Latest / Intellectual Medicine / EpiSwitch PSE vs. PSA: Don't Spend $900 on This Test Before You Know This

Transcript

EpiSwitch PSE vs. PSA: Don't Spend $900 on This Test Before You Know This · Intellectual Medicine

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  270% better. That's the headline folks.
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  The new test is 270% better than the old fashioned PSE.
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  Now remember the wisdom of Mark Twain who said there are lies,
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  there are damn lies and there are statistics.
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  So we're going to look at this and give you the answer, give
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  you my thoughts. Is this new test 270% better
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  than APSA and therefore, should you spend the money to get it?
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  Well, let's go into that, right? 270% refers to something called
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  the diagnostic odds ratio. Well, don't be embarrassed if
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  you haven't heard of the term before.
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  It's something that statisticians use.
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  So when you crunch that and you use some gymnastics, statistical
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  gymnastics, you can label a percentage between what's called
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  the PSE. The EPI Switch PSE is a test
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  that is promoting itself as 270% better than APSA.
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  You have to go back to the sources.
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  So the EPI Switch PSE test is a credible blood test that can
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  shed light on to the likelihood of severe or aggressive prostate
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  cancer being present, right? So it can have some merit, but
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  it's got limitations and it's not better than the PSAI think
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  the PSA test is superior. I'm going to explain why in the
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  next couple of minutes. So you've got the EPI switch PSE
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  test that has a yes, no fork in the road.
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  When you get the test performed, it'll come back.
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  Either yes, this looks like you have cancer, or no, it doesn't
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  look like you have cancer. If it's a no, there's still a
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  10% chance cancer could be there.
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  OK, so it's a good test, but like any test folks, it's got
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  limits. The limits are further enhanced
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  if your PSA level is above 10. Furthermore, this test, I'm
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  going to throw a stat at you. I could play that game too.
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  The EPI Switch test is 8900% more expensive than APSA.
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  Runs around $900. APSA 10 bucks.
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  So we've got a price differential that has to be
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  factored. Why?
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  If you only had one task to do your entire life, that would be
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  a difference maker going forward.
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  And the EPI Switch is probably the one for you.
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  The problem is this, you go to see your dock, your PSA is 7.
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  They want to you want to get more information.
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  So you say I want that PSC EPI Switch test, you know the 270%
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  one dock. That's one I want.
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  Suppose it comes back. No risk of cancer, relatively
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  speaking. Suppose it comes back like that.
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  Well, guess what? A year from now, you still have
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  a high PSA. You still have the same problem.
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  What are you going to do then? Another test now?
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  Maybe, Maybe do it every year at $900 per pop.
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  The problem is that cancer, prostate cancer, is not a single
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  point in time. If you're a man, you have a
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  prostate gland. My hope for you is you someday
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  acquire prostate cancer cells within your gland.
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  Now, before you throw an egg at me, this is almost inevitable if
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  you live long enough, based on catabaric studies.
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  So I'm not wishing prostate cancer death on anybody.
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  In fact, I'm advocating that we should take actions to alter the
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  probability the risk of this cancer extending.
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  If it sleeps in the gland, we're good to go.
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  So here's where the PSA test has its advantage.
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  It originally was FDA approved and came to market not to
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  diagnose prostate cancer, but to track treatment.
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  That is its strength, looking at things over time.
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  So you hear this term a lot. Is the cancer aggressive or is
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  it? Is it a turtle or a rabbit?
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  That's silly. It's not just the cancer, it's
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  you, it's the host. How does the cancer go from
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  being indolent to now being active?
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  The cancer itself is only part of the equation.
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  That's why I don't like biopsies.
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  There's snapshot a single point in time there's a risk of
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  infection, and every time you get one, the lifetime risk of
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  infection goes up. If you have a 3% risk of an
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  infection with one biopsy, a rough estimate, that risk is up
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  to 9% if you get three of them over time.
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  Furthermore, they don't really know how to assess the
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  infection. I mean, if you got a spiked
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  fever, that's one thing, but suppose you just get low grade
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  prostatitis. So the biopsy's a bad play, and
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  that's why I advocate, you know, fight cancer like a man.
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  No biopsy, ever. I don't care what the test shows
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  you. I don't care what the EPI switch
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  shows you. You don't get a biopsy.
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  Therefore, a test intended to help you decide whether or not a
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  biopsy is warranted has less merit if you embrace my
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  philosophy, the science behind it, and the approach that I
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  advocate. We all have to live without
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  prostate men. We want to take you to our
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  grave. If it has some cancer cells
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  within it, I don't care. Let them sleep.
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  You got a high PSA. Would the EPI switch be worth
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  getting? I will give it this, and I'll
