Review of THE GREAT PROSTATE HOAX, by Richard J Ablin, with Ronald Piana
How a multibillion-dollar industry was built on the misuse of a prostate cancer (PCa) screening test – with millions of men’s lives destroyed in the process.
That the FDA never did approve PSA test as a cancer detecting test, escaped the FDA’s notice as Big Medicine marketed PSA for that very purpose.
Richard Ablin discovered prostate specific antigen (PSA) in 1970. The FDA approved the Hybritech’s test in 1993, after troubled discussion and an aggressive and dishonest presentation by William Catalona, from Hybritech, as a screening tool. But the industry promoted it as a cancer detecting test despite acknowledging that test showed 80% false positive results. Ablin has been trying to stop the use of PSA ever since. He says the PSA test is a “public health disaster”. His book, published last month, provides minute details of the men and a few women who deliberately ignored the FDA approval and developed a marketing campaign for its use as “a travesty against men”. Not until the US Government Preventative Services Task Force declared in 2011, that the test should not be used in routine screening, was this misuse recognised.
The American Urological Association was “outraged at the Task Force’s failure to amend its recommendations on PCa testing to more adequately reflect the benefits of the PSA test in the diagnosis of PCa. It is inappropriate and irresponsible to issue blanket statement against PSA testing.” The task force never issued a blanket recommendation against PSA testing. The co-chair Dr LeFevre said “We are charged with making recommendations about what preventive services are most likely to benefit the health of Americans and the scientific evidence we reviewed sends a different message about PSA screening than the widely held belief the PSA-driven early detection of PCa is a lifesaver with insignificant harms.”
Every year 30 million men undergo regular PSA screening for PCa, they have a million biopsies nearly all of which are unnecessary, but get them scared into joining the great money making industry of biopsies, surgery, radiation, penile implants, etc. Cost in the USA is estimated at $28 billion per year (1993 dollars). The chances of a man dying of PCa is only 3%, yet men age 70 have 70% chance of having PCa, that they had without knowing anything about it for decades. PCa is very slow growing cancer that some believe should be called neoplasms, not cancer. The big C frightens men and their wives into doing things that make no sense if considered carefully in a sober moment, but “cancer” fixes most men with a single need: “get it out”. The urologists, surgeons, oncologists make a fanciful income out of this incorrect reaction.
Dr Jules Harris, professor of medicine, University of Arizona College of Medicine said “exposing the truth about PSA’s misuse and the subsequent profiteering by the PCa industry was the biggest medical story of the past 30 years. But it was the FDA’s failure to act in the best interests of the American public that was particularly troubling. Harris should know all about that: he was one of the voting panel members at the FDA meeting approving the use of PSA.”
More recently “nerve sparing and robotic surgery have been claimed to reduce the unacceptable side effects of incontinence and erectile dysfunction, but the data says these therapies are not better than open surgery. The A$2.5m cost of a da Vinci robot (plus A$110,000 pa service contract), and in the case of proton machines costing A$220m, means they must be used frequently in order to amortise debt and start turning a profit. So centres promoting robotic surgery will not let data get in their way. Why should they? Most of what men know, or believe they know, about their health comes from the 24/7 blitzkreig of direct to consumer advertising. The FDA approved the da Vinci robot on the basis of 113 gallbladder procedures. 1,400 hospitals are stuck with an overpriced da Vinci machine that can’t pay for itself without radical prostatectomies by the hundreds.”
“Think of PSA as oil. If the test was made irrelevant, an industry would crumble. You do not need to be a conspiracy theorist to grasp what stakeholders will do to keep this industry booming.” In 2009 the New England Journal of Medicine published the results of two trials, stakeholders could not punch holes in the studies’ collective conclusion: “PSA-based screening results in small or no reduction in prostate cancer-specific mortality.”
Francis Fukuyama pointed out in his excellent book, The End of History and the Last Man, our medical history is filled with men who refused, in the face of evidence, to change their course even when it was proven wrong. This type of ego-driven conviction has led medicine into its darkest corners.
Otis Brawley, chief medical officer of the American Cancer Society, suggested that many in the urological community promoted PSA to keep the heady revenues flowing. “We in medicine need to look into our soul and we need to learn the truth. If your income is dependent on you not understanding something, it is very easy not to understand something.”
In 1891 Dr William Coley said stimulating the immune system can be an effective way to treat cancer. For decades Big Pharma has supported Medical Schools across the USA. They influence what is taught (to maximise the sale of their drugs), so either no nutrition, or little nutrition is taught in medical schools.
