No cupcakes here! Gold-medal school fights obesity (AP)

DANVILLE, Ill. � Five-year-olds dance hip-hop to the alphabet. Third-graders learn math by twisting into geometric shapes, fifth-graders by calculating calories. And everyone goes to the gym � every day.

In the middle of America's heartland, a small public school, Northeast Elementary Magnet School, has taken on a hefty task � reversing obesity.

And it's won a gold medal for it, becoming the first elementary school in the country to receive that award from the Alliance for a Healthier Generation. The Alliance was founded by the American Heart Association and the William J. Clinton Foundation to reduce childhood obesity. Only two other schools have taken the gold.

The cafeteria here serves fresh fruit and veggies, low-fat or no-fat milk, no sodas or fried foods and no gooey desserts. There are no sweets on kids' birthdays and food is never used as a reward. Teachers wear pedometers and parents have to sign a contract committing to the school's healthy approach.

Northeast Elementary is not in some posh, progressive suburb. It's in Danville, Ill., an economically struggling city of 30,000 in farm country some 150 miles south of Chicago. But teachers, parents and students have embraced the rigorous curriculum and kids even call it "fun."

From the outside, it's a drab 50's-era yellow brick building in a blue-collar neighborhood of modest frame homes, a few blocks from a homeless shelter and a Salvation Army donation center. Inside, it's a cheerful oasis for almost 300 kids and has caught the attention of some of the nation's biggest obesity-fighting advocates.

Former President Bill Clinton says the steps Northeast has taken are an exemplary way to tackle "a terrible public health problem."

"We will never change it by telling people how bad it is. We've got to show people how good it can be," Clinton said, paraphrasing a colleague at the Alliance's June awards ceremony in Little Rock, Ark.

Northeast's strict, no-goodies program might sound extreme, but students seem to have bought it.

During a recent nutrition lesson, first-graders sat raptly on the hallway floor as a teacher read "The Very Hungry Caterpillar," a classic kids' story about a caterpillar that can't seem to stop eating � all kinds of fruit at first. But when the bug moved on to chocolate cake and ice cream, the youngsters gasped and said in hushed tones, "junk food," as if it were poison.

"We're a healthy school," says 10-year-old Naomi Woods, a shy, slim fifth-grader. "We're not allowed to eat junk food or stuff like that."

Sandy-haired Timothy Mills, a fourth-grader, says the focus "just keeps us more fit, plus we have a lot more fun."

Like Mills, an earnest, heavy-set 9-year-old, Northeast kids aren't all skinny. Even some kindergartners are clearly overweight. But they still jump enthusiastically to the alphabet song, and though chubbier kids struggle to run around the football field during gym class, there doesn't seem to be much grumbling.

Physical education teacher Becky Burgoyne said it's sometimes tough to get kids of "all different shapes and sizes" to be physically active.

"I just ask that students do their best and improve on what they can already do," Burgoyne said.

Some schools "may have physical education twice a week, once a week, and that's not acceptable. Children need to move," she said. "To have a healthy body is to have a healthy brain and therefore they become better at reading and math and science. It all works together."

The students mostly mirror Danville and surrounding Vermilion County � generally poorer, less healthy than the state average, with many families struggling with obesity and related problems.

The percentage of overweight kids at Northeast increased in 2009, the program's third year, but dropped slightly last year, to 32 percent; 17 percent are obese. Those are similar to national figures, Principal Cheryl McIntire said. With only three years of data, it's too soon to call the slight dip in the percentage of overweight children a trend. But she considers it a promising sign, and there's no question that the children are learning healthy habits.

In a recent math class, fifth grade teacher Lisa Unzicker explained how food labels can be misleading by listing only calories per serving, not per container. Pointing to an image of a pretzel bag label projected on a screen at the front of the classroom, she taught students to figure out how many calories are in a whole bag, based on the amount in each serving.

You have to be careful about potato chips and candy bars, she told the class. "This is why it pays to be a very conscious consumer."

