The Health $care Industry and the Prostate: Don’t Let Big Bucks Trump Your Quality of Life

Prostate health costsI love my doctor and trust what she recommends. However, I’m becoming increasingly aware of how harmful, and downright dangerous, the system of which she’s a small part can be to our overall health and well-being. For more than 20 years I’ve been seeing her regularly and most of what she’s offered has been compassionate, sensible, and helpful. Though she has a busy practice, she stay up on the latest science and isn’t afraid to change her recommendations to keep pace with new knowledge.

For years she has recommended a yearly PSA test. She explained that it was a good way to assure that if I developed prostate cancer it would be detected early and treatment would keep me living long and well. However, in recent years she has told me that there is increasing debate about the value of PSA testing.

My own experiences illustrate the problem. When my PSA test was slightly elevated my doctor said I should see a urologist. After consultation, he said he didn’t think I had prostate cancer, but thought I should have a biopsy just in case. As soon as he mentioned the word “cancer,” like most people I became panicked. I completely blocked out the words, “I don’t think you have…” All I heard was “prostate cancer” and “biopsy.”

He told me the biopsy was simple, safe, and would help us to diagnose cancer if it was present. As I described in my article, “Is the Test Worse Than the Disease?” the needle biopsy resulted in a serious prostate infection, which lead to two months being catheterized and walking around with a urine bag attached to my leg.

The urologist told me that these kinds of infections were rare and it was good to be checked because it turned out I didn’t have signs of prostate cancer. But was it worth having the test with the attendant consequences? I don’t think so. Also, once you start testing, where do you stop? You may not have signs of prostate cancer, but you can never be sure, so come back next year for another test.

In the book, The Great Prostate Hoax: How Big Medicine Hijacked the PSA Test and Causes a Public Health Disaster, Richard J. Ablin, PhD, the scientist who discovered PSA in 1970 and science writer Ronald Piana, have serious doubts about the value of the PSA test. They say, “Every year, more than a million men undergo painful needle biopsies for prostate cancer, and upward of 100,000 radical prostatectomies, often resulting in crippling side effects such as incontinence, impotence, and psychological trauma.”

Luckily I haven’t become one of the 100,000 men each year who has had his prostate removed. Based on the latest science Ablin and Piana say, “The shocking fact is that most of these men would never have died of this common form of cancer, which frequently grows so slowly that it never even leaves the prostate.” Based on what I’m learning, I’ve decided to stop getting my yearly PSA test. Here’s why:

  1. Since PSA increases with age, eventually it will go up high enough to be of concern to the “Health $care” system.
  2. The doctor will recommend a biopsy, which has its own risks as I well know, and eventually they will find “cancer.”
  3. Most of these so called cancers are not dangerous and don’t need to be removed. Internationally regarded pathologist Jonathan Oppenheimer, M.D. believes they should not even be called “cancer,” but more accurately Prostatic Epithelial Neoplasia (PEN).
  4. Oppenheimer points out that a committee of experts convened by the National Cancer Institute recommended in July 2013 that the use of the term “cancer” should be “reserved for describing lesions with a reasonable likelihood of lethal progression if left untreated.”

The Golden Prostate: There’s Big Money to Be Made

Why do we continue to screen, biopsy, and operate when there is so much evidence that these procedures do more harm than good for most men? The answers aren’t too hard to find.  They include money, money, and money; and did I mention money? Here are a few money facts to consider:

  • PSA tests cost $20 to $50 for an at home test or up to $120 or more if performed in a hospital. We’re testing 30 million men a year in the U.S., which comes to a hefty sum for the pharma/medical complex (remember Eisenhower’s warning about the military/industrial complex).

But the PSA is just the first step on the path to big bucks. As Ablin and Piana remind us in The Great Prostate Hoax, “Those 30 million tests lead to more than a million biopsies which lead to upward of 100,000 prostatectomies that are not proven to increase a man’s chances of survival but can devastate a man’s quality of life.”

The pharma/medical complex sees an opportunity for big money, they go after it regardless of the costs to society or to individual men and their families. Here are some additional “cutting edge” procedures that Ablin and Piana describe as having questionable value in helping men, but great value to the profits of the pharma/medical complex:

  • Robotic surgeries to remove the prostate are becoming increasingly common. “The da Vinci Surgical System is the only FDA-approved surgical robot on the market,” say Ablin and Piana. “Each unit costs close to $2 million dollars. Hospitals purchasing da Vinci robots must also agree to a $100,000 per year service contract.” No wonder these surgeries are being recommended. With that kind of cost, you better get a lot of use out of the machine.
  • Proton beam therapy for radiation treatment is expanding throughout the country. Each center costs $200 million dollars and there are eleven centers operating in the U.S. with twelve more in development. These centers are being built say Ablin and Piana “despite no clinical evidence that proton therapy is more effective than other far less expensive radiation treatments.”

This bit of information helped me understand why many believe that Medicare will go bankrupt in the near future. If a drug or procedure is approved by the FDA, which is increasingly influence by big business, Medicare is required to approve payment for doctor-ordered tests and procedures no matter how much they cost or whether there is a less expensive alternative

Plus, many of the most respected doctors in the field are paid large sums of money by pharmaceutical companies as incentives and rewards for prescribing their drugs and procedures. In an article, “Dollars for Docs: How Industry Dollar Reach Your Doctor,” written by Propublica: Journalism in the Public Interest, the authors describe the data base Propublica has developed:  “It contains approximately $4 billion in payments to doctors, other medical providers and health care institutions that have been disclosed by 17 pharmaceutical companies and their subsidiaries since 2009.”

So next time your doctor suggests a PSA test, a “simple biopsy,” prostate radiation or surgery, it’s a good idea to take your time and think it over. What are the costs vs. the benefits? Even if you are on Medicare or have private insurance, someone’s paying and someone else is getting rich. We each have the power to “just say no.” If we say “yes” to the test or subsequent procedures, we should do so after knowing the facts and being aware of our feelings. Let me know what your experience has been.

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  1. Ronn Jerard says:

    Dr. Diamond.
    What’s the harm in getting a PSA blood test to measure your number, but refusing to agree to a biopsy? Surely, there’s no harm in doing this, is there?

    • Ronn, Good question. One answer is that the PSA test doesn’t give us information that can prolong our life and it causes us to worry (and our doctor to worry) if the numbers increase slightly. So, if you do get a PSA test and the doctor recommends you get a biopsy, what will you do? For me, when I was getting tested, my answer was to take a number of supplements I thought could prevent prostate cancer and also to change my diet to one that was more cancer preventing. Then the questions is, if I’m going to do that if my PSA goes up, why deal with the anxiety and fear about having it done.

      But you’re right if you do the PSA test and don’t get a biopsy or surgery you avoid the most serious
      costs, both personal and financial, of dealing with a possible neuroplasia that is not really a dangerous cancer.

  2. nice blog…prostate cancer is considered as a very dangerous disease…i think psa test is good..