Took me awhile to "skate in." Whether readership of this blog agrees or disagrees with your comments Dr. Vorstman, believe we are listening. I encourage you to continue to share.
Thanks for the following info: Compare AS uptake rates elsewhere: only ~ 10% of Gleason 6 patients in the state of Michigan opt for treatment and fewer than 5% do so in Sweden and the United Kingdom. Only 20% of those with favorable intermediate risk (Gleason 3+4=7 or GG 2) opt for surveillance in the United States. In Michigan, 45% of these patients choose AS, a rate that may lead the world.
I think that PSA is more misunderstood than misused. So many jump into a biopsy based on a PSA when the data they really needed was age, volume and genetics (SelectMDx). They just need to drop the DRE and start picking up the U/S probe. Following that, MP-MRI.
No need for a needle or scalpel until all the data is in.
So let's get back to fundamentals. More important than all the complications associated with prostate cancer care is the question - does the test or treatment save significant numbers of lives?
Let's start with PSA screening:
Two publications conclude that PSA screening fails to save significant numbers of lives - the links are embedded and you should check them out - as well as the two books below.
Unsurprisingly, because the PSA test is so highly unreliable when used for prostate cancer screening, urologists' own clinical studies in 2009 determined that PSA testing failed to save significant numbers of lives. Years later, another review of PSA-based screening for prostate cancer also concluded that PSA testing failed to extend life significantly.Â
Let’s move on to prostate cancer surgery:
At least three publications conclude that prostate cancer surgery fails to save significant numbers of lives again. The links are included so you can validate for yourself. Unsurprisingly, urologists’ own studies have determined that radical prostatectomy is not a lifesaver. Furthermore, whether the whole gland was treated with surgery or radiation or, untreated and monitored by AS, the 10-year and 15-year survivals were similar for each group. Let's repeat, NO treatment had similar survival rates to surgery or radiation at 15 years.
The recycling of prostate cancer misinformation and the the propaganda about standard of care, prostate cancer awareness and active surveillance simply exploits false hope and false promises and only exposes countless men to unbridled harm. As well, it makes a mockery of informed consent and shared decision-making. Instead, the business of prostate cancer is an excuse for intellectual dishonesty and licensed malpractice. It’s time for physicians to be honest, abandon medical care that’s of NO benefit (only 11 percent of medical treatments are of KNOWN benefit) and work on finding radically new tests and treatments for prostate cancer. The nonsense of early detection leads to cure is a barefaced lie - an outrageous lie that’s been perpetuated since the original paper about radical prostatectomy in 1904. Our profession is supposed to keep patients from harm and injustice.
Read more
The Rise and Fall of the Prostate Cancer Scam - A Horan
Took me awhile to "skate in." Whether readership of this blog agrees or disagrees with your comments Dr. Vorstman, believe we are listening. I encourage you to continue to share.
Thanks for the following info: Compare AS uptake rates elsewhere: only ~ 10% of Gleason 6 patients in the state of Michigan opt for treatment and fewer than 5% do so in Sweden and the United Kingdom. Only 20% of those with favorable intermediate risk (Gleason 3+4=7 or GG 2) opt for surveillance in the United States. In Michigan, 45% of these patients choose AS, a rate that may lead the world.
I think that PSA is more misunderstood than misused. So many jump into a biopsy based on a PSA when the data they really needed was age, volume and genetics (SelectMDx). They just need to drop the DRE and start picking up the U/S probe. Following that, MP-MRI.
No need for a needle or scalpel until all the data is in.
So let's get back to fundamentals. More important than all the complications associated with prostate cancer care is the question - does the test or treatment save significant numbers of lives?
Let's start with PSA screening:
Two publications conclude that PSA screening fails to save significant numbers of lives - the links are embedded and you should check them out - as well as the two books below.
Unsurprisingly, because the PSA test is so highly unreliable when used for prostate cancer screening, urologists' own clinical studies in 2009 determined that PSA testing failed to save significant numbers of lives. Years later, another review of PSA-based screening for prostate cancer also concluded that PSA testing failed to extend life significantly.Â
Let’s move on to prostate cancer surgery:
At least three publications conclude that prostate cancer surgery fails to save significant numbers of lives again. The links are included so you can validate for yourself. Unsurprisingly, urologists’ own studies have determined that radical prostatectomy is not a lifesaver. Furthermore, whether the whole gland was treated with surgery or radiation or, untreated and monitored by AS, the 10-year and 15-year survivals were similar for each group. Let's repeat, NO treatment had similar survival rates to surgery or radiation at 15 years.
The recycling of prostate cancer misinformation and the the propaganda about standard of care, prostate cancer awareness and active surveillance simply exploits false hope and false promises and only exposes countless men to unbridled harm. As well, it makes a mockery of informed consent and shared decision-making. Instead, the business of prostate cancer is an excuse for intellectual dishonesty and licensed malpractice. It’s time for physicians to be honest, abandon medical care that’s of NO benefit (only 11 percent of medical treatments are of KNOWN benefit) and work on finding radically new tests and treatments for prostate cancer. The nonsense of early detection leads to cure is a barefaced lie - an outrageous lie that’s been perpetuated since the original paper about radical prostatectomy in 1904. Our profession is supposed to keep patients from harm and injustice.
Read more
The Rise and Fall of the Prostate Cancer Scam - A Horan
The Great Prostate Hoax -Ablin & Piana