My status and Views on Prostate Cancer 101215

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My status and Views on Prostate Cancer 110110 THIS IS A WORK IN PROGRESS, SUMMARIZING WHAT I HAVE LEARNED SO FAR ABOUT PRIMARY PROSTATE CANCER TREATMENT AT A STAGE SIMILAR SIMILAR TO MINE. COMMENTS, FEEDBACK FEEDBACK AND CHALLENGES CHALLENGES ARE WELCOME. WELCOME. IF YOU WOULD LIKE ACCESS TO PROBABLY THE BEST LIBRARY ON THIS TOPIC IN TORONTO, CONTACT ME. John Leppik 416-446-1111

 [email protected]

© John J Leppik 2007-10 for protection of commercial rights only

My status and Views on Prostate Cancer 110110 ................................................ ............................. ..................................... ............. ..... 1 MY DIAGNOSIS............................................... ........................................................ ................................................................................ ................................ ........ 1 MY PROGRESSION...................................................... .............................................................................................................. ............................................................... .............. ............ .....2 A LITTLE BACKGROUND................................................... ............................................. ....... ............... .............. ...... 2 MORE RECENT NEWS.................................................... ............................................................................................... ........................................... ........ ............... .............. ............. ...... 3 Making an Informed Decision .................................................. ....................................................... ............................................................... ........ 5 Given My Diagnosis, What is My Risk of Shortened Longevity? Longevity? .................................................. ......20 20 What is the Evidence Supporting Orthodox Treatments? .......................................................................21 21 Early Testing and Early Treatment Controversies ...................................................... ..................................................................... ...................... .............. .......22 22 What I have learned about different approaches to treatment:............................................... ..................22 22 So What Am I Doing ....................................................... ............................................................................................................... ..................................................................... .............23 23 Additional Alternative Treatments of Interest...................................................... ................................................................. ................... ............... .............. ......... ..26 Summary of What I Have Learned About Medical Practice...................................... Practice...................................... ........ ............... .............. .............. ....... 28 Phillip Day’s Netting of Cancer....................................................... ................................................................................................. .......................................... ....... .............. .......29 29 My Developing View of Health and Illness.................................................... ....................................................................................... ................................... ...... 30 Please consider skeptically the following numbers as they are a work in progress not yet consistent. ..31 .. 31 So many years of almost no progress? ...................................................... ........................................................................................ .................................. ....... ............. ......34 34 Relative Risk ................................................ ........................................................ ........................................................................... .......................... ............... .......... ..34 So What Is My Bottom Line .................................................... ............................................................................................... ........................................... ........ ............... ............. ...... 38

MY DIAGNOSIS Much of what follows follows relates to my personal personal case of prostate cancer which colours my selection of information and views but much applies generally to primary or initial prostate cancer  treatment and should be useful to anyone with any cancer as it raises many issues concerning the consequences and realistic benefits of treatment. My case particulars are: January 2006 at age 68 advised that I had prostate cancer. Otherwise I was fit and in good health o Had had presumed benign prostate enlargement for some ten years which was o treated with XATRAL. o Used Andrial from 1998 to diagnosis. o Over 10 years PSA had risen from 3 to 6, followed by three readings over four  months averaging 8.5 o Biopsy - Four of ten needles were positive Site 2 Right Mid, two cores Gleason 3+3 10% Site 4 Left base, one core Gleason 3+4 20% Site 5 Left mid 2% Adrenocarcinoma, conventional type both lobes •

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Gleason 3+4 ~5% o Since the readings were barely over Gleason 6, I asked for a recheck two times. The lab refused both times. Prostate sized digitally at 50cc o Proceeded with Active Surveillance and changed XATRAL to AVODART 0.5mg o August 2006. o PSA readings – June 7.0 August 3.1 November 2.9 March 2.1 Second Biopsy: March 2007: Out of ten samples, one was cancerous. The worst was Gleason 3+3=6. Right Lateral 0 2 cores Medial 0 3 cores Left Left Late Lateral ral 3+3 3+3 10% 10% 1 of 3 cores cores cance cancerou rous s Medial 0 2 cores Prostate sized digitally at 30cc Classification Stage 1, cancer in prostate only Grade 2 moderate To date, digital exams have confirmed it remains non-palpable Stage 1c.

MY PROGRESSION Biopsy 1

Biopsy 2

I have been advised that it is normal for the PSA reading to drop to half when taking Avodart. I and Dr. Klotz have no explanation for why it has dropped to a seventh. Perhaps some of the things that I have been doing are having an effect even though allopathic medicine will not accept this.

A LITTLE BACKGROUND You have arrived here because you have been told that you are at risk of dying prematurely in a miserable way. That is the bad news that many men older older than 40 are given in our society today. today. The good news is that the likelihood that you will not die of prostate cancer is high and you yourself can managr your outcome. The New York Times reported that, “Some doctors swear by one treatment, others by another. But no one really knows which is best. Rigorous research has been scant. Above all, no serious study has found that the high-technology treatments do 2

better at keeping men healthy and alive. Most die of something else before prostate cancer becomes a problem.” “No therapy has been shown superior to another,” an analysis by the RAND Corporation found. Dr. Michael Rawlins, the chairman of a British medical research institute, said “We’re not sure how good any of these treatments are.”

MORE RECENT NEWS At a New England Journal of Medicine Perspective Roundtable concerning Screening for Prostate Cancer commenting on the findings of two 2009 study reports that studied over a quarter million men over an average of ten years, “I think that  there is convincing evidence of harm. harm. The two studies together show marginal to no benefit across several years of follow-up at the cost to so many men of  overdiagnosis and overtreatment. So that deceptively simple PSA test inevitably  leads to a cascade of biopsies, which lead to prostate-cancer diagnoses, leading to aggressive treatments for those prostate cancers, leading to men having substantial  side effects from from those treatments, urinary incontinence, sexual dysfunction. And  the problem being that, for many of these men, they suffer those downstream troubles for a cancer that was never, ever destined to cause them harm in their  lifetime.”  Dr. McNaughton-Collins

As you are reading this, the unfortunate reality is that much damage has already been done to your quality of life life for the remainder of your years. At minimum, someone someone has suggested that you consider having a PSA test. Since there is no evidence that that anything desirable can result from this diagnostic test, the decision is usually left up to you. Whatever your decision and whatever the test result, you have been advised that you are in danger of becoming the victim of  a cancer that may kill you in a miserably painful way. Here is what the inventor of the PSA test thinks of its use: "I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster. The medical community must confront reality and stop the inappropriate use of P.S.A. screening. Doing so would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments." Richard J. Ablin is a research professor of immunobiology and pathology at the University of Arizona College of Medicine and the president of the Robert Benjamin Ablin Foundation for Cancer Research. If you don’t take the test, you will wind up reconsidering this inadequately informed decision many times over the years.

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If you take the test and it is negative, you have learned nothing because this test misses many more cancers than it detects. If you get a positive indication, the decisions, uncertainties and fears that you face are much amplified. You are now asked to consider having a biopsy as that was the main reason for  for  having the test. A biopsy consists of shooting shooting a tiny, hollow tube through your prostate to extract whatever gets stuck in that tube. Depending on your particular case, this is repeated six to twelve times in one session. It is an uncomfortable and painful process whether done with local anesthetic or not. The pain ebbs within a half hour, the bleeding if any may last last for weeks. There may be sexual function alterations. Some suspect that it may be cancer-spreading. Nothing will be quite the same again. The chances are about three to one that no cancer will be found in these samples, but that does not mean mean that you do not have cancer. We know from autopsies that the percent likelihood of a North American man having some prostate cancer is roughly the same as his age. If cancer is found, your situation is seriously escalated as you have been diagnosed to definitely have the most feared disease. For most men and their families, this is a shocking disturbance to their views on life, living and future. future. Now you are faced with a decision maze that you will most likely never master and you have become a very attractive prospect to the multibilliondollar cancer industry that offers too many options o ptions for you to understand and there will be a background urgency that you have limited time to kill this thing dead. If you have adequate medical coverage, the slide into into treatment is almost almost irresistible. Some cannot tolerate the thought of having cancer within them, so it simply must be removed. Very few who enter this process will discover that there is no evidence that any of the establishment-approved primary treatments will improve their lives. Treatment vendors minimize the degradation in your quality of life resulting from their work. After all, dead people have no quality of life at all, and surely there must be some benefit to such serious treatments. The main primary treatments of surgery and radiation have been practiced for over a hundred years and executed on millions of men. Of the studies referenced above, one one could show no reduction in prostate cancer deaths due to to early diagnoses and treatment. The other found a statistically questionable benefit. Assuming the benefit was real, it found that to eliminate one death due to prostate cancer over 10 years, 1400 men had to be screened and 48 men had to be treated. This improvement may have amounted amounted to one extra day or month for one person when compared to treatment when necessitated by symptoms. Even though my reaction to my diagnosis has not been traumatic, being diagnosed has cost me a great deal of time time in research. That however has not been altogether altogether a waste as it has been challenging, eye-opening, interesting and rewarding. For too long I have ignored becoming knowledgeable about health. Having become interested at about age 70 promises to yield better quality and longevity, cancer or no cancer. My bottom line is ‘Show me comprehensible evidence that a treatment is likely to help me improve in some desirable combination the quality and duration of my life and I will take it. Think of this item as my appeal for more relevant and useful information for those who find themselves on this road.

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Making an Informed Decision The essential questions are simple and quite straight forward: What treatments are available for my situation? What evidence is there of delivered survival and quality-of-life benefits? What are the expected negative consequences? • • •

You will find that there are many claims, beliefs and fears, and much partial, selected, biased and misleading information, and a few rare disclosures of what will appear to you as reality. Your assessment of reality is what will lead you to your decision. Don’t make it wishfully or  flippantly. It takes time for a neophyte to develop an understanding, and with prostate cancer, there almost always is time. And when there is no time, you can't be helped anyway. Your  cancer treatment choice is a bet-your-life choice. My research has convinced me that the medical profession does and has over many years dispensed treatments that have rendered patients’ remaining lives both more miserable and shorter. How could this be? There are so many reasons: trying to help, patient’s need to have something done, the best they know to do, ignorance, income, established practice, organizationally blessed, different perspective and priorities, etc. Consider your diagnosis to be an early affirmation that eventually you will die of something. Most likely it will be from something other than prostate cancer. A good plan would be to use this situation to improve quality of life between now and then. Even better would be to develop a life plan that will increase the years that you would have lived on the path that you were on. What qualifies me to assess and comment on treatment options and results? I am a Professional Engineer who has spent almost 50 years in the computer business with about 30 of  these in managing, assessing and troubleshooting research and development projects. I have no medical qualifications. The fact that I and you are not medical doctors disqualifies us from practicing medicine and from giving medical advice, but it does not disqualify us from deciding on what treatment if any we want to undergo. We don’t have to be highly specialized professionals to establish whether a ship will float or an airplane will fly. We can assess the results of professionals trying to achieve such feats. We can do the same with prostate cancer  treatment, so whether it is going to be flying, floating or submitting to treatment, we are confronted with the need to make a decision on which our lives depend. Diagnosing failed computer research and development projects was a murky business that could be resolved only by finding a path to success. Finding a path to successful prostate cancer treatment has been murkier. After more than four years of searching, I have found cause to change how I live and what I eat, and some hope that these changes will improve my outcome. I have found no evidence that would move me to take any of the orthodox treatments. I am getting increasingly interested in alternative treatments and am spending most of my time researching them. The good news is that with a prostate cancer diagnosis most of us have time to search and ponder how to handle our cancer. All this of course applies to my particular  condition. Hopefully it is also a useful guide to what to look into if you have a related condition. If you encounter someone claiming that their treatment has an 80% success rate, run, run fast and hard for this is a gross misrepresentation. 80% of men who have primary treatment do not need it because they would not have suffered any symptoms, so they suffer the consequences of treatment with no benefit. 5

There are lots of claims and data for you to consider. For my purposes, I divided them into three piles: Those that establish that a treatment has no or very limited benefits. This is a tiny pile I think because very few see a reason for promoting such knowledge. Those that clearly establish benefits in quality of life and longevity over the negative consequences of the treatment and compared to alternative treatments. I have found no such pile for my stage of prostate cancer. Here we have all the rest. Some claim is made and data are presented which are designed to lead the reader to believe that this is the way for them to go. Here are some examples: o A new treatment that improves on past methods and results. This does not necessarily mean net positive results. o A high survival rate for a specified number of years. But is it higher than other  treatments or no treatment? Specific improvements in some measures such as PSA readings, tumor size, or  o whatever. But is the end result that is most important to you better? Remember the old adage about liars, damned liars and damned lying statistics. Almost everything that we are offered in any sales situation uses many ingenious ways of  highlighting what is advantageous to the seller and obfuscating that which is disadvantageous to the buyer. •





What follows is a working log my thoughts over the past 4+ years that relate to my search to establish my action with respect to primary prostate cancer treatment. I have chosen to give references only where the source has particular relevance to the meaning of the item. My intent now is not to prove anything but to provide clues to the kinds of information a reader may wish to pursue in order to reach their own decision. This also greatly simplified my task.

