The Pros and Cons of Testing PSA Levels for Prostate Cancer

Given the clear harms and the small and uncertain benefits, most men would presumably decide to decline PSA testing if they knew all the facts, but that’s up to each man to decide.

If you do get diagnosed with prostate cancer, what can you do with diet in addition to whichever other therapies you might choose? See:


Thanks for watching. I hope you’ll join in the evidence-based nutrition revolution!
-Michael Greger, MD FACLM

[spoudaois]

I am a Urologist and psa testing and treatment have evolved. There is less screening for older patients and some with prostate cancer are watched and not treated unless there are signs of aggression. One can die of prostate cancer, and there are huge differences in the high grade vs low grade disease. I tell them all to avoid dairy and consider a plant based diet.

[sherwinmoscow]

70 yr old male here. I was diagnosed with PC (Gleason 7) last year, had SBRT (5 radiation treatments in 10 days), with no residual issues. PC treatment has evolved. No longer are they recommending treatment for Gleason 6, which is 50% of those diagnosed. Certain groups have a higher likelihood of PC, including factors such as family history, African American, etc. I have known three men who have died from PC, and none of them were tested, and by time it was discovered, it was too late. Cheers!

[paulmaxwell]

I think this is one of your most important videos, Dr. Gregor. Every man and woman should view it before making a decision on mammography or PSA testing. In the absence of a FULL explanation of risks and benefits, and a discussion of absolute risk reduction, we are NOT making informed decisions.

The American Academy of Family Physicians recommends against both PSA tests AND digital rectal exams? (1:50) I didn't know this. As I explain below, I debated long and hard regarding the risks and benefits of PSA testing, went ahead, didn't like the results and successfully lowered my number entirely via dietary changes. For me, it was a good-news story. For a close friend, it wasn't: he endured multiple biopsies, radiation, chemotherapy only to be told by his doctor that the cancer was indolent and should have been left alone. Now he suffers from fecal incontinence.

[z.j.maayan]

Wow. I have been recommending PSA screening to my primary care patients as I have been taught to do. Thank you, Dr G. I will now change that to a discussion of risks and benefits.

[cloudsowhite]

New and better tests are what is needed. Not fewer tests, but BETTER tests.

[mkaberli]

I am 78 years old. My PSA has been climbing over the years. I asked my urologist if there is anything I can do, such as diet and exercise, to improve my situation. He flatly said, "Nope, that's your plot in life and you have to live with it. With that in mind, I'm not too inclined to trust this doctors opinion about anything, especially since I now know that the US has the highest rate of prostrate cancer in the world. I suspect the SAD plays a large role in that statistic.

[Magnulus]

Thank you for this heads up, as this is very serendipitous as I just got a doctor that wants me to get a PSA. I eat a Vegan diet and I'm only 48, and it seems odd she wants me to get a test for something that I'm not at especially high risk for. I was unaware of the risks of over-medicalizing prostate cancer. But I've experienced over-treatment in the past from a neurologist, and I don't want to go down that route again.

[contact]

I had slightly increased PSA at the age of 48 values between 4-5.5 went WFPB and stopped drinking coffee, which made a difference, now 5 years later my values are constantly below 1.0…..

[IMSColoradoSprings]

PSA tests are very easy and so are the biopsies. My friend died of prostate cancer with the "watch and see" situaion. He was only in his mid sixties. Regardless of the studies and recommendations, it's up to you. It used to be the glove treatment and by the time the doctor can feel a tumor, it can be too late.

[dannyspitzer]

Great info...everyone should watch this and your mammogram series

[oleeb]

I prefer getting the PSA. Mine is very, very low and it makes me feel better knowing that is the case.

[MrJonFischer]

16 years ago, I had an elevated psa reading of 13. I ignored it. Then 6 years later, I had a reading of 33. I had the biopsy showing a gleason score of 7 to 8. This all happened 10 years ago. I decided on the "robot" style prostectomy. My removed prostate was lab examined and found to be 65% cancerous. Today I have almost no aftereffects from the surgery. Amongst my friends, 4 of them have died from prostate cancer. I personally advise to get a psa test.

