ROBOTIC PROSTATE CANCER SURGERY: A PUBLIC HEALTH NIGHTMARE

Prostate cancer awareness, PSA screening for prostate cancer and the ill-conceived, debilitating radical surgery/robotic prostatectomy “treatment” are generally worthless and harmful, and represent an unbridled scam in public health.

 

For many years, it has been quite clear that most so-called prostate “cancers” behave as noncancerous and are, in fact, more like a pseudo-disease.

 

Basically there are two types of prostate cancer:

> a very common, non-killer form which you can live with and,

> a less common, killer form which needs attention and treatment but NOT by prostatectomy.

Unfortunately, the very deceptive, all-inclusive “cancer” label is applied by physicians very conveniently to any and all pathological grades of prostate “cancer” from mostly insignificant to the less common significant. This intentionally misleading, broad-brush labeling of every prostate “cancer” as though it were some fast moving, potential killer cancer when only some prostate cancers exhibit this potential, requires urgent correction to stop the many unscrupulous physicians misleading patients purposefully for self-gain.

 

Of the approximately 16% lifetime chance of a man receiving a diagnosis of prostate cancer (about ¼ million new American men are given a prostate cancer label every year but MOST of these “cancers” behave as noncancerous) only some 3% or so of newly diagnosed men will eventually die from their prostate cancer. Clearly then, because many men are given the “prostate cancer” label but only a small number of men actually die from their cancer, the “prostate cancer” label needs serious qualification. Understanding the significance of the “cancer” label qualification is very important since it is an established fact that most men given the “prostate cancer” label will be treated unnecessarily for their insignificant, non-killer prostate cancer and be left commonly with debilitating treatment after-effects and zero benefit.

 

Presently, this cancer qualification process is done through a subjective pathology grading system developed by Gleason. The resultant estimated Gleason score (along with estimations on the amounts of cancer in each needle biopsy core) indicates the potential for a particular prostate cancer to be significant. Although this subjective visual grading of prostate cancer is a very established practice, there can be some equivocation amongst pathologists regarding arbitrary, so-called intermediate Gleason grades and scores of 3+4 and 4+3 where there may be some controversy as to whether monitoring or a treatment may be appropriate. Therefore, getting a consensus on your pathology from a recognized independent reference laboratory before considering any treatment for your disease is a very wise choice.

 

 

Surprisingly, there appears to be a relative consensus amongst pathologists for the diagnosis of the very common, INSIGNIFICANT, non-life threatening Gleason 6 (3+3) prostate “cancer”.Fortunately, this very common 3+3 prostate “cancer” is not a real cancer but the continued mislabelling of this disease allows ongoing unbridled exploitation of men by the prostate cancer industry resulting in a shocking amount of overtreatment, harm and no benefit. Furthermore, the 3+3 does NOT progress to become significant.

 

As underscored by esteemed urologist Laurence Klotz MD from Toronto, both MOLECULAR and CLINICAL DATA show that the Gleason 6 (3+3) LACKS the HALLMARKS of a cancer. Because the Gleason 6 (3+3) “cancer” lacks these hallmarks of a cancer, it behaves as noncancerous, has no spreading potential, is non-killer and poses no health-risk. The cancer designation for the Gleason 6 therefore, is a misnomer. Not only do these clinical and molecular biology findings indicate a benign profile for the most common stage T1c Gleason 6 (3+3) prostate “cancer” but also for the T1c stage Gleason 3 + 4 cancer which behaves like the 3+3. Therefore, with any of these diagnoses you should think long and hard before being deceived into undertaking any prostate cancer treatment.

 

Fortunately also, there appears to be a relative consensus amongst pathologists in their ability to diagnose the less common, aggressive and significant prostate cancer grades like the 4+4 and above (the highest Gleason score is a 10) which are potentially lethal and do demand attention and treatment. This is especially important because it is only the Gleason scores with a primary grade of 4 or 5 which are responsible for the deaths in the 3% given the diagnosis of prostate cancer. Although these less common potentially lethal prostate cancers need treatment, the radical surgery/robotic prostatectomy has failed to produce any significant improvement in survival for even these particular cancers.