Teachers and parents credit McIntire for the school's success. The principal joined Northeast in 2008, a year after the staff moved to adopt the healthy focus, and has made it her mission to instill that mantra.

McIntire literally "walks the walk." When students need a talking-to, she walks to their classrooms and escorts them to and from her office rather than just messaging for them. When it's her turn for recess duty, she walks with her pedometer around the school's big field instead of standing on the sidelines. She recalls a student recently calling out, "Hey, Mrs. McIntire, are you doing your steps?"

McIntire is closely involved with choosing school menus and secured money from the state and local school district that have paid for fresh produce, including things like kiwi fruit that many children have never seen before.

A recent lunch menu featured whole-grain, reduced-fat cheese pizza, broccoli and cauliflower buds, sweet corn, chilled pears, low-fat pudding, and 1 percent low-fat milk.

McIntire has changed her own eating habits, giving up potato chips and shedding 15 pounds since last year.

Tall, slender and a youthful 56, McIntire guides Northeast with a firm but loving hand. She greets students by name each morning, helps with untied shoelaces, and offers hugs. And she scolds kids who have messy uniforms or are rude to their classmates.

School hallways feature signs about good food choices and being healthy, and a poster about the Alliance's gold award is prominently displayed near the school office.

The Alliance established a Healthy Schools' program in 2006, with funding from the Robert Wood Johnson Foundation. It helps schools that want to become healthier and meet alliance criteria for winning medals. More than 500 schools have won bronze and silver awards. Those gold medals are tougher to come by. Memorial High School in West New York, N.J., was the first school in the country ever to win a gold. Last year, Northeast became the first elementary school to do that. Rio Hondo Elementary in suburban Los Angeles is the latest to win it.

Ginny Ehrlich, chief executive officer for the Alliance for a Healthier Generation says of Northeast, "They truly stand out." The school has done a remarkable job of making "healthy eating and activity the norm."

Since Northeast is a magnet school, students have to apply to attend, although they don't need to test in. Besides committing to the healthy mindset, parents must volunteer 26 hours at the school each year.

"There certainly are people who are much more invested than others, but we have gotten so much positive feedback from parents," McIntire said.

In her first year, McIntire recruited students by posting advertisements in the local newspaper. "I don't need to do that anymore," she said. For the current school year, there were more than 80 applications for 48 kindergarten slots.

"We have people calling everyday wondering if their child can get in," she said.

Shelbi Black says Northeast has had an "amazing, life-altering" influence on her kids, 10-year-old Kayla and Carter, 5. They've come home requesting fruits and vegetables they used to reject. Carter was thrilled to make frozen fruit shish kebobs in school, and Kayla "was so excited the other day because she made her goal in running the mile and she was so happy that she knocked down her time from last year," Black said.

Tim Mills' mom, Charlyn Hester, says since the school adopted the healthy program, her family has switched from eating lots of convenience foods to lean grass-fed beef and lots of fruits and vegetables. Her oldest daughter, a recent Northeast graduate, has slimmed down and Hester says she thinks Tim and his 11-year-old sister will, too. Hester herself has lost almost 100 pounds since 2009.

The family's grocery bills are higher, but Hester, a freelance writer, says she and her husband, a security officer, have decided it's worth spending more on food and forgoing things like a new car, for their kids' health.

"It's not necessarily a financial hardship, but it's certainly an investment," she said.

Health department officials say they have not calculated obesity rates for children in Danville and the county. Psychologist Richard Elghammer, who works with a large rural health clinic in Danville, says about one-third of the kids treated there are overweight or obese � similar to the national average. National data suggest that the county's obesity rate alone for adults, about 32 percent, is also similar to the national average. About two-thirds of adults are overweight.

But Vermilion County rates of obesity-related illness including heart disease are higher, and more than 80 percent of county residents don't eat government-recommended amounts of fruits and vegetables, according to national surveys.

