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By Robert Bruce Email: robertbruce1@bigpond.com
Revolutionary Findings on the
“48 out of 49 medical procedures are unnecessary” Two major studies recently published in The New England Journal of Medicine have shown that the accepted medical approaches to the treatment of prostate cancer are likely to be causing harm and saving very few lives. The question is whether this convincing and growing body of evidence will lead to radical rethinking about one of the major issues in men’s health.
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In Australia over 11,000 men are diagnosed with prostate cancer each year. Most of those diagnosed undergo invasive treatments involving surgery, radiation or hormone therapy. The side effects of the treatment are significant with very high rates of sexual impotency (up to 100% with surgery and hormone therapy), urinary incontinence and bowel disorders. The trauma of the treatment, the psychological and emotional challenges and significant quality of life issues often seem to be ignored in deciding whether treatment is really necessary. The question that is often not addressed is how life-threatening is prostate cancer, and will the treatment significantly improve life-expectancy. The two studies just published address these questions. The results profoundly challenge the whole medical model around prostate cancer. They both show the rate of death from prostate cancer is low. The significant trauma being experienced by men being treated for prostate cancer results in
almost no benefit, and in many cases, the treatment actually reduces life-expectancy. Before exploring the results of the studies, I would like to relate my own experience with prostate cancer to give some insight into the gut-wrenching anguish being faced by men with this diagnosis.
My Journey with Prostate Cancer I was diagnosed with prostate cancer two and a half years ago, shortly after I turned sixty. The diagnosis was a result of a routine medical check-up and a PSA blood test, a common indicator of prostate cancer.
A biopsy a few months later, confirmed that I had cancer. Like many men, I had experienced no symptoms from the cancer. www.wayoftheheart.net
My urologist recommended that I should undergo treatment as quickly as possible offering a choice of surgery or radiation. The surgical removal of the prostate (a radical prostatectomy) is the most common treatment in Australia. The downside of the treatment is the damage done to the erectile nerves during surgery and the high probability of sexual impotency. The other side-effect, in about 5% of cases, is the possibility of urinary incontinency. This seemed a minor threat compared to the almost certain loss of sexual potency, although still a significant impact on the quality of life. Various forms of radiation were also discussed and the outcomes seemed similar to surgery. The possibility of “watchful waiting”, to monitor whether the cancer was progressing, was discounted because, at the age of sixty, I was considered too young and too healthy, and I would run the risk the cancer would eventually spread. My partner and I were both shocked by
I was told that I had “a potentially fatal cancer” and my reluctance to move ahead was risking my chances of survival... I had a sense that my body and my life would never be the same again if I chose any of the treatments being offered. the situation and the options we had been given. We had only been in our relationship for three months and, up until this moment, it had felt like a relationship with a lot of potential. While trying to cope with the magnitude of what we had been told, we also felt we were being pressured to make a decision and get on with the treatment. I was told that I had “a potentially fatal cancer” and my reluctance to move ahead was risking my chances of survival. I felt I was caught between a rock (a life-threatening cancer) and a “not very hard place”, sexual impotency! I sought a second, and a third, and a fourth opinion from other urologists, but still felt uncomfortable with what I was being told. I had a sense that my body and my life would never be the same again if I chose any of the treatments being offered.
I chose instead to pursue an alternative approach to the treatment of cancer, The Gerson Therapy.
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Dr. Max Gerson was an inventive German doctor, who, in the 1940s developed a rigorous therapeutic regime proven to be effective with cancer. The therapy prohibits all salt, sugar, fats and oils, meat and acidic foods all of which are now known to support cancer growth. It requires the consumption of six large vegetable/fruit juices every day to boost the immune system, the use of organic produce and up to four coffee enemas a day to remove the toxins from the body as quickly as possible. I supported my programme by attending a ten day retreat at The Gawler Foundation in Victoria. This reinforced the dietary regime I was following, but added
an important emphasis on meditation and the psychology of wellness. For the next two years I continued my daily routine of diet, juicing and enemas. The only measure of my condition was my monthly PSA blood test. In the first few months my PSA level dropped from 12 down to 9, but then it stubbornly refused to drop further. My hope had been the therapy would heal the cancer and my PSA level would return to normal. As the months went past, it became apparent that this was not happening. And I was not sure whether my steady PSA level of 9 was sufficient evidence that the cancer was not spreading. I felt like I was playing a game of Russian roulette, but not knowing how many chambers in the gun were empty. The medical advice was that my odds weren’t very good. I was beginning to doubt the wisdom of my choice. I first came to hear of the new research into prostate cancer when a friend sent me an article from The New York Times. As I read the article, I could feel the deep anxiety in my body falling away.