 

This earth-shattering knowledge that the Gleason 6 (3+3) prostate “cancer” behaves as noncancerous and does NOT require treatment and, that the high-grade 4+4 and above potentially lethal prostate cancers do benefit from treatment but NOT from the robotic prostatectomy, should have advanced our understanding of prostate cancer management by a quantum leap. Shamefully, it has not.

 

Fortuitously, a few upstanding physicians have been demonstrably immune from the propaganda and herd mentality endorsing the blatantly misguided PSA screening for prostate cancer and the misguided surgical treatment philosophy for managing screen-detected prostate cancer. These doctors capable of reasoned, scientific and independent thought, refused to be party to the many falsehoods concerning prostate cancer management and challenged the dogma of conventional “wisdom” vigorously. In fact, the obvious threats to patient welfare in those men given a prostate cancer label have been well detailed by Anthony Horan MD is his book, “How to Avoid Over-detection and Over-treatment of Prostate Cancer”, Otis Brawley MD in his book, “How we do Harm”, and Richard Ablin PhD and Ron Piana in their book, “The Great Prostate Hoax”. Dr. Richard Ablin discovered the PSA, Dr. Anthony Horan is a very experienced urological surgeon who has painstakingly detailed the trail of injustices concerning prostate cancer management while Dr Otis Brawley is the Chief Medical and Scientific Officer for the American Cancer Society. Based upon their “field evidence”, these doctors had no trouble recognizing the fact that the Gleason 6 (3+3) prostate “cancer” was NOT a health-risk and that most treatments were harmful. Even organizations like the very reputable and authoritative US Preventive Services Task Force (USPSTF) have offered very cautionary warnings regarding the lack of merit for PSA prostate cancer screening as well as the lack of merit for treating screen-detected prostate cancer.

 

Unfortunately, real progress in prostate cancer management has been thwarted time and time again, by greed, corruption and institutional interests. This unbelievably despicable process ensuring that the Gleason 6 “cancer” continues to be treated and then be treated by a scientifically unproven, debilitating surgical approach has been enabled by several egomaniac prostate cancer “experts” prostituting themselves as paid “informers” for companies and organizations vested in prostate cancer detection and treatment. The egregious and toxic manner in which these doctors, along with those having positions on regulatory oversight committees, have the gall to misrepresent themselves as stewards of health and care while under the influence of money cannot be downplayed. Nor can such unprincipled and amoral behavior be sanctified by one of their ever-ready insincere, conflict-of-interest disclaimer forms.

 

With such a rancid foundation of financial ties in place tainting peer review, it is no wonder that we have been witness to the false elevation of prostate cancer to a cause de celebre status and “milked” for all that can be extracted. For example, an approval by the FDA for use of the PSA as a monitoring blood marker of prostate cancer activity was easily manipulated by vested interests in the prostate cancer industry to misconstrue its approval for slack and inappropriate use in prostate cancer detection. Similarly, the robotic approach for radical prostatectomy was given a “pass” again by the FDA even though the place of robotics in this highly troubling surgical scenario was always suspect. After lobbying the FDA and supplying scant clinical information comparing laparoscopic gallbladder surgery to robotic gallbladder surgery, and despite the fact that robotics were found to be no more effective than laparoscopy, the FDA approved robotics for “soft-tissue” surgery in 2000. Not only was the manner in which this study information was obtained underscore an obvious conflict of interest, but equally important, gallbladder surgery has absolutely nothing in common with the complexity surrounding prostate excision. Along with the gross lack of scientific support for any radical prostatectomy, this FDA approval for robotics in prostate cancer treatment is yet another shining example of junk science and greed influencing “new research” to justify old, ill-conceived treatment philosophies.

 

Prostate Cancer Surgery: one hundred years of medical lies

The radical prostatectomy for prostate cancer treatment has been a very bad operation since its inception over 100 years ago for two fundamental reasons. First, many men had “cancers” which behaved as noncancerous and did not require any sort of treatment whether whole gland or focal, and second, the radical prostatectomy treatment was obscenely debilitating and without proven benefit for saving significant numbers of lives. During these last 100 years or so, not only has this radical surgery/robotic prostatectomy procedure simply exposed vast numbers of men to “treatment” risks and complications which were absolutely unwarranted but these risks were commonly much greater than for living with the risks of their prostate “cancer”. Devoid of science, this surgical approach to prostate cancer management has its origins in a misguided and archaic treatment philosophy which through pseudoscientific cant and consensus medicine has been allowed to prevail over Hippocratic doctrine, medical ethics and scientifically conducted, evidence-based-medicine studies.