Finding 001 So far I have encountered many claims for high levels of cures for prostate cancer. It appears that almost any treatment can make one a survivor. How can this be?

Hypothesis

Most prostate cancer occurs in old age and grows slowly, thus most people do not live long enough for the cancer to get them. The cure rates are computed in a peculiarly self-serving way by those providing treatments. Anyone who is treated and eventually dies of something else is counted as a survivor and a cure. Thus most of the untreated are equally valid “cures” if they die of something else. It has been hard to get data on how many die of something else due to their prostate cancer treatment.

Finding 002 There are many claims to improved treatment technologies, with more people surviving more years.

Question

How much of this ‘improvement’ is left after we discount the effects of earlier  diagnosis of lesser cancers? It is obvious that this will show an apparent improvement even when there is no improvement. As there are no data to establish improvements after millions have been treated, the reasonable conclusion is that there have been none.

Finding 003

I have decided to go with the treatment that results in the best balanced outcome in life extension and quality-of-life with my emphasis on the close-in years. I feel fit and healthy today and expect that this will continue for some years. I am reluctant to make these years miserable for the possibility of a few more years, more decrepit years at the end of  6

life. To date, I have found no data that establish life-extension benefits for any of the primary treatments.

Hypothesis

Since 100 years of treatment of millions of patients cannot substantiate a substantial and growing benefit, the only reasonable conclusion is that there is no benefit to treatment, only harm.

Finding 004

The primary treatments, surgery and radiation, have been used for over 100 years and presently there are over 200,000 men diagnosed with this disease annually in North America. Very detailed diagnosis and classification systems have been developed and there are very detailed tables and charts to tell us our statistical life expectancy at diagnosis, dependent on the classification of our cancer. This seems to be a statistician’s dream, yet there are no statistics available for differentiating the benefits of the various treatments, and nontreatment.

Hypothesis

There are no statistical data because there are no life extension benefits for these treatments. This is supported by: Dr. Gleason, the inventor of the Gleason grading and scoring system for prostate  cancer, doing the pathological examinations of 111 men in a Veteran’s Administration controlled study which concluded that radical prostatectomy bestowed no identifiable benefit over watchful waiting after 23 years of follow-up. Dr. Robert Leibowitz, an oncologist, concluded, "If radical prostatectomies worked,  the data would be there. The reason the data are not there is because radical prostatectomies don't work." He later refined his position in 2004 to "No prospective randomized trial has ever found radical prostatectomy to be both necessary and effective." Dr. Pitts, the developer of nerve sparing radical prostatectomy concluded “There is  always a better treatment option. Any apparent ‘cure’ of prostate cancer by surgery will happen without the surgery….” Radical prostatectomy appears to be the most studied primary treatment. The data situation is poorer for the other treatments. I am open to new data. In the meantime, total absence of evidence of benefit in this very active field speaks volumes.

Finding 005

Everyone wants to write about and treat low-grade, prostate-encapsulated

cancers.

Hypothesis

This makes lots of sense as treating cancers that do not need treatment yields a high percentage of cancer “survivors” and “cures” due to how the results are presented.

Finding 006

Most authorities are very skeptical of alternative treatments. Typically, the American Cancer Society suggests that treatment methods be screened for: Has the method been objectively demonstrated in the peer-reviewed scientific  literature to be effective? Has the method shown potential for benefit that clearly exceeds the potential for   harm? Have objective studies been correctly conducted under appropriate unbiased  circumstances and subjected to peer-review scrutiny?

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Comment

Unfortunately I have not encountered any treatment whatsoever that passes these criteria. Certainly radical prostatectomy, external radiation, brachytherapy, combined external and internal radiation and HIFU (High Intensity Focused Ultrasound) do not pass.

Finding 007 Overall longevity improvements for elderly men have been discouragingly slow. For 70-year-old white American males, life expectancy has increased by 3.3 years in the past 150 years. Those with prostate cancer today live no longer than those who had it in 1920. The percentage of men dying of prostate cancer has been constant since 1930.

Hypothesis

Medical wonders are enabling a higher percentage of newborns to live to old age, but there has been very little progress in enabling old people to live longer. Prostate cancer treatments have demonstrated effectiveness in the last 80 years and they were not effective then. Today, men live longer with the knowledge that they have prostate cancer because they are told earlier. That is not progress.

Finding 008

Some people suggest that we all have cancer always and that it is never  cured. One would think that cutting out or burning out all of a small, totally encapsulated cancer would at least slow its progression. I have found no data to support this.

Hypothesis

If cancer is ubiquitous and normally kept in check with a fully functioning immune system, then its eruption is probably due to a failing immune system. In that case, cutting out a tiny beginning is not going to change anything. It is the immune system that needs help and primary cancer treatments often cripple its capabilities or  overload them. In Europe, where many deaths are autopsied, many spontaneous remissions have been found in people who never suspected cancer.

Finding 009

There are overly many claims to benefits and improvements that are not supported with data that should be easily and readily available. Many claims to ‘cures’ are based on misrepresentations of facts. The claim that a ten-year survival after treatment is a cure is misrepresentation if ten-year survival was highly likely without treatment. It appears impossible to get any data on specific doctor’s treatment success records. There are lots of  data to support the need to treat, but almost nothing on the benefits of specific treatments. There are scientific, peer-reviewed studies and renowned doctors in this field who say that the benefits are marginal, to nonexistent, to harmful.

Comment

The choice of treatment is invariably left to the patient’s ignorance, as there is no way to differentiate the benefits amongst treatments. Thus treatment decisions get made in ignorance, in emotional turmoil and in fear of known negative consequences. Based on data that I have found so far, there is no benefit to the primary treatments. Certainly such treatment seriously degrades the quality-of-life in the close-in years

Finding 010 The Toronto Man to Man support group that I have attended has little interest in data and is hostile towards any questioning of treatment benefits. The regular participants have all been treated and their motto is “Decide and never question”. They do make a positive contribution through information on treatment resources, information on post-treatment symptoms and by providing living and talking examples of life after diagnosis and treatment. They call themselves cancer survivors.

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Comment

Comfort with diagnosis and treatment is no replacement for evidence, information, demonstrable benefits and documented cures.

Finding 011

The gold standard for treatment efficacy is an undetectable PSA reading for  five to ten or more years. There are lots of statistics on this and the implication is very clear  that this represents extension of survival for the patient.

Hypothesis

There is no identifiable extension of survival due to undetectable PSA readings. The survival of patients who would have survived without treatment is not evidence of cure or benefit from treatment. It is however clear that many treatment organizations trumpet this as a clear benefit, perhaps because they cannot show any real benefit.

Finding 012

Most treatment facilities want to treat early-stage and encapsulated cancer. Many emphasize that you have only one chance to kill it dead and that is to have them do it now. The implication being that to not do this is to invite a miserable and early death from this disease which could be cured now by them.

Hypothesis

Analysis of the statistics indicates that roughly 70% of all biopsied men have extra-capsular cancer. Yet of all men with it, diagnosed or not, only 7.5% will die of it. Thus being encapsulated cannot be the key differentiator for successful cure and survival as most men with extra-capsular cancer live to die of something else.

Finding 013

I have found no data to show that the prime treatments result in less life expectancy than no treatment. What little organization-vetted opinion I have found published ascribes marginal benefits like 1 in 15 to 1 in 40 to treatment, without accounting for the loss of  quality of life due to treatment.

Hypothesis

An individual working a career in an organization funded for treating or improving such treatments is unlikely to pay much attention to indicators that show negative consequences and is much more likely to pursue and report data establishing the successful contributions of their own work and organization. Such positive data collections are most likely to be published and promoted. Thus it is reasonable to assume a bias in published data that may more than undo any opined benefits. This dissertation itself is Exhibit A in support of a claim of bias in all dissertations as I have chosen to document the astounding lack of evidence.

Finding 014

One cannot spend much time researching the situation on prostate cancer and not ask, “Has the work done been good science?” The main treatments of surgery and radiation have been practiced for over 100 years. In that time there have been some 10,000,000 patients. How can there not be any data on which treatment accomplishes what benefit? How much has been spent on prostate cancer research? How appropriately has medical research overall been focused?

Assessment

The evidence says that the science and treatment management have been abominable. How can there have been some 10 million patients over 100 years with no data on which treatment accomplishes what? The current burn rate for  prostate cancer research is about a billion dollars per year. Should they not have something definitive to say about the value of specific treatments? How can one take the advice and judgment of any practitioner in this field? If nothing works, as appears to be the case, why is this industry allowed to treat hundreds of thousands of patients 9

with seriously life-degrading processes? Where is oversight? Please tell me that I am mistaken, but do it with evidence.

Finding 015 There are many detailed tables, charts and graphs and predictive algorithms that indicate likely treatment outcomes based on diagnostic data. One of the most sophisticated from a major treatment establishment is the Memorial Sloan-Kettering Cancer  Center Predictive Model at http://www.mskcc.org/mskcc/html/10088.cfm This is no surprise as there must be a mountain of data on the millions who have had this disease. What is a surprise is that there is no data that establish the benefits of treatment over no treatment. This is very curious.

Hypothesis

In an industry that shouts every minor advance, imagined or real, from the roof tops, this vacuum screams for attention. A number of renowned practitioners have said that this is so because there are no benefits. Occasionally someone trots out an old study like the Swedish study and claims benefits. A closer scrutiny of what and how the study was done and reported all too often raises doubts or leads to different conclusions.

Finding 016

Every and any treatment can make claims for many “cures”.

Hypothesis •





How could this possibly be? There are at least three reasons: If most of the people that you treat do not need treatment and the treatment does not kill the patient immediately, then you have a “survivor” The human organism has the means to survive many afflictions, even cancer. Almost all of us have survived many afflictions on our own, but if someone has administered something during the self-healing process, they have grounds for  taking credit. The placebo effect is present in all treatments. It appears to kick-start malfunctioning healing processes. All treatments can have this effect and will thus have some “cures” to their credit.

Finding 017

The Surveillance Therapy Against Radical Treatment (START) trial is trying to determine if newly diagnosed men with early stage, favorable risk prostate cancer are more likely to benefit if they receive immediate treatment with either radical prostatectomy or radiation therapy compared with active surveillance and treatment if their cancer progresses.

Hypothesis

This appears to confirm that the treating profession has no data for improved longevity due to treatment.

Finding 018

There is a great deal of hopeful information about diet and supplements being helpful in preventing, retarding and curing prostate cancer.