Dr. Thomas Halloran, an internist who treats adults in Danville, has been working to provide financial support and resources to Northeast, through his medical group, Carle Clinic. Halloran says many of his patients have diabetes and other illnesses tied to a lifetime of obesity and poor health habits. By instilling healthy habits in kids starting in kindergarten, the school is making an important contribution to the community's health, Halloran said.

___

Online:

Alliance for a Healthier Generation: http://www.healthiergeneration.org

Northeast's Facebook page: http://on.fb.me/oAutYo

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Boston hospital performs double hand transplant (AP)

BOSTON � A quadruple amputee who received new hands through a transplant operation says he is looking forward to doing ordinary things again: getting dressed, taking a shower, making coffee and, sweetest of all, touching the faces of his two grandsons.

Richard Mangino, 65, of Revere, lost his arms below the elbows and his legs below the knees after he had a kidney stone in 2002 and contracted a severe bloodstream infection.

Last week, a team of more than 40 surgeons, nurses and support staff at Boston's Brigham and Women's Hospital worked for more than 12 hours performing a hand transplant.

Mangino said at a news conference Friday that he had adjusted to his life as a quadruple amputee. The former director of the ground crew for United Airlines at Boston's Logan airport, Mangino taught himself to do daily activities with his prostheses, mowing the lawn, shoveling snow and painting. He said people kept telling him what a "miracle" he was.

"But the one miracle I have prayed for, since my oldest grandson Trevor was born, was to be able to feel the sense of touch again ... to touch his and Nicky's little faces, and stroke their hair, and to teach them to throw a ball," he said. "To me, that would be a miracle. And today, my miracle has come true."

Doctors said it will take six to nine months for Mangino to regain sensory function in his hands, but days after surgery he began independently moving his fingers.

The donor's name was not made public.

In a statement, the wife of the donor said her husband, in talking about donation, always said, "It's just a body."

"I didn't have to struggle with the decision," she said of donating her husband's hands. "After I digested what it entailed, I thought, if it can help someone else out � I felt strongly that my husband would feel the same way," she said in her statement.

Dr. Bohdan Pomahac, director of plastic surgery transplantation at Brigham and Women's, said there have been approximately 50 hands transplanted worldwide, about a dozen of them in the United States. He said Mangino's surgery was only the fourth bilateral hand transplant in the U.S.

Mangino's procedure was the second bilateral hand transplant by surgeons at Brigham and Women's, which has performed four face transplants.

In May, a Connecticut woman who was mauled by a chimpanzee received a new face and two hands at the hospital, but the hand transplant failed after Charla Nash developed pneumonia and other complications after surgery.

Mangino's surgery involved multiple tissues, including skin, tendons, muscles, ligaments, bones and blood vessels on his forearms and hands.

He said he is looking forward to being able to do everyday things without having to struggle.

"I won't have to perform a miracle anymore to just get up in the morning," he said.

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Obama pulls plug on part of health overhaul law (AP)

WASHINGTON � The Obama administration Friday pulled the plug on a major program in the president's signature health overhaul law � a long-term care insurance plan dogged from the beginning by doubts over its financial solvency.

Targeted by congressional Republicans for repeal, the program became the first casualty in the political and policy wars over the health care law. It had been expected to launch in 2013.

"This is a victory for the American taxpayer and future generations," said Sen. John Thune, R-S.D., spearheading opposition in the Senate. "The administration is finally admitting (the long-term care plan) is unsustainable and cannot be implemented."

Proponents, including many groups that fought to pass the health care law, have vowed a vigorous effort to rescue the program, insisting that Congress gave the administration broad authority to make changes. Long-term care includes not only nursing homes, but such services as home health aides for disabled people.

Known as CLASS, the Community Living Assistance Services and Supports program was a longstanding priority of the late Massachusetts Democratic Sen. Edward M. Kennedy.