 

Although there are several options available for the treatment of localized and significant prostate cancer (external beam radiation, dose-painting radiotherapy, radioactive seeds, proton beam, cryoablation, laser and hifu) and all of which come with risk, it is the toxic radical prostatectomy, the original treatment for prostate cancer, which hands down is the most virulent. Virulent, as this surgery carries not only very significant risk but delivers an extraordinary list of “in your face” complications commonly persisting lifelong. Amazingly, the complications resulting from this “treatment” have never registered even the slightest of risk-benefit concerns from most  urologists. Instead, surgeons and their culture for invasive action saw these “somewhat undesirable issues” as a great challenge to undertake even more surgical experimentation on men in the hope that the experience garnered from more operating would eventually, bring about better treatment outcomes for prostate cancer. After all, both surgeons and patients had an inherent but misguided belief that all cancers and particularly prostate cancers, were best “cut out”.

 

Therefore, generation after generation of urologists, along with the inevitable “look at me, I’m a better surgeon than you” bravado, each tried to outperform their colleagues by performing more and more radical prostatectomies whether by conventional or robotic routes and whether these cancers needed treatment or not. However, despite ever increasing numbers of victims being subjected to this very nasty surgical “treatment”, significant improvements in survival and diminished complication rates failed to materialize. Shamefully, the patently obvious poor

surgical outcomes remained inconsequential to the goal of urologists determined to prove that their premise of a surgical approach for prostate cancer treatment was valid and that everyone else was wrong. Never once did surgeons consider seriously a most fundamental healthcare principle: “are we saving significant numbers of lives without inducing significant harm?”

 

The PSA (prostate cancer specific antigen) blood test came along in the 70s and although never meant to be used as a screening biomarker for prostate cancer detection, this marker was quickly hijacked by the prostate cancer industry for widespread and self-serving use. In a very short order, the use of this highly unreliable screening blood test resulted in countless numbers of anxious men being directed towards risky and unnecessary needle biopsies of the prostate which then resulted commonly, in the detection of insignificant prostate “cancers” and which then led to valueless and costly imaging studies. Following the detection of these many insignificant prostate cancers, men were railroaded through fear-mongering and false hope, like lambs led to slaughter, towards heavy-handed, life-altering surgery for zero benefit. During this time of easy, very lucrative and successful exploitation of the PSA blood test, urologists continued “refining” their radical prostatectomy treatment since good prostate cancer surgical outcomes still continued to elude urologists. Remaining shockingly unaffected by the terrible negative quality-of-life outcomes resulting from their radical prostatectomy, surgeons chose instead to continue their closed-minded and entrenched quest to validate their procedure.

 

After an unbelievable number of men were exposed to this human experimentation, a refinement in surgical technique called the “nerve-sparing” procedure was described. This technique, it was suggested, would at least prevent compromise of the neurovascular bundles containing the nerves for erection and therefore minimize one of the most common and distressing complications associated with the radical prostatectomy, loss of erections or impotence. Despite the initial fervor for this nerve-sparing “breakthrough” however, additional studies undertaken elsewhere, showed that the nerves for erection only coursed in the neurovascular bundles about 50% of the time. Therefore, when this “nerve-sparing” technique was applied, it resulted in the preservation of erections only about 50% of the time or, like so many “advances” in the prostate cancer arena, no better than a coin toss.

 

When widespread indiscriminate PSA use, more and more experimentation with the radical

prostatectomy and refinements in surgical technique still failed to bring about significant improvements in survivorship or in the complication rate, urologists turned desperately towards the incorporation of so-called advanced technologies striving to make their operation “work”. From laparoscopic prostatectomy, urologists quickly went on to the robotic prostatectomy as the general perception for both physicians and patients again, was that the more advanced and “hi-tech” the technology, the “better” the outcome. Perception however, trumped reality once more in medicine and despite the elementary fact that whatever the technology used to remove the prostate, the only way the prostate could be removed was through an act of cutting. It was this act of cutting using whatever means which, like the ill-conceived and futile concept of excising a segment of spinal cord, necessarily led to all of the prostatectomy complications.

