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What Is Prostate-Specific Antigen (PSA) Test & Should You Get One? · Intellectual Medicine

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  I've got to share with you public service announcement, one
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  of the greatest threats to men's health.
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  This is a public health catastrophe in the making.
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  I'm talking not about prostate cancer, but about the PSA test.
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  Let me explain. Doesn't it make sense?
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  Isn't it intuitive that if we can test for something like
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  prostate cancer and catch it early, we can make a difference?
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  It's a big problem with that statement.
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  It doesn't hold true. It is true about other cancers,
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  but the prostate is unique. There's nothing quite like it.
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  So let's let's unravel the origins.
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  In the 1990s, Doctor Albin, APHD researcher, discovered the
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  prostate specific antigen, the PSA.
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  Shortly thereafter, a test was manufactured around his
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  discovery, the PSA test. He was vehement in warning the
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  public that this test is not a screening tool for prostate
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  cancer, and his concern was that it would be capitalized on by
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  medicine to generate fear to push men into procedures that
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  are highly profitable and of dubious value and potential
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  harm. He was right.
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  He wrote a book about it called the The Prostate Host, a great
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  prostate hoax. His concern has been validated.
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  The drum beat of screening PSA testing.
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  Look, I'm not against PSA testing.
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  I'm against the way it's interpreted and the way it is
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  utilized in my view and the view of many others.
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  To scare the bejesus out of men, to let them go do something that
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  horribly affects the rest of their life.
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  Think about the ark. How do we get in the space?
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  A lot of this is presumption, intuitive conclusions.
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  Nobody bothered to research whether or not removing a
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  prostate gland would make a difference, they just assumed it
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  would. 1950s Prostatectomy becomes a standard of care from
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  the 1950's, the 1960's, the 70s, eighties and nineties. 2000 the
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  rate of death from prostate cancer kept going up.
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  What gives? 2012 to 2023 the per capita rate
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  of death from prostate cancer has been flat.
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  Now tell me folks, just logical conclusions.
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  If whacking out prostate glands and irradiating them was
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  effective, wouldn't we expect that rate to go down?
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  Isn't that what we want for our trillion dollars in Cancer
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  Research? Here's the problem, and it's not
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  an evil cabal. It is the law of self-interest.
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  The PSA test scares men. To do what?
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  Get a biopsy. Got to do a biopsy.
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  Got to know what's going on. It's a it's a shot in the dark.
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  The biopsy itself is traumatic. The biopsy itself creates blood,
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  ruptures, the capsule of the prostate gland, potentially
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  disseminating prostate cancer cells if they're in there.
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  These are atypical Dorman cells. Now I'm going to pause and
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  highlight this detail that when, if I, as a doc, if I cut through
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  a Melanoma, a skin cancer, I cut right through that instead of
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  excising it completely so that it doesn't disrupt the cells.
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  That's malpractice. That is known to be a risk
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  factor to spread Melanoma and make it systemic.
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  If I cut through it, When a surgeon does an excision of a
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  breast mass, he or she doesn't cut through it, chop it up in
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  little pieces. They cut it out carefully.
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  They say we got clean margins. Why do they care about clean
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  margins? Because they do not want to
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  disseminate cancer cells. Now, how do we go from that to
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  the belief that we can stick a needle in your prostate, you
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  know, 12 times, make a bloody mess of it?
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  Yeah, don't worry about it. No risk of prostate cancer
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  dissemination. It begs logic.
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  It is paradoxical. These two things don't go
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  together. You can't on the one hand say
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  I'm practicing, I I'm performing malpractice if I cut through a
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  Melanoma or the surgeon is is guilty of malpractice if he cuts
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  through a breast tumor and at the same time tell us it's OK to
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  chop up your prostate. It makes no sense.
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  Now where's the research? It's not there.
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  We have a tendency to not research things.
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  We'd rather not know the answer. We'd rather not know that answer
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  because it could disrupt a multi billion dollar industry.
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  There's a reason why the Pharmaceutical industry and the
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  medical establishment does not chase down negative consequences
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  for things that are profitable. Only bad stuff can happen.
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  So it's buried and it's presumed that it's OK.
