We cannot protect everyone from everything.  Society only has so much money and we have to allocate it wisely.  Otherwise we won't have money for the truly needy. 

It's time to allow the math to dictate some of our actions. 

Certainly, someone will say that this test saved someone's life and that is undoubtedly true but let me provide an example. 

Fire sprinklers in every home in America would save some lives too but it turns out that would cost a trillion dollars and people would still be 40 times more likely to die from an accidental fall or poison. 

We cannot remove every element of risk from our lives and if we let special interest groups dictate every conversation, we will go broke. 

We cannot protect everyone from everything. Society only has so much money and we have to allocate it wisely. Otherwise we won't have money for the truly needy.

It's time to allow the math to dictate some of our actions.

Certainly, someone will say that this test saved someone's life and that is undoubtedly true but let me provide an example.

Fire sprinklers in every home in America would save some lives too but it turns out that would cost a trillion dollars and people would still be 40 times more likely to die from an accidental fall or poison.

We cannot remove every element of risk from our lives and if we let special interest groups dictate every conversation, we will go broke.

There is more to PSA testing than a single number. First a series of tests over time will show if the number is constant or rapidly increasing. Second is %free PSA which is another metric in evaluating the cancer potential. There are other more sophisticated tests as well. Sadly many Urologists are in the business of selling biopsy's. And when a biopsy comes back and there is any CANCER the patient doesn't hear much after that.

I am not a doctor but a prostate cancer patient. The patient really needs to educate himself before making decisions. The internet has a treasurer trove of information on prostate cancer.

I had a PSA which was positive, a biopsy which found a tiny cancer, and a radical prostatectomy. Am I sorry? You  just have to watch someone die of metastatic prostate cancer as I have--it's slow, miserable, and prolonged. No thanks. BTW I'm a physician so I know all the risks and side effects and still decided I'd rather die of something else.

My dad had the test, which came back positive and then he had the surgery to remove the cancer.  Am I happy he had the test?  Yes, it is a relief to him and his family!  I am happy he was proactive and took care of it early, so he doesn't die or it expands to another area in his body.  Better to be safe than sorry!  I advocate for getting the test.

My dad had the test, which came back positive and then he had the surgery to remove the cancer.  Am I happy he had the test?  Yes, it is a relief to him and his family!  I am happy he was proactive and took care of it early, so he doesn't die or it expands to another area in his body.  Better to be safe than sorry!  I advocate for getting the test.

I was always a bit dubious about the PSA test. Fortunately mine have always been low, very low. (0.47 in 2003 and 0.38 in 2008) I think with proper guidelines and limited to just certain ages, the PSA test could still be useful. I'm now approaching the age where further testing just won't be worth it.

Exactly who or what is this so-called influential gov. panel? The article states rather vividly that this panel recommends healthy guys not get tested. How does one know they are healthy as it relates to prostate conditions? I have prostate cancer but have never felt any ill effects. How did I become aware of this condition? My urologist has monitored my PSA levels for years and recently noticed a spike in the resulting test readings. He recommended a biopsy. It revealed a tumor on the right side of the gland. One can assume being healthy, but some disorders within the body can only be detected via professional testing. For all those who prefer playing Russian roulette with their health, go for it. As for me, I rely on those who know more about the body than wannabe physicians; aka lay people and so-called government panels.

In my annual physical in 2009 my PSA was 4.55. A review of earlier physicals showed a slow but steady increase. A biopsy revealed 12 of 14 positives with a Gleeson score of 7. A pelvic MRI and body scan revealed the cancer had not spread outside the prostate. The truly scary thing was that the cancer could have started as far back as 10 years earlier. I had a high intensity focused ultrasound (HIFU) one-time non-surgical treatment and 3 months later my PSA was 0.28. That was 2 years ago. It fluctuates some but has never been over 0.55. Do I reget getting it done? No. Side effects - none.

I was diagnosed with Prostate Cancer in 10/2009. I had the radical prostectomy. I wish I hadn't. It has left me incontinent and having erectile dysfunction. After the surgery I was told I would never be able to have another wet orgasm. My doctor pushed me into having the prostectomy. I have to wear urinary pads daily, I have tried cialis and viagra....doesn't work for me, I was so shocked and devasted that I didn't know what to ask or how to follow through. I wish now, I would have known what questions to ask and what my options were. I am now 55

I am 69 years old. Six years ago my PSA reading was 8 so further exams were held.