 

From surgical refinements, technology developments and the PSA blood test (including PSA

derivatives, PSA kinetics, PSA doubling time and PSA density), urologists explored the use of more and more biomarkers like the PCa3, PSA hybrids and others with each “discovery” being pushed by their respective biotechnology company as “new and improved” for prostate cancer detection. Every possible new laboratory, technological and imaging development was being evaluated in the hope of validating finally, the place of surgery for prostate cancer. Urologists evaluated (and invested in) various imaging formats like CT scans, special ultrasound technology, NaFl CT/PET scans and recently, the sophisticated mp-MRI.

 

Currently, it is the mp-MRI which is the technology “flavor-of-the-month” and touted as the “go-to” prostate cancer detection method. This particular imaging technique, when used for prostate cancer detection, can allow for the simultaneous targeting of any “suspicious” areas with a needle for biopsy. By “target” biopsies it is inferred of course, that the mp-MRI is 100% reliable for detecting only the less common SIGNIFICANT prostate cancers as we know already that the very common INSIGNIFICANT cancers like the Gleason 6 (3+3) do NOT warrant detection or treatment because they behave as noncancerous. However, clinical experience with the mp-MRI to date has been the same as for most laboratory and technology “breakthroughs” in prostate cancer work: real results are at variance with the marketing “information” provided by urologists, hospitals and the various biotechnology companies. At this time, although the mp-MRI shows promise, it is definitely not foolproof because of both false negatives and false positives. This possibility of falseness is especially concerning in terms of “cancer” detection where use of the all-inclusive prostate cancer label implies again that all prostate cancers are significant and life threatening when they are not. Treating the many insignificant prostate cancers like the 3+3 which behave as noncancerous simply exposes men to treatment risks and harm without any benefits. If urologists could guarantee that the mp-MRI would detect reliably, only the high-risk significant prostate cancers early and perfectly and allow for simultaneous outpatient focal therapy of these cancers, we just may be, finally, achieving real prostate cancer treatment benefits for some men.

 

Physicians in general, possess an uncanny ability for self-serving, creative writing. They have been quite comfortable in taking and using information extracted from clinical “studies” hopelessly affected by the all-inclusive prostate cancer label, subjectivity issues and bias. These subjectivity and reliability issues are of particular concern with respect to findings on the digital rectal examination (DRE) of the prostate, the reading of the prostate needle biopsy slides by the pathologists and in the reading of imaging studies by radiologists where, for these various evaluations, there can be stark differences in ability and reliability between physicians. As well as these individual subjectivity and reliability concerns impacting clinical studies (and staging of disease) to the point where interpretations can be decidedly unreliable, these clinical studies can be jaundiced even more by the incorporation of self-serving definitions for what constitutes a treatment success and for what constitutes a treatment complication.

 

If this intentional obfuscation of prostate cancer information is not bad enough, very problematic is the practice of designing these self-serving clinical studies in such a way as to lend credence to the very philosophy of using surgery to treat prostate cancer. By using these many non-scientific strategies, urologists have reported on every possible quasi-relevant clinical issue related to the surgical attempts for prostate cancer treatment from lymph node status to margin status and everything else in between as if it were relevant and vital. Even technology company marketing spin misconstrued as scientific data has been included in this prostate cancer “information” package distributed by hospitals and urologists. So tainted and devoid of any evidence-based data is this huge trove of prostate cancer information that not only is it highly suspect, unreliable and misleading, but the general acceptance of this marginal medical information by urologists has allowed the quackery of radical prostatectomy to continue.