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  Nonsense. So you got that risk and
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  ultimately before we talk about, you know, PSA and screening and
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  now there are more tests coming out screen for your for your
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  prostate cancer. Here's the nub of the issue.
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  Conventional treatments cause harm have not been proven to
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  diminish a man's risk of dying from prostate cancer.
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  That is the research based reflection on some of the best
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  studies 1 published in the New England Journal of Medicine in
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  2023 demonstrated that men who have the gland removed or
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  irradiated of the same death rate, rate of death from
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  metastatic prostate cancer as men who did nothing 20 years
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  later. That should have been a stop.
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  The press moment that should have caused every doctor to say,
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  hey, what are we doing? We're taking healthy men.
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  The typical scenario PSA test is done.
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  It's elevated all right. What is elevation?
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  The numbers that they use. Folks are made-up.
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  They're completely arbitrary. There is no deep research behind
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  the numeric cut off. And the consequence, Sometimes
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  people call it three, sometimes it's four.
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  I say it's none of the above. Is it worth looking at if you
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  can then interpret it rationally?
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  Now here's the problem. We've established a multi
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  billion dollar industry around the PSA test.
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  The the test itself is a profit center.
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  New tests are coming out and we're we're chasing down that
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  rabbit hole. We're all not all but medicine
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  is looking for the next best screening test that can help us
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  determine should we should we not biopsy a gland is a cancer
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  likely present or not? It doesn't matter how good the
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  test is if it ends up directing you towards a biopsy because
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  there's no test that would be adequate, the eyes of
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  conventional medicine to avoid a biopsy procedure.
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  They're ultimately going to be chasing this and that causes
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  harm, as we spoke of. So we got the PSA test being
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  misinterpreted, misguided. Look, that PSA number for most
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  men, almost all men, it's going to gradually go up.
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  It has to do with the inevitable increase in the size of the
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  prostate gland in the large cohort of us.
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  We don't care about PSA numbers. We don't care about prostatic
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  hypertrophy unless it gives us a problem.
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  We just don't want to die from prostate cancer, right?
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  That's the bottom line. The PSA test shunting you in
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  toward a biopsy. Scary to think about.
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  You know, a 12 to $13 billion industry.
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  My protocol, the approach that I've adapted over years,
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  includes using non biopsy biomarkers, APSI like that for
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  screening, for tracking I should say, and the prostate health
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  index. Those two tests can give you a
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  pretty good information about where things stand.
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  Combine that with an MRI of the prostate if needed.
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  Now you can look at the anatomy without sticking a needle in it.
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  What we do with that, that's challenging, isn't it?
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  So I see men all the time. Elevated PSA, an abnormal MRI of
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  the prostate. The next step, the doctor wants
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  to do a biopsy. Whoa, pause the thought.
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  You don't want to get sucked down that pathway.
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  You don't want to become another, I don't know, person in
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  the queue in the conveyor belt. We didn't get the biopsy.
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  We didn't get the multi billions with AB billions.
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  If my protocol were more widely adopted, urological procedure
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  would diminish greatly. And they should.
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  We shouldn't be doing this to men until we can prove benefit.
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  Stop harming them. I don't want to be harmed.
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  I don't want my patients being harmed.
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  And that's what's being promoted out there.
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  Billion dollar industry. How about the Kimberly-Clark is
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  a company that makes absorbent pads and guess what?
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  They donate to prostate cancer awareness now.
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  Who the hell is not aware that it's there?
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  What they want to do is promote the concept using fear.
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  Your prostate is in fact the second leading cause of cancer
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  death amongst men behind lung cancer.
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  OK, that's a fact. It hadn't changed despite all of
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  our treatments haven't budged. The fact that it is the second
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  leading cause of cancer death does not justify the treatments
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  we have now imposed on men, since we now know, you know,
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  that the efficacy of those treatments is little to none
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  regarding the ultimate outcome. So why does this keep going?
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  Why, it's very emotional. Everybody knows somebody, or has
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  heard of somebody who died from prostate cancer, who suffer the
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  consequences of the terminal phase of it or suffer the
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  consequence of the treatment. What we do to men is ghastly,
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  but you have a powerful emotional mutual bias.
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  The surgeon, not an evil guy. This is what he was taught to do
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  from 1950 forward. Urological surgeons, we cut
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  stuff out and we're going to get better at it.