Comment

This is counterbalanced by major recent studies that suggest that we know very little to nothing about dietary consequences. It does however appear prudent to con sume moderately in great variety so as to not miss some critical ingredient.

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Finding 019 In wars lasting many years, costing enormous sums, incurring many casualties, it becomes essential for the commanders to show incremental results, or hope of  victory will be lost. What is to be done to solve this problem of no results in the War on Cancer?

Comment The best answer it to achieve results, but after rep eated failures, there is strong incentive to do otherwise. Mass screenings, early detection, wrong diagnosis and early treatment of minor cancers gets more people directly into this life and death struggle and all the numbers g et better because now they include many people who would not have known that they had a problem. This is all good, provided that there is evidence of  benefits for the patients. As patients, we should assess claims with a  jaundiced eye and demand evidence of at least statistical benefits before choosing treatment. Unfortunately, very few of us can understand medical evidence.

Finding 020

Most statistics are beyond ordinary life and my comprehension. Consider a hypothetical medical trial that announces that a new treatment reduces mortality due to a particular cause by 50%. It monitored two groups consisting of 1000 patients each over a 10-year  period. Group A received the treatment and Group B received a placebo. The death rate due to this particular cause in Group A was one half of that in group B.

Comment

As stated, the result looks great. Looking more closely, we find that Group A experience five deaths and Group B ten deaths. Taking a different view, we see that Group A had 995 survivor s and Group B had 990 survivors. So over a ten-year period, those in Group A had five more chances in a thousand of surviving, or one half of a percent. That may be useful, provided this result in not within statistical error due to the nature of the trial, but it is insignificant. Such misrepresentations are almost universal in this field. All treatment is to some extent harmful and all drugs are to some extent poisons. It is not unusual to find that the overall mortality in the treated group is higher than in the untreated. Thus more than the claimed benefit is lost due to negative side-effects.

Finding 021

Without question, prostate cancer is a serious disease. It is the most commonly diagnosed cancer in men in North America and it is second only to lung cancer in killing men. Autopsies show that some males will have it at birth and at 90 we are almost certain to have it. 80% who have prostate cancer will not have symptoms and will not die from it. Of all men 3% will die from it. 7.5% of those diagnosed with prostate cancer will die from it. The good news is that even if you are diagnosed to have it, you have around 13:1 odds of surviving it and dying of  something else. No primary treatment has been show to improve these odds.

Comment

So why all this hoopla about early and ongoing testing and early treatment that has dramatic downsides? Out of every 100 50-year-old men, 40 will have prostate cancer. Out of these 40, about 8 will experience symptoms sometime and of these about 3 will die of prostate cancer  11

sometime. Today, with no primary treatment, these numbers will be a little better and with primary treatment they will be a little poorer. With early testing, as many as 40 will be traumatized with a diagnosis of  cancer and with no-cost-to-patient treatment and poor information, most will take treatment 'to get rid of it' Thus about 30 people who would never have experienced any symptoms will experience the trauma, take primar y treatment and live with the downsides for no reason at all. This will be so even if there were demonstrable benefits to primary treatment. So why the highly promoted early testing and treatment, resulting in a huge dollar co st and in great degradation in the quality of life for so many men?

Finding 022

An active prostate cancer surgeon was asked why he continued this work when he could show no benefits. His answer was that when people are told that they have cancer, they need some source of hope and he provided that hope. Without hope, people would go to some quack and waste their money.

Comment

How is he different?

Finding 023

Two seven-year studies of over 400,000 men concluded that PSA testing is almost certainly causing unnecessary suffering in men who receive treatment for prostate cancers that they would very likely have died with, rather than from. The intensive screening increased cancer detection rates by 22 per cent. But after seven years, that improved detection did not lead to any fewer deaths because the vast majority of prostate cancers take a long time to kill, if they ever do.

Finding 024

This disease occurs more frequently and progresses more rapidly in some identifiable groups of people in the same community.

Question

Would this be due to different lifestyles with different hazards, or  different genetics resulting in different immune systems? Race and genes appear to relate to differences in immune capability.

Finding 025

An internal Health Canada document in 2005 suggested that radiation from diagnostic imaging causes 2,500 cancer deaths annually.

Question

How much cancer is caused by external and internal radiation of  prostate cancer? In these treatments the amount of radiation administered is very much higher.

Finding 026

There is a large and activist movement to encourage all men past the age of 40 to get free, government-funded and regular testing for prostate cancer.

Comment • • •



This serves many purposes: It puts more people into the treatment pipeline It creates more pressure for more funding It makes the numbers, as they are reported, show benefits and progress even when none has been achieved. It gives comfort to those who have chosen treatment. 12

It provides growth for the treatment industry. These benefits are achieved at great cost to the treated, who according to available data get no net benefit and suffer many adverse consequences. •

Finding 027 Over the past 100 years, cancer has changed from an obscure disease to the most feared. Its death toll has risen from 4% to 25 or 40??% of North American population. What are we doing wrong?

Hypothesis: Possibly nothing. Now many more newborns have the good fortune of surviving to old age. In the early 1900’s, many were wiped out in childhood by diseases that we have largely defeated. Something will get all of  us eventually. Now we mostly die of diseases that most did not survive long enough to have.

Finding 028 With prostate cancer being diagnosed earlier due to PSA testing, the excess mortality of those so diagnosed compared with the general population is as low as 1 percent in five years and 5 percent in10 years.

Hypothesis It is difficult to draw clear conclusion from this. Presumably men in this group have lifestyles and immune systems that render them more susceptible to prostate cancer. Certainly the mortality should be higher because prostate cancer kills and everyone in this group has prostate cancer. Also most people in this group get treated with significant hazard to their wellbeing and no demonstrable benefit in reduced mortality. The good news is that the increased mortality is so low.

Finding 029

Caregivers work in a conflict of interest.

Hypothesis Doctors, pharmaceutical companies and hospitals make their  living out of treating medical problems rather than eradicating their causes. A chemo therapist when asked why he administered such drugs when there was no evidence that they helped the patients explained that cancer patients needed hope, his treatment gave them hope and if he did not treat them, they would probably go and waste their money with some quack.

Finding 030

Almost everything in our daily lives may ‘be associated with’, ‘linked to’, ‘related to’, ‘beneficial’, ‘statistically significant’, “may help’, ‘can improve’ etc. with respect to some cancerous condition.

Hypothesis These are all code words for ‘We don’t know but feel obliged to show some appearance of progress even though no causal relationship has been established.’ This produces a great deal of confusion and uncertainty in the patient and moves most toward handing themselves over to the treatment system. When asked why he continued in such a practice, a doctor explained that people need hope for without hope they would go and waste their money with a quack. 13

Finding 031

Most human cancer research is done with mice. Human cancer cells are planted in mice with compromised immune systems. After growth has been established, various ways of stopping such growth are tried. This method has resulted in little that is useful in treating human cancers.

Hypothesis Could that possibly be because they have not seen the elephant in the room? Why is it necessary to compromise the immune system? Would the cancer not survive in an uncompromised mouse? Would the cancer survive in an uncompromised human? What do cutting, radiation, chemo and drugs have in common? They do damage and compromise our immune systems.

Finding 032

The cancer research establishment has published 1.56 million papers in hundreds of journals and there are over 100 international conferences annually.

Thought What do they have that is so important to share? Could they share some of it with me? It seems there is an indigestible mound of information and no useful knowledge for improving the outcomes of the $100 billion per year  treatment industry that has a negligible record of successful treatment.

Finding 033

There are so many in the cancer research and treatment industry who claim to know what works and what doesn’t and they love to taut their knowledge. Thirty thousand experts gathered in Orlando for the 45th annual meeting of the American Society of Clinical Oncology (ASCO) in 2009. This is the largest and most important gathering of international scientists on cancer treatment, with more than 4,000 abstracts on advances in cancer, prevention, treatment and care....

Thought What if anything was shared there that would enable a newlydiagnosed man to make their treatment decision more knowledgeably? Thirty years of such conferences appear to have contributed very little towards cures or life extension. If people were being cured, the treatment decision would be straight forward. Unfortunately the main finding from this conflab of tens of  thousands was that ginger reduced chemotherapy-related nausea and vomiting. The ability of ginger to calm nausea has been known for years.

Finding 034

Cancer is never verifiably cured. That's why treatment results are expressed as a likelihood of surviving for a specified number of years such as five. Those who survive this long are counted as ‘cured’. If they eventually die of cancer, they remain in the ‘cured’ column: cured but dead of cancer.

Thought

There are so many ways to misrepresent with statistics, data, evidence, experimental results and selective disclosure. In an operation that can show little benefit for spending hundreds of billions of dollars, the temptations appear to be irresistible. Do we have a word for statements that are factually true but communicate a falsehood as in an announcement that some treatment decreases your chances of dying of a particular disease in the next five years by 50% without saying that it doubles your chances of dying of  something else? 14

Finding 035

In Canada, we have had too many instances of egregious medical errors such as the tainted blood, erroneous child autopsies and incompetent cancer test processing. When one relates this to what one sees in a hospital visit such as people you would not hire as floor sweepers, gross disinterest, systemic ignoring of patient, blatant disinterest, etc. Why would one voluntarily got to be treated in a hospital?

Thought

This certainly makes one think of “Death by Doctoring” and the long history of medical treatments doing more harm than good. There is now a popular move towards ‘evidence based treatment’ as exemplified by a variety of  sites on the net but they contain woefully little evidence. There is no evidence that any of the primary treatments for cancer do anything but make patients who have been shocked by the diagnosis of cancer except possible in the cases of a few rare cancers that don’t bother most of us. With the unreliability that we have witnessed in cancer testing, how many people are being treated and maimed when they did not have cancer? But they do get counted as cancer survivors. Could such errors be the source of the miniscule improvement in that cancer patient survival rate in the past 30 years?

Finding 036

This document is largely a collection of ongoing learning about options that may be worth pursuing. Some will appear contradictory because they are mutually exclusive. I certainly have not found a final definitive answer to our plague of cancer, but neither has orthodox medicine. That is why over 600,000 people in North America continue to die every year. There is an unending list of several hundred alternative treatments for which there are claims of success that are dismissed out of hand by orthodox medicine.

Thought

We know that some cancer patients experience remission from their  cancer for no identifiable reason. These are known as spontaneous remissions. Thus any treatment, even destructive treatments can claim some victories even if they were of no help at all. I have found at least a handful of alternative treatments that I am trying and am prepared to try, if the need develops, before trying the orthodox treatments. These will be covered in an upcoming section titled “Possible Alternative Treatments”. The lack of progress in orthodox treatments and the promise in alternatives have led to a dogfight of legal turf battles. As an example, in the USA the National Council Against Health Fraud (NCAHF) headed by Dr. William Jarvis has posted the names of  2,500 physicians on its Quack List because they have had to try better ways to serve their patients’ needs. Stepping outside the medical system orthodoxy is a very dangerous business in the USA. No alternative treatment is considered helpful by the medical orthodoxy. The irony is that with prostate cancer no orthodox treatment has been shown to meet the criteria demanded of alternative treatments. Treatments that shrink the tumor but kill the patient cannot be considered beneficial to the patient. If the patient dies during the treatment, as a consequence of the treatment, due to a subsequent opportunistic infection, a heart attack or stroke soon after treatment, they can hardly be counted as cancer survivors, but they are.

15

Finding 037

There is a great to-do about men over 40 getting tested to assure early treatment, but what is the urgency? A cohort of 47,866 US men aged 40-75 with no cancer  history in 1986 was followed for 14 years, during which, 2,965 new cases of prostate cancer  were ascertained, 448 of which were advanced prostate cancer.