[andrewrivera]

My PSA was slowly rising through out my 40’s topping out at 6.35 at age 52, I went to 2 different urologists who screamed at me there was no way to lower the PSA and that I needed a biopsy! FF 2 years doing low carb and fasting it was 3.0, last year at 57 years young it was 2.9! I asked my doctor how this could be, she ran out of the examination room!

[acoustic]

Prostate cancer treatment guidelines have been changing. I think most PCPs do PSA screening after a certain age. I was diagnosed with Gleason 6 and doing active surveillance but several friends had aggressive cancer. I'm pretty sure they're glad they were screened. Hopefully, cancer research will lead to a better understanding and treatments.

[rdc]

Say what you want, it saved my life. Just a blood test you don't have to do anything else unless you choose to. Hopefully pursue more than one opinion as well.

[gregmoore]

READ THIS: If PSA is high, next step is the "4Kscore" test - another easy blood test. Most doctors (like the one in this video) don't know about this newer "4Kscore" test so you have to research it yourself and tell your doctor about it.

[eileensien]

Thank goodness my father got his PSA tested when his first cousin was dying OF prostate cancer in his early 70s.
Seems that they both had that ASHKENAZI gene linked to greater risk of prostate cancer.
My Pop's PSA at 66 was 11 !
No operation was needed. He was treated with radiation to shrink his 3 tumors.
A year later, he had radiation proctitis bleeding. NJ proctologist (a true A-hole doctor) told my father, "Good news and bad news. Good news: It won't kill you. Bad news: You'll have to live with it." (I was with my father at that appointment.)
When we got to the parking lot, I told my father: "You're going to Florida. Call 3 proctologists there — they've seen tons of A-holes. If they don't say that they can stop it, I'll come down with my curling iron and I'll cauterize it for you!"
First office he called, the receptionist said, "Oh, yes, radiation proctitis, very common. Seven to 10 laser treatments and you'll be fine."
He called me to ask if he should bother to call any other proctologists. 😂
I told him: "No. If the receptionist knows the procedure, the doctor is a specialist at it."
Anyway ... 11 years later, after his wife died from colon cancer, his PSA was down to 7.4 at the age of 76.
That's when I took over the food shopping and meal prep. Having learned the dietary relation to her colon cancer, I turned his diet to 90-95% plant-based. He preferred almond milk with his Cheerios to the "blue water" [skim milk] he previously used. He never knew that meatloaf and meatballs I made were mostly smashed beans. He was no wiser about it, but all the healthier for it.
By 85, his PSA as down to 4.3!

If he hadn't had his PSA checked, would he have died from prostate cancer like his cousin? Most likely.
So, suggesting that one shouldn't get the damned blood test is irresponsible.

"To save one life is as if to save the world entire."

[HappyCat]

This is dated. It's not simply a case of elevated PSA, it's how elevated and how fast. Sometimes it's elevated due to prostatitis or other issues which can be managed. If these treatments don't result in improved then an MRI is scheduled to look lesions, if any. Only after lesions are seen on an MRI are biopsies performed. My BFF just went thru prostate cancer treatment, his brother died of prostate cancer 20 years ago. My other BFF has severe BPH and it's been quite a journey over the last 15 years and we've seen how monitoring and treatment standards have evolved. But the new standard is MRI before any biopsies.

[geoffwhite]

This video ignores the more recent advances in PSA testing. I'm referring to PSA Velocity & PSA Density. I'm told these metrics can give a better indication of who would genuinely benefit from prostate cancer treatment & who would not.

[alainkoningverdraag]

So far I haven't found anything better drinking than copious amounts of a mix of six or more dark leafy green vegetables, steamed and blended with water (like apple sauce) three times a day, for excellent recovery, bar none. But it must not be a one-time thing. It's astounding how effective this is over time. And for anyone claiming how bitter it can taste, just add honey to the mixture and warm it a bit before drinking; it just works wonders for your health.