PSA blood tests are wildly unreliable, resulting in many misdiagnoses. Dr Richard Ablin, the man who discovered the PSA has asked everyone to stop using his test – see his plea published in the New York Times below.
Roger Mason The Natural Prostate Cure, 2012 ed, p117, reports that women also have PSA in their bloodstream, yet have no prostate gland, proving that this antigen is not prostate specific. Global fine needle aspiration, or biopsies often follow a rise in PSA – often caused by BPH and aging, or regular bike riding!
The National Institute for Healing published a report March 2012 – see below stating that PSA Tests Useless for 98% of Men
Biopsies are dangerous as they can lead to cancer cells escaping from the gland and are only accurate by chance as it is so easy to miss a small area of aggressive cancer, particularly if the gland is inflamed and large. Radiation, or brachytherapy, permanently seeding the gland with radioactive pellets is less expensive than radical prostatectomy, but side effects include chronic diarrhoea, exhaustion, rectal pain and fissures, incontinence, infections and impotence. If cancer returns (as it often does) it is not possible to then surgically remove the gland.
The Great Prostate Mistake
EACH year some 30 million American men undergo testing for prostate-specific antigen, an enzyme made by the prostate. Approved by the Food and Drug Administration in 1994, the P.S.A. test is the most commonly used tool for detecting prostate cancer.
The test’s popularity has led to a hugely expensive public health disaster. It’s an issue I am painfully familiar with — I discovered P.S.A. in 1970. As Congress searches for ways to cut costs in our health care system, a significant savings could come from changing the way the antigen is used to screen for prostate cancer.
Americans spend an enormous amount testing for prostate cancer. The annual bill for P.S.A. screening is at least $3 billion, with much of it paid for by Medicare and the Veterans Administration.
Prostate cancer may get a lot of press, but consider the numbers: American men have a 16 percent lifetime chance of receiving a diagnosis of prostate cancer, but only a 3 percent chance of dying from it. That’s because the majority of prostate cancers grow slowly. In other words, men lucky enough to reach old age are much more likely to die with prostate cancer than to die of it.
Even then, the test is hardly more effective than a coin toss. As I’ve been trying to make clear for many years now, P.S.A. testing can’t detect prostate cancer and, more important, it can’t distinguish between the two types of prostate cancer — the one that will kill you and the one that won’t.
Instead, the test simply reveals how much of the prostate antigen a man has in his blood. Infections, over-the-counter drugs like ibuprofen, and benign swelling of the prostate can all elevate a man’s P.S.A. levels, but none of these factors signals cancer. Men with low readings might still harbor dangerous cancers, while those with high readings might be completely healthy.
In approving the procedure, the Food and Drug Administration relied heavily on a study that showed testing could detect 3.8 percent of prostate cancers, which was a better rate than the standard method, a digital rectal exam.
Still, 3.8 percent is a small number. Nevertheless, especially in the early days of screening, men with a reading over four nanograms per milliliter were sent for painful prostate biopsies. If the biopsy showed any signs of cancer, the patient was almost always pushed into surgery, intensive radiation or other damaging treatments.
The medical community is slowly turning against P.S.A. screening. Last year, The New England Journal of Medicine published results from the two largest studies of the screening procedure, one in Europe and one in the United States. The results from the American study show that over a period of 7 to 10 years, screening did not reduce the death rate in men 55 and over.
The European study showed a small decline in death rates, but also found that 48 men would need to be treated to save one life. That’s 47 men who, in all likelihood, can no longer function sexually or stay out of the bathroom for long.
Numerous early screening proponents, including Thomas Stamey, a well-known Stanford University urologist, have come out against routine testing; last month, the American Cancer Society urged more caution in using the test. The American College of Preventive Medicine also concluded that there was insufficient evidence to recommend routine screening.
So why is it still used? Because drug companies continue peddling the tests and advocacy groups push “prostate cancer awareness” by encouraging men to get screened. Shamefully, the American Urological Association still recommends screening, while the National Cancer Institute is vague on the issue, stating that the evidence is unclear.
The federal panel empowered to evaluate cancer screening tests, the Preventive Services Task Force, recently recommended against P.S.A. screening for men aged 75 or older. But the group has still not made a recommendation either way for younger men.