 

In addition to an ability for creative writing, urologists are endowed with a particular ability for creative speak. Where truth, calm and reassurance are in the interests of real patient welfare, many surgeons have crafted an amazing ability for the use of misinformation and misrepresentations in an ever so subtle but clever manipulation of the cancer label along with the slick manipulation of the senses of fear and hope. Surgeons are well aware that the

panic-inducing “cancer” word generates considerable anxiety, disbelief and a desperate turn towards “survival mode”. Although these emotions are totally understandable for some cancers, they are quite irrational in the context of most prostate cancers. In fact, far too many men with these non-killer-type Gleason 6 (3+3) prostate “cancers” have been caught up in the surreal, confusing and deceptive discourse involving the word cancer. Unfortunately, the surgical “experts” offering counsel know exactly how to entrap their victims psychologically with the most outrageous, false and defenseless list of imagined benefits concerning their “minimally invasive” robotic prostatectomy. These surgeons will even have you deceived into thinking you shared in the decision making and helped to “select” your treatment upon hearing:

* cancers are “best” cut out

* radical surgery/robotic prostatectomy can “save” your life

* the postoperative impotence and incontinence may be necessary to “save” your life

* treatment is better than “letting the cancer get away”

* your disease is contained “so we better get it out quickly”

* younger men do “best” with surgery

* aggressive tumors respond “only” to surgery

* other treatment options have less success

* your disease is multifocal/bilobar and therefore responds “best” (or only) to surgery

* if other treatments like radiation fail, subsequent “salvage” surgery is problematic

* you will be a “survivor”

* surgery follows healthcare “guidelines”

* surgery represents “standard of care”

* surgery is the “gold standard”

 

If you should believe all of these fairy tales and allow yourself to be deceived into thinking that the misguided robotic prostatectomy is a scientifically proven, “state-of-the-art procedure” which will “save your life”, it is very likely you will be another miserable statistic complaining that you “made the worst decision of your life”. An even greater deception of course, would be thinking that you were “cured” and a “survivor” after having been treated for a Gleason 6 disease which behaves as noncancerous.

 

Because of this realization now by some urologists that a gross amount of harm and zero benefit is generated by the over-detection and over-treatment of Gleason 6 (3+3) prostate “cancers”, periodic retooling of the prostate cancer management and PSA “guidelines” is being undertaken. However, true to form, urologists have exercised their creative writing and speaking skills once more by interpreting these “new” guidelines for prostate cancer screening and treatment with cleverly crafted rhetoric designed to continue the ongoing concern and anxiety in men regarding their particular prostate cancer. In this way, doctors have deceived men once again to continue seeking screening with the highly unreliable PSA, undertake risky prostate biopsies and undertake worthless, debilitating surgical treatment of Gleason 6 (3+3) “cancers” which do not require treatment. By retaining the “cancer” word for the noncancerous behaving Gleason 6 disease and continuing to generate concern and doubt when none should exist, urologists have ensured very successfully that their prostate cancer business and its over-detection and over-treatment program for any and all “cancers” will continue unabated.

 

In addition, all of this creative writing and speak has ensured that men with persistently elevated but stable PSAs, meaningless precancerous findings like HGPIN or a dubious family history of prostate cancer are “hyped up” and prepared for endless PSA monitoring, poking and biopsies. Not surprisingly, the many well-meaning medical oncologists, primary care physicians, foundations, organizations and prostate cancer support groups have been so severely flummoxed by this “conventional wisdom” concerning prostate cancer management and treatment that they are absolutely impotent in providing effective and sound patient guidance. Even healthcare insurance companies have no idea what they are approving or denying for payment in prostate cancer management.

 

Creative writing and creative speak are not only the domain of urologists but this highly unpalatable affliction has tainted all levels of society as well as the business of health and care. Truth and honesty are now but just an option in medicine and the moral descent to these lowly values of creative writing and creative speak appear to have evolved quite easily through the very undesirable practice of over-promising but under-delivering on treatment expectations. Shamefully, this dishonorable practice is well-oiled in the prostate cancer pharmaceutical industry where contrary to their sickening spin, real success at controlling significant cancer is measured only in a very small number of miserable months and at great cost (see www. theprovengetrials.org). Exacting great costs and exploiting those depending on someone’s help and mercy is done now without an ounce of conscience whatsoever. In an almost symbiotic relationship with pharmaceutical and technology companies, physicians are quite comfortable siphoning off those precious healthcare dollars in this callous business of over-promising and under-delivering. In fact, because dollars are at stake, consultations for the management of your disease have become a very malicious exercise in selling you some sort of evaluation or treatment which often benefits the physician more than it does you.