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  So we don't leave you so impotent and leaking urine.
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  So they say. So the surgeon then does your
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  biopsy says, look, you got early stage prostate cancer, Good
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  thing we caught it early. Now we're going to cut out your
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  gland. You guys know the risk of death
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  is still out there. In fact, no better than if you
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  did nothing, right? Surgeon, however, has a patient
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  and this story unfolds every day in America.
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  You have prostate cancer. Oh my God, It's an emotional
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  reaction and it should be a horrible thing to hear.
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  And here are your treatment options, Sir.
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  You can do radiation or we can cut out your gland, or you can
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  do watchful waiting, which is medical lingo for hey, I do
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  nothing. Let's see how it goes.
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  Call us when it metastasizes. Weight.
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  Men faced with this type of a presentation will naturally
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  select in most cases, some form of active intervention.
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  That's a problem no matter if if you have an early stage prostate
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  cancer, your risk of dying from that in the first five years is
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  practically 0. It has a 99% five year survival
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  rate. That's a problem when trying to
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  respond to the emotional reaction.
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  You have a surgeon just whack your prostate out.
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  You're suffering impotence and incontinence.
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  You have an empathic wife. They want to make you feel bad,
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  so she kind of goes along to get along.
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  You get that plastic liner for the bed.
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  You know, you get the little bag thing.
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  So when you go to the restaurant and you're leaking urine, you
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  don't make a mess. Good Lord, if this were what it
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  took to survive, maybe. But now you have a mutual bias,
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  right? I had my hands up here.
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  Mutual bias. The surgeon doesn't want to
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  believe he imposed harm with no merit.
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  The patient buys it. They do not want to believe that
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  they're leaking and impotent and feel crappy for no value.
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  And when the cancer does not occur, nobody thinks at that
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  point that hey, this was an indolent phenomenon that would
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  have never progressed anyhow. They believe that the surgery
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  cured them. I see this all the time in the
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  headlines now. President ex president Biden has
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  a nodule on his prostate. Who the heck is looking at the
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  nodule on a prostate on an 80 something year old dude who
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  probably is counting his lifespan in months or years?
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  Short years. Look, I'm all on board living
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  long but you got to face reality.
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  You know, A nodule on the prostate of an 83 year old
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  should be ignored. Or you should do my protocol.
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  Why? Because I'm not going to hurt
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  you. This protocol doesn't hurt
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  people. We need different approaches.
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  Where are they going to come from?
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  They're not coming from the ivory covered institutions of
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  Cancer Research. Certainly not things that are
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  cheap. Certainly not things that are
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  non patentable. It's not going to happen.
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  That's why I do my podcast. That's why we, we the people at
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  a grass roots level, got to make our own decisions.
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  You've got to be affirmative and assertive.
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  If you choose to get the prostate removed, that is your
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  prerogative. It's not necessarily the wrong
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  decision. You know, I, I can't tell you
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  for sure what the future holds. I can tell you what the research
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  has shown us. I can tell you what has happened
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  to people. I can guarantee you harm if you
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  do radiation or surgery. I don't care if it's a da Vinci,
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  If it's a Leonardo, I don't care what kind of da Vinci or that
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  robotic surgery that they promote.
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  There's one the company that makes that machine.
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  It's the only product they make. As far as I'm aware, it's the
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  only thing they make. Well, their entire fortune
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  depends on the belief that that machine can take out a prostate
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  gland with less impotence and incontinence.
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  Unfortunately, the research does not support that superiority.
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  Either way, you're a huge risk, colossal risk.
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  But the industry churns on 1992 thousand.
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  It's not going to change from the top down.
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  There's too much money being made.
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  The hospitals have invested heavily.
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  They buy a Da Vinci piece of equipment.
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  They need ROI, return on investment.
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  They buy a proton laser. So what about the radiation?
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  That's horrible. You irradiate anything and
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  you're going to do damage to surrounding tissue.
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  You cannot contain the beam. It hits the bladder, it hits the
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  rectum. Five years later, you're getting
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  radiation proctitis, radiation cystitis, peeing blood, leaking
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  stool. Oh, I'm sorry, Sir.
