The scientist who discovered the prostate specific antigen in 1970 explains emphatically why he considers use of the PSA test for routinely screening healthy men for cancer to be a profit-driven national disaster.
With the assistance of science writer Piana, Ablin (Pathology/Univ. of Arizona Coll. of Medicine) pulls no punches in this attack on what he sees as the misdeeds of the urology community, the biotech industry and the Food and Drug Administration. The author explains that PSA is not a cancer-specific biomarker, and he asserts that the use of the PSA as a diagnostic test has crippled millions of healthy men, afflicting them with incontinence and impotence. A high PSA number leads to a biopsy, which leads to surgery. The author charges the FDA with negligence for allowing the profit-motivated biotech industry to market the PSA test as a cancer test and greedy urologists in directing frightened men to undergo unnecessary biopsies and prostatectomies. Ablin’s account is replete with names of specific individuals, companies, agencies and organizations, and he provides excerpts from documents and letters to back up his charges. Conversations with men who have undergone prostate surgery put a human face on the alarming statistics he provides. In addition to the human suffering that their stories reveal, the cost to Medicare of prostate surgery is hefty. While misuse of PSA is Ablin’s central theme, he sees this situation as representative of a larger problem: science for sale. Citing the revolving door between the FDA and big medicine, the author asserts that those charged with protecting American health care consumers are often in tacit collusion with those who come before them for approval of their products.
Serious charges voiced in strong language, certain to be met with rebuttals from those whose ox has just been gored, and a must-read for any man concerned about his prostate.