Is the PSA test really worth it for men?

October 7, 2011 (CHICAGO)

It's not a new debate, but this is the first time a respectable organization has made this recommendation. And it's left a lot of men wondering what they should do now.

The official report hasn't even come out yet but it has rekindled an on-going debate with no definitive answer. The Prostate Specific Antigen test, or PSA, is a blood test that has long been controversial since its overall benefit in saving men's lives has been challenged by a number of studies. This report will recommend that healthy men skip PSA testing.

Among the reasons expected to be cited is the PSA screening does not save lives and instead can result in unnecessary treatments that can leave men with discomfort, impotence and incontinence. Dr. Craig Niederberger is a urologist at the University of Illinois Medical Center at Chicago who has studied the value of this test. He admits the PSA is not perfect but doesn't agree with the upcoming recommendation.

"My concern is that the actual recommendation will change the recommendation for screening so that it's for no men and my reaction to that was real concern," Dr. Niederberger said. "We may be missing those men with prostate cancer who would benefit from treatment."

Here's where the problem begins. Prostate cancer can be a slow growing cancer in which men who have it may actually die with it as opposed to from it. Also, one study in 2004 found for every 48 prostate surgeries performed only one patient actually benefits. The others would have lived just as long without it.

The problem is no one can say for sure which men have the deadliest form. That's why doctors often do what's called "watchful waiting," keeping an eye on the cancer before they make the surgery decision.

So what's a patient to do? Dr. Niederberger says combined with other tests, the PSA can be effective. Is it for you? It depends on your family history, risks factors and more. He says these are all conversation you should have with your doctor.

"The main thing is don't let this really change your conversation with your physician, in fact, I would use this as a starting point with your physician about prostate cancer screening," Dr. Niederberger said.

The report wasn't supposed to be released until next week. Now that it has been leaked, the united States Preventive Services Task Force has posted its recommendations online. Find the draft at

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