Prostate-specific antigen testing does have a place. After treatment for prostate cancer, for instance, a rapidly rising score indicates a return of the disease. And men with a family history of prostate cancer should probably get tested regularly. If their score starts skyrocketing, it could mean cancer.
But these uses are limited. Testing should absolutely not be deployed to screen the entire population of men over the age of 50, the outcome pushed by those who stand to profit.
I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster. The medical community must confront reality and stop the inappropriate use of P.S.A. screening. Doing so would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments.
Richard J. Ablin is a research professor of immunobiology and pathology at the University of Arizona College of Medicine and the president of the Robert Benjamin Ablin Foundation for Cancer Research.
PSA Tests Useless for 98 Percent of Men
If you’re thinking of getting a PSA test, you need to see what the latest research shows.
That because a huge new study shows that PSA tests aren’t just useless…but can ruin your life too.
The study was headed up by Dr. Philip Prorok. He leads research for the US National Cancer Institute.
“PSAs don’t result in any benefit,” he says. But they do cause “harm from false positives and over diagnosis.”
You can read his full report in the Journal of the National Cancer Institute.
The new findings are just more proof of what we’ve been telling you for years. The screenings are not an accurate test for prostate cancer. And worse, they start the ball rolling for millions of men to wind up needlessly impotent or incontinent.
Even the doctor who discovered the test now calls it “a profit-driven public health disaster.”
And the Stanford University urology expert who wrote the first paper supporting it back in 1987 now says “we must find a new cancer marker.”
That’s because he’s spent the last 25 years doing follow-up research. And he now says PSA tests only help two percent of men.
For the other 98 percent, they flag up benign prostate enlargement (BPH), but “have no relationship to cancer.”
16-Year Study Shows PSA Tests Do Nothing to Save Lives
The new study looked at men from 1993 to 2009. They were between 55 and 74.
Dr. Prorok and his team compared the results for men who got the test against those who didn’t.
And at the end of the study he found two things.
- There was a 12 percent increase in prostate cancer cases in the screened group.
- There was no difference in deaths between the two groups.
So why are these results so important?
“PSA testing did not reduce prostate cancer mortality,” he says. “But there was a persistent excess of prostate cancer cases in the screened arm, suggesting over-diagnosis of prostate cancer.”
He says the results mean only one thing. The test picks up slow-growing tumors that aren’t lethal.
In other words, if you get a PSA test, you may be one of the millions of men treated for prostate cancer, when you don’t need to be.
And those treatments can leave you impotent or incontinent.
Five Other Trials Show PSA Tests Don’t Do Any Good
Another study on PSA tests was published late last year in the Annals of Internal Medicine.
It was headed up by Dr. Roger Chou. He’s a top cancer researcher at the Oregon Health and Science University.
He looked at the findings from the five best trials on PSA screenings published up to that date. These trials included research from top-notch groups including the Cochrane Library Database. And as we’ve told you before, that’s considered the gold standard in scientific research.
The first study looked at 76,693 men over seven years. All of them were between 55 and 74 years – the same age group Dr. Prorok studied.
After seven years of follow-up, the study got the exact same results as the latest study.
It found that PSA tests “increased prostate cancer incidence” but had “no effect on prostate cancer mortality.”
In other words, lots more men going through life-changing cancer treatments…but no extra lives saved.
The next study looked at 182,000 men from seven countries. This one ran for about a decade. Again, it found lots more cases of prostate cancer, but no difference in prostate cancer deaths.
So the study repeats the same message.
Get the screening…don’t get the screening. It comes to the same amount of men dying from prostate cancer.
The results were the same for the other three trials he looked at.
There was “no difference between screening and control groups in prostate cancer mortality risk.”
What these findings boil down to is that PSA screenings result in “overdiagnosis of low-risk cancers that would not have caused death during a man’s lifetime.”
And he also puts together some data about the consequences of this.
“Overtreatment of such cancers expose men to unnecessary harms,” he says.
He found that overdiagnosis was “as high as 50 percent.”
And says about 48 men have to be treated for prostate cancer to prevent one death.
If you’re one of the other 47 men…you’ll get no benefit from the ordeal. And it may change your life.
He reported the following three findings from his research:
- One out of every three men treated with prostatectomy ended up with erectile dysfunction (ED).
- One out of seven treated with radiation therapy wound up with ED.
- One out of five men treated with prostatectomy suffered urinary incontinence.
Experts Speak Out About Findings
Plenty of experts have reviewed these studies. And several are speaking out about them.