Although sponsored by the government, it was supposed to function as a self-sustaining voluntary insurance plan, open to working adults regardless of age or health. Workers would pay an affordable monthly premium during their careers, and could collect a modest daily cash benefit of at least $50 if they became disabled later in life. The money could go for services at home, or to help with nursing home bills.

But a central design flaw dogged CLASS. Unless large numbers of healthy people willingly sign up during their working years, soaring premiums driven by the needs of disabled beneficiaries would destabilize it, eventually requiring a taxpayer bailout.

After months insisting that could be fixed, Health and Human Services Secretary Kathleen Sebelius, finally admitted Friday she doesn't see how.

"Despite our best analytical efforts, I do not see a viable path forward for CLASS implementation at this time," Sebelius said in a letter to congressional leaders.

The law required the administration to certify that CLASS would remain financially solvent for 75 years before it could be put into place.

But officials said they discovered they could not make CLASS both affordable and financially solvent while keeping it a voluntary program open to virtually all workers, as the law also required.

Monthly premiums would have ranged from $235 to $391, even as high as $3,000 under some scenarios, the administration said. At those prices, healthy people were unlikely to sign up. Suggested changes aimed at discouraging enrollment by people in poor health could have opened the program to court challenges, officials said.

"If healthy purchasers are not attracted ... then premiums will increase, which will make it even more unattractive to purchasers who could also obtain policies in the private market," Kathy Greenlee, the lead official on CLASS, said in a memo to Sebelius. That "would cause the program to quickly collapse."

That's the same conclusion a top government expert reached in 2009. Nearly a year before the health care law passed, Richard Foster, head of long-range economic forecasts for Medicare warned administration and congressional officials that CLASS would be unworkable. His warnings were disregarded, as Obama declared his support for adding the long-term care plan to his health care bill.

The demise of CLASS immediately touched off speculation about its impact on the federal budget. Although no premiums are likely to be collected, the program still counts as reducing the federal deficit by about $80 billion over the next ten years. That's because of a rule that would have required workers to pay in for at least five years before they could collect any benefits.

"The CLASS Act was a budget gimmick that might enhance the numbers on a Washington bureaucrat's spreadsheet but was destined to fail in the real world," said Senate Republican Leader Mitch McConnell of Kentucky.

Administration officials said Obama's next budget would reflect the decision not to go forward. Even without CLASS premiums, they said the health care law will still reduce the deficit by more than $120 billion over 10 years.

Kennedy's original idea was to give families some financial breathing room. Most families cannot afford to hire a home health aide for a frail elder, let alone pay nursing home bills. Care is usually provided by family members, often a spouse who may also have health problems.

"We're disappointed that (Sebelius) has prematurely stated she does not see a path forward," AARP, the seniors' lobby, said in a statement. "The need for long-term care will only continue to grow."

Sebelius said the administration wants to work with Congress and supporters of the program to find a solution. But in a polarized political climate, it appears unlikely that CLASS can be salvaged. Congressional Republicans remain committed to its repeal.

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Worried about vitamin safety? Experts offer advice (AP)

Two studies this week raised gnawing worries about the safety of vitamin supplements and a host of questions. Should anyone be taking them? Which ones are most risky? And if you do take them, how can you pick the safest ones?

Vitamins have long had a "health halo." Many people think they're good for you and at worst might simply be unnecessary. The industry calls them an insurance policy against bad eating.

But our foods are increasingly pumped full of them already. Even junk foods and drinks often are fortified with nutrients to give them a healthier profile, so the risk is rising that we're getting too much. Add a supplement and you may exceed the upper limit.

"We're finding out they're not as harmless as the industry might have us believe," said David Schardt, a nutritionist at the consumer group Center for Science in the Public Interest.

This week, a study of nearly 40,000 older women found a slightly higher risk of death among those taking dietary supplements, including multivitamins, folic acid, iron and copper. It was just an observational study, though, not a rigorous test.

Another study found that men taking high doses of vitamin E � 400 units a day � for five years had a slightly increased risk of prostate cancer.

