Were it the case each of us a wide reader, names you note here of the "Who's Who"-plus others- found in Jack McCallum's, "The Prostate Monologues" would appear familiar, your message redundant. But why spend the time at all when blessed with "The Active Surveillor!" The power of your innate ability, result of treatment by BIGGEST names in industry 12 years ago, is not solely in research near impossible for typical subscriber to obtain on his/her own; no, equally important is repetitive highlighting through which each of us-with time-learn, bringing ALL of us along for the ride. While 6 to 60% and counting in 10 years is remarkable, some support groups aligned to medical center's remain closed-lip to ongoing open discussion; USTOO groups guilty also. You've been 'round long time, Howard, seen it all. One has to wonder whether impact of your newsletter shared before such groups likely greater than the millions spent by national organizations were we to simply open our mouth.
So, I did good? Or, no? Thanks, Steve. I lucked out being in Chicago. If I hadn't been a medical reporter, I would not have had the contacts I had. But I am convinced if I were living in some major cities today in US or Europe, I wouldn't have had all the biopsies. So guys who followed may benefit from my being in effect a research subject. There are some issues with some support groups that get stuck in the time of when the leaders underwent treatment. But that's not universally true. Many of the strongest advocates for AS (I can name names) are men who underwent treatment a decade ago, were unhappy with the result and now want to help the newbies. Howard
Catalona says, "When surveilling patients, it really must be acknowledged that we are rolling the dice to some extent because we know from experience that 30% to 50% of them harbor worse cancer than we thought based mostly on sampling error in their biopsies." If the miR Sentinel test is as accurate miR says it is (over 90%) we now know who harbors cancer and what grade. The gamble advances to what to do with intermediate and advanced positives. What would Vorstman say to do with them?
Dr Catalona's rhetoric is emotional - "we are rolling the dice to some extent because we know from experience...." - Sadly, too much of the prostate cancer arena is founded on supporting preconceived notions. We use the PSA marker for testing despite a 78% false positive rate, we use a risky needle biopsy detection method that samples blindly and randomly 0.1% of the prostate - we call the G6 a cancer when its genetic pathways for invasion and spread are inactive as in normal cells. Then we develop all sorts of pathology nuances such as perineural invasion and low risk, intermediate risk categories etc, while pathology and imaging are subject to errors of interpretation. Nothing we are doing seems to be driving survival - our "treatments" like robotic prostatectomy are highly suspect - the 10 year survival whether one is treated or not is about the same. We need to get away from assumptions, opinions and junk science and get back to scientific principles to garner only irrefutable and reproducible scientific fact so we can truly help our patients. In the meantime, we are only harming countless men. Let's get back to basics - which prostate cancers are potentially lethal, how can that subgroup be detected reliably and safely with a high degree of certainty early enough so that reliable treatments will lead to survival - not a semblance of cure. Two important books, The Rise and Fall of the Prostate Cancer Scam and The Great Prostate Hoax have underscored the nonsense going on in the prostate cancer arena. The whole prostate cancer business needs to be turned on its head and we need to stop teaching our residents quackery. Lastly, your question of a gamble - it's about not walking into a trap of unscientific double speak.
Dr. V. Thanks for responding to our reader, Charles. So much with this cancer and its treatment is confusing and contradictory. HW
Were it the case each of us a wide reader, names you note here of the "Who's Who"-plus others- found in Jack McCallum's, "The Prostate Monologues" would appear familiar, your message redundant. But why spend the time at all when blessed with "The Active Surveillor!" The power of your innate ability, result of treatment by BIGGEST names in industry 12 years ago, is not solely in research near impossible for typical subscriber to obtain on his/her own; no, equally important is repetitive highlighting through which each of us-with time-learn, bringing ALL of us along for the ride. While 6 to 60% and counting in 10 years is remarkable, some support groups aligned to medical center's remain closed-lip to ongoing open discussion; USTOO groups guilty also. You've been 'round long time, Howard, seen it all. One has to wonder whether impact of your newsletter shared before such groups likely greater than the millions spent by national organizations were we to simply open our mouth.
So, I did good? Or, no? Thanks, Steve. I lucked out being in Chicago. If I hadn't been a medical reporter, I would not have had the contacts I had. But I am convinced if I were living in some major cities today in US or Europe, I wouldn't have had all the biopsies. So guys who followed may benefit from my being in effect a research subject. There are some issues with some support groups that get stuck in the time of when the leaders underwent treatment. But that's not universally true. Many of the strongest advocates for AS (I can name names) are men who underwent treatment a decade ago, were unhappy with the result and now want to help the newbies. Howard
Catalona says, "When surveilling patients, it really must be acknowledged that we are rolling the dice to some extent because we know from experience that 30% to 50% of them harbor worse cancer than we thought based mostly on sampling error in their biopsies." If the miR Sentinel test is as accurate miR says it is (over 90%) we now know who harbors cancer and what grade. The gamble advances to what to do with intermediate and advanced positives. What would Vorstman say to do with them?
Dr Catalona's rhetoric is emotional - "we are rolling the dice to some extent because we know from experience...." - Sadly, too much of the prostate cancer arena is founded on supporting preconceived notions. We use the PSA marker for testing despite a 78% false positive rate, we use a risky needle biopsy detection method that samples blindly and randomly 0.1% of the prostate - we call the G6 a cancer when its genetic pathways for invasion and spread are inactive as in normal cells. Then we develop all sorts of pathology nuances such as perineural invasion and low risk, intermediate risk categories etc, while pathology and imaging are subject to errors of interpretation. Nothing we are doing seems to be driving survival - our "treatments" like robotic prostatectomy are highly suspect - the 10 year survival whether one is treated or not is about the same. We need to get away from assumptions, opinions and junk science and get back to scientific principles to garner only irrefutable and reproducible scientific fact so we can truly help our patients. In the meantime, we are only harming countless men. Let's get back to basics - which prostate cancers are potentially lethal, how can that subgroup be detected reliably and safely with a high degree of certainty early enough so that reliable treatments will lead to survival - not a semblance of cure. Two important books, The Rise and Fall of the Prostate Cancer Scam and The Great Prostate Hoax have underscored the nonsense going on in the prostate cancer arena. The whole prostate cancer business needs to be turned on its head and we need to stop teaching our residents quackery. Lastly, your question of a gamble - it's about not walking into a trap of unscientific double speak.
Thanks, Charles. He may be reading this. But I'll ask him.