Bert Vorstman MD, MS. FAAP, FRACS, FACS www.urologyweb.com
1. the PSA will save your life
The USPSTF (US Preventive Services Task Force) has already given the PSA-based screening of healthy males a “D” or, fail grade because it is non-cancer specific and highly unreliable. It has a very high false-positive rate that leads to the detection of mostly benign and non-lethal prostate cancer and, at best, MAY save 1:1000 men (according to the USPSTF). Because it is so unreliable, the PSA test simply leads to a gross amount of over-evaluation and injury from the unnecessary treatments of non-lethal prostate diseases. Unfortunately, the potentially lethal high-grade cancers which need detection, often escape detection as they make little or no PSA.
2. a biopsy will rule out a cancer
It has been established for many years now that the standard 12-core needle biopsy of the prostate is not only very risky but, also grossly unreliable as it samples randomly only a tiny volume of the prostate (less than 1%) and, often misses important regions of the prostate where cancer may reside.
3. you have prostate “cancer”
It has also been established for many years that not all cancers are equal and, in fact, many prostate cancers don’t even act as cancerous. Such is the case for the very common Gleason 3+3=6 prostate “cancer” which incredibly:
– lacks several molecular biological mechanisms found commonly in real cancer cells
– unlike a typical cancer cell, the Gleason 6 has a cell division time of about 475 days so that it takes some 40 years to grow to half an inch
– is part of the aging process as the Gleason 6 disease is commonly detected in 50% of 50 year olds; 60% of 60s etc, etc and, is without impact
– not potentially lethal
– not a health-risk
– is a pseudo-cancer
4. the radical (robotic) prostatectomy will get it all
The FDA “approved” label given to the the radical (robotic) prostatectomy deceives the public by implying that it went through rigorous scientific evaluation for safety and benefits when the procedure was simply rubber-stamped by the FDA using their 510(k) process and, not surprisingly therefore, is not only associated with a raft of complications but, fails to extend life. The surgery is highly debilitating as all the legal actions on Google and the FDA MAUDE site attest to. Even worse, it is commonly used to “treat” the Gleason 6, a prostate disease which is part of the aging process and does not require any type of radical or focal treatment as it is a bogus cancer.
5. it was your decision
Both the processes of “shared decision making” and, the so-called “informed consent” are commonly highly suspect as they are based upon an alchemy of physicians biases, medically illiterate patients and a prostate cancer label. A label with incredible shock value and, which simply allows unscrupulous physicians to ply salesmanship and, the engendering of doubt and fear to railroad patients towards unnecessary treatments. Regrettably, the deceptions surrounding the highly unreliable PSA-based screening, the risky and unreliable prostate needle biopsy, the bogus Gleason 6 cancer, the scientifically unproven robotic prostatectomy treatment philosophy and, the spurious process of “shared decision making” have resulted in many, many men worldwide being injured for zero benefit. If only we could get rid of all of this background noise about the Gleason 6 and turn our direction towards finding a simple reliable screening test that could detect reliably, early high-grade disease for early, reliable, effective outpatient treatment, we might arrest this worldwide public health disaster. Then, instead of another bogus claim about making a “survivor” (although limp and leaking) after his unnecessary Gleason 6 treatment just maybe, we could help those with real, potentially lethal high-grade prostate cancers.