The Great Prostate Hoax

great prostate hoax

The Great Prostate Hoax: How Big medicine Hijacked the PSA Test and Caused a Public Health Disaster, by Richard J Ablin, Ph.D. and Ronald Piana. Originally published in 2014, 272 pages.

This is without a doubt the most controversial modern medical book I have ever read, bar none. The backlash against it was swift and strong, as I found out once I began barely scratching the surface to gain some insight into the author’s background. Before I offer my thoughts, here is the goodreads promotional blurb:

Every year, more than a million men undergo painful needle biopsies for prostate cancer, and upward of 100,000 have radical prostatectomies, resulting in incontinence and impotence. But the shocking fact is that most of these men would never have died from this common form of cancer, which frequently grows so slowly that it never even leaves the prostate. How did we get to a point where so many unnecessary tests and surgeries are being done? In The Great Prostate Hoax, Richard J. Ablin exposes how a discovery he made in 1970, the prostate-specific antigen (PSA), was co-opted by the pharmaceutical industry into a multibillion-dollar business. He shows how his discovery of PSA was never meant to be used for screening prostate cancer, and yet nonetheless the test was patented and eventurally approved by the FDA in 1994. Now, doctors and victims are beginning to speak out about the harm of the test, and beginning to search for a true prostate cancer-specific marker.

I started this book without a clear position on the subject either way. For certain, I am wary of big medicine, big pharma, and the scalpel-happy specialists who dominate western medical practice. But there have also been men in my life, whom I loved dearly, who battled prostate cancer. The rub in this book is based on a saying the author quoted at the very beginning of the book:

Some men die of prostate cancer. All men die with prostate cancer.

Of course he is referring to men who reach a certain milestone in life -approximately 70 years of age- and the rub is knowing the difference between men who can live perfectly fine and dandy never knowing if they have prostate cancer, and those for whom knowledge is a matter of life and death. The current urological standard of using PSA testing to make these determinations are what Dr. Amblin dissects in his book.

Based on the numbers of men left incontinent, impotent and otherwise impaired by what he feels are unwarranted biopsies and prostatectomies, Dr. Amblin comes down firmly on the minority side of the argument, concluding that using PSA to justify surgeries and biopsies which harm men is unacceptable. PSA is a naturally occurring antigen which can vary based on a number of factors, from horseback riding to an amorous night with one’s spouse right before the test the next morning and as such, Dr. Amblin cautions against the stock being put into it.

He also takes pains to explain the medicinal intricacies, which I found hard to follow at times. The sections where he outlines what he believes were profit driven motives to expand the use of PSA  testing into a must-have test for all men over 50 are quite interesting. All the conspiracy theory sections of my brain lit right up!

However, as the wife of a husband who is not only closing in on 50 years old in the next 5 years, and is also a member of a higher risk ethnic group where prostate cancer is concerned, I can’t say that Dr. Amblin convinced me. He did give us a lot to think about.

four out of five stars

…because I got a good education from this one.




19 thoughts on “The Great Prostate Hoax

  1. hearthie says:

    All I have to offer is that I’m glad that my grandpa’s doctor was of the school of “all men die WITH prostate cancer” and didn’t feel a need to carve up my (then at least 90yo) grandfather when he tested positive. And no, my grandpa didn’t die of cancer, of any sort.


  2. stmichaelkozaki says:

    This is a good review, and I’m going to get this book from the library. Thank you.

    All the conspiracy theory sections of my brain lit right up!
    As a skeptic I was a non-believer in CT. Then I read Ron Unz ( This guy has an IQ of 180 or something, is very skeptical, and man was I a fool. I don’t feel so bad though, since Ron was fooled himself for the same reasons I was, and I’m like a child compared to him.

    However, as the wife of a husband who is not only closing in on 50 years old in the next 5 years, and is also a member of a higher risk ethnic group where prostate cancer is concerned, I can’t say that Dr. Amblin convinced me. He did give us a lot to think about.

    Cancer is really new to industrialization (grain & seed oil consumption). Totally preventable for 95%, like autoimune disease. It makes me sad because much of my family on one side is dead of it (American Indian genetics) more sensitive than African Americans to grains. Only European, Asian, and genetic fellow travelers have had enough grain in their genetic background to evolve for it (like liquor) but it’s still poison so everyone who indulges gets hit, some must much worse. It’s diet, diet, diet.

    Hey, speaking of race, a convo around my house was raging over the song “Fast Car” (humiliated to say I cry every. single. time.) and desire to hear your thoughts (esp. from the sex, race, & moral angles). I understand the artist is not, er, your cultural thing, but I’m still interested in your thoughts good/bad/ugly. I honestly have no idea what you will say.


  3. Elspeth says:

    Is this Ttracy Chapman’s “Fast Car”? Or some newer song.

    By the way, you’d be surprised at my cultural leanings when it comes to music. Country, folk, a lot of stuff besides the music of my background and upbringing.


  4. Bike Bubba says:

    Mayo also notes that a vegetable and fruit-rich diet helps a lot, as does keeping the weight down. Harvard notes that a man’s wife can help prevent him from developing at least the less lethal forms in a generally mutually delightful way. That reduces the risk of going through what my friend Jim went through for no particularly good reason.

    Remembered as well that I have a step-relative–the husband of my step-dad’s cousin–who did die of one of the nastier forms of prostate cancer. So all the rigamarole is not totally worthless, you just want to enhance your odds that you go through it for a good reason and not for no particular reason.


