The so-called robotic surgical treatment for prostate cancer is doubly egregious in that not only is it reserved for mainly prostate cancers which are NOT real cancers but even worse, this robotic operation has failed miserably in the goal of saving significant numbers of lives as well as being associated with an unbelievable incidence of complications and lifelong after-effects.
The Gleason 6 prostate “cancer”
> the very common Gleason 6 (3+3) prostate “cancer” behaves as noncancerous and does not require treatment.
> on both clinical and molecular biology levels, the very common Gleason 6 (3+3) prostate “cancer” has NO hallmarks of a real cancer
> the Gleason 6 (3+3) prostate “cancer” is a pseudodisease, has no spreading potential, does not progress and is not a health-risk. The word “cancer” for the Gleason 6 disease is a misnomer
> Gleason 6 (3+3) disease should NOT be called a cancer
> some prostate cancers do have lethal potential but these are the high-grade cancers and not the Gleason 6 disease
> continuing to call the Gleason 6 disease a “cancer” and calling for “prostate cancer awareness” is distorting the evidence and simply allows the ongoing deception of vulnerable men by physicians for self gain
> urologists are quite comfortable exploiting patient medical illiteracy and gaming the system
> the intentionally misleading broad-brush labelling of every prostate “cancer” as though it were some fast moving potential killer- when only some prostate cancers exhibit this potential- requires urgent correction to stop the many unscrupulous physicians misleading men about their cancer and the debilitating robotic prostatatectomy for self-gain
Radical prostate surgery/robotic prostatectomy
> the surgery for prostate cancer began as a treatment philosophy and was allowed to become mainstream in the absence of supporting scientific evidence-based-medical data demonstrating any merit for this treatment
> the surgical treatment philosophy relies on the scientifically unsubstantiated premise that prostate cancer can save lives by being cut out
> this treatment philosophy premise has never impacted the prostate cancer specific mortality because this procedure simply fails to save significant numbers of men’s lives
> surgical treatments for prostate cancers are associated with a jaw-dropping incidence of often life-long complications such as the very common limp and leaking
> the approval of robotics for prostate cancer is yet another example of junk science and greed influencing “new” research to justify old ill-conceived treatment philosophies
> the FDA approval for prostate cancer surgery and particularly for robotic prostatectomy is devoid of substance and scientific validation
> robotics for prostate cancer surgery was given a “pass” by the FDA. The FDA was supplied scant clinical information comparing laparoscopic gallbladder surgery to robotic gallbladder surgery and despite the fact that robotics was 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 the approval for soft-tissue surgery based upon gallbladder studies has absolutely nothing in common with the complexity surrounding prostate anatomy and its excision
> most men with a prostate cancer label are over-treated for zero benefit and in addition to being left with lifelong memories of a foolish “treatment”, they have been deceived into thinking they were survivors
> several doctors and organizations have echoed warnings to men
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.
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.
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.