The Test a Top Urologist Gives His Patients But Refuses to Take Himself

# The Test a Top Urologist Gives His Patients But Refuses to Take Himself

A prominent urologist screens his patients for prostate cancer using the PSA blood test while personally declining the screening himself. This paradox highlights ongoing debate within medicine about whether routine PSA testing benefits most men or causes unnecessary harm.

The PSA (prostate-specific antigen) test has divided the medical community for decades. Organizations like the U.S. Preventive Services Task Force recommend against routine screening for average-risk men, citing high rates of false positives that lead to invasive biopsies and overdiagnosis of slow-growing cancers that rarely become life-threatening. The American Cancer Society takes a more nuanced stance, recommending informed discussions between doctors and men about screening risks and benefits starting at age 50.

The urologist's reluctance to undergo his own test reflects a real tension in modern medicine. Doctors often recommend procedures to patients that they themselves would avoid, especially when evidence remains contested. This selective approach suggests the physician may view the test's downsides as outweighing benefits for asymptomatic men without family history or other risk factors.

Prostate cancer remains the second-leading cancer killer among American men. Yet many tumors grow so slowly they never cause symptoms or death. The challenge lies in distinguishing aggressive cancers requiring treatment from indolent ones that do not.

PSA testing can detect cancer early, potentially saving lives in high-risk populations. Black men face nearly twice the prostate cancer death rate of white men and benefit from earlier screening conversations. Men with family histories of aggressive prostate cancer also represent a different risk calculus.

For average-risk men without symptoms, the evidence supports shared decision-making rather than blanket screening. This means urologists discussing what elevated PSA levels actually mean, acknowledging false positives, explaining biopsy risks,