  5. Bike Bubba says:

    One other note; regarding Stephen’s comment, they’ve found some pretty old bones with evidence of cancer in them. It may have increased with industrialization–diabetes and heart disease certainly have–but there remains the question of whether that’s inherent with industrialization, or whether we’re simply dying of cancer because we’re not dying of smallpox and cholera anymore. I’m leaning mostly towards the latter–as someone whose life has likely been saved a time or two by modern medicine (I was a breech birth, had an intussusception, more), I quite frankly welcome the opportunity to worry about cancer instead of typhus, diphtheria, and the like.

    #FirstWorldProblems, no?

    Liked by 1 person

  6. stmichaelkozaki says:

    Bike, we know from teeth how humans fare in old age over the centuries. Of course cancer is a biological process, and it’s always been with us, but it’s only become a primary cause of death among youngish people recently. Just like diabetes and autoimmune disorders. We know a lot looking at human skeletons; the first big-time grain-eaters, the Egyptians, we have done hundreds of autopsies on, and know they had the same problems we have, while others living near did not. This isn’t complex: humans evolved to eat meat/fish, veggies, nuts, and limited fruit over at least 2 million years. Anything else in quanity causes the machine to malfunction over time. Yes, some races have taken enough bad stuff to handle it better, but it’s still too new to not cause problems for everyone.


  7. stmichaelkozaki says:

    Yes, Fast Car. I may have asked you before too but remain puzzled. Regarding “your crowd”I I was thinking of Chapman being a, well, not-normal-type so didn’t want you to think I was classifying you and yours with her just ’cause of race.

    But I am mainly fascinated by the female-male-anti-feminist theme (w/the racial angle if that’s important, don’t know). OK, so I’m lacking in many non-white non-Hispanic females to asks (I get a “null signal” from all the women I’ve asked) so I thought of you. Maybe I’m off the reservation…


  8. Bike Bubba says:

    Source, Michael? One thing that is going to separate Egyptian burials from those in other parts of the world, really, is that soft tissues are preserved by Egyptian-style embalming, while they are not in most other parts of the world. So you will, before finding any differences in disease rates, see a lot of evidence of soft tissue cancers (breast, colon, liver, pancreas, brain, etc..) that you would never see in burials even just on the other side of the Sinai Peninsula. For that matter, even bones are not preserved after a century or so unless there is a good amount of mineral content in the water.

    In other words, your source may be confusing the results of Egyptian burial practices (and its desert climate) with medical outcome differences.


  9. Elspeth says:

    I like the melody, her voice, the way she executes the song.

    The lyrics themselves are kind of depressing, hopeful and simultaneously you dread what the future might hold for thee two people who start out with nothing heading for nothing.

    On the other hand, life is unpredictable and you never know. We started out with nothing and no map either, but made good.

    I suppose we came from better stock. Drunkard daddies are not in our backgrounds.

    Short version? I like the song.


  10. stmichaelkozaki says:

    Mike, I’m referring to embalming of Egyptian flesh. We have literally hundreds of autopsies. You can find dozens of good sources here. There is no real debate on the issue that I’ve seen, it’s pretty obvious, and I’ve read thousands of hours on it over the last decade.

    If you are interested, I could give you many sources & UTube vids; the science is well documented and convincing (note most MDs don’t know anything, ask them basic technical questions to prove this to yourself, they are too busy keeping hours to keep up with the literature). And once you look over the data (plus try a good diet yourself by cutting grains, sugars, and seed oils) there is zero question at all. It’s just simple human evolution and genetics; we’ve known all this since 1930 or so from dentistry and hunter-gatherers. Westin Price from 1930 for a good start here, since he uses photos of people side-by-side who have started to eat grains and seed oils against hunter-gatherers, and it’s laughable to compare them and see what’s happening to us. Hell, just look around any mall today :-). Modern humans should be the most fit in history due to our caloric and nutrient surplus…but it’s just the opposite! But anyone can change their diet and see immediate results. A 50 yo looks 30 yo (or less, just like hunter-gatherers) once eliminating grains/sugar/seedoils and lifting…wife is pregnant at 46 w/out even trying, for example. Of course, fixing one’s diet is not simple or easy as we are all addicted to white flour and sugar (read The Hungry Brain by Guyenet for this part)


  11. stmichaelkozaki says:

    E: Thank you, does help. My angst: I’ve never heard any song, voice, or lyrics better designed to arouse my evil White Knight and also from a non-white culture is even more disturbing, since most seem more grounded and/or matriarchal (both a good antidote to WK). I listen to the song to feed my WK and feel like crap afterwards.

    Another interesting experiment: compare the lyrics of FC to Telegraph Road Dire Straits. This is a white man writing the same thing, and Chapman eats him alive. I want the secret, so I can get the antidote!

    Liked by 1 person

  12. Robyn says:

    Interesting. Thanks for the read on this one Els. I’ve been commenting on and off about this test to my Man … but now, I’m not so sure. Perhaps it’s just another mark to add to the tally board of the differences between males and females. For us girls, early intervention is best. But for the guys, not so much and apparently in some cases, not at all.

    Liked by 1 person

  13. Elspeth says:


    You’re welcome. It certainly offered us a lot to think about. Since both of our fathers battled the disease, with radically different results (but also different approaches to the treatment options) we are not firmly entrenched on any position.

    It is helpful however to know that there actually ARE different medical schools of thought and different options to consider.


  14. stmichaelkozaki says:

    I’m going to get this book from the library.

    I’m skimming this book right now (it’s one of 9!) and am pretty impressed. Thanks for reviewing it.

    Liked by 1 person

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