Hypothesis

So about 6% were found to have prostate cancer and about 1% had advanced prostate cancer. ‘Advanced prostate cancer’ means that not much could be done for them. ‘Not advanced prostate cancer’ means that there is no treatment needed before troublesome symptoms appear. If there are troublesome symptoms, one would want evidence-based alleviative treatment. Thus there appears to be no case for looking for the cancer or treating it before there is a need. Source: Dietary intake of n-3 and n-6 fatty acids and the risk of prostate cancer.docx

Finding 038

It appears to be widely known, to many people well qualified in medicine, and it has been widely published, that most cancer treatments do little good and much harm to patients.

Hypothesis

How could this be, and at such enormous expense? Is there no one who can challenge the medical establishment? It appears that the establishment has had great success in ignoring all criticism without comment.

Finding 039

Natural nutrients and vitamins are not known to interfere with orthodox cancer  treatments, indeed they help with recovery from these treatments, so whatever your choice, they are useful for your overall health and recovery.

Comment Even though some doctors object to possible interference with their  procedure, the American Association of Poison Control Centers reported that there were no deaths in 2007 caused by vitamin or dietary mineral supplements. This compares with an estimated 100,000 deaths annually from prescription drugs taken as directed.

Finding 040

“…where accurate records are kept of cancer-related deaths, the cause of  mortality can be attributed to the ravages of chemotherapy, radiation, or surgery” attributed to Dr. Ralph Moss in Cancer Therapy: An Independent Guide to Non-Toxic Treatment and Prevention.

Comment This accusation lurks in many places and obviously with the lack of  progress in cancer treatments, the temptation must be great to not attribute a heart attack, stroke, or pneumonia to earlier cancer treatment when there is uncertainty.

Finding 041

A condition in which the immune system is having difficulty fighting a serious infection spread via the bloodstream is known as sepsis. It mostly occurs in people whose immune system has been compromised by cancer, diabetes, chemo, AIDA, aggressive drug treatment, multiple diseases, or old age. In the seriously afflicted, the next step often is death. In the past 20 years, the frequency of sepsis being identified as the cause of death has doubled.

Comment Is sepsis really a cause of death or a stage of dying from what has degraded the capabilities of the immune system? Could this be used as a means to reduce the death count for the real cause of death?

16

Finding 042

There are many ways of adding life to the here and now years, such as exercise, diet, vitamins, travel, exploration, reading, study, socialization, making time for what you put off, loving, just being and enjoying.

Comment Why trade this off for the possibility of some more decrepit days in an uncertain future? This of course is a very personal tradeoff risk.

Finding 043

A cancer diagnosis causes great stress.

Comment The relative risk in the first week after diagnosis of a fatal cardiovascular  event is 11.2 and in the first year it is 1.9 The relative risks of suicide are 8.4 and 2.6 respectively. The risks are higher for men under 55 at diagnosis.

Finding 044

Prostate cancer diagnosis is not without risk.

Comment In 2005 Ontario, of men who underwent transrectal ultrasound biopsy, more than half did not have cancer but 1 in 25 of these were hospitalized for  urological complications within 30 days, mostly due to infections. The overall 30-day mortality rate due to the biopsies was one in a thousand. Increasing Hospital Admission Rates due to Prostate Biopsies.docx

Finding 045

For a long time chemo therapy was thought to be ineffective against prostate cancer so it was not used. It's use is now becoming more common. It is curious that the US Cancer Chemotherapeutic National Service Center has decided that test compounds should be lethal at doses over about 35 grams (500mg/kg).

Comment This by definition eliminates all safe substances such as vitamin C and laetrile and the stringent testing requirements are impossible to fund for non patentable substances. Why?

Finding 046

The most dramatic diagnosis is that of a younger man who wishes to have more children. It is generally believed that since they have a longer life expectancy they should choose surgery because it will clean the cancer out and if this is not achieved remedial radiation is possible.

Comment "Surviving Prostate Cancer Without Surgery" by Bradley Hennenfent M.D. advocates banning radical prostatectomies until there is some evidence that they have some value. Even more astounding, he references a study that showed that younger men do better with watchful waiting that men over 61 (p269). He suggests that young age is no reason for choosing treatment, but it is often used to clinch the sale.

Finding 047 Orthodox medicine condemns complementary and alternative treatments as useless because they have not been validated by controlled scientific studies.

Comment There are no controlled scientific studies that validate surgery, radiation or chemo as beneficial for primary care for cancer patients. There is however much data to establish that many complementary and alternative treatments achieve better results for patients. 17

Finding 048 Treating patients that did not need to be treated is a great way to improve the survival statistics for treatment.

Comment Could anyone possibly be doing this? The data on prostate cancer make the answer an absolute YES! As there has been little progress in cancer treatment in the past 40 years, the answer is YES almost everywhere.

Finding 049 “You won’t read or hear much about these techniques elsewhere either, because they have not been formally "proven" by conservative researchers. However, were you aware that 85 percent of therapies currently recommended by conventional medicine have never been formally proven either?” Dr. Mercola.

Comment It is tough to find any curative data or proofs for any conventional treatment of cancer. There certainly is none for primary conventional treatment of prostate cancer. If the reader knows otherwise, would he please share that data with me. Please include the studies and data that support such claims.

Finding 050 Whatever you do, you are likely to survive your prostate cancer. Comment The going rate is that 80% who have prostate cancer will not experience symptoms or death from it, and 92.5% will not die from it. For the average male in North America, the likelihood of dying of prostate cancer is the same am the likelihood of dying in a traffic accident in their lifetime. Having been diagnosed would probably put you at the same risk as a frequent driver.

Finding 051 What is the likelihood of the medical brotherhood reporting the right cause of  death? If a patient having cancer is treated with surgery, radiation and/or chemo, what is reported as the cause of death? Obviously there is often considerable uncertainty. It is unlikely that the credit will be given to the efforts to cure. On the other hand, if this patient is pronounced terminal but does go and take alternative treatment and survives, the allopathic brotherhood dismiss the value of the alternative treatment and takes credit for the cure. What about preexisting conditions and opportunistic infections and disorders that are facilitated by the ravages of the treatment? It is most interesting how many medical studies of treatments find that the treatment under study extends longevity with respect to the treated disease, but the shortening of longevity due to all causes is featured less prominently.

Comment There are so many ways of counting. Why would anyone choose one that is unfavorable to their own interests?

Finding 051 “To date, there have been no randomised clinical trials which have demonstrated that screening for prostate cancer reduces mortality or increases life expectancy.”

Reference Discussion of the controversies associated with prostate cancer screening 1010.docx

Finding 052

“Moreover the wide adoption of screening for prostate cancer has led to a decrease in the average age that patients are diagnosed with prostate cancer. Screening has also resulted in the diagnosis of low-grade, less-aggressive prostate cancers which would 18

probably never lead to complications or death from the disease. Radiotherapy for prostate cancer has been linked to the late occurrence of second malignancies both in the true pelvis and outside the targeted area due to low-dose radiation scatter. Secondary malignancies following prostate irradiation include predominantly bladder cancer and, to a lesser extent, colon cancer. Those secondary radiation-induced bladder tumors are usually aggressive and sometimes lethal. Care should be given to the long-term follow up of patients under radiation therapy for prostate cancer, while the indications for its use in certain cases should be reconsidered.”

Reference Secondary malignancies following radiotherapy for prostate cancer 10-10.docx Finding 053 In Dr. Klotz’s active surveillance practice, a PSA doubling time of three years is considered an indicator for more aggressive treatment. His experience is that the median doubling time is seven years and 20% of patients in this program have a PSA doubling time greater than 100 years.

Reference When combined with other studies that have found that there is no longevity benefit to treating before palliative help is needed, this looks like a pretty good bet for those who qualify and his experience is that 50% of newly diagnosed do qualify.

Finding 054

Aggressive screening programs have been used to detect cancers earlier with the claim that they can be treated more successfully. This has been particularly the case for  prostate and breast cancers.

Reality This has produced many victims what have suffered greatly without any benefit because cancers that would have never become life threatening were found and treated. Major  studies have established this. Such undertakings have produces much revenue and false claims to improved survival rates at enormous costs in money, suffering and mortality.

So what do all these findings add up to? After spending enormous amounts of skill, time and money for over thirty years in the War on Cancer, there has been no progress. Oh yes, there are many claims, but the claimed advances are insignificant when compared to the problem and most of them are based on fiddled data rather than any real progress in managing and curing cancer. The overall picture is that in North America more people are suffering and dying from cancer after more than two trillion dollars (that’s two million millions) having been spent on this problem. How could such a situation persist? Only by the research and treatment establishments insisting on pursuing a totally erroneous concept of what cancer is. Put more plainly, there is no evidence that the cancer research community knows what it is doing, or it do not want a solution. Serendipity, the faculty of making fortunate discoveries by accident, should have made more progress. Cancer is not an incurable disease. Everyone knows that there are spontaneous remissions. If  cures can happen spontaneously, then they can also be activated by intentional interventions of  the right kind. When was a rotting apple cured by having the rot cut out? When was a rotting apple cured by having the rot burned out by rot-producing radiation? We need not ask “When was a rotting apple cured by soaking it in a poison that is required to be lethal at a specified concentration because chemo is seldom used with prostate cancer. 19

Given My Diagnosis, What is My Risk of Shortened Longevity? Before receiving my diagnosis, if I were an average 69-year-old Caucasian male in North America, my life expectancy was the dark blue curve in the graph below. At that time my quality of life was great so I rated it at 100%. As time passes, this quality will decrease and in a statistical 15.3 years it will be zero. But, having been diagnosed with prostate cancer, my life expectancy would probably be shortened by some unknown amount. To draw this graph, I arbitrarily used a reduction to 11 years as this made the graph quite readable by spacing out the curves. Thus if I had no treatment, my statistical outlook would be 11 years and this is represented by the light blue curve. If I had treatment, my quality of life would be reduced. I arbitrarily pegged this at 70%. Since there is no evidence of life extension due to treatment, my life expectancy would also be 11 years and this is represented by the yellow curve. This is obviously not a good deal when compared to the light blue curve as there is quality-of-life degradation with no extension. Those who take treatment do it with the hope that they will recover life expectancy and thus experience the red curve. One could even hope for the orange curve. It represents reduced negative effects of  treatment and extended life expectancy due to one threat having been eliminated, but that is wishful thinking. More realistically, since only 7.5% of  those with prostate cancer die of it, then 92.5% of men with the cancer diagnosed do not have their life foreshortened at all and very few die in the first 10 years. Estimating reduced longevity, out of 100 men 7.5 lose on average 2.5 years, gives me a life expectancy of ((100x15.3-7.6x2.5)/( 100x15.3))15.3 = 15.1, a two-month reduction, and even less because my cancer shows no signs of being the aggressive kind. The next graph is more realistically plotted. It clearly shows that average longevity would not be much affected by even by 100% effective treatment. All primary treatments decrease quality of  life in the close in and highly likely years when my health is still good. Notice that the light blue curve is almost on top of the dark blue curve. But what if my cancer is one of the aggressive ones? Will I be sorry then! This needs a little more research as data is very scarce. So far the indications that I have found are that if you have the aggressive kind, there is little that can be done beyond palliative care. Some think that such a disease is more due to failure of the immune system than aggressive growth. When a practitioner  is prepared to say in public that we are moving towards forty people needing to be treated by surgery and/or radiation to avoid one death due to prostate cancer, 20

then treatment is of very dubious value. Such avoidance is counted even if the benefit is only one day as it means that one person out of forty wound up dying of something else. Living is dangerous and none of us gets to lead the average life. But this is an assessment of  risk. The degradation in quality of life is almost certain if I get treated and the likelihood of  lowered life expectancy is minimal and in the uncertain future if I do not get treated. Prostate cancer treatment, when there are no seriously troublesome symptoms, appears to have no upside. I have found no primary prostate cancer treatment for which there are data to establish that it recovers longevity and/or quality of life (that would be lost to the cancer if not treated) that could possibly justify the downsides of treatment. Thus I see treatment as a greater risk to my prospects than no treatment. Now at the beginning of 2010, I have had four years without the debilitating consequences of treatment, and the outlook is good for the next 11.3 years. In fact the outlook is improved because I have learned much about maintaining good health and am thus improving my prospects of extending my time that I would have had without my diagnosis.

