The PSA Test is Misunderstood And Scary

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Will the majority of men really die of Prostate Cancer if something else does not kill them first? Why are men so afraid of Prostate Cancer in their lives?


Have you gotten a scare when your doctor emailed or called and said you need a follow up with her or him because your PSA Test was either “abnormal” or had increased by over 1.0 point in a year?  Well take a deep breath and we’ll ease your mind so you can actually approach this blood test with the proper amount of respect.

The PSA test is a screening test, which means that the results are not very specific, and they catch every person who has prostate cancer, BUT they have the drawback of notifying a high percentage of men that their test is normal but they have NO CANCER!!  In other words, 70%  of men who are told their test is abnormal have no prostate cancer, in fact have no abnormality at all!

Let’s look at the substance, PSA itself. It is a chemical produced by normal prostates every day, and is also produced by prostate cancer.  The presence of PSA does NOT mean cancer.  The elevation of PSA may be caused by many other factors. These include: having sex or masturbating within 72 hours before the test is drawn, having a prostate exam, riding a bike or exercising in the 72 hours before the test, taking the drug Allopurinol for gout, or having  the conditions Benign Prostatic Enlargement, or a prostate infection. If you have any of these or did not prepare for the test properly then tell your doctor, and ask for a repeat test.

Other evaluations that are appropriate to undergo before you have  a prostate biopsy, depending on the level of your PSA, include a blood test for free PSA which if it is high you are normal, and if it is low you are more likely to have prostate cancer. There is a new urine test that looks for the presence of prostate cancer cells but is not standard at this time and a prostate ultrasound or other imaging might be considered to decide if biopsies are necessary.

For those of my patients who are taking testosterone pellets, I can put your mind at ease that testosterone does NOT cause prostate cancer.  In fact Dr. Abraham Morganthaler from Harvard has done exhaustive research on the question as to whether testosterone replacement causes prostate cancer or not, and he has found unequivocally that it is LOW testosterone that stimulates the development of prostate cancer.  There have been many men who have prostate cancer who have followed their treatment with testosterone replacement and have not had recurrences.

The easiest fact to understand and grasp without obtaining a degree in statistics is the fact that the increased incidence of prostate cancer exactly mirrors the declining level of testosterone in men. For example until the age of 45 the level of testosterone is constant is most men with just a minor drop from age 39-45, and the rate of prostate cancer also stays relatively constant until the age of 45 at which time it increases at the same velocity as the level of testosterone plummets.  Prostate cancer is a disease of old age in men, and in old age men have very little testosterone!  Dr. Morgantaler is so concerned that Low testosterone causes prostate cancer, he biopsies the prostates of all the men who come to him for testosterone, to make sure they don’t begin their treatment with prostate cancer due to the low levels of T.

One of Dr. Morgantaler’s studies that has not concluded at this time, has found that the first year of testosterone therapy has seen only 1.3 percent prostate cancer rate, while the one year cancer rate in the same portion of high risk men sees a 25% prostate cancer rate!  It is an ongoing study which most probably won’t hit the headlines because it will not be “scary” but reassuring!

In his book Dr. Morgantaler provides all of the information from his many studies that are very convincing and will provide those readers who need to see the clinical data described in detail, in his book Testosterone For Life, by Abraham Morgantaler, which can be found on  I will provide one of these books to every new male patient that I see (who is interested in reading).

One of my closest friends is also my patient at BioBalance Health.  He has seen me for 5 years and has remedied his fatigue, slowness of thought, back pain, irritability and loss of strength and stamina, with testosterone pellets.  My friend is an amazing brilliant and active man who has maintained his youthful self with testosterone pellets.  My girlfriend, his wife is over a decade younger and just as beautiful and active.  Frankly it is hard for mere mortals to keep up with either of them, but five years ago my guy friend started to get on his three daughters nerves, and he was walking bent over and slower so his concerned and loving children asked me to consider “talking him into pellets”.  I finally did and he now back in action. Great success story, right?  

Not completely, because when my friend  sees his primary care doctor for a yearly check up and his doctor tells him how great his lab looks and how wonderful everything in the health panels are, but he said in his own words, “that testosterone level is too high and it will harm you.” Then he implied that his PSA of 1.4 (with normal being < 4.0) was a sign he was developing prostate cancer!  I’m sorry but this type of scare tactic takes a toll on patients and is unethical.  Many doctors think that they are doing patients a favor when they scare them away from a “new” treatment, that they in fact don’t understand, but they do more harm than good!  My friend had many sleepless nights and stressed over it leaving a note on my desk, “do I have prostate cancer?”.  It took some time to get him to trust my word and my practice again.  Let me tell you that that behavior makes me plenty angry, because he is my patient too and that doctor is harming him by causing him to endure days of terror worrying about cancer, when he has no sign of it!  But in general this attitude about testosterone is universally considered “ the truth” because when you propagate a lie over and over again, it doesn’t make it more true, yet it does make it a “universal truth”, until the real facts are revealed!

Medicine does this all the time, and it is sad and embarrassing for those doctors who weigh the “truth” that is passed on to us as gospel, with our experience with our own patients and find it wrong!  Such was the contention about eating eggs 20 years ago.  Medicine told us that all cholesterol foods were BAD and that we should not eat them.  Eggs are primarily cholesterol and lecithin perfectly matched to provide us with the perfect protein, and the majority of people took them off their diet. Let me digress here that the way eggs are produced in the US are wholly unhealthy for both the chicken and the one who eats it, but eggs as a food are ideal and necessary to the health of the human brain.  Did you know our brain is 90% cholesterol? And we need to eat cholesterol for our brain, liver, muscles, and every cell wall in our body…it was the voice of medicine like this dictum to avoid eggs, that brought us to this point today where dementia is rampant and Americans take more than 3 drugs each, per day.

So now that we know that testosterone replacement doesn’t cause prostate cancer, but that low testosterone does contribute to it, we can go on and make sure we prepare for the PSA properly, and that we do not panic over the results, if positive.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.  

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