The Great Prostate Hoax
By Richard J. Ablin, PhD and Ronald Piana
St. Martin’s Press LLC
The more quotes I read from Ben Franklin, the more I like the old guy. Page one of The Great Prostate Hoax starts off with one of his quotes: “He’s the best physician that knows the worthlessness of most medicines.” In more recent times, that quote could be expanded to include many tests, like the PSA test. The first author, Dr. Ablin, discovered PSA in 1970, so he knows exactly what it is—and what it isn’t.
When men have their PSA checked, what the test measures is the infinitesimal amount of PSA in the bloodstream. The first key point Ablin makes is that there is no “normal” PSA level. But that is how millions of men are screened for prostate cancer, right? Right. So how does that work? That’s the next key point. It doesn’t.
Why do the test? For most who have lived on this planet for a while and have been paying attention, you know the answer, but for the newbies, here’s how it works. Millions of men get tested every year ($). The tests generate a lot of false positives. That means additional, more expensive tests or biopsies ($$). Many of those biopsies are bound to find cancer, especially in older men ($$$). This leads to treatment and in many cases, surgery ($$$$$$$$). Add all that up, and you have billions of reasons why they do it.
I said earlier that the PSA test is worthless. I should clarify that it depends on your point of view. For the medical industry, the test is not worthless. It’s a gold mine. For the unwary customer, it is worse than worthless.
If treatment was effective, then maybe there would be some justification for this test, but survival rates for treated men are the same as for men who opt out of treatment. These treatments are not exactly harmless either. The typical result of surgery is incontinence and impotence. Prostate cancer is usually very slow-moving, and most men will die with prostate cancer, not because of it. In fact, only 3 percent die because of it. Robotic surgery has been promoted as a better and safer option. Technology always makes things better, right? Strangely, the data say that robots don’t do any better than mere human doctors.
The pattern is familiar. The health care system deems that there must be lots of testing. The tests often measure things that just are not that important, like cholesterol, PSA or blood pressure. Even if the results are not completely useless, they are mischaracterized and used to panic the victims into hasty and expensive decisions that can ruin their life. But, hey, at least someone is making a lot of money. The thumb is UP for this book.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Spring 2020