What is the Evidence Supporting Orthodox Treatments? Having read “A systematic review of randomized trials in localized prostate cancer” by Shabbir  M. H. Alibhai, MD, Laurence H. Klotz, MD, here is my summary as one who has been diagnosed: There are more than ten treatments for prostate cancer for which there are claims of  cures, life extension and improved quality of life. When I first encountered this, my observation was that this means that none of the treatments have any such benefits. If  one had clear and demonstrable benefits, then the others would evaporate or shrink into niche-specific treatments. If they all achieved cures, there would be no need to fear  prostate cancer. Over the past 100+ years of prostate cancer treatment, there have been only four  randomized studies comparing two primary treatments. This study of these studies has concluded that there is only one treatment for which there is sufficient quality data to characterize expected consequences of treatment. This treatment is radical prostatectomy for men with low or moderate grade prostate cancer who are in otherwise good health. It is not a cure and has no demonstrated improvement in life extension or  quality of life over watchful waiting as studied over follow-ups spanning as many as 23 years. However, it has shown decreases in disease-specific mortality and local and systemic disease progression of clinically detected cancers compared to watchful waiting. Better data are years away. Note that a decrease in disease-specific mortality does not confirm increased longevity. If it did, that claim would be made explicitly. It suggest that as a consequence the patient is more likely to die of something else sooner than if he were not treated. At this time there is no data available that would suggest that any treatment will result in a better outcome than watchful waiting, or active surveillance, or expectant management, or whatever you wish to call it followed by alleviative treatment if and when necessary.

21

Early Testing and Early Treatment Controversies There is a widespread movement to encourage men to go for early and frequent PSA testing in the belief that early detection and treatment will save lives. In PSA testing, there are many false-positive results that lead to additional medical procedures that have potential risks, costs and anxiety for the patient and his family. Only 25 to 30 percent of men with an elevated PSA test result who go on to have a biopsy are found to have prostate cancer. The percentage is even lower for older men who tend to have high PSA readings. Most prostate cancers are slow-growing and may exist for decades before they are large enough to be detected by PSA testing. Such cases present false-negative results for 10% of  men tested. Most experience psychological stress and worry about being more likely to get prostate cancer. It has not been shown that this test saves lives, and it is not clear that there are any benefits to outweigh the risks in follow-up diagnostic tests and cancer treatments. Thus many men and their families wind up with upset and worry and many men take treatments that have long-term problematic consequences and no demonstrable offsetting benefits. Why would and could such a situation exist? I think that it persists because we have learned to be frightened about cancer, some cannot tolerate the thought of not doing anything about cancer, others are anxious to lend a helping hand and money, organizations owe their existence to the war on cancer, there is a cancer industry that survives and thrives on cancer treatment and in the face of death without a silver bullet we experience a great drive to do something.

What I have learned about different approaches to treatment: •









Most mainline treatments help only some patients a little bit and there is con siderable doubt about the overall effect being positive as most if not all drugs and treatments assault our systems. The con artists often peddle treatments that supposedly cure multiple illnesses completely and quickly. The placebo effect is miraculous. Our immune systems know how to keep us health when provided with even meager resources. That’s how we are still here. Sometimes they malfunction or fail in some area. Then we get a disease, but our immune systems can be restarted. A restart can be achieved in any number of ways: drugs, operations, manipulations, laying on of hands, praying, acupuncture, herbs, psychic surgery, seeing a doctor, accident and change of any kind. Thus the placebo effect is our most potent intervener and it is the reason why any treatment can demonstrate some successes. When I got started with what to do with my problem, I found ten possible cures the first day. I opined to my urologist that this meant that none of them worked, for if one did, the rest would be discarded. He disagreed, but I have found that I was right. Too bad! When the choice of treatment is left to the patient, you can be sure that the doctors do not know what would definitively help.

22







Having talked to many people about my prostate cancer and treatment options, it appears that almost everyone knows that most people are better off without primary treatment which is the removal or destruction of the prostate. It is only the treatment industry and its support groups that advise otherwise and promote early detection and treatment. A friend recently advised that if I ever lose confidence in my approach, he knows two urologists who will put me back on track. What I do know is that I will not accept damaging treatments for which there is no evidence of desirable outcomes.

So What Am I Doing  I have concluded that there is no orthodox primary treatment that will be beneficial for me. I will see how the cancer progresses and take palliative treatment that is evidence-based to alleviate any intolerable situation that may come along. In the meanwhile, I am on the Active Surveillance Program operated by Dr. Klotz at Sunnybrook Hospital in Toronto. At this time I am on a three-month schedule for PSA testing and a sixmonth schedule for visitations. These should provide me with evidence of whether the cancer is being kept at bay or progressing. If there is evidence of progression that will indicate a need to reconsider my plan. My most likely action will be to intensify my pursuit of alternative treatments that will help my body to do what it knows how to do to achieve healing. On this program, I take Avodart 0.5mg daily as recommended. It is intended to reduce my benign prostate enlargement which had gotten to 50 cubic centimeters (5 is normal) and has achieved a reduction to about 35. For some time I also took Flomax CR 0.4mg daily as added help with urine flow. I successfully replaced the latter with an over-the-counter saw palmetto compound labeled Proactive and most recently with GNC Prostate Formula. My urination symptoms are manageable. I frequently experience great urgency, get up one to three times per night and do not empty my bladder. I am taking other medication as follows. I take Atacand 16mg to lower my blood pressure. It appears to be working, but I intend to look for reasons and options for getting off it because I think taking a medicine for life is a bad plan unless there is real evidence that it is saving my life. I was prescribed Lipitor for managing my cholesterol but am not taking it because I believe the evidence clearly says it will shorten my life. I am now pursuing alternative treatments for my cancer. There are an incredible number of  these. Some lists include over 400 and none qualify by orthodox medical criteria for prostate cancer treatment, but so what, the orthodox treatments do not qualify either by these same standards. I think I have found about ten that are supported by better data than the orthodox primary treatments. DIET I have modified my diet considerably and quite like it. As dietary information is so incredibly unreliable and changing, my guiding principle is my best guess of what cavemen did as that is our best guide for what is natural for us: mostly fruits and vegetables eaten raw, meat, foul and fish probably cooked on an open fire: 23

Less red meat, more fish and poultry, but not too far this way as I am a mixed diet type with type O blood. I should thrive on red meat. Minimal dairy, occasional butter, yogurt, cheese Few grains and mostly whole grains Minimal processed foods and almost no junk food that will not go bad on the shelf  Lots of vegetables, broccoli, cauliflower, cabbage, sauerkraut, onions, mostly raw and sometimes blender chopped. Spiced with ground fresh hot peppers, ginger, garlic and turmeric in caesar salad dressing Cooked tomatoes, ketchup and tomato juice Lots of varied fresh fruits and berries, watermelon, melon, some dried or juiced, including seeds when possible Pomegranate seeds in season and juice when fresh not available Lots of nuts (fresh and processed) including three Brazil nuts daily for selenium Tea, regular and green, with lemon juice and honey Concoction of Hot pepper, Ginger, Garlic, Onion, Turmeric, Horseradish, Mustard, Wasabe, Black pepper plus assorted Spices A little alcohol including red wine Honey and cinnamon Dark chocolate •

• • • •

• •

• • •



• • •

My current vitamin and additive regimen consumed every day or two: A Alpha lipoic acid •

10,000IU Used as an antioxidant for the treatment of diabetes, HIV, cancer, liver ailments, and other conditions. 300 to 1,800 mg daily



Amygdaline 500mg reducing Apricot kernels 15, as I have no way of validating the content of the Amygdaline pills purchased on the internet. B100 Complex B12 0.7ml spray B6 100mg Beta Carotene 20,000IU check further  C 15 to 25g, as ascorbic acid crystals with sodium bicarbonate, in juice consumed in 4 to 6 parts Calcium Magnesium Zinc USP Chlorella 3 pills To remove heavy metals from blood Cod Liver Oil 1 to 2g D>= 5,000IU + sun + tanning lamps E 400 to 800IU Flax Seed Oil 1g Folic Acid 1mg Ginseng few drops Iodinefew drops of Lugul’s solution K 100mcg K2 10,000IU Krill oil 1g • •

• • • • •

• • • • • • • • • • • •

24

Lecithin 1,200mg Lutein 20mg Magnesium 250mg Mercola’s Immune Support Niacin 650mg Olive leaf extract Omega-3 1g One-a-Day Potassium 100mg Probiotics 1 capsule Quercetin Selenium 200mcg Sodium bicarbonate Tums Ubiquinol 100mg

• • • • • • • •

multivitamin for men over 50

• • • • • •

for alkalinity for calcium and alkalinity occasionally

X

• • • • • • •

Looking for  Naltrexone Acetyl L-carnitine Astaxanthin Thiamine (B1)

Other needs; Eyes recommended daily intake for lutein and zeaxanthin, recent studies show a health benefit for lutein supplementation at 10 mg/day and for zeaxanthin supplementation at 2 mg/day •

NOTE: The American Association of Poison Control Centers reported that there were no deaths due to vitamin or dietary mineral supplements in 2007. There were 1,597 fatalities from drugs and other ingested materials. EXERCISE I have increased regular exercise. I do floor, weight and balance exercises, walk,  jog, climb hills and stairs, swim, dance, garden, shovel snow an d get most of my motivation from getting ready for downhill skiing in winter and windsurfing in summer. I am not totally rigorous about all of this because it is hard to get all this done in a day, but it has changed my lifestyle for the better according to current opinion. I feel myself well and in good shape except I would like to be 10 pounds lighter, six foot and 180 pound. As there is no primary treatment for which there is evidence of improved longevity, I do not plan to take any treatment other than the above regimen and that which may be needed to relieve serious symptoms if and when they occur. Thus I do not plan to have any more biopsies. I found both of them troublesome in different ways and there is no point in having them if my plan is not subject to their outcomes. I plan to track my PSA for feedback on progress. This plan has evolved over the past five years and continues to be subject to change due to new information, evidence and experience, so I continue my searches. The high doses of Vitamin C and D as well as the amygdaline and apricot pits are complementary and alternative treatments. 25

I continue to look for information on cancer, diet and alternative medicine from sources outside of allopathic medicine in North America because I no longer trust what allopathic medicine in North America has to say on these matters. There is just too much misrepresentation, omission, self-serving financial interests and outright lying. This is far from doing nothing. The results of monitoring my PSA are graphed near the beginning of this document.

