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The PSA Debate

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Bonus Interview:
Dr. Richard J. Ablin, discoverer of PSA, explains why PSA is not good for screening

click here if you cannot view audio player: AbilinPSAMp3.mp3

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click here if you cannot view audio player: AbilinPSAMp3.mp3

PSA stands for Prostate Specific Antigen, a marker for prostate tissue. It was discovered by Richard J. Ablin, PhD, early in his career, in 1970. He was looking for a way to identify prostate cancer and realized that PSA would not do that, because it is produced by all prostate tissue, not just cancer. He recently wrote an op-ed piece in The New York Times expressing his dismay at the use of PSA for routine screening, a purpose to which it is not well-suited. Here is our interview with him on this issue.

Guest: Richard J. Ablin, PhD, President of the Robert Benjamin Ablin Foundation for Cancer Research and Research Professor in the Departments of Immunobiology and Pathology at the University of Arizona College of Medicine.

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When I was 52 years old I had the second routine physical of my lifetime. In 2007 (my first physical) my PSA was 0.9. On my second physical my PSA was 4.8. I went to a urologist who did a limited biopsy (5 samples - normally he does 16-20) because he was convinced that I did not have cancer --- I had NO SYMPTOMS and my digital exam was normal. Three of the 5 samples were positive for cancer and the type that I had was aggressive.

Meanwhile, a personal friend of mine had a routine physical for an insurance policy and his PSA was 40. I had a prostatectomy on March 17, 2009 and am now cancer free. My friend passed away from cancer shortly after. I thank God for routine PSA testing, otherwise I could have been another Michael Landon. Anything that can detect a fatal disease early is worth a few false positives.

I am not aware of any surgeon that would remove the prostate just based on a PSA. It is the biopsy that determines surgery. Also, a good doctor is going to factor in the patient's age and health when he discusses this with the patient. It is misleading to say that the PSA promotes unnecessary surgery.

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