If you're a man, read this

Healthy men should no longer receive a PSA blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence in many, a key government health panel has decided.

This issue is not new. I have played the PSA game for more than a decade, and I no longer care to play. My number goes up, I'm off to the urologist. Then it goes down. Then it goes up again, and I'm off to the urologist, who now wants to biopsy. Over and over.

The recommendation:

is based on the results of five well-controlled clinical trials and could substantially change the care given to men 50 and older. There are 44 million such men in the United States, and 33 million of them have already had a PSA test — sometimes without their knowledge — during routine physicals.

“Unfortunately, the evidence now shows that this test does not save men’s lives,” said Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force. “This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does.”

Moreover, there is no evidence that a digital rectal exam or ultrasound are effective, either. “There are no reliable signs or symptoms of prostate cancer,” said Dr. Timothy J. Wilt, a member of the task force and a professor of medicine at the University of Minnesota. Frequency and urgency of urinating are poor indicators of disease, since the cause is often benign.

From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence or both. As a result of these complications, the man who developed the test, Dr. Richard J. Ablin, has called its widespread use a “public health disaster.”

Plenty of reputable people are opposed to this new recommendation. What should you do? Talk to your doctor, and ask a lot of questions about everything you hear. Remember, there's a difference between public health statistics and your own body. Read everything you can. Get a second opinion, and a third. Ultimately, the decision is yours.

You can read a lot more about this here.