All health information is suspect since widespread financial sponsorship of healthcare organizations by companies in the biotech, pharmaceutical and food industries have twisted health facts for the sole purpose of influencing consumer/patient decision-making to benefit corporate and physician greed. The noble profession of healing is in decay.
https://www.bloomberg.com/news/features/2017-08-29/medical-journals-have-a-fake-news-problem
http://www.whatthehealthfilm.com/
Why the Gleason 3+3=6 cancer is a fake cancer
The very common Gleason 3+3=6 prostate “cancer” actually LACKS the hallmarks of a typical cancer and, should never have been labelled as a cancer. However, the gaming of this cancer tag allows urologists and their prostate cancer industry to make a lot of money.
> the diagnosis of Gleason 6 “cancer” is based only upon a low-power microscopic interpretation
> no man has died from pure Gleason 6 “cancer” despite the prostate cancer industry’s underhanded efforts to paint all cancers as equal
> the Gleason 6 “cancer” lacks a number of molecular biological mechanisms commonly found in real cancer cells (Klotz and others)
> unlike a classic cancer cell, the Gleason 6 has a very long cell doubling-time of 475 +/- 56 days so that from mutation to a growth of about 1 cm (smaller than half an inch) in diameter takes some 40 years
> the incidence of areas of Gleason 6 disease in the prostates of otherwise healthy men approximates one’s age from about 50 years onward
> pure Gleason 6 is not a health-risk and maybe viewed as part of the aging process
> by including the Gleason 6 pseudo-cancer in prostate cancer statistics it is clear that the incidence of real prostate cancer is greatly overstated creating a dangerous illusion that prostate cancer is the second most common cancer in men
> likewise, prostate cancer and family history or ethnicity issues are also likely to be overreaching because of the inclusion of Gleason 6 disease
> most if not all, clinical prostate cancer treatment “studies” and “findings” for radical (robotic) prostatectomy, radiation, proton beam and focal therapy options using
cryoablation, HIFU and laser can be dismissed as they include the bogus Gleason 6 prostate cancer
> also negating the conclusions of most if not all of these so-called prostate cancer studies is their reliance on non-validated (no pathology second opinion) Gleason grades, the inclusion of any and all Gleason scores (i.e. including the fake Gleason 6 cancer) as well as the inclusion of patients with varying tumor volumes (amounts of cancer)
> the unfortunate men who underwent treatment for their bogus Gleason 6 cancer are survivors of the treatment and not, survivors of the phony cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708232/
Why the Prostate Cancer Awareness program is a scam
The prostate cancer industry’s early prostate cancer detection-to-treatment program utilizing PSA-based screening of otherwise healthy men is a scam that was designed to profit from risky and unneeded treatments of mainly fake cancers.
> the PSA (prostatic specific antigen) test is NOT cancer-specific
> there is no specific PSA level that detects an important prostate cancer
> the PSA levels of what constitutes a normal value are artificial
> the PSA test is highly unreliable and unable to discriminate between normal prostate, inflamed prostate, the fake Gleason 6 cancer, a little cancer, a lot of cancer or, the 15% or so of potentially lethal high-risk prostate cancers that do demand detection and treatment
> most PSA elevations reflect only benign prostate enlargement (big prostates, “big” PSAs) and/or, the bogus Gleason 6 cancer
> many high-grade cancers lose the ability to make PSA so PSA-based screening often misses these important potentially lethal prostate cancers
> all PSA levels fluctuate normally. Laboratory errors and other causes such as taking the test the day after sex or, after a recent bout of prostatitis or, a urinary tract infection can lead to a false positive PSA so no action should ever be undertaken on a single so-called abnormal PSA level
> most men have no symptoms attributable to even a significant prostate cancer
> the rectal exam to check the prostate for a cancerous nodule (DRE or, digital rectal exam) is no better than a coin-toss, open to interpretation and generally, worthless
> the so-called “standard” 12-core ultrasound-guided needle biopsy of the prostate is a risky, unreliable and highly unscientific test that samples randomly only some 0.1-0.3% of the prostate leaving over 99% unsampled. This gigantic sampling error has lead to spurious claims of prostate cancer upgrading and progression when instead, an area of high-risk cancer has simply been missed by the pseudo-scientific but “standard” 12-core needle biopsy. Conversely, the 3T mp-MRI (in expert hands only) examines the whole of the prostate
> the interpretation of your biopsy slides by the pathologist is also subject to reading errors and, underscores the importance of getting a second opinion from a recognized authority
> fundamental to this prostate cancer detection con is the keeping of the Gleason 6 pseudo-cancer under the cancer umbrella so that corrupt urologists can continue their trickery that the Gleason 6 is a cancer and health-risk or, could possibly upgrade and progress to become a health-risk
