PSA Again

 There are multiple testing modalities[1]. We have examined them decades ago[2]. Various other markers have been proposed[3]. Ase the UK has just announced[4]:

The UK National Screening Committee (UK NSC) has recommended that all UK nations implement targeted prostate cancer screening for men aged 45 to 61 who have both a BRCA2 gene change that increases cancer risk and a family history of breast, ovarian, pancreatic or prostate cancer.  As part of this approach, eligible men would be offered a prostate specific antigen (PSA) test every two years.  This final recommendation modifies a draft recommendation the UK NSC made in November 2025, which also included men with BRCA1 gene changes. Since then, the committee has been consulting with organisations, experts and the public, and considering the latest evidence on the risks and benefits of screening these groups, among others.  “Today’s announcement will be disappointing for many people, but the PSA test currently used to help detect prostate cancer isn’t effective enough to support wider screening, as shown in multiple large-scale trials,” explains Dr Ian Walker, Cancer Research UK’s Executive Director of Policy. “Screening should only be introduced when the benefits outweigh the harms, including unnecessary and invasive overtreatment, and right now, the evidence is only strong enough to screen men aged 45 to 61 with BRCA2 gene changes and a relevant family history.”  We now urge governments across the UK to accept the UK NSC’s recommendation and begin to implement targeted screening.  At the same time, they should continue to invest in research that brings us closer to effective screening for more men. We also aim to be part of that work. Over the past three years, Cancer Research UK has invested £28m to find new and better ways to prevent, detect and treat cancer, and we will continue to help more men affected by prostate cancer live longer, better lives.

MedCityNews notes[5]:

On Wednesday, 60 organizations representing providers and patients with cancer submitted a letter to Robert F. Kennedy Jr., secretary of Health and Human Services, urging him to protect the U.S. Preventive Services Task Force (USPSTF).  USPSTF is an independent panel of experts in disease prevention. It provides recommendations for clinical preventive services like screenings, counseling services and medications.  However, the task force hasn’t convened in over a year. And last week, Kennedy fired the vice chairs of USPSTF: John Wong, a professor of medicine at Tufts University, and Esa Davis, professor of medicine at the University of Maryland.

Ironically the USPSTF had taken a stand comparable to the UK, Namely, limit PSA testing. Just to put things in perspective, PSA and %Free tests cost about $50. Here in the US one can get them at Quest and other Labs without a doctors order. If one were to be tested ever six months, and the results examined over time, then any significant change would present as a warning. 

We have shown decades ago that PSA was useful, but only if examined in an ongoing temporal mode. Most physicians do not do this, they just look at the most recent. Thus is one’s PSA goes from 1.2 to 2.8 in six months, I would recommend another three months later and then a biopsy. 

Your survival is in your hands. Is it worth $100 a year? I would think so.

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[1] https://www.researchgate.net/publication/325047047_PSA_EVALUATION_METHODOLOGIES

 

[2] https://www.researchgate.net/publication/315363580_THE_PSA_CONTROVERSY_DETAILS_MODELS_ANALYSIS_AND_RECOMMENDATIONS

 

[3] https://www.researchgate.net/publication/325106056_PROSTATE_CANCER_PROGNOSTIC_MARKERS

 

[4] https://news.cancerresearchuk.org/2026/05/28/uk-nsc-recommends-prostate-cancer-screening-for-men-with-a-brca2-gene-change-and-family-history-of-cancer/

 

[5] https://medcitynews.com/2026/05/60-cancer-patient-and-provider-orgs-call-on-rfk-jr-to-protect-uspstf/

 

Memorial Day

 

Burial after Battle of Surigao Strait, October 1944, on my father's destroyer. Almost a third of the crew, from friendly fire, the USS Denver.

Warnings Against Something Undefined

 Moses came down from the mount with ten commandments. "Thous shall not kill" Simple. We know what killing means and don't do it. However we now have legal systems where killing has many shades of grey. Manslaughter, homicide, etc. The commandment was simple, any and all killing. But what is war? Self defense. It gets murky and many theologians spent millennia on the details.