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  give you this. If you are of a conventional
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  medical mindset, and if you are somebody that wants to consider
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  a biopsy and by extension wants to consider prostatectomy and
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  radiation, none of which I recommend, then the test may
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  have some value. If it comes back low risk or no
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  in the yes no scale, then you can perhaps more comfortably
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  punt and wait a while, but you're still left with a
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  dilemma. You know what comes next.
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  The beauty of APSA is that you can track it and cancer will
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  manifest itself. If the PSA is escalating
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  rapidly, that's a tell that lets you.
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  And I know, hey, this cancer starting to get on the move and
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  we need to do something more than the current level of
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  intervention. Never the surgery, never the
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  radiation. Why not the surgery?
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  Why? Why the harm, The horror of
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  harm. The idea that you can just cut
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  the cancer out, hey, if we catch it early, we can cut it out and
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  you won't be affected by cancer has turned out to be a false
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  hope. We now know that the surgery
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  does make a difference. Radiation doesn't make a
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  difference with regard to death, so the emphasis on decision
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  points regarding a biopsy now get erased.
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  The decision point man is what are you going to do?
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  You know, with this high PSA, what are you going to do about
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  your risk? How do you modify that?
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  You can do it. You can carry the cancer cells
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  with you. So the EPI switch at 270%
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  better. That's nonsense.
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  It misses the point that this is a lifetime challenge that needs
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  to be monitored going forward. If you're 50 years old and you
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  have a high PSA and get an EPI switch test at that age, you can
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  do it every year for the next 20 years.
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  Well, maybe I suppose it's an option, but then what are you
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  going to do if it goes from not risk to risk?
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  Furthermore, it's not a quantitative test.
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  It doesn't give you a numeric outcome.
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  What I like about APSA, it's a six.
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  It can go to A7, It can go to a 10.
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  You have to interpret it carefully.
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  The problem, folks, is not the test.
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  The problem is a physician interpreting the test.
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  Rest assured, if that physician is a urologist, they're going to
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  lead you toward a biopsy. It's what they do.
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  It doesn't mean they're bad people.
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  They've just been indoctrinated to believe that the biopsy is
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  the is the absolute top of the heap test to do and therefore
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  they're going to keep bugging you until you agree we'll get
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  APSA, then we'll get an MRI here.
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  Here's a here's a tip for you guys.
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  If you have APSA that is elevated and your man above 60,
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  the likelihood that you'll have a stone cold normal MRI of the
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  of the prostate is almost zero. I mean, it is really uncommon.
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  It does happen, but in the vast majority of times there are
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  nodules, there's a Pyrads of three or four maybe.
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  It looks like it adds another layer of uncertainty, but it can
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  be a layer of fear. It can be utilized as a cudgel.
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  See your, your Pyrads is 3. We got it.
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  We must, you have to, we got to do a no, no, and no.
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  So the EPA switch PSC has gotten a lot of traction lately from
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  the study. So I went back and looked at the
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  source. Where did the 270 times greater
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  come from? A study published in 200 and
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  2023. And the study was sponsored by.
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  Guess what? Guess who?
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  Yeah, the company that makes the test.
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  And eight of the principles involved in the study are
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  employed by the company that makes the test.
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  It doesn't disqualify it. But aren't we just a little bit
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  skeptical about this Blizzard of promotion?
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  All of a sudden it's going viral and it's the greatest thing and
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  we should do this and we've got to make the government pay for
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  it. We'll go broke chasing our tail.
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  So I guess, I guess I'm not getting any endorsements from
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  the company anytime soon. But the point here is not to
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  disparage. The test in a vacuum is a
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  scientific sort of phenomenon. And the test has some attributes
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  of value. But we have to look at the big
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  picture, men, how do we assess this risk over the span of our
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  lives? How do we manage it?
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  How do we prevent its extension? How do we live with it so it
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  doesn't dominate our thought, so we don't react out of fear?
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  The EPPY switch test, the PSE test is not 270 times better
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  than PSA. It is certainly 8900% more
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  expensive. And it has profound limitations
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  because you can't track along with your condition.
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  So there we go. Stick with your PSA, make sure
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  it's interpreted properly. I would venture to propose that
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  you ought to have a non surgeon interpreted for you.
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  Good family doc. All right, well that's all I got
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  for this moment. But thanks for tuning in and
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  stay with me for more insightful comments and statistical
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  analysis. Until next time, see you then.