It gave me the answers that I, and many other men, had been looking for. It confirmed that my suspicion of the medical options were well-founded. I was filled with relief that I hadn’t compromised the quality of my remaining life and I felt sad for those men who had. I wondered how many more men would have to suffer before a more humane approach to prostate cancer would be adopted.
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The Findings of the Studies The two studies just published, one conducted in Europe and the other in America, were both large scale, long-term studies commenced in the early 1990s. The European study focused on 162,000 men between the ages of 55 and 69 in seven European countries. They were divided into two equal groups; the first group being offered regular screening for prostate cancer and the second group, the control group, was not screened at all. The men in both groups were monitored for the next nine years to track the incidence of prostate cancer and the resultant death rate. The American study was similar and involved 77,000 men from 10 medical centres across the United States. In both studies, the screening for prostate cancer was based on the PSA test and then confirmed with a biopsy. The European study found the incidence of prostate cancer over nine years was 8.2% in the screened group and 4.2 % in the unscreened group. In other words the introduction of widespread screening in any community would almost double the number of men who would be diagnosed with prostate cancer. The study showed that while the incidence of cancer was high, the resulting death rate was low. After nine years only 2-3% of the men diagnosed with cancer had died. The study found that the screening and treatment did reduce the rate of death by 20%. However, because the death rate is low, the number of lives saved was small – seven fewer prostate cancer deaths for every 10,000 men screened. To prevent one death from prostate cancer over nine years it was necessary to diagnose and treat an
feature additional forty eight men. Dr. Peter Bach from a leading US cancer centre explained the results in the following way:
“If a man is diagnosed with prostate cancer today and is treated for it, there is a one in 50 chance that in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life”. The American study produced some even more surprising results. The primary finding of the study was: “After 7 to 10 years of follow-up, the rate of death from prostate cancer was very low and did not differ significantly between the screened group and the unscreened group.” In fact, after seven years the death rate for the unscreened group was 13% lower, and this trend appeared to be continuing at ten years. In other words, best medical practice involving early detection and prompt treatment is actually resulting in higher death rates. While the European study is showing that screening and treatment result in some margin improvements in survival rates, in the American study, earlier medical intervention is reducing life-expectancy.
It appears better for men to take their chances with prostate cancer than to undergo screening and treatment! One additional finding in the American study makes this conclusion even more compelling. At ten years, the deaths from prostate cancer were: No. of deaths: 38,300 men in each group
Screened group: 92 Unscreened group: 82 In addition to the higher deaths from prostate cancer, the men diagnosed with cancer in the screened group also had 87 more deaths from causes other than prostate cancer, than their counterparts in the unscreened group. When this indirect number of additional deaths is included in the overall mortality rates, it becomes a convincing case against screening and treatment. The researchers in the American study offered many reasons to explain their unexpected outcomes. All of the explanations were technical, and none were particularly plausible. For me, the reasons seemed obvious. Having personally experienced the trauma of diagnosis, and looked into the abyss of treatment, it seems likely that the psychological impact of treatment and resulting impotency, is destroying their will to live. The much higher death rate from causes other than prostate cancer seems to point clearly to this explanation. So far much of the discussion of this www.wayoftheheart.net
new research has been focused around the edges, picking holes in the methodology and trying to defend existing approaches. History shows that science and medicine advance more quickly when research produces the unexpected. The first reaction is to explain it away and argue “the earth is still flat”. In doing so we risk losing the insights and advances that might have otherwise been available. This latest research is too comprehensive and unequivocal in its finding to be dismissed. The cat is out of the bag; prostate cancer is not nearly as lifethreatening as we have been lead to believe, and the current approaches to screening and treatment have little or no benefit and huge cost. I accept that I may still die from prostate cancer. I am comforted to know the odds of this happening are not as high as I thought. I am also relieved that my decision not to undergo medical treatment has not materially affected my chances of survival. I know there are many things I can do – diet, juicing, exercise, meditation – which will improve my chances of survival much more than the 1 in 50 improvement offered by medical intervention. Oh, and yes, my partner and I are getting married in November! b
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