Test revealed there was cancer in my whole prostate. It was removed by the Vet. Admin Hospital in Tucson. When an analysis of the remove prostate was done it was rated a very rapid prostate cancer and if I had not removed the cancer it would have spread to the rest of my body. Both the original PSA and the later biopsy were simple and effective to indicate I had prostate cancer. If I had not had the test and the operation I would be in the grave at this moment. Simple test, simple procedure that was minimally invasive saved my life. I do recommend a regular PSA test for most men over their prime. If identified and classed as a slow acting cancer, continued PSA test will at least let the person know what his future can be.

I am 57 today. In 1999 my dad was diagnosed with Prostate Cancer. Since 1999 I have had my PSA tested. All through the years my PSA had increased at low rate with my PSA well within the "normal limits" for my age. Then in 2010 my PSA jumped from 2.5 to 3.5, still in the limits but the acceleration was a concern, retest in six months. Six months later 5.1! Went to my Urologist, the Digital Exam did not reveal any problem, slightly enlarged but normal for my age. His opinion was I could have an infection, a month of antibiotics, retested, PSA was now 5.6…. His recommendation was to biopsy. The results from the 12 samples five on the left side was malignant with a Gleeson core of 7 (3,4). The bone scan and MRI confirmed that day I did not have cancer outside the Prostate. I chose Radiation and Hormone Therapy over Radical Prostectomy, but waiting was not an option. The reason is the chance of reoccurring Prostate Cancer is equal with a Radical Prostectomy and dying from bone is not a fate I want to consider. I have three weeks left. Yes there are side effects, but it is manageable. As for rather not wanting to know till I have a form a cancer that I cannot survive, NOPE.

It's better to know, but the test is run far more often than necessary. For example, it's a standard part of my every-three-month blood test for diabetes. A PSA less than 4 means no prostate cancer and my July test read 0.376. Since prostate cancer acts so slowly, why do I need another one this year or even next year? I don't pay for it directly because I have no copays for tests, but costs like that are certainly built into my insurance premium. The insurance companies complain about how costs are rising, but paying for such things, paying for inside-the-ear-canal hearing aids and 5-day batteries instead of over-the-ear aids and long-lasting batteries (as nations with universal healthcare tend to do), etc. are why we pay 50% more for healthcare than other nations. And we can NOT afford it.

We are all going to die. To a large extent I think it is about "picking your poison" and minimizing your discomfort.

While there are indeed clinical studies showing that routine PSA screening testing does not appear to save lives, there are also, as is generally the case with public health studies, clinical studies that do show that routine PSA screening can save lives.

However, a greater underlying problem is our inability, at this time, to predict in advance which men with prostate cancer will go on to die prematurely of their disease and which men can safely live essentially normal lifespans with their prostate cancer (with or without treatment). Until we have better prognostic models that can accurately identify those cases of prostate cancer that are likely to cause premature death (versus the many cases of this disease that will, ultimately, not lead to premature death), the entire argument regarding routine PSA testing will remain a point of debate, and disagreement, among public health and cancer experts.

Robert A. Wascher, MD, FACS

Author, "A Cancer Prevention Guide for the Human Race"

Owebammacare govt panels, coming to your neighborhood soon!

Bob,

If I want sprinklers in my house it's none of your damned business or the governments either!  Your implication that society would be burdened with the cost of sprinkler or PSA tests is so much specious B.S.!! 

Stop the paranoia and live your lives.....gees....what a bunch of girls ! The treatments are simply ways to make you impotent and incontinent. Do you really want that ? Forget about it and have fun....not knowing. We all have to die....right ?

My husband had an elevated PSA Test. He had biopsies, which showed high grade aggressive prostate cancer. He had surgery; cancer was throughout the prostate and  exceeding the capsule in two places. If he had not had the PSA Test, he would be dead long ago.

