Protect your prostate bro
https://unbekoming.substack.com/p/the-great-prostate-hoax
https://open.substack.com/pub/unbekoming/p/the-great-prostate-hoax?utm_campaign=post-expanded-share&utm_medium=web
12-point summary
Here's a 12-point summary of the book, including key data and statistics for those that don’t want to read the longer Q&A below.
PSA (Prostate-Specific Antigen) is not cancer-specific. It's present in normal, benign, and cancerous prostate tissue. There is no specific PSA level that definitively indicates cancer.
Routine PSA screening leads to significant overdiagnosis and overtreatment. For every 1,000 men screened, only 1 man may avoid death from prostate cancer, while many others suffer unnecessary biopsies and treatments.
Prostate cancer is age-related. About 40% of men aged 40-49, 70% of men 60-69, and 80% of men over 70 have prostate cancer. Most of these cancers are slow-growing and unlikely to cause death.
The lifetime risk of dying from prostate cancer is only 3%, meaning 97% of men will die from other causes, even if they have prostate cancer.
Radical prostatectomy, a common treatment resulting from PSA screening, often leads to significant side effects. Up to 60-80% of men experience erectile dysfunction and 10-20% have long-term urinary incontinence.
PSA screening has not significantly reduced prostate cancer mortality. Studies show similar death rates between screened and unscreened populations.
The PSA test has a high false-positive rate of up to 80%, leading to many unnecessary biopsies and treatments.
Active surveillance is increasingly recognized as an appropriate option for many men with low-risk prostate cancer, potentially avoiding unnecessary treatments and their side effects.
The U.S. healthcare system spends an estimated $3 billion annually on PSA tests alone, with billions more on subsequent procedures and treatments.
New technologies like robotic surgery and proton beam therapy, while heavily marketed, have not shown superior outcomes to traditional treatments but are significantly more expensive.
Conflicts of interest are prevalent in prostate cancer care. Many researchers and physicians promoting PSA screening have financial ties to companies that profit from increased screening and treatment.
The FDA approved the PSA test for screening in 1994 despite significant reservations from its own advisory panel. This decision, along with aggressive marketing by medical companies, led to widespread adoption of PSA screening before its benefits and harms were fully understood.
https://unbekoming.substack.com/p/the-great-prostate-hoax