Now along comes the Bishop of Rome and AI. I read through this missive and no where do I see a definition of AI. Lots of warnings, prognostications, etc. Moses was told not to kill. That was an absolute. Also do not steal, do not lie, do not worship false gods, and watch out for that coveting stuff! I never could imagine coveting my neighbor's wife, she was a bit old and nasty, but alas it was there. 

Imagine if Moses came down with this document! We are warned of something we cannot define. I knew who my neighbor's wife was, and never thought of coveting her.  But I really do not know what AI is. Every high tech now claims to have it, massive data centers are being constructed, but what is it. Is there an AI Lite? I am told my cell phone can get it. 

Somehow we really should get our religious beliefs in order.  

The USPSTF

 The USPSTF is an artifact of Obamacare. If it concludes tah something is essential then it gets covered. If it concluded it is not then it is not covered.

As the NY Times notes:

 Under the Affordable Care Act, most insurance plans must fully cover services that it assigns an “A” or “B” grade. That gives the panel’s 16 volunteer members significant influence over the care Americans can afford. Over the past year, Mr. Kennedy has undermined the task force’s work, including by not replacing members whose terms ended in December. The task force issued fewer recommendations than is typical last year and missed a deadline for a legally mandated report to Congress after Mr. Kennedy postponed its meetings indefinitely.

 Well the classic incompetence in my opinion and in my experience was their rejection of PSA tests for older men. It was based upon flawed trials in Europe and the US. One key flaw was the PSA tests were given just once every 4 years. Aggressive prostate cancer goes from nothing to death in less time. Annual PSA would likely save these lives. This fifteen years later the extended trial demonstrated this but the USPSTF never got the message.

Likewise breast cancer kills women in their 80s but they were denied screening by this jumbled mass of bureaucrats. 

Now Kennedy and in turn is dumping this deadly organization which in my opinion is  essential and far to late for the lives lost by their incompetence. 

Yes or No

 One of the things I learned as an expert at trials is to answer yes or no to a question that allows that. Such as: "Have you ever traveled to Russia?", "Yes". Now I find that the younger generation, it now includes almost everyone, cannot do this. The have to tell you stories. 

For example if one asks a patient:

Miss Jones, have you had this pain for several days." 

The answer is a yes or no. Instead one gets what she had for dinner last night, how she arrived by Uber today at the clinic, where she went last weekend with her boyfriend, and on and on until you repeat the question as if she never heard it, and you get another set of desiderata. 

I see this across many environments. I assume they are not avoiding an answer it is just that they want to share their social life; meals, contacts, places, pets, etc. This phenomenon has become more so as social media has exploded. 

I just wonder if it is due to age or my lack of social media contact. It is great for an attorney since the witness will just ramble on telling you everything without aver asking. 

What Security?

 I had gotten a notice from the IRS to validate who I am. After some 65+ years they decided to force me to use the third party ID.me service. Now being somewhat astute at communications and computers I did find this complex. It demand that you have a cell phone with the updated capabilities that exceed my less expensive one about just three months ago. It took me some 4 hours to figure out how to work this annoying third party system. I had to give them a scan of my drivers license, front and back, my signature, my SS number, and connect to some foreign agent to validate me live and record my face, voice and God knows what other biometrics. Now some third party with foreign connections has more personal information on me that my attorney and accountant. The risk of ID theft has increased in my opinion many orders of magnitude.

To reiterate, the IRS demands you go through this process otherwise they will default any and all returns! I wonder what moron invented this scheme? Also why have a commercial third party control all this data?

Now the real problem is that for me, 4 hours is a burden, but I have a PhD from MIT in EECS and have spent sixty years in computers and communications. What does an 80+ year old have to do flopping around this junked up system? Our Government has managed to harass the older folks not to mention everyone else. I have a passport, why not use that? Answer, the want your video, voice, eye motions etc to have a full set of biometrics less a DNA swab. China and Russia are not this bad!

Now can it be scammed. Easy! One's drivers license has been used extensively to enter buildings in NYC and check into hotels. Thus getting that ID is simple. SS numbers are everywhere. AI allows for fake video to be used in their biometric system. Creating a false identity is simple! In fact they have made it fool proof.  

This has not in my opinion and my experience improved security, it has dramatically degraded it. It creates a massive burden on older  people. I would love to know who made this decision!