Your honesty & frustration are all too memorable. As a widow, 5 years now, I want to encourage you. My late husband was diagnosed Oct. 1989 [at 53] - and we had almost 17 good years before he lost the battle at age 70 in his unplanned journey. Clinical trials are incredible; also a non-surgical solution suggested by his Oncologist [ErecAid System by Osbon out of Agusta, Georgia 30903] was 100% successful for management of impotence. You can move on...and make the best of the decision and it is a waste to blame your Oncologist while you have 'today'. My husband had the surgery Nov. 1989 because he wanted to fight - and he/we did. After 8 yrs. when the PSA went up & he had some pain in hip - radiation knocked it out - for another 2-3 yrs. The last year and 10 months were difficult, but he had given it a great fight. Don't give up. Strides are being made. Research - MD Anderson [for us] was and is still incredible for leading the way in clinical trials...and Dana Farber I am sure. No way could my husband and I, 22 years ago, have lived with a ticking time bomb without suggested surgery. His oncologists (Concord, Mass) were tops in their field.His Gleason count was hovering in '4' range. That was deciding factor - not the doctor. Best of luck. Sorry for the ignorance we have to endure sometimes on these sites.

Long story short: Diagnosed with PC at age 57. Had surgery. One pelvic lymph node tested positive. Had salvage radiation therapy 16 months after surgery because of rising PSA. I'm 61 years old now and PSA continues to rise gradually. Last two PSA's stabilized at 8.3. Uro suggests holding off on androgen deprivation therapy for now. Says it robs you of your manhood. I'm due for another PSA test and uro appointment any day now. I dread these appointments for fear of what I'll find out. I tend to wake up in the wee hours of the morning worrying about the family and friends who depend on me. I'm a pretty fit 61. I just took a 12 mile backpacking trip carrying a 50 lb. pack. No sweat. I didn't have a PSA unitl age 57. One of the biggest regrets in my life. My point is this: all this worry and uncertainty, for me and my family, could have been avoided had I detected the cancer earlier. For any man out there that's looking for some justification, some excuse not to get a PSA test, this government panel study will surely give it to many of them. Don't be like me: get tested no later than age 50.

The panel would have been a joke, except it seems to have the power to make these decisions. There was no urologist or oncologist on the panel, so what were they looking at? I am an 18 year survivor of Prostate cancer, and it was found through a routine PSA. I was 48! Since then, I have had radiation and am now on hormones. I facilitate a men's group of Prostate CA patients, and one of the things we have learned is that: By the time a patient has symptoms, it is too late to do much more than put a band aid on it and call the funeral parlor. Maybe this panel is part of President Obama's "Shovel ready" projects. Wait, until we are "Shovel ready". Think of how much MediCare money that would save!

I was diagnosed with prostate cancer at 53.  I had surgery only.  I am now 55.  I'd rather be incontinent than dead.  Thank you medical science!

Go back and read doctorwascher's post. The big problems are that AFTER you do a PSA and AFTER you do a biopsy that shows cancer, the docs have no way of telling how aggressive YOUR cancer is or whether it has spread unless it has REALLY spread and is large enough to detect in your bones, lungs, etc. The only test for virulence/ aggressiveness is the Gleason Score which is about a half century old and merely "grades" the distortion of your cancer cells to "normal".

Every guy I've talked with who is facing this or has already gone through it remains frustrated by the inability to get definitive answers. It is true that many men over a certain age (40, 50, or 60) have prostate cancer but that most will die of something else BUT nobody can tell you which group you are in. So, since having the prostate cut out, if done before the cancer moves out of the prostate, can "cure" you. Of course, until it is cut out, you do not have the benefit of a path exam of the organ and the nearby tissue. And yes, lads, if you have it cut out, you too will be able to say, "I used to have a dick; now I have a pee-pee". But the question is simply a gamble and for most men, its a better idea to have it out and accept those consequences than to leave it in and risk a very unpleasant journey to death.

This reminds me of the so-called "expert" government panel that last year said that mammograms were unnecessary before the age of 50. At age 43, I had 3 enlarged lymph nodes removed and biopsied. I was lucky that they turned out to be benign. Who knows what would've happened if they were not detected and removed.

It would not surprise me one bit if these government "experts" were linked in some way to the insurance companies and their lobbyists. I don't trust the government with my health or my money.

You need to do what you feel is right for you. Get tested! Don't listen to these idiots.