. At 7 it is more serious and above that it is aggressive.

As to your over treatment claim, most the men in these posts, including those that have passed away, are/were in their 50's. I was diagnosed at 63. If men over 70 want to forego the test, more power to them. They probably will die of something else. But 50's and early 60's? If the treatment can cure us there's nothing "over" about it. And lets face it, not getting treatment is much more likely to be fatal then getting it.