 Additional Alternative Treatments of Interest  We are built out of naturally occurring materials. Most substances used in alternative therapy are natural substances found in our environment. They are not patentable so there is little money to be made from promoting them. Unnatural or man-made products are patentable and thus exclusive to the patentee. If exclusive products are supported by data suggesting desirable results, they can generate large fortunes for the owner. Such promises are great motivators for  research, development, testing and investment. The possibility of immense fortunes also attracts cheaters, so there is great rationale for regulation to protect the public from scoundrels. The medical industry in our world is largely driven by that industry in the USA. We in Canada mostly participate or follow. Thus the remainder of this section will address the situation in the USA. not readily available in the U.S. because these substances are not approved by the Food and Drug Administration. The full answer, however, is a bit more complex. The reason they do not carry approval is that they have not undergone the extensive FDA testing that all new drugs must pass before being approved for common use. That’s the law in the United States. This process takes around seven years of research work to complete, requires tens of thousands of  pages of reports, and costs hundreds of millions of dollars. The only firms that can afford this are large pharmaceutical companies. Not even they will undertake such expense unless they can eventually make a profit through sales, and that means they must obtain a patent on the substance being tested. However, substances found in nature cannot be patented, only manmade chemicals and processes can. Since Laetrile and many other substances used in alternative-cancer treatments are found in nature, they cannot be patented. That means they will never be tested according to FDA protocol. Consequently, they will never be officially approved no matter how effective they may be. That is why you often hear it said that alternative cancer  therapies are "unproven". That is a very misleading statement. They may not have been proven by FDA protocol, but many of them definitely have been proven as both safe and effective by actual clinical experience in the treatment of thousands of cancer patients. Unfortunately, until the laws are changed, the only officially approved substances we will ever have for the treatment of cancer in the United States are man-made, patented chemicals! www.cancure.org/unapproved_by_FDA.htm

The most astounding statement about orthodox cancer treatment that I have encountered so far  was referenced in Finding 22. An active prostate cancer surgeon was asked why he continued this work when he could show no benefits. His answer was that when people are told that they have cancer, they need some source of hope and he provided that hope. Without hope, people would go to some quack somewhere and waste their money. How is he different? 26

In 2000, the BC Cancer Agency researchers joined forces with scientists from across Canada to zero in on why some patients forgo conventional cancer treatments in favor of alternative therapies and why others use them to merely complement the conventional treatment prescribed by their oncologist http://search.phsa.ca/cgi-bin/MsmGo.exe?grab_id=0&page_id=2382&query=alternative&hiword=ALTERNAT%20ALTERNATE %20ALTERNATED%20ALTERNATES%20ALTERNATING%20ALTERNATION%20ALTERNATIONS%20ALTERNATIVELY%20ALTERNATIVES%20alternative

By the end of 2008 their compilation of “objective information for patients and their families, relating to complementary and alternative (CAM) cancer therapies they present information on 140 at www.bccancer.bc.ca/PPI/UnconventionalTherapies/Index.htm Such a compilation of information provides a reference point, but is indigestible and quite useless because they present no evaluation. Its extent and detail leave the impression of completeness that it does not have. Other sites list as many as 400 alternative cancer treatments, often with less detail. Alternative Cancer treatments that I am using or consider of possible value, subject to further  research are: Vitamin C was used by Doctors Cameron of Scotland and Abram Hoffer of  Victoria BC to treat terminally ill cancer patients with astounding results. They used very high doses of Vitamin C combined with other nutrients. Dr. Hoffer’s work is most recent. He treated only terminally ill patients and extended their  survival by more than 20 times that of those who did not take the supplements. Linus Pauling, a double unshared Nobel Prize winner and vitamin C advocate, reviewed and endorsed these treatments Apricot kernels: At www.1cure4allcancer.com/the_ultimate_one_page_cancer_report.html you can watch “The Ultimate Cancer Cover Up Video” which consists of six eight-minute videos that document various primitive populations that have been cancer free. Their common characteristic is that their diets include levels of a substance (alternatively called Vitamin B17, laetrile, amygdalin, sarcarcinase, or nitriloside) that is much higher than in our diets. Vitamin D holds considerable promise when combined with other nutrients and approaches. I am taking 5,000IU daily Dr. Burzynski's antineoplaston therapy supported by Dr. Whitaker  Dr. Kelley treatment based on Dr.Beard and pancreatic enzymes Dr. Gerson therapy presently in a limited FDA trial Dr. Coley’s toxins Dr. Issels treatment Flaxseed oil and cottage cheese Oxygen therapy Lipoic acid This is a list of my current pursuits. Not one is a guarantee, but some have documented impressive results. I’ll take Dr. Hoffer’s 20 times survival option any time. Unfortunately, he is recently deceased, but someone must be carrying on and I now have four of his books to read. 27

All of these are rejected by orthodox medicine because they have not demonstrated benefit through the orthodox testing protocols. Ironically, neither have the orthodox treatments. Nevertheless, several of the alternative treatments have good data to support their benefits. They have not passed the orthodox testing processes because no one is interested in spending the hundreds of millions of dollars to run those tests as there is no money to be made out of unpatentable processed, procedures, or lifestyles. The search is interesting and I have time with my disease, but in the meanwhile I have been changing my ways.

Summary of What I Have Learned About Medical  Practice. Here are some things that I have learned in the past several years since I have been paying attention to health matters. • •



















Western medicine is capable of performing miracles in some cases. Much of Western medicine is worse than quackery as it does no demonstrable good and simply kills the patient in great pain and misery. In Western medicine the treatments are often extremely expensive and do very little for a small number of the many patients treated. Western medicine has a strangle hold on the treatment of disease. No one else is allowed to claim cures. Huge bureaucracies (AMA and FDA) have been established to enforce this. All Western drugs are essentially poisons that are intended to do something specific but affect all of our systems in strange and often unknown ways. We are alive because our systems know how to keep us healthy and have done so for a long time. Sometimes they get handicapped by damage, poison, interference, lack of  needed resources, lifestyle, etc. Our malfunctioning systems can be triggered to reboot in a variety of strange ways, the placebo effect being very common. A consequence of this is that any and all treatment, even smearing with chicken shit, can lay claims to some victories. I accept that there is a lot of wisdom and experience in folk cures and that many of them work, but our economic system and the medical stranglehold on authentication assure that we do not have any validated data on which of them work and how well. I think there is a lot of charlatanism in all forms of treatment. Claims that one thing will cure almost everything very quickly are to me a huge red flag with "Snake Oil" emblazoned across it. When I am offered half a dozen different treatments for the same ailment and I have to make the choice, then I suspect that none of them will do me much good. The medical industry is in the business of managing and treating disease. Achieving and sustaining good health is counterproductive.

Additional items to be considered How are deaths within six months of treatment counted? I have encountered several allusions to deaths after treatment being classified as deaths due to other causes rather than deaths 28

consequent to treatment. There are probably good reasons for the reluctance to do radical prostatectomies for men 70 and older. I suspect a strong tendency to classify them as deaths due to other causes as the patient is presumed cured of prostate cancer. Even when death was clearly due to other causes, has anyone looked into the possibility of the other cause having been triggered by the cancer treatment. Occasionally, I have been puzzled by data on medications that show benefits for the disease being treated but a reduction in quality of life and longevity. There is no evidence that chemo has helped anyone live longer even though it has shrunk tumors. In such cases the treatment is considered to have been successful even when the patient dies of the side effects. There is a suggestion that doctors administrating chemo make most of their income from markup on the drugs. A survey established that most doctors administrating chemo would not take it themselves or  give it to family members. . (Need more data)

Phillip Day’s Netting of Cancer  This topic has engaged my interest and investigation for over twenty years and I have published five books on the subject. I became interested in cancer because my relatives kept dying of it in spite of the doctors' best efforts to fix them. The broad-strokes of cancer and why we fail with it (when we shouldn't) can be summarized as follows: The medical establishment has no cure for cancer  More people today are making a living from cancer than are dying from it They have re-defined the word 'survive' to mean you've 'made it' if you're still alive five years after initial treatment! In fact, more advanced diagnostic techniques have brought time to be able to claim '80% of women are surviving breast cancer' by this rule, when it should be considered whether  these women survive the disease at all whatever the time-frame My extensive investigations reveal the orthodoxy has got the wrong end of the stick about cancer. More and more doctors agree Cancer, according to Professor John Beard, is a healing process that has not terminated upon completion of its task Clinical evidence shows a person's chances of surviving cancer are dramatically improved by making certain dietary, stress and lifestyle changes There are at least eighteen extant cultures who do not get cancer or show almost no incidence of the disease in their society These have been well studied by scientists and physicians, who conclude that diets, lifestyle and lack of industrial development are responsible Nature has a veritable power-house of anti-cancer foods that can be used to prevent or  reverse the disease • • •















29

My Developing View of Health and Illness Dr. Robert Buckman, medical oncologist at the Princess Margaret Hospital in Toronto, tells a story about the doctor/patient relationship in healing. Our bodies, if treated reasonably, know very well how to stay healthy, but from time to time something happens to disturb their  equalibrium and we don't feel so good. Then we go to our doctor, who does or gives us something, knowing full well that we would recover on our own from most ailments. When we feel better, we give the doctor credit for fixing us up and he accepts it. This happens many times through our lives and eventually comes a condition that we do not recover from. The doctor's explanation is that we should have come sooner. This has been the essence of helpful doctoring through the ages. I expect that is why the Hippocratic Oath starts with an admonition to do no harm. Unfortunately much of doctoring has been and still is harmful. Nobel laureate Albert Schweitzer M.D. commented “It’s supposed to be a seacret, but I’ll tell it anyway. We doctors do nothing. We only help and encourage the doctor within.” Once you see it, it is so obvious. We are here because our life systems have been quite capable of keeping us functional. When they malfunction, we die. Along the way, when our  systems are starved for resources to do their job, we get exposed to invasion and limited malfunctions and we become ill. Modern medicine is mainly focused on managing such occurrences rather than preventing or curing such illnesses. However a more effective and much cheaper fix is to provide our systems with the natural resources they need. Recovering from injury, partial malfunctions, invasions, poisonings, lack of resources, exhaustion, etc. constantly challenge all living things. All human cultures have developed various ways of stimulating our systems to return to normal healthy activity. The variety of  techniques is endless and includes heart transplants, massage, diet, drugs, herbs, psychic surgery, the laying on of hands and the ubiquitous placebo effect. Some work sometimes, many do not and we have little understanding of most, but all treatments can claim some successes because of the placebo effect as the thought that we are being helped sometimes reboots our  immune systems. ((rework this section. We get back to normal by solving the resource problem or by a shock that rebooks our systems)) Orthodox medicine in developed countries uses mainly drugs, surgery, radiation and hospital care. It is held in high esteem because some of its work has produced miraculous or apparently miraculous cures. But all of it can be dangerous to good health. Drugs are unnatural substances or poisons developed for income by pharmaceutical companies, surgery assaults the body with physical damage, radiation is known to be highly carcinogenic and hospital care is becoming a leading cause of death. Taken together, these make an enormous economic enterprise that is most thoroughly entrenched by legal protections in the USA. All components need revenue, profit, careers and future prospects, and these needs influence their actions. Perhaps the most glaring example of how these needs can distort how the system ultimately works is in the pharmaceutical industry. The profit motive has proven to be a great incentive in our overall economy for producing useful products efficiently. Unfortunately, in the medical industry it has a consequence that no one but the beneficiary of the profit would choose. In the cause of protecting the public, the development and qualification of drugs has been made a lengthy and costly process that can only be paid for with high confidence in eventual large 30

profits. In such a situation, which of the following paths to business success would the owner of  the business choose? Find an affordable treatment that will cure the ailment at a competitive cost. Find a treatment that will manage the ailment for the patient's lifetime and make sure that there can be no competitor. • •

The huge costs of development and of testing in today’s system make patent protection essential. There are no incentives to putting natural substances through these processes because they can be provided by anyone relatively cheaply because they cannot be patented. The drug businesses fight desperately any claim that a natural and usually cheap product could do the work of their drugs, or be even better. Today, it is a criminal offence in the USA to make any curative claims for a natural product that has not been validated through the process and the Food and Drug Administration is there to enforce this. The overall rational to justify this is that it is for the protection of the public. The overall effect of this is that medicines and treatments are totally foreign to our vital biological processes, are very expensive, and are for  long-term-use rather than curative. We have not seen many cures from this industry. Drugs that achieve interim goals such as shrinking a tumor or lowering cholesterol are approved and used widely, often to the end of life. The fact that they may hasten death of the patient is an inconvenient and unfortunate coincidence. ================================================================== And of course, my necessary disclaimer as I have no medical qualifications. These statements, observations and opinions have not been evaluated by the FDA or any comparable agency. This information is not intended to diagnose, treat, cure, or prevent any disease or to advise. The information provided is for informational purposes only and is not intended as a substitute for advice from your  physician or other health care professional or any information contained on or in any product label or  packaging. You should not use the information in this item for diagnosis or treatment of any health problem or for prescription of any medication or other treatment. You should consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or if you have or suspect you might have a health problem. You should not stop taking any medication without first consulting your physician. As with most prostate cancer advice, you decide at your own risk. ==================================================================

Please consider skeptically the following numbers as they are a work in progress not yet consistent. Sorting out the numbers for males in Canada and USA. •

The percentage of men in whom PC can be found on autopsy is roughly the same as their age. Thus in 100 1-year-old boys, one will have it beginning and in 100 men celebrating their 90th birthday virtually all will have it and there will be many serious cases. 31



3% of all men die of PC. 100% of men die of something.