“We have put a huge amount of time, effort and energy into PSA screening,” says Dr. Virginia Moyer of the Baylor College of Medicine. “That passion should be going into finding a better test instead of using a test that doesn’t work.”
Dr. Thomas Schwenk, dean of the University of Nevada School of Medicine, agrees.
“I think this recommendation is long overdue,” he says.
And Dr. William Golden says the new findings come as no surprise to him. He’s a professor of medicine at the University of Arkansas for Medical Sciences.
“This advisory mirrors my advice to patients over the last 10 years,” he says. “I have long believed that prostate cancer has a cure worse than the disease.”
But not all experts are convinced. In fact, some doctors are disappointed by the findings.
Dr. Pat Walsh of Johns Hopkins University is one of them. He’s made a good living out of prostate surgery and calls the findings, “a shame.”
And some experts are still defending PSA tests.
Dr. Leonard Gomella says the findings are an “appalling affront to all men.”
While Dr. William Catalona of Northwestern Memorial Hospital just dismisses them.
“The extent to which PSA screening causes over diagnosis and overtreatment is exaggerated,” he simply says.
“Test is Hardly More Effective Than a Coin Toss!”
But the two men behind PSAs both agree that the screenings cause more harm than good.
Dr. Thomas Stamey is the Stanford urologist who first promoted the PSA test in a medical paper. Back then he believed that PSA levels might be a good flag for prostate cancer.
But that was 25 years ago. He’s continued to look into PSA tests and now says his early findings were too hopeful.
He says the problem is that PSA tests flag up too many false positives. In fact, a high PSA score is more likely to do with the natural swelling of an aging man’s prostate, than cancer. And it’s not just a theory. He’s published his research in the peer-reviewed Journal of Oncology.
“We show that PSA is related to only benign enlargement of the prostate,” he says. “PSA today no longer has any relationship to cancer except for two percent of men.”
The man who discovered PSA, back in 1970, agrees. His name is Dr. Richard Ablin. And he’s gone on to lead research at the University of Arizona.
“The test simply reveals how much antigen a man has in his blood,” he says.
And he supports what Dr. Stamey says.
“Benign swelling of the prostate can elevate a man’s PSA levels,” he says.
So too can infections and drugstore pain killers.
“PSA testing can’t detect prostate cancer,” he says blunty. “The test is hardly more effective than a coin toss.”
But the PSA test is the first link in a chain of events that lead to biopsies…treatment…and sometimes impotence.
And it’s the overdiagnosis and treatment that’s the real problem.
That’s because prostate cancer obviously is very real. Plenty of men have it. But in most cases it’s slow spreading and won’t be the thing that kills them.
About 16 percent of American men will be diagnosed with prostate cancer, but only three percent will die from it.
“The majority of prostate cancers grow slowly,” says Dr. Ablin. “Men lucky enough to reach old age are much more likely to die with it than die of it.”
That’s why he says we “must stop the use of PSA screening and rescue millions of men from unnecessary, debilitating treatments.”
Biological Switch is Key to Prostate Health
The best way to protect your prostate health is to take matters into your hands.
We’re putting together a big report on how to do this. It includes a whole lifestyle protocol that protects your prostate through diet, exercise and other holistic practices. It also includes information about a botanical formula that’s been shown to boost prostate health in three peer-reviewed journals.
In the meantime, emerging research shows that one of the biggest factors in prostate cancer has to do with your hormones.
You see, young men have lots of testosterone and only small amounts of estrogen. But as they age they generate more estrogen and less testosterone.
Now as you know, prostate cancer is an older man’s problem. It very rarely affects young men. And that’s why so many forward-thinking doctors think this biological switch is one of the biggest factors behind it.
We’ve told you before about some good ways to balance your hormones and get that ratio back to where it used to be when you were young.
But the first step is visiting your doctor. They can run up a report to see if your hormones are out of balance. And if they are, it’s easy to balance them.
One thing you can do is resistance training. It’s a good way to boost testosterone naturally. And your leg muscles produce the most testosterone in your body. So you’ll want to start doing leg curls, squats and lunges.
There are also plenty of foods that can boost testosterone. Good examples include fish, eggs and red meat. That’s because they’re loaded with protein. And protein increases testosterone.
But just remember, to get the best benefits go for the most healthy options. Forget about processed meats and farm-raised fish. Instead, opt for wild-caught salmon and organic, hormone-free meat.
Wishing you good natural health,
Editorial Director, NHD “Health Watch”