As many as one-third of Americans take vitamins and nearly half of people 50 and older take multivitamins, surveys suggest. Americans spent $9.6 billion on vitamins last year, up from $7.2 billion in 2005, according to the Nutrition Business Journal. Multivitamins top the list, at nearly $5 billion in sales.

Yet there is no clear evidence that multivitamins lower the risk of cancer, heart disease or any other chronic health problems. No government agency recommends them "regardless of the quality of a person's diet," says a fact sheet from the federal Office of Dietary Supplements. And vitamins aren't required to undergo the strict testing required of U.S.-approved prescription medicines.

Some fads, such as the antioxidant craze over vitamins A and E and beta-carotene, backfired when studies found more health risk, not less. And studies that find more disease in people with too little of a certain vitamin can be misleading: Correcting a deficiency so you have the right daily amount is different from supplementing beyond recommended levels.

The best way to get vitamins is to eat foods that naturally contain them, said Jody Engel, a nutritionist with Office of Dietary Supplements. "Foods provide more than just vitamins and minerals, such as fiber and other ingredients that may have positive health effects."

Schardt adds: "It's virtually impossible to overdose on the nutrients in food."

Some folks may need more of certain nutrients and should talk with their doctors about supplements:

� Postmenopausal women regarding calcium and vitamin D to protect bones.

� Women planning on pregnancy regarding folate, or folic acid, to prevent birth defects.

� People over age 50 and vegans who may need vitamin B12. "As we get older, a number of us no longer produce enough acid in the stomach to extract the B12 in food," Schardt explained.

� Pregnant women, who may need extra iron.

� Breastfed infants and possibly other infants concerning vitamin D.

Vitamin D is a nutrient many of us may need to supplement. Last fall, the Institute of Medicine, a panel of scientists who advise the government, raised the recommended amount but also warned against overdoing it. People ages 1 to 70 should get 600 international units a day, older folks 800 units.

If you do need a supplement, beware: Quality varies. Consumerlab.com, a company that tests supplements and publishes ratings for subscribers, has found a high rate of problems in the 3,000 products it has tested since 1999.

"One out of 4 either doesn't contain what it claims or has some other problems such as contamination or the pills won't break apart properly," said company president Dr. Tod Cooperman.

For example, one gummy bear calcium product had 250 percent of the amount of vitamin D claimed on the label. Another liquid product made with rose hips had just over half the amount of vitamin C listed.

"You don't have to pay a lot. Price is not necessarily linked to quality," he said. "The quality doesn't really relate to where you're buying it. I know many people are surprised by that or don't want to believe it, but that is the case. We find good and bad products in every venue."

Mark Blumenthal, executive director of the American Botanical Council, suggests looking for "seals of approval" or certifications of quality from groups that spot-test supplements such as the USP, or United States Pharmacopeia; NSF International and NPA, the Natural Products Association.

Experts offered this advice:

� Keep it simple. The more ingredients there are in a supplement combo, the more chance that one of them will not be the right amount, Cooperman said.

� Consider a supplement combo tailored to your gender and age, the Office of Dietary Supplements suggests. Multivitamins often contain little iron, and ones for seniors give more calcium and vitamin D than products aimed at younger adults.

� Take vitamin D with dinner. A study found significantly more absorption of that nutrient when it was consumed at the largest meal, which tends to have more fat, than at breakfast, Cooperman said.

� Watch out for vitamin K � it promotes clotting and can interfere with common heart medicines and blood thinners such as warfarin, sold as Coumadin and other brands.

� Current and former smokers are advised to avoid multivitamins with lots of beta-carotene or vitamin A; two studies have tied them to increased risk of lung cancer.

� For cancer patients, "vitamins C and E might reduce the effectiveness of certain types of chemotherapy," Engel said.

� People having surgery should know that some vitamins can affect bleeding and response to anesthesia.

With any supplement � ask your doctor.

