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2008-08-05
 

The PSA test does more harm than good

The U.S. Preventive Services Task Force has published new guidelines for prostate cancer screening. The report in the Annals of Internal Medicine points out that the benefits of the Prostate Specific Antigen (PSA) test are uncertain or minimal, whereas the risks are large and dramatic. The PSA test itself is just a simple blood test; it is what happens after an elevated PSA result is obtained that causes the harm.

The level of PSA which indicates cancer is not the same for every man. Therefore, it is necessary to do surgical biopsies to determine if there is cancer. A positive PSA test causes anxiety and may lead to unnecessary surgical biopsies which can be painful and cause serious complications. Several studies have shown that men age 65 and older who were not treated for prostate cancer were equally likely to survive as those who were treated. Many of the ones who were treated ended with impotence, incontinence or other undesirable side effects. The new recommendation basically concludes that if the therapy is not providing substantial benefit, the screening is not beneficial either.

In the US, prostate cancer is diagnosed in about 186,000 men each year, and about 29,000 die from it. There is some evidence that the phytonutrients and polyphenols in pomegranate fruit juice and green tea can reduce PSA levels and prevent prostate cancer.[1,2]
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[1] Arshi Malik, Farrukh Afaq, Sami Sarfaraz, Vaqar M. Adhami, Deeba N. Syed, and Hasan Mukhtar, Pomegranate fruit juice for chemoprevention and chemotherapy of prostate cancer, Proc Natl Acad Sci U S A. 2005 October 11; 102(41): 14813-14818.

[2] Gupta S, Ahmad N, Mukhtar H., Prostate cancer chemoprevention by green tea, Semin Urol Oncol. 1999 May;17(2):70-6. PMID: 10332919


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