> by plying contrived dangers and disinformation about the Gleason 6 “cancer”, urologists and their Prostate Cancer Awareness propaganda have generated a false prostate cancer crisis to serve just their predatory practices and, exploit those made vulnerable
> the deceptive cancer tag for the Gleason 6 has caused a monstrous worldwide public health disaster. This crime against humanity has also squandered vast sums of precious healthcare dollars
> the real value of the Prostate Cancer Awareness agenda is for men and their partners to be fully aware that PSA-based screening is highly unreliable and risky and, commonly leads to unneeded and toxic “treatment” of Gleason 6 disease
https://urologyweb.com/gleason-6-prostate-cancer/
Ablin and R. Piana, The Great Prostate Hoax
Why most Prostate Cancer Treatments are Fake
The radical (robotic) prostatectomy is a scientific fraud that fails to save significant numbers of lives and only causes great suffering. Even the FDA “approved” and “standard practice” labels for the robotic prostatectomy are designed to fool the public into believing that the surgery has been proven to be safe and effective when all standard scientific evidenced-based testing was actually bypassed using the FDA’s 510(k) loophole. Even other treatment options like cryo, laser and HIFU have used this loophole to pretend their FDA “approval” was real.
> the rot in the prostate cancer story began with Johns Hopkins H. H. Young’s report, “The Early Diagnosis and Radical Cure of Prostate Cancer”. Not only was there zero evidence for early diagnosis of prostate cancer and, no evidence for cure but, Young’s contention that his radical prostatectomy furnished “remarkably satisfactory functional results” was also a bare-faced lie. In fact, the first two men died from his radical surgery (one postoperatively and, one after treatment for a complication common to this procedure) and, the remaining two survivors were left with debilitating urinary issues
> the endorsement of this culture for radical surgical cure by their urology hierarchy allowed more urologists to “prove” their preconceived notions and treatment philosophy with self-serving studies, dogma, propaganda and cronyism to transform this ideology into something deemed “standard practice” and “gold standard”
> physician herd mentality and consensus medicine also capitalized on the public’s misconception about the benefits of “cutting it out”
> shockingly, urologists have remained mesmerized by the illusion of radical curative surgery and, locked on a quest to “perfect” this crippling surgery for the past 100 years or so instead of determining scientifically whether it was safe or even effective
> despite the advent of robotics, little has changed and the radical robotic prostatectomy is still associated with more early and late complications than probably any other cancer surgery
> the radical prostatectomy is also associated with a high-rate of residual cancer
> additionally, there is clear evidence that surgical manipulation during the prostatectomy releases cancer cells into the bloodstream
> urologists have always been aware of the dangers of their radical surgery since they have developed numerous techniques to counter the many, life-threatening complications
> urologists also developed a very lucrative prosthetic industry to manage the many “limp and leaking” complications stemming from their radical prostatectomy “treatment”
> urologists’ claims of successful surgery are commonly manipulated by self-serving definitions of success i.e. men are “dry” if they use 1-2 pads per day to control leakage
> the dangers of the robotic prostatectomy are clearly evident from a Google search showing endless lawsuits filed against urologists and the robot device manufacturer
> scores of self-reported harms have also been recorded on the FDA’s own product safety website, MAUDE (Manufacturer and User Facility Device Experience) but, representing only about 8% of actual adverse events
> several warnings have been issued by the USPSTF (U.S. Preventive Services Task Force), a Government oversight agency whose recommendations warned that the harms of PSA-based prostate cancer screening and treatment outweigh any benefits
> many other warnings have come from empathetic physicians and organizations
> even the robot makers themselves have clearly recognized the many dangers of the robotic device for radical prostatectomy as their website disclaimers are getting longer with each revision
> shamefully, the prostate cancer industry and its urologists have had the gall to challenge the damning evidence against PSA-based screening, the labeling of the Gleason 6 as a “cancer” and the radical prostatectomy as a “treatment” with even more prostate cancer lies
https://urologyweb.com/prostate-cancer-treatment-the-disturbing-facts/
https://urologyweb.com/robotic-prostatectomy-spreads-prostate-cancer-cells/
https://urologyweb.com/robotic-prostatectomy-complications/
Horan MD, “The Big Scare”
Horan MD, “How to Avoid the Overdiagnosis and Overtreatment of Prostate Cancer”
What to do about your PSA?