__

Online:

Vitamin facts: http://ods.od.nih.gov/factsheets/list-VitaminsMinerals

and http://ods.od.nih.gov/factsheets/MVMS-HealthProfessional

FAQs: http://ods.od.nih.gov/Health_Information/ODS_Frequently_Asked_Questions.aspx

Dietary advice: http://www.dietaryguidelines.gov

Vitamin E and prostate study: http://jama.ama-assn.org/content/306/14/1549

Video interview with author: http://jama.ama-assn.org/content/306/14/1549/suppl/DC1

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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UK says Britons need to cut 5 billion calories (AP)

LONDON � British health officials say the country needs to slash 5 billion calories from its collective daily diet to slow the obesity epidemic.

In a report issued Thursday, the department of health said most adults in the nation of about 60 million people are already eating far more than they need. The average Briton eats about 10 percent more calories than necessary, the report said.

The U.K. has one of Europe's fattest populations: more than 60 percent of adults and one third of children aged 10-11 are overweight or obese. The new report aims to change diet and exercise habits enough so that the number of heavy Britons begins to fall by 2020.

Britain's chief medical officer, Sally Davies, said people need to be more honest with themselves about just how much food they're eating every day. "We are still too heavy as a nation," she said at a press conference. "Not enough of us are getting it right."

Obesity raises the risk of health problems including heart disease, diabetes, and cancer. Experts said treating fat patients costs the national health service 5.1 billion pounds (US$8 billion) every year.

Health Minister Andrew Lansley said Britain will continue working with the food and beverage industry in a deal to reduce the amount of salt and fat from their products and to post calorie content where possible. The deal was previously slammed by health charities and leading medical organizations who argued the food and drink industry were dictating government policies.

Lansley said the government would consider whether a 'fat tax' could help, but said he would prefer a voluntary and cooperative approach.

The government will also introduce various initiatives to encourage people to exercise, including several linked to the London Olympics next year.

Though London 2012 officials promised they would get 2 million more people exercising by the time the Olympic torch is lit, that goal looks increasingly unlikely. Only about five percent of Britons currently meet the recommended guidelines to get 150 minutes of physical exercise every week.

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Prostate testing's dark side: Men who were harmed (AP)

Terry Dyroff's PSA blood test led to a prostate biopsy that didn't find cancer but gave him a life-threatening infection.

In the emergency room, "I didn't sit, I just laid on the floor, I felt so bad," said Dyroff, 65, a retired professor from Silver Spring, Md. "I honestly thought I might be dying."

Donald Weaver was a healthy 74-year-old Kansas farmer until doctors went looking for prostate cancer. A PSA test led to a biopsy and surgery, then a heart attack, organ failure and a coma. His grief-stricken wife took him off life support.

"He died of unnecessary preventive medicine," said his nephew, Dr. Jay Siwek, vice chairman of family medicine at Georgetown University. "Blood tests can kill you."

Since Friday, when a task force of independent scientists said routine PSA testing does more harm than good, urologists who make a living treating prostate cancer have rushed to defend the test, as have patients who believe it saved their lives.

Less visible are men who have been harmed by testing, as Dyroff and Weaver were. The harm is not so much from the test itself but from everything it triggers � biopsies that usually are false alarms, and treatments that leave many men incontinent or impotent for cancers that in most cases were not a threat.

Once a PSA test suggests a problem, many men can't live with the worry that they might have cancer. And once cancer is found, most men feel they have to treat it, usually at the urging of their urologist.

"There are many men who have had serious consequences from treatment. Those stories don't get told and they are not uncommon," said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, which thinks the task force reached "an appropriate conclusion" about the PSA test.

"I'm not going to criticize men who believe that their lives have been saved by this test," because that's what doctors have told them, Lichtenfeld said. "If you're sitting there and you wet your pants three times a day, you've got to believe it's worth it, that it saved your life."

