Outrage #1
That men continue to be deceived about and railroaded into unnecessary treatments for the so-called Gleason 6 (3+3) prostate “cancer” has NO hallmarks of a cancer when on both clinical and molecular biology grounds it behaves as noncancerous, has no spreading potential and is not a health-risk. Only some high-grade prostate cancers are potentially lethal but NOT the Gleason 6 “cancer” which is a pseudo-disease.
Outrage #2
Continuing to intentionally deceive men about their prostate “cancer” with the all-inclusive generalizing cancer term as if their noncancerous behaving Gleason 6 (3+3) disease is equal to the less common potentially lethal high-grade prostate cancer which actually needs treatment.
Outrage #3
The majority of men being “treated” for prostate cancer have the noncancerous behaving Gleason 6 (3+3) “cancer” which is a pseudo-disease and these men have been deceived into thinking they are prostate “cancer survivors”. Their Gleason 6 disease was never a real cancer and these men are NOT “cancer” survivors but “survivors” of their misguided treatment.
Outrage #4
The prostate cancer specific antigen (PSA) blood test is HIGHLY UNRELIABLE when used for cancer “detection”. Furthermore, it detects mostly the very common Gleason 6 “cancer” which is a pseudo disease and is not a health-risk and does not require detection or early detection or treatment. In fact, the PSA was approved by the FDA not as a biomarker for early prostate cancer detection but as a marker for monitoring cancer activity AFTER treatment. Despite these FDA determinations, the renegade prostate cancer industry and its urologists hijacked the PSA marker by misrepresenting its approval for prostate cancer detection for very lucrative self-serving gain.
Outrage #5
The deception surrounding screening for prostate “cancer” and the errant promotion of National Prostate Cancer Awareness Month every September encouraging men to have checkups. As well as hoodwinking industry, corporations and organizations to endorse this misguided and unworthy call for prostate cancer screening, all of this spin about “prostate cancer awareness”, “early detection”, “educating the public” and “promoting research towards cure” sounds ideal but has simply caused great suffering and absolutely failed to impact prostate cancer specific mortality.
Much of the prostate “cancer” checkups in men is burdened by subjectivity, unreliability and inaccuracy. Highly unreliable are mens voiding symptoms. Highly subjective is the digital rectal examination (DRE) to assess the prostate feeling for possible prostate nodules which may be “cancerous”. Highly risky, potentially lethal and often painful is the office prostate needle biopsy. Also highly subjective are the reading of your prostate biopsy slides by the pathologist and the interpretation of your x-ray or imaging studies by your radiologist. Validation of independent physicians is always recommended.
The surgical “treatment” philosophy for prostate cancer is an absolute sham with no scientific evidence-based-medicine data indicating any benefits along with a list of complications not found in any other cancer treatment. Not only has there never been hard data to support any surgical treatment for prostate cancer and this lack of patient benefit remains even for the ill-conceived and misguided robotic prostatectomy. 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.
Shamefully, although urologists have known for a long time that the Gleason 6 is a disease and NOT a cancer and that only high-grade prostate cancers are potentially lethal and that therefore, only the less common high-grade prostate cancers demand detection and treatment but not with robotics has not corralled the evil frenzy with which doctors continue exploiting patients medical illiteracy for self gain. Several physicians and organizations have attested to the fact that the common Gleason 6 disease, mischaracterized as a cancer, lacks any of the hallmarks of a cancer both on clinical grounds and molecular biology grounds and that there are zero benefits for screening this disease and especially for treating this disease with the debilitating robotics.
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.
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.iom.edu/vsrt The Healthcare Imperative, lowering costs and improving outcomes
www.pbs.org/programsmoney-medicine
www.uspreventiveservicestaskforce.org
You can learn more about the many failings in prostate cancer management by visiting:
Dr Bert Vorstman’s website, https://urologyweb.com/exclusive-medical-reports
Dr Vorstman’s blog at; https://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.