7.5% of all men with PC, diagnosed or not, will die if PC.



20% of men with PC diagnosed or not, will have symptoms from PC.



















20% of men diagnosed to have PC will die of PC. Individual risk varies from 5 to 90% depending on type, size and progress of the PC. 80% of men diagnosed with PC will have slow-growing cancer that doubles in size in 4 to 5 years. 80% of men who have primary treatment do not need it because they would not have suffered any symptoms, so they suffer the consequences with no benefit. The 20% of diagnosed and treated who are destined to suffer symptoms or death do not recover longevity because of the treatment Being diagnosed at a young age does not increase the likelihood of dying of PC. The outlook becomes poorer with increased size at diagnosis, with more rapid growth and with progression to other parts of the body. There is no technology for predicting any individual's trajectory. Most who are diagnosed will live 10 years or more and 80% will die of something else. Men diagnosed at age 70 and beyond have a high likelihood of dying of something else. All men treated for PC are damaged for the rest of their lives. In a study of 828 men under age 61 on watchful waiting, 97% had metastasis free survival ten years. A beneficial treatment may be found in that time.

This is a work-in-progress because the numbers in this collection do not jibe with each other, but to expect them to do so is beyond the state of the art today. A study completed in 1993 by German bio-statistician Ulrich Abel found that the overall success rate for most cancers treated with standard allopathic treatment (chemo, radiation, & surgery) was only 4 percent. Statistically averaged, 96 percent of cancer patients treated conventionally died of cancer or from complications related to their treatment. The only group of cancers treated conventionally that had a higher batting average was some blood cancers such as leukemia or Hodgkin’s, which approached a 35 percent success rate, still well below half.* Source: Cracking the Cancer Code: The Secret to Transforming Your Health from Inside Out by Matthew J. Loop

“These are the sad bleatings of a service industry that is stuck in operating at great expense and delivering no identifiable benefits. “Before you read this book, I must give you the following FDA mandated warning and disclaimer: I am not a doctor. This book is for educational purposes only. It is not intended as a substitute for the diagnosis, treatment, or advice of a qualified, licensed medical professional. The facts presented in the following pages are offered as information only, not medical advice, and in no way should anyone infer that I am practicing medicine. 32

“A conscious effort has been made to only present information that is both accurate and truthful. However, I assume no responsibility for inaccuracies in my source materials, nor do I assume responsibility for how this material is used. This is not a comprehensive book, thus it does not contain information on all alternative cancer treatments, but rather those treatment protocols which I have deemed the most important and most effective. “My statements regarding alternative treatments for cancer have not been evaluated by the FDA.” Cancer – Step Outside The Box

“Medscape Best Evidence, powered by the McMaster Online Rating of Evidence ("MORE") program, vastly improves the signal-to-noise ratio in keeping up to date. By employing filters for research quality and clinical relevance, these alerts can shrink the approximate 50,000 articles per year  that appear in more than 110 journals and might be relevant to your clinical practice down to a manageable amount that is likely to be truly important to your clinical practice.“ “My doctors have always had lots of great advice about what to do for my different medical problems. But I’m the one who ultimately has to live with the result. And I can only do that if I’m thinking about what’s best for me, what’s going to work for me, what I can actually live with, and what I can actually do.” “For an optimal outcome, decisions that are less clear, sometimes referred to as “preferencesensitive conditions,” must take into account the needs, desires, and lifestyle of the individual patient. Unfortunately, patients often make decisions about medical treatments without complete understanding of their options. Instead, health care providers may encourage patients to make a particular choice or may not present complete and balanced information on all viable options. It’s important for patients to understand that options exist for almost every treatment decision— including the option to do nothing.” From:

Foundation for Informed Medical Decision Making at www.fimdm.org This is an Ottawa operation with lots of interesting promotion, but no content yet.

33

So many years of almost no progress? 

Consumer Reports onHealth July 2009

In 1986 the New England Journal of Medicine … Dr. Bailer and Dr. Elaine Smith…. wrote: "Some 35 years of intense and growing efforts to improve the treatment of cancer have not had much overall effect on the most fundamental measure of clinical outcome - death. The effort to control cancer has failed so far  to obtain its objectives.” It has been said that with respect to deaths from prostate cancer there has been no improvement from the 1920’s after millions of hopeful dreatments with advancing technology.

Relative Risk  Most people and the press have great difficulty in assessing risk relatively because must risks are hyped to sell the concern under consideration. Cancer is probably the most feared disease in our society probably because it is causes great suffering, is often terminal and the treatments are often horrible with nasty consequences. Its impact on loss of life expectancy (LLE) is often relatively small because most cancers occur in old age. There are many ways of expressing 34

and quantifying risk. The LLE is the product of the probability for a risk to cause death and the consequences in terms of lost life expectancy if it does cause death. As an example, statistics indicate that an average 40-year-old person will live another 37.3 years, so if that person takes a risk that has a 1% chance of being immediately fatal, it causes an LLE of 0.373 years (0.01 x 37.3) or 136 days. The following table gives LLE in days for various risks: Living in poverty 3500 Being male (vs. female) 2800 Male smoking 20 cigarettes/day 2300 Heart disease* 2100 Being unmarried 2000 Socioeconomic status low 1500 Working as a coal miner 1100 Cancer* 980 30-lb overweight 900 Grade school dropout 800 Sub-optimal medical care* 550 Stroke* 520 15-lb overweight 450 All accidents* 400 Vietnam army service 400 Alcohol* 230 Motor vehicle accidents 180 Pneumonia, influenza* 130 Drug abuse* 100 Suicide* 95 Homicide* 90 Air pollution* 80 Occupational accidents 74 AIDS* 70 Small cars vs midsize 60 Married to smoker 50 Drowning* 40 Falls* 39 Radon in homes* 35 Fire, burns* 27 Radiation worker, age 18-65 25 Firearms* 11 Birth control pills 5 Peanut butter,1 Tbsp./day 1 Hurricanes, tornadoes* 1 Airline crashes* 1 *Asterisks indicate averages over total U.S. population; others refer to those exposed. PROSTATE-CANCER, QUESTI1ONS Most men routinely get screened for prostate

cancer, in part because most doctors routinely recommend it. But there's actually 35

little hard evidence that the prostate-specific antigen (PSA) blood test, introduced almost 20 years ago, actually saves lives. Researchers had hoped that two large randomized trials, published in March, would resolve the uncertainty. But they didn't. One of the studies, of 182,000 European men ages 50 through 74 who were followed for an average of nine years, found that PSA screening cut prostate cancer deaths by about 20 percent. But the other, a U.S. study of nearly 77,000 men ages 55 to 74 followed for 10 years, found no mortality benefit. Why the difference? The European doctors generally biopsied men whose PSA levels were over 3 nanograms per milliliter, instead of 4ng/ml as in the American study. But adopting that lower threshold isn't necessarily the answer. That's because the lower cutoff point may have led to a high rate of over diagnosis and overtreatment. The European researchers themselves noted that to prevent one prostate- cancer death, 1,068 men would have to be screened, and of those, 48 would have to undergo cancer treatments, with all the attendant costs and risks including impotence and incontinence. Recommendation:  There is little reason for men over age 75 to have the PSA test, since prostate cancer typically progresses so slowly that men over that age who are diagnosed with the malignancy are more likely to die with the cancer than of it. Black men under age 45 and other men under age 50 usually don't need the test either, since the disease doesn't become common until after those ages. Other men should have an honest, thorough discussion with their doctor about prostate cancer, including an assessment of their medical and family history of cancer, as well as their concerns about cancer and the side effects of treatment. Consumer Reports onHealth July 2009 In 2008, there were 10 million adults in the United States who had been diagnosedwith cancer. http://jco.ascopubs.org/cgi/content/abstract/26/4/665

“…….the insanity of modern medicine is alive, well, and growing. With direct-toconsumer advertising, side effect–riddled drugs are dangled in front of you like expensive, flashy, and dangerous fishing lures. Bypass surgery and angioplasty are so ineffective when compared with conservative therapies that they should be banned. Yet because they generate trillions of dollars, their use is increasing. And although the death rate from cancer hasn’t budged in decades, we continue to spend billions on early detection and toxic treatments. Dr. Julian Whitaker’s “Health & Healing” newsletter, August 2009, Vol. 19, No. 8

It appears that cancer is an ever-present and opportunistic disease. As it is a byproduct of a defensive response, it has proven to be very difficult to fight with destructive means which provide it with opportunity. Yet there is much evidence that it can be kept at bay by constructive and life-supporting challenges that remove such opportunity. 36

The unfortunate outcome of androgen ablation therapy of hormone-refractorymetastatic prostate cancer  is, almost without exception, the emergence of an even more aggressive, hormone-unresponsive formof  the malignancy ( 28). The predictability of this development supports the view that androgen-independent  prostate cancer cells are already present in early stages of the disease as "seeds" that "sprout" into frank  neoplastic disease in the aftermath of the selective destruction of androgen-dependent prostatecancer  cells. Therefore, at least in principle, prostate cancer  prevention might entail eradication of incipient  populations of androgen-independent prostate cancer cells. One strategy toward this end is to target EGFR-dependent activation of the mitogenic MAP kinases Erk1/2 in androgen-independent prostate cancer cells. from Resveratrol, A Candidate Nutritional Substance for Prostate Cancer Prevention.doc

Consider taking the 500 mg capsules of resveratrol when fighting cancer. This gives you 2 50 mg of the active resveratrol per capsule.

Life is the most quickly recycled product of  our world, even faster than water. It lives off itself. Drs. Boyle and Brawley of the International Prevention Research Institute, Lyon, France said, "The real  impact and tragedy of prostate cancer screening is the doubling of the lifetime risk of a diagnosis of   prostate cancer with little if any decrease in the risk of dying from this disease."  “The PSA era is over in the United States," says Dr. Thomas Stamey, professor of urology and lead author of a study published in the Journal of Urology. "Our study raises a very serious question of  whether a man should even use the PSA test for prostate cancer screening any more. From the time it first  became standard to remove prostates in response to high PSA levels to the present - reveals that as a screen, the test now indicates nothing more than the size of the prostate gland.”