Many men who agree to a PSA test do not understand what it is. Some common misconceptions:

� It shows cancer. In fact, PSA is just a measure of inflammation, and it can be elevated for many reasons besides cancer: normal enlargement of the prostate with age, an infection, even recent sex, a strenuous bike ride or horseback riding.

� It's been proven to save lives. Only two large, well-done studies have looked at this, the task force says. The American study found annual screening did not lower the chances of dying of prostate cancer. However, cancer fear is so great, and belief in the value of screening so ingrained, that half the men assigned to the group not offered PSA tests got one anyway. That made comparisons to the group given annual screening difficult. For that reason, some doctors don't believe the study's conclusion.

The other study, conducted in Europe, found a small benefit for certain age groups screened every two to seven years � not annually. However, one Swedish center had such rosy results that scientists think it may have biased the whole study. If that center is excluded, no benefit from the PSA test is seen.

� The task force's stance goes against past advice. Routine PSA testing has been supported by some advocacy groups and by urologists, the doctors who do the tests and treatments. But it has not been pushed by major scientific groups, the American Cancer Society or the government.

� It finds cancer early so you're more likely to survive. About 90 percent of prostate cancers found through screening are early-stage. Most will grow so slowly they will never threaten a man's life, but there's no good way to tell which ones will. Research suggests that tumors causing symptoms are more likely to warrant treatment than those that are not. Also, finding aggressive prostate tumors early may not affect how lethal they prove to be; the PSA test may just let men learn of them sooner than they otherwise would.

The task force said that in the European study, the rate of overdiagnosis from PSA screening � finding cancers that do not need to be treated � was estimated to be as high as 50 percent. Based on that study, 1,410 men would have to be screened, and 48 patients would have to be treated, just to save one life from prostate cancer.

Yet the public perception is that if PSA testing finds a cancer early, it must be good.

"Most people tend to think `if it may help, I'm all for it.' But we don't know if it will help," said Siwek, the Georgetown doctor whose uncle died.

Once a PSA test suggests a problem, "it's hard to stop the conveyor belt or the cascade effect" that leads to more testing and treatment, said Siwek, who also is editor of the journal American Family Physician. "The inclination is, `I've got to do something about it.'"

Dyroff, the retired professor, agreed to a biopsy after a blip in his PSA. Several days later, he ran a high fever, felt weak and faint, and spent three days in the hospital fighting a bloodstream infection. A week later he relapsed and required a combination of intravenous antibiotics to finally recover.

A recent Johns Hopkins University study found surprisingly high rates of hospitalization after prostate biopsies and a 12-fold greater risk of death in those who develop infections.

Tony Masraff, a Houston restaurant owner, reluctantly agreed to a biopsy and then was diagnosed with prostate cancer in 1999. His urologist pushed surgery and balked when Masraff asked about other options such as radiation. After some research, Masraff decided just to monitor his tumor, and has seen his PSA rise very slowly over more than a decade.

Now 74, he hasn't had treatment "and I never will," he said. "I'm not concerned because I don't want the debilitative effects � I don't want to wear a diaper, and I like women."

"There's a huge number of people that are being operated on that don't need treatment," said Masraff, who formed a foundation for research into less invasive options.

The need to find a better screening tool is the real message from the task force, said Dr. Christopher Logothetis, prostate cancer research chief at the University of Texas M.D. Anderson Cancer Center in Houston. It may even be that there are better ways to use the PSA � employing it as a baseline test and tracking its rise over time � that might prove better than annual testing.

"If the debate gets reduced to `there's a right and a wrong,' we will lose what we are being told here, which is to search for the path forward," he said.

The cancer society's Lichtenfeld agreed. "Maybe it's time to listen to evidence instead of hope," he wrote in his blog.

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Online:

Task force recommendations: http://www.uspreventiveservicestaskforce.org/tfcomment.htm

Task force evidence report: http://bit.ly/ovhKUW

PSA decision guide: http://bit.ly/cXq1QE

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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