Do You Need This Prostate Test? Dr. Oz Weighs in On The Question

Numbers support recommendation against having a PSA test

Comedian and actor Ben Stiller went public with his claim that taking the prostate-specific antigen (PSA) test saved his life. So should every man make it part of their yearly exam to request a PSA test to monitor their levels as a measure to protect themselves against prostate cancer? Dr. Oz weighs in on this question on the Today show.

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The general health adage is that if you are male and live long enough, that you will eventually have prostate cancer. The prostate is part of the male reproductive system, located in front of the rectum and beneath the bladder—hence the “why” behind the dreaded digital exam. Typically walnut-sized, this organ surrounds the urethra and secretes a fluid that becomes part of the seminal fluid in ejaculate.

Unfortunately, as a man ages, the prostate usually increases in size and begins to pinch the urethra and thereby interferes with urine flow from the bladder to the penis. However, what is scarier is that sometimes, abnormal uncontrolled cell growth occurs as a tumor in the prostate gland and stands a chance of becoming malignant where cells break away from the tumor and spread cancer throughout the body.

The good news is that more often than not, the prostate tumor remains benign rather than malignant and a man will live out his normal life dying from some other health-related ill or just old-age.

So what’s the controversy regarding taking a PSA test yearly? As it turns out, after crunching the numbers, health experts found that just taking the test results in less health benefits than not taking the test at all. In fact, a large proportion of men taking the test wind up requesting invasive procedures that typically cause them more harm than good.

Why Health Experts Do Not Recommend PSA Testing

According to the U.S. Preventive Services Task Force (USPSTF)—an organization that makes recommendations about the effectiveness of specific clinical preventive services for patients without related signs or symptoms―their analysis of prostate research studies demonstrates that prostate-specific antigen (PSA)-based screening for prostate cancer should not be recommended for men based on the fact that the harm from testing alone greatly outweighs any potential benefits.

Some Basic Numbers Backing Why Health Experts Recommend Against PSA Testing

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Prostate cancer develops mainly in older men. About 6 cases in 10 are diagnosed in men aged 65 or older―it is rare before age 40. The average age at the time of diagnosis is about 66.

According to the most recent data, when including all stages of prostate cancer, your odds of survival are actually pretty good:

• The 5-year relative survival rate is almost 100%
• The 10-year relative survival rate is 98%
• The 15-year relative survival rate is 95%

And since, the average lifespan of a typical white male in the U.S. is approximately 78 years (other races in the U.S. fall slightly lower in average lifespans), the odds of dying directly from prostate cancer are significantly low.

What isn’t so relatively low, however, are the risks of complications from taking the PSA test and then seeking therapy to treat it—if you actually have it. As it turns out, out of every 1,000 PSA tests performed, 100-120 are false positives. According to the USPSTF, of the men who decide to have a biopsy after testing positive, up to 33% will have moderate or major bothersome symptoms, including pain, fever, bleeding, infection, and temporary urinary difficulties; 1% will be hospitalized.

Furthermore, of those treated for prostate cancer—either by surgery, radiation or hormonal therapy―a statistically significant number of men will develop serious cardiovascular events, deep venous thrombosis or pulmonary embolus, erectile dysfunction and/or urinary incontinence due to their treatments. In other words, new health issues are much more likely to develop with treatment for a cancer that is very unlikely to lead to a person’s eventual cause of death.

Dr. Oz’s recommendation―you are better off focusing on practicing good health for prostate cancer prevention than focusing on a test to see whether you have an elevated prostate-specific antigen level that may or may not signal a cancer that in all likelihood will not be the cause of your death.

For more about prostate health, here is an informative article on The Eight Commandments for Preventing Prostate (and Other) Cancers.

Reference: Today show “Ben Stiller’s prostate cancer diagnosis: Dr. Oz weighs in on PSA test

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