 

The philosophy for treating prostate cancer surgically evolved naturally through a confluence of mechanical thought and egos but also, because of the nebulous benefits of surgical tradition, consensus medicine and conventional wisdom. When a treatment philosophy such as the radical prostatectomy was allowed to germinate in this way and then allowed to become mainstream without any scientific endorsement, responsibility for patient protection and welfare had, once again been abdicated. In fact, the few scientific challenges to the treatment philosophy of radical prostatectomy were rewarded with peer hostility bookended by professional cronyism and a “closing of rank”. This oppressive, controlling and conforming party-line medical culture defending so-called traditional treatment philosophies against justified scepticism and criticism is an age-old medical problem. The peer hostility experienced by Lister and Semmelweis and many others is still alive and well today as evidenced by the very troubling medical fiascos concerning the treatment philosophies of lobotomy, uterine morcellation during hysterectomy (well detailed by the Wall Street Journal), prophylactic oophorectomy during elective hysterectomy and radical prostatectomy. Unfortunately, time and again, physicians egos and greed cloud their ability to recognize and amend bad treatment philosophies, In fact, physicians are often the biggest obstacles to real medical progress.

 

Urologists appear to have reached the point now where they have been forced to face up to the possibility that the radical surgery/robotic prostatectomy, however it is dressed, robotically or conventionally (retropubically or perineally), may not be the panacea for prostate cancer treatment afterall. Although urologists continue to ignore the clear and obvious fact that their radical prostatectomy still fails to save significant numbers of lives, there is some realization now, begrudgingly, that the terrible complications caused by their misguided surgery need to be addressed. Therefore, a number of urologists have begun counseling their potential victims preoperatively on outcome expectations so that men will not be too disappointed after their surgery with their inability to have normal sex and with their need to wear diapers (limp and leaking). Not mentioned usually, are the postoperative problems of a shortened penis and the 20-40% incidence of residual cancer along with a host of other very likely complications.

 

Although urologists are for ever bumbling about trying to address the many grave concerns surrounding the worthless PSA screening, the noncancerous behaving Gleason 6 “cancer” and their “gold standard” radical surgery/robotic prostatectomy which causes great harm and fails to save significant numbers of lives, the wives, partners and girlfriends of the men who have suffered from this surgical catastrophe know the real story. It is well known that most men find it very difficult to express their disappointments and regret especially after having been assaulted surgically for prostate cancer. However, the women in the lives of these men will not hide their feelings about how they were deceived and that their men were effectively emasculated, robbed of their manhood, made incontinent and pushed into depression for no good reason. The treatment outcomes endured by these “guinea pigs” were so much different from the rosy pictures which had been painted by their most “gifted” surgeons. Not surprisingly, this unbelievable minefield of medical lies and betrayal surrounding prostate cancer has led deceived patients and their lawyers to take legal steps towards making urologists accountable for their ignorant treatment philosophy.

 

Finally, two of the most barbaric and non-curative surgical procedures ever developed for mankind came from the same medical institution over 100 years ago. Although the radical mastectomy attempting to cure breast cancer was finally realized for what it was: an overly aggressive, debilitating and non-life-saving experience for nearly every woman who had the misfortune to be subjected to this procedure, the ill-conceived and festering radical surgery/robotic prostatectomy attempting to cure prostate cancer continues its misguided course even today. The fact that this toxic radical prostatectomy has not only failed to dent the prostate cancer specific mortality rate significantly but is also associated with a greater list of complications than possibly any other “life-saving” cancer operation is absolutely unconscionable. In fact, this very risky procedure is often seen by urological surgeons fortuitously, as a staged procedure. First, getting paid for excising the prostate and then getting paid for additional surgeries to correct one of the many complications resulting from their attempts at “saving your life”. The extraordinary failings of the robotic prostatectomy continue to be dealt with by physicians through a process of denial and mindless, self-serving counter challenges instead of honest review and correction. The perverse use of self-serving clinical studies and “information” along with the marketing of this technique as the “gold-standard” and FDA “approved” when the surgery was merely the first treatment conceived for prostate cancer and then inappropriately FDA-rubber-stamped, represents profound professional and intellectual dishonesty.

