Dr. Vorstman, uro skeptic, shares his favorite reads with the TheActiveSurveillor.com's Prostate Cancer Book Club
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(Editor’s Note: Urologist Bert Vorstman, MD, is a leading skeptic of prostate cancer treatment, including AS. Thousands have read his controversial columns in TheActiveSurveillor.com.
(This blog recently launched its TheActiveSurveillor.com’s Prostate Cancer Book Club. You can join Vorstman and patient Victor W. in contributing your own reviews. Let me know which prostate cancer book you wish to review. Contact me in the comments.)
By Bert Vorstman, MD
Prostate cancer detection and treatment remain very controversial subjects. However, there are two earth-shattering books packed with facts that will empower you so you don’t become another sorry statistic injured during the prostate cancer testing and treatment journey.
“The Rise and Fall of the Prostate Cancer Scam'' by Anthony H. Horan MD. The Big Write. (2020) This book is a revision of previous edits that went by different titles, i.e. “The Big Scare - the Business of Prostate Cancer” and, “How to Avoid the Overdiagnosis and Overtreatment of Prostate Cancer.”
And,
“The Great Prostate Hoax” by Richard J. Ablin PhD and Ron Piana. St. Martin’s Press. (2014)
Anthony H. Horan, MD, (recently deceased) was a urologist working in the front lines of prostate cancer management. It didn’t take him long after starting practice for him to realize that the prevailing so-called standard-of-care dogma about prostate cancer testing and treatment was at great odds with the clinical evidence before him. Eventually, he felt compelled to write a book detailing the many misrepresentations and fabrications in the prostate cancer arena that were passed off as being scientific facts.
Horan’s book describes in detail that:
> The transrectal ultrasound-guided needle biopsy was not only risky with the complications of bleeding and septicemia but associated with a significant false-negative rate.
> The origins of the radical prostate surgery treatment and Dr. Hugh H. Young’s claims that his patients' conditions were “excellent '' post-operatively contradicted the results published. In fact, the radical prostatectomy was neither safe nor effective. Young performed the first radical prostatectomy on April 7, 1904 at Johns Hopkins Hospital.
> Life extension has not been demonstrated by radical surgery or radiation in properly randomized, controlled, prospective studies.
> The prostate cancer cell has a generally slow doubling time taking years to grow.
> Bone marrow aspiration studies along with sophisticated staining techniques have shown that many aggressive cancers have cells already spread into the bone marrow when the cancer is barely detectable within the prostate.
> Radiation is generally ineffective, associated with significant bladder and rectal complications as well as carcinogenic effects. He claims that radiation has its only role at the end-game of palliation.
Richard Ablin, PhD, discoverer of the PSA, teamed up with Ron Piana, an investigative science reporter, after Ablin became increasingly disturbed by the politics and fraud behind the PSA story. Furthermore, Ablin maintained that the PSA was never meant to be used for screening prostate cancer. Ablin and Piana also record how:
> The robotic prostatectomy was FDA approved without scientific evidence for safety or benefits.
> The FDA's MAUDE (Manufacturer and User Facility Device Experience) website showed a marked jump in adverse events concerning the robotic device.
> Studies comparing open surgery and robotic prostatectomy showed no difference in cancer recurrence rates, urinary incontinence, and impotence.
Both books recorded:
> The origins of prostate-specific antigen (PSA) testing and its lack of specificity. In particular, the PSA was unable to discriminate between BPH, prostatitis and cancer. In fact, PSA testing was no better than a lottery. And, the more malignant prostate cancers can lose the ability to make PSA so they are no longer trackable through PSA monitoring. Ablin and Piana also had the benefit of access to the transcripts of the Immunology Devices Panel meetings of the Medical Advisory Committee (an FDA advisory committee) so that they were able to determine how the PSA test garnered FDA approval. Some panelists had concluded that the PSA studies delivered suffered from serious design flaws. Additionally, PSA testing was associated with an incredible 78% false positive rate.
> Concerns about the blatant financial conflicts of interest in the business of prostate cancer.
More prostate cancer nuggets.
> Piana also interviewed Jonathan Oppenheimer MD about the current state of prostate pathology. The quote from Oppenheimer, “for instance by calling the 3+3 = 6 Gleason score cancer pathologists are doing a disservice to patients by scaring them into having conditions treated that will not harm them.”
> In 2009, results from PSA studies run by urologists came to the conclusion PSA-based screening results in a small or no reduction in prostate-specific mortality.
> In 2011, the USPSTF (United States Preventive Services Task Force) used the PSA studies conducted by urologists that revealed little or no benefit to institute a D-grade recommendation against PSA screening.
> Another stunning revelation from a well-regarded study, “Radical Prostatectomy versus Observation for Localized Prostate Cancer”, concluded that radical prostatectomy did not significantly reduce all-cause or prostate cancer mortality, as compared with observation through at least 12 years of follow up.
