Doug Kaufmann:
Why do you believe that the PSA test continues to be used as a prostate cancer screening test?

Dr. Richard Ablin:
There are two reasons. The primary one is money. But there is also a false ethos operating in our medical system that says, “It’s all we have, and it’s better to do something than nothing.” Wrong! Donald Berwick, the first head of the Centers for Medicare & Medicaid Services under Obama, gave a chilling parting remark as he left office, stating that upward of 30% of all health spending is waste, providing no benefits to patients. The PSA test is a prime example. But despite the growing controversy over PSA testing, many doctors and their male patients still want to believe that the test will “catch” the cancer early, when cure is still possible. Unfortunately, this is false hope. The clinical reality can be summed up this way: Put 1,000 men into a theater who undergo PSA testing. Then put 1,000 men into another theater who do not get screened. Eight men in each theater will eventually die of prostate cancer. I delve deeply into this problematic issue in my book.

Now to money: PSA is the lynchpin of a multibillion dollar business, from the test itself, to biopsies, treatment, post-op therapies, diapers, ED drugs, on and on. For example, across the nation we are building $200 million proton beam centers that use prostate cancer as their cash cow. Without PSA tests, these centers will crash like huge dominos. Without PSA tests, more than half of the urology offices in the U.S. will go belly up. The breathtaking scope of the PSA profit-over-patient industry is explained in my book.

MORE TOMORROW…

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