When the data says no but urologists say yes
The prostate cancer arena is a minefield of dangers for unwitting men who enter because so-called standard practice and standard-of-care are based mostly on assumptions, biases, inaccuracies and junk science. A mix that’s made even more toxic by the power of money.
Why “science” is mostly junk science.
John Ioannidis MD, has established clearly that, “most published research findings are false”. Not only are the vast majority of studies designed inappropriately and fail to provide reproducible and irrefutable data but those reviewing these so-called studies commonly lack the skills to determine what is sound scientific methodology or what are believable data. Simply put, garbage in, garbage out.
Prostate cancer junk science.
- The PSA (prostate specific antigen) is not specific and highly unreliable as a screening marker for serious prostate cancer. Not only is the PSA associated with a false positive rate of about 78 percent but many of the 15 percent or so of potentially deadly high-grade prostate cancers commonly don’t make much PSA and are therefore, missed. Predictably, PSA-based screening fails to save significant numbers of lives. https://www.nejm.org/doi/full/10.1056/NEJMoa0810696
- The ultrasound-guided needle biopsy of the prostate is highly risky and samples blindly and randomly only about 0.1 percent of the prostate. In other words, urologists have no clue about what’s going on in the rest of the 99.9 percent of the prostate or what they will be treating.
- Pathology interpretation is also highly unreliable as the Gleason grading and scoring system is complex and fraught with observer error and errors of interpretation.
- The common Gleason 3+3=6 “cancer” is a pseudo-cancer as on clinical and molecular biology grounds it LACKS the hallmarks of a cancer. Therefore, the G6 should not be labelled as a cancer, not be screened for, not detected, not treated and, not be included in prostate cancer statistics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708232/
- Imaging studies for “staging” to determine whether a high-grade prostate cancer is localized to the prostate or not are highly unreliable for detecting small-volume spread and image reading by radiologists is also subject to errors of interpretation.
- Robotic prostate cancer surgery became mainstream and “standard practice” without any supporting objective evidence for safety or effectiveness. After the FDA approved the robotic device for use in gallbladder surgery (despite a lack of benefits) urologists utilized the FDA’s 510(K) process to rubber-stamp an approval for use of the tool in robotic prostatectomy. Not surprisingly, because this surgery was unproven it came with a trove of complications. Even urologists concluded that the radical prostatectomy “did not substantially reduce prostate cancer mortality”. https://www.nejm.org/doi/full/10.1056/NEJMoa1113162
- No evidence-based studies have been done with validated and identical Gleason grades, scores, tumor volumes and imaging results with patients equally distributed between various treatment options and followed for 20 years or more to determine safety and effectiveness.
- Corrupting most, if not all, treatment studies is the inclusion of the bogus Gleason 6 and or, treatment of participants arbitrarily with testosterone suppression. Not only can testosterone suppression produce life extension, but the treatment of Gleason 6 disease will also skew treatment results towards a semblance of cure.
The current state of prostate cancer treatment.
Sadly, most of the information about prostate cancer treatment comes from the self-serving prostate cancer industry. Absent of evidence-based scientific support, their management dogma is based purely on preconceived notions. A carefully crafted game plan that has also fooled the FDA and bypassed consumer protection laws. Misconstrued as standard-of-care and unchallenged by physicians who should know better, the current state of prostate cancer detection and treatment poses a glaring danger to the health of vulnerable patients.
A recent interview with an actual urologic surgeon that objectively assesses the current state of prostate cancer treatments was just published on November 25th in The ASCO Post. In partnership with the American Society of Clinical Oncology, The ASCO Post features highly validated coverage of clinical cancer research, policy news, patient care, clinical practice issues, and thoughtful commentary by leaders in the field of clinical oncology. In partnership with the American Society of Clinical Oncology (ASCO), The ASCO Post communicates news of evidence-based multidisciplinary cancer care to a broad audience of oncology professionals and ASCO members. This article is dedicated to Anthony Horan MD, a urologist and author (The Big Scare) who challenged fearlessly the culture and the business of prostate cancer. He was always on the right side of what should never have been a controversy.