 

The eradication of misguided treatment philosophies can be achieved by mandating scientifically conducted evidence-based-medicine studies and allowing only treatments endorsed by positive data from these kind of studies. Only after garnering the data from real scientific studies and independent of FDA oversight, will the public be able to make truly informed decisions for their medical care and not just from an understanding influenced by medical spin and conflicts of interest. Choices made from facts and truthful medical data will trump eventually the sensitive, super-inflated egos, arrogance and conceit of those physicians embracing worthless and harmful treatment philosophies. The unwavering and stupefying endorsement of this mutilating radical surgery/robotic prostatectomy by the urology hierarchy along with the endless mischaracterizations and misrepresentations is appalling.

 

Until the radical surgery/robotic prostatectomy goes the same way as the radical mastectomy, dropped as another embarrassing example of medical experimentation, there will be ongoing unbridled exploitation of vulnerable patients and especially those made vulnerable by a “cancer” label. This egregious and reprehensible medical charade where, under the guise of modern medicine there is continued support for the radical surgery/robotic prostatectomy as a “treatment” when it clearly fails in the definition of a treatment is, and has been for far too many years, an extraordinary worldwide disservice to mankind. This fraudulent radical robotic prostatectomy treatment represents simply, another example of a very troubling medical legacy as well as a shameful, scandalous public health nightmare.

 

Selected bibliography:

Ablin RJ, Piana R. The Great Prostate Hoax: how big medicine hijacked the PSA test and caused a public health disaster

Abramson J. Overdo$ed America

Barrett S. and Jarvis W. The Health Robbers

Blum R, Scholz M. Invasion of the Prostate Snatchers

Brawley O. How We Do Harm

Brawley OW. Prostate Cancer Screening: what we know, don’t know, and believe. Ann Intern Med 2012;157:135-6

Dawley H. Proton Warriors

Goldacre B. Bad Science

Hadler N. Worried Sick

Hennenfent B. Surviving Prostate Cancer without Surgery

Horan A. How to avoid the Over-diagnosis and Over-treatment of Prostate Cancer

Klotz L. Adequate Patient Selection: active surveillance in prostate cancer. SIU Newsletter Vol 9, May 2013

Larson CA. Prophylactic Bilateral Oophorectomy at time of Hysterectomy: ACOG revises practice guidelines for ovarian cancer screening in low-risk women. Current Oncology 2014; 21, February: 9-12

Miles S. The Hippocratic Oath and the Ethics of Medicine

Onik G. The Male Lumpectomy

online.WSJ.com FDA advises against  morcellation use in hysterectomy

Wooten D. Bad Medicine, doctors doing harm since Hippocrates

www.dranthonyhoranmd.com

www.iom.edu/vsrt The Healthcare Imperative, lowering costs and improving outcomes

www.pbs.org/programsmoney-medicine

www.uspreventiveservicestaskforce.org

www.theprovengetrials.org

 

You can learn more about the many failings in prostate cancer management by visiting:

Dr Bert Vorstman’s website, http://urologyweb.com/exclusive-medical-reports

Dr Vorstman’s blog at;  http://urologyweb.com/uro-health-blog/

Contact him at bvorstmanmd@gmail.com

 

About Bert Vorstman MD, MS, FAAP, FRACS, FACS

Dr. Bert Vorstman is a Board Certified urological surgeon. After training at the Otago Medical School in Dunedin, New Zealand he completed a urology residency at Auckland Hospital, Auckland, New Zealand. He Fellowship trained in Pediatric and Adult Reconstructive Urology at the Eastern Virginia Medical School in Norfolk, Virginia and after NIH sponsored, pioneering research on “Urinary Bladder Reinnervation” he earned the honor of a Masters of Surgery Diploma from the University of Otago, Dunedin, New Zealand. Dr. Vorstman was a faculty member at the University of Miami, Jackson Memorial Hospital, Miami, Florida and then went on to found Florida Urological Associates, a very busy private, urology practice in Coral Springs, Florida. Dr Vorstman’s passion and dedication is to help men and their spouses/partners understand fully the implications of their particular prostate cancer as well as the minimally invasive treatment options available in selected men with localized significant prostate cancer.