A 2004 study found that for every 48 men who undergo operations for prostate cancer, only one will live longer as a result. But half will suffer permanent side effects affecting a certain cherished organ. Other research is even more damning, finding zero effect on the death rate.
How can that be? Several reasons: The [PSA] test often yields false positives, it can't tell if the cancer is truly dangerous, and surgery doesn't always work. A lot of patients get treated for cancers that won't kill them, and others get treated for cancers that will kill them anyway.
Richard Ablin, a scientist at the University of Arizona College of Medicine, discovered the enzyme that the test picks up. But he has decried mass screening as "a hugely expensive public health disaster."Each year, 20 million men get a test that will almost certainly do them no good.
The prevailing approach to prostate cancer illustrates our collective disregard for medical expense. Some $3 billion a year is spent in this country for PSA screening, with Medicare, Medicaid and the Veterans Administration often picking up the tab.
That doesn't count the cost of the roughly 85,000 surgeries done each year on cancerous prostates, or the expense of treatment for the side effects that often ensue. The federal task force didn't factor finances into its recommendation. But the rest of us ought to.
Unfortunately, it's hard to picture any politician demanding that the federal government stop burning cash for tests that are more to be feared than welcomed. As we learned from the uproar over "death panels," many Americans think when it comes to medical care, more is better and less is an atrocity.