091016 Checkup PSA 1.47 Prostate smooth, soft, symmetrical, no nodules, typical size for 71 Dr Klotz on Active surveillance program: 500+ in program 30% have opted for treatment 20% dead 1% died of PC 19:1 died of something else It’s 30:1 for elderly Better than those treated?? Laugh. Not really, different. Stop autopsies at 80 Who gets diagnosed? 1 in 10,000 under age 40 will be diagnosed, the rate shoots up to 1 in 38 for ages 40 to 59, and 1 in 14 for ages 60 to 69. The majority of all prostate cancers are diagnosed in men older than 65. …..highest cancer risk seen is in men whose family members developed prostate cancer before age 60. Weil 37

Drs. Boyle and Brawley of the International Prevention Research Institute, Lyon, France said, "The real  impact and tragedy of prostate cancer screening is the doubling of the lifetime risk of a diagnosis of   prostate cancer with little if any decrease in the risk of dying from this disease."  www.examiner.com/x-14041-Charlotte-Health-and-Happiness-Examiner~y2009m6d29-Prostate-cancer-test-value-not-proven-says-report and www.cancer.gov/cancertopics/factsheet/detection/PSA

“The PSA era is over in the United States," says Dr. Thomas Stamey, professor of urology and lead author of a study published in the Journal of Urology. "Our study raises a very serious question of  whether a man should even use the PSA test for prostate cancer screening any more. From the time it first  became standard to remove prostates in response to high PSA levels to the present - reveals that as a screen, the test now indicates nothing more than the size of the prostate gland.” www.medicinenet.com/script/main/art.asp?articlekey=39078

So What Is My Bottom Line Healthy and active people with strong immune systems live longer, cancer or no cancer. Humans have roughly the same body structure and chemistry as other mammals. No other  mammals have cooking facilities. They eat their food raw and mostly alive. Our ancestors did the same, all the way back to the beginning of life, with the exception of the most recent 10,000 years, a blink in evolutionary time. Wild animals seldom suffer from degenerative diseases like cancer, arthritis, cardiovascular, diabetes, obesity, lupus, scurvy, etc as we do unless they too are put on long-term cooked diets. This suggests that we eat as much of our food raw as possible. To further assure that our  systems get all the materials that they need to stay healthy, we should strive for variety in our  foods and consider augmenting with processed vitamins. Vitamin C is a special case as only humans, guinea pigs and some rare bats do not make their own and thus must get it all from their diet. It is very difficult if not impossible to achieve the levels of vitamin C through diet that other mammals live with normally. When we get sick, and particularly with cancer, our systems use much more vitamin C than normally. Dr. E. Cameron in Scotland in the 1980’s treated and documented 500 terminally ill cancer  patients with about 10g of vitamin C daily and achieved better quality of life and four times the longevity experience by similar patients not thus treated. Dr. Abram Hoffer in Victoria, Canada in the 1980’s and 1990’s treated and documented 1,300 terminally ill cancer patients with 2 to 40g of vitamin C daily, augmented by other vitamins. He achieved better quality of life and seventeen times the longevity, averaged over 30 types of  cancer, than experienced by similar patients not thus treated. The American Association of Poison Control Centers reported that there were no deaths in 2007 caused by vitamin or dietary mineral supplements. This compares with an estimated 100,000 deaths annually from prescription drugs taken as directed. There is no evidence that orthodox primary cancer treatment improves quality of life or longevity except with a few rare and mostly childhood cancers. 38

When this dietary and vitamin approach is combined with orthodox treatments, patients suffer  less pain, less nausea and have better outcomes. This approach does not cure cancer, but keeps it at bay.

100105 Most cancer victims die of cachexia a wasting away, opportunistic infections and organ failure.

Referenced Notes:

Immediate Risk for Cardiovascular Events and Suicide Following a Prostate Cancer Diagnosis, the RR of fatal cardiovascular events was 11.2 (95% CI 10.4–12.1) during the first week and 1.9 (95% CI 1.9–2.0) during the first year after diagnosis. From 1987, the RR for cardiovascular events, nonfatal and fatal combined, was 2.8 (95% CI 2.5–3.2) during the first week and 1.3 (95% CI 1.3–1.3) during the first year after diagnosis. While the RR of cardiovascular events declined, the RR of suicide was stable over the entire study period: 8.4 (95% CI 1.9–22.7) during the first week and 2.6 (95% CI 2.1–3.0) during the first year after diagnosis. Men 54 y or younger at cancer diagnosis demonstrated the highest RRs of both cardiovascular events and Citation:

Fall K, Fang F, Mucci LA, Ye W, Andrén O, et al. (2009) Immediate Risk for Cardiovascular

Events and Suicide Following a Prostate Cancer Diagnosis: Prospective Cohort Study. PLoS Med 6(12): e1000197. doi:10.1371/journal.pmed.1000197

FINDING A 2009 publication of a study found that in the first week after a prostate cancer diagnoses the relative risk of a fatal cardiovascular event was 11 and of suicide 8. Comment: It is apparent that a cancer diagnosis is traumatic and poorly informed victims make very dad decisions

Medical industry business model   As I learn more about our medical industry, I am becoming more of a believer in huge conspiracies, which may actually be unintentional consequences of the capitalist economic  system when applied to health care. An industry flourishes as demand flourishes. The medical  industry would atrophy if all diseases were cured easily or if all sick people died quickly. The way to flourishing medical industry health is to have lots of sick people who survive for a long  time with intensive and expensive treatments. That seems to be the way that we are going. Why should an industry not go the way that natural forces move it to go? How could it not go that way when that way is so very lucrative, and the other way leads to self-destruction?  39

Consider the cancer industry as an example. There has been very little progress in patient  wellbeing and survival in the 40 years since the USA declared the War on Cancer. Almost all  efforts are focused on treating the symptoms in increasingly exotic ways. There is hardly any  hope for a cure and very little is being done on prevention. More expensive treatments that are started earlier and with some success lasting longer  assures a huge and growing revenue stream that guarantees the welfare of the industry. A cure would obliterate the industry. Whether we have arrived at this point by accident or conspiracy, it is clear that very few new  cures have been developed over the past 40 years and treatment expenditures have skyrocketed. The industry business model demands this outcome.

So Where Am I After All This Input? I am in greater uncertainty than I started because I have consumed a great breadth of inconsistent, incomplete and contradictory information, most based on opinion and very little based on evidence and data. Am I worse off as a result? No, for I have identified sources, trends, possibilities, options, questions and unknowns to resolve. As stated elsewhere, I still claim the right to decide what I will do about my cancer and think that others faced with the same dilemma may be able to shorten their search and improve its outcome by reading mine. Read the following as the author's opinions based on limited information, research and competence. •



It is clear that there is no source of unbiased advice that covers the issue of what to do in any individual circumstance. Every source is limited, projects its own interests and serves its own wellbeing. Some are inadequately informed or misinformed. Some misrepresent and others outright lie. Many want to treat cancer that probably should not be treated because this increases their success rate. Studies that have failed to establish real benefits are contorted to taut subordinate benefits that are of no final value. Studies are rigged or results are reported selectively to prove that competing treatments are of no value and possibly dangerous. The legal system that is supposed to protect the public from charlatans has been corrupted to protect the industry. The scene is a product of the free enterprise system in which the objective is to maximize profit which is most readily achieved by maximizing the consumption of treatments at the highest possible price. This is not much different in fully government operated systems as there are still drugs, equipment, wages, status, scope of operation. Since the issue is to avoid  premature death, there is no practical limit to demand. The interest of patients are prevention, or  minimal treatment of minimal duration at minimal cost that will do the job. In the provision of  health care, corresponding objectives are the direct opposites.

There has been very limited improvement in patient outcomes due to cancer treatment in the last 40 years. There is generally no demonstrable benefit to the patient from primary surgery, radiation or chemo in recovery of longevity. Most reported progress is in reduction of the damage 40

done by treatment, in reducing the inconvenience of treatment to the patient and in keeping the cancer from interrupting other life processes.



We have all heard many reports that more cancer patients are living longer. Most such reports are outright lies. As it is accepted that there is no cure for cancer, these reports refer to cancer  survivors, usually those who are still alive five years after treatment. In the past, people got into the cancer treatment process after experiencing bothersome symptoms. In recent years, the industry has devised means for detecting cancer before symptoms occur and there are great campaigns promoting earlier checkups by everybody. These checkups are promoted to us as means for us to survive cancer with early treatment. Of course the five-year survival numbers improve, because if your cancer is found and treated three years earlier, you will be a five-year  survivor at the same stage of the disease as when your parent would have been a two-year  survivor. This has been a great means for claiming progress even when there has been none.



I don't know of a circumstance in which I would accept chemo treatment. It is true that chemo can slow tumour growth or even shrink tumours. There is plenty of evidence that it does great harm to the wellbeing of the patient and no evidence that it recovers longevity. Most practitioners would not take such treatment or administer it to family members.



Cancer is our most feared disease, it appears not so much because it will eventually very likely result in death, but because the treatments are so horrendous. Many patients chose to stop treatment.





When assessing cancer survival statistics, be sure to also get the overall survival statistics. An apparently unchallengeable benefit can be ascribed to treatment when treated people are less likely to die from their cancer than untreated people. A closer inspection may reveal that the untreated  people live longer because of fewer deaths due to other causes. As has been observed many times "There are liars, damned liars and statisticians". It's all a matter of how you classify, what you count and what you choose to report. A prognosis of cancer changes many things in everybody's life. Plans are upset and remade. Prospects and opportunities look foreshortened. There can be panic, recklessness, depression, hopelessness. Suicide and cardiovascular deaths increase dramatically. Relationships, lifestyle, diet and exercise programs are revamped. The situation imposes great urgency to make decisions that you are unprepared and incompetent to make. There is great relief to be had in the knowledge that there is much more time to adjust to the prognosis than most people and advisers think. If the urgency is such that the treatment decision has to be made in a month, or two, or three, your  situation is most likely such that the treatment will probably destroy any enjoyment of the little time that you have left. Some people cannot stand the thought of cancer growing within them. For them, treatment can be a release which will enable them to resume the life that they had. For  the rest, there is time. For me, in the week between the phone call and getting to see the doctor for  details, I dug up ten treatments for which there were curative claims. That told me that none of  41

them worked because if one had serious curative consequences the others would not survive. From there it was an easy decision to start searching for a treatment for which there was evidence that it would achieve some combination of quality of life and length of life that I found desirable over the consequences of doing nothing. I have found several which I am now practicing and  prospects for others that I am looking into. They do not include surgery, radiation, or chemo. It has been a learning and take charge experience that has taken a lot of time. After four years, I am now much better prepared to live a better and longer life than I would have been without a cancer  diagnosis. •



Lower Risk

A recent study of 190 men found that the ones who performed moderate exercise regularly were two-thirds less likely to have a biopsy positive for prostate cancer  compared with their sedentary counterparts. Moderate exercise was described as walking 3 to 6 hours each week. The study, published in the November 2009 issue of  "Journal of Urology," also found that men who had the equivalent of 1 to 3 hours of  walking each week had an 86 percent lower chance of having an aggressive form of  prostate cancer, according to researchers at the Duke University Prostate Center and the VA Medical Center in Durham, North Carolina. http://www.livestrong.com/article/46384-prostate-cancer-exercise/ •

Drs. Boyle and Brawley, of the International Prevention Research Institute, Lyon, France said, “The real impact and tragedy of prostate cancer screening is the doubling of the lifetime risk of a diagnosis of  prostate cancer with little if any decrease in the risk of dying from this disease.” [1] [1] www.examiner.com/x-14041-Charlotte-Health-and-Happiness-Examiner~y2009 m6d29-Prostate-cancer-test-value-not-proven-says-report and www.cancer.gov/cancertopics/factsheet/detection/PSA The PSA era is over in the United States,” says Dr. Thomas Stamey, professor of urology and lead author  of a study published in the Journal of Urology. “Our study raises a very serious question of whether a man should even use the PSA test for prostate cancer screening any more.[2] From the time it first became standard to remove prostates in response to high PSA levels to the present – reveals that as a screen, the test now indicates nothing more than the size of the prostate gland.”[3] [2] www.medicinenet.com/script/main/art.asp?articlekey=39078 [3] through the years, Stamey has come to believe that the PSA test is actually not a useful predictor of  the amount or severity of prostate cancer. He said elevated levels of that protein, prostate specific antigen, a protein normally produced by the prostate gland. actually reflect a condition called benign prostatic hyperplasia, a harmless increase in prostate size.

According to the American Cancer Society “The five-year relative survival rate for men with advanced  prostate cancer is 30.6%, compared with 100% for patients diagnosed with localized or regional prostate cancer.” That sounds reassuring and indicative of progress does it not? But it says nothing about relative

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