The chances of having zero benefit and only lifelong complications from PSA-based screening and unneeded “treatment” are far greater than the very small chance of an adverse course from the failed detection of a high-risk prostate cancer.
> never act on just one “abnormal” PSA. Any raised level of PSA needs repeating a few times to determine if the elevated level is real
> in addition to repeating the PSA and PSA derivatives, the PSA density can be very helpful. The prostate size can easily be measured via a suprapubic ultrasound and then its volume can be divided into the PSA to obtain the density. This number should be less than about 0.16 and, a normal density measurement can usually eliminate the need for risky and inaccurate 12-core, template or, saturation prostate biopsies
> if the PSA, PSA derivatives and PSA density levels are persistently abnormal or, show worsening trends, a 3T mp-MRI of the prostate (not with an endorectal coil and, by an expert in the field) can examine the whole of the prostate. This is far more reliable than the unscientific and random needle biopsy of the prostate (but not foolproof)
> the goal of the 3T MRI is to identify only PIRADS 4 and 5 areas as these may be indicative of potentially lethal high-risk cancers. By design, the MRI tends to leave undetected, the bogus Gleason 6 cancer
> if present, high-risk PIRADS 4 and 5 areas, can be targeted for a needle biopsy during real-time MRI (this is far more accurate than using MRI/ultrasound fusion techniques)
> all pathology specimens need validation to have a consensus on whether a significant cancer has actually been detected. PTEN biomarker studies may also be helpful but for the most part, biomarker and genome studies are costly and not foolproof and, screening with the 3T MRI is far more direct and superior
> CAT and bone scan “staging” is unneeded for Gleason 6 disease and generally, highly unreliable for evaluating whether high-risk prostate cancer is localized or has spread since bone marrow aspiration studies using sophisticated staining techniques can often detect metastatic pattern 4 and above cancer, long before it can be detected on these imaging studies
> the CAT scan and bone scan can be useful once the PSA is 15-20 ng/ml or more. The Na fluoride PET/CAT scan can be more sensitive
> validated Gleason 6 disease detected by a needle biopsy does not require treatment but, a follow up MRI to check for possible missed high-risk disease is highly desirable
> active surveillance (by any criteria) employing periodic worthless prostate exams and risky painful 12-core biopsies of the prostate are not only unscientific and harmful but, abusive when 3T MRIs in expert hands can check the whole prostate for the presence of any potentially lethal high-risk cancers. If follow up MRIs are clear, further monitoring can be undertaken with 6-12 monthly PSAs to ensure these values remain stable. If these values trend abnormally, another 3T MRI and/or target biopsy can be undertaken
> be aware that there is an “intermediate risk” category of Gleason 7 prostate cancers. There are two vastly different Gleason 7s, a 3+4 which, if associated with only small amounts of validated pattern 4 disease, can be monitored as it behaves similar to 3+3. But, 3+4s with more significant amounts of pattern 4 cancer may require treatment. The Gleason 7, 4+3s, do have lethal potential and usually need treatment
> validated high-risk 4+3, 4+4, 4+5, 5+4 or, 5+5 prostate cancers, IF believed to be localized, may be treated with focal therapy options using cryoablation, laser or HIFU as long as the cancer(s) is ideally located within the prostate and, of small volume
> validated high-risk 4+3, 4+4, 4+5, 5+4 or, 5+5 prostate cancers, IF believed to be localized BUT more extensive or, not ideally located within the prostate (i.e. close to sphincter), a combination of a few months of androgen deprivation therapy along with radiation (not seeds) or proton beam to the prostate and pelvis are reasonable treatment options. For the many reasons stated previously, the radical (robotic) prostatectomy is not, and has never been, a reasonable “treatment” option
https://urologyweb.com/prostate-cancer-biomarkers/
https://urologyweb.com/topics/mens-health/prostate-cancer/
https://urologyweb.com/uro-health-blog/
Bert Vorstman MD, MS, FAAP, FRACS, FACS
www.urologyweb.com