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  It's, you know, it's a consequence of your radiation,
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  but you know, it's a good thing you did it because you're not
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  dead from prostate cancer. You see how that emotional
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  reinforcement becomes the cultural belief self reinforced
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  based upon a false premise. Now they have the proton laser.
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  Cost crazy money for the hospital to buy this equipment.
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  They promote this as being capable of targeting things
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  better. We can hit the nodule and not
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  damage surrounding tissue. There's a, there's a host of
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  problems with that. Number one, the cost is, is, is
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  incredibly high. OK, that's a problem #2 hitting
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  a nodule not been shown to prevent death from prostate
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  cancer. And we know the prostate gland,
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  right? Is it's like a sponge.
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  It's got nooks and crannies. We know that cancer is not
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  necessarily present in a tumor state.
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  It can be cellular, invisible. You can't know where to hit it
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  with that laser beam. Hitting a visible module just
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  may be a false target. So we got problems with
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  treatment. We've got problems with
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  screening. We're left in this sort of
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  horrible space. What is a man to do?
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  Well, folks, first and foremost, do not sacrifice vitality unless
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  there is a concrete, proven, overwhelming evidence of
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  benefit. Might you die of prostate
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  cancer? The possibility exists whether
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  you whack the gland out or radiate it or even do my
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  protocol. There's no guarantee out there,
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  guys. I'm sorry, doesn't.
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  Well, there is a guarantee. There's a guarantee that we're
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  all going to die, but we don't have to crawl across the finish
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  line leaking urine. I've been physically weakened.
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  And don't even get me going about androgen deprivation
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  therapy or castration treatment. It is barbaric.
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  It's considered cruel and unusual punishment if you're a
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  prisoner. And yet we do it to men every
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  day. Every day we whack their
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  testicles in the form of cutting down testosterone.
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  So am I against conventional treatment for prostate cancer?
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  I am. Do I feel that we need
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  alternatives? Clearly.
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  Should those alternatives include destroying the prostate
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  gland? I don't see merit in it.
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  I've seen other approaches, techniques to try to destroy the
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  gland is not as as traumatic. I don't buy them.
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  The problem with this field is we need to follow it for 10
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  years to make a judgement. The first thing they say in
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  medicine, right First, do no harm.
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  Imagine a drug intended to cure prostate cancer, but it has
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  horrible side effects, causes impotence and incontinence.
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  And imagine that drug was found not to be effective.
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  The FDA would pull it off the market tomorrow.
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  There's no FDA for surgery, folks.
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  Nobody's pulling prostatectomies off the market.
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  Hospitals, the machine manufacturers, the absorbent pad
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  manufacturers, the surgeons all command the space.
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  I'm imposing on them my humble perspective as a primary care
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  doctor because I stand outside of that sphere.
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  There are many urologists that are questioning current
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  standards and current approaches, but it's difficult
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  to speak out when you're in a room full of urologist.
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  Look, I love my colleagues. I have a urologist.
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  He was great when I had a kidney stone, right?
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  They got their niche. They can fetch stones.
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  I'm on board with that. But cutting out prostates?
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  Just say no. So the public health crisis is
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  real. It has to do with the way the
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  PSA is being misused to scare men, totally healthy, intact men
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  to do things that are just ghastly.
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  So we need a better approach, we need to think differently, we
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  need to get to the cellular level.
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  Think about your global health. Well, listen, I hope you've
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  enjoyed this public health announcement.
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  Should you get APSA test? I think it has merit.
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  What should you do with it? That's the question.
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  You need to do your own research on this guy's.
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  The answers coming from a urologist office are going to
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  lead you down the dogmatic pathway 9 times out of 10.
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  Biopsy. To treatment, it's not wrong to
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  consult with the urologist just to gain the sort of standard of
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  care perspective. But those of you that are
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  carrying skepticism, good for you.
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  Find another source of information.
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  My podcast may be one of those or other providers, some of whom
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  are in your community. Perhaps you can even link with.
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  We hope to make this approach more accessible for more men.
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  I think it should be offered. It's the next best thing to
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  doing nothing. We believe it's superior in the
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  potential outcome. Only time will tell.
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  All right. Well, thanks for your time and
• 20:56
  I'll look forward to our next chat.