> In 1993 economists calculated that routine PSA screening of men 50 years and older along with the tests and procedures costs the U.S. healthcare system some $28 billion per year.
Both books are supported by hundreds of scientific references underscoring the concern that the prostate cancer narrative is based mostly on pseudo-science.
Summary.
These two books should be required reading for anyone stepping into the prostate cancer arena - especially urologists. Clearly, the general acceptance of PSA testing and robotic prostatectomy as standard practice by the prostate cancer industry is in serious need of review. This is especially true as urologists’ own clinical studies have concluded that both PSA testing and prostate cancer surgery fail to save significant numbers of lives. Every step in the patient’s prostate cancer journey should be able to withstand the challenge - where is the irrefutable and reproducible scientific data supporting that recommendation?
A simple question desperately waiting for solutions since Ablin and Piana have concluded that “Big medicine hijacked the PSA test and caused a public health disaster.”
Vorstman previously wrote in TheActiveSurveillor.com:
[Note: Ablin made a big splash in 2010 with this op-ed in the New York Times: “The Great Prostate Mistake.” One of the controversies it triggered is over Ablin’s claim that he discovered the PSA molecule at Roswell Park Comprehensive Cancer Center. The management at Roswell Park disputes this, saying Ablin discovered a PSA molecule, not the one used to develop the blood test. They attribute the discovery to T. Ming Chu, PhD, DSc, another Roswell scientist.
[That’s all TAS.com will say on this flap.]
The Prostate Cancer Book Club’s first review:
“Man to Man”
By Victor W.
Michael Korda is a well-known writer and was the Editor-in-Chief of Simon & Schuster Publishing company for many years before retiring in the early 2000s. He wrote a number of books about history and biography, including the recounting of his medical experience in the “Man to Man: Surviving Prostate Cancer.” (Random House, 1996.)
This book is much acclaimed. Reviewers said: ”A frank, moving, exceptionally well-written account by a prostate cancer survivor brave enough to write freely about the disease” and Korda “…. writes as no one else has. An important book, one that should be in the waiting rooms of urology practices.”
“Man to Man” is an old book, nearly 30 years ago. Some of the treatment decisions then are now generally considered wrong, such as radical prostatectomy for a Gleason 6 diagnosis. There was no MRI imaging or genomic testing available.
Korda did his research to explore radiation therapy and included in the last chapter his joining the country’s first prostate cancer support group in New York, where he reported the seething anger and regrets of some folks having serious side effects after their treatment.
Korda’s storytelling of the diagnosis, treatment modality decisions, logistical and emotional impacts upon the patient and his family, and the aftermath is mostly the same as now.
I want to hear and learn more from our support group about the suffering, pains, regrets, and scars of those who decided to have treatment either through surgery, radiation, or other means.
Would it be wise to delay treatments as long as possible (and then longer) to wait for better therapeutic advancements such as those of dostarlimab, an experimental drug studied at New York’s Memorial Sloan Kettering Cancer Center. A small (18) number of rectal cancer patients seemingly experienced a complete “medical miracle.” Their cancers simply vanished after six months of treatment.
Would it be too risky to allow the cancer to metastasize to a much more dangerous and incurable stage? These are complicated and difficult questions.
I am hopeful that each of us will continue to learn about prostate cancer, to be our own advocates, and be aware that doctors do not know it all. Also, be optimistic and never give up, just like the heroic exhortations by Korda throughout his book.
Don’t miss the ASPI webinar, “Eat to Beat Prostate Disease,” on July 30 at 12-1:30 PM Eastern, featuring William Li, MD.
Free Registration: www.aspatients.org or go direct to: https://bit.ly/3t5lFLx
Free prostate-healthy recipes for all registrants.
Join Dr. Channing Paller, associate professor of Oncology and Urology at Johns Hopkins University, Sidney Kimmel Comprehensive Cancer Center, and Rob Finch, Director of Urology Medical Affairs at Myriad Genetics as they discuss the impact of genetic factors in prostate cancer and the PROMISE study.
“Genetics, the PROMISE Study, and Prostate Cancer: a Town Hall Webinar”
July 20, 6:00 p.m. - 7:00 p.m. Eastern Time
Bert, Thanks for the reviews. And Victor covered Korda's book. I have another review coming soon. Stay tuned. Howard
Anthony Horan also mentions Michael Korda in his book, The Rise and Fall of the Prostate Cancer Scam, chapter 13 headlined - Humanists report on their experience with prostate cancer. Here Dr Horan mentions the prostate cancer support group and "the persistent undercurrent of bitterness....." Also, if Mr. Korda was treated for the Gleason 6 disease then he is a survivor of the debilitating, scientifically unproven radical prostatectomy "treatment" and not the bogus cancer.