Re: Mortality rate for PCa

August 9, 2004

Hi Terry,

Interesting take ! I agree with your statement: " there are men who do not

need to have immediate invasive treatment following a diagnosis of PCa " . I

hope all newly diagnosed men understand that.

I stand by my statement that PC is one of the biggest killers of men. Page

B-633 of the WHO Mortality Stats for 1995 in the UK states that for men over

the age of 75 years, prostate cancer accounts for 451 deaths per 100k of

population. On the same page Acute Myocardial Infarction accounts for 1032

deaths per 100k, and Other Ischemaeic Heart Diseases account for 864 deaths

per 100k. Neglecting the fact that many men with PC on HB will die of

iatrogenic related causes(such as a heart attack), PC is still a BIG KILLER.

OK there are bigger killers, but in the round PC is BIG compared to say

Meningitis which takes 1.5 men per 100k, or Diabetes Mellitus which takes 87

men per 100k of population.

Nevertheless, as you so aptly demonstrate with your opining, PC is still

regarded by many as an indolent (pussycat) disease for the many ;-)

Terry, if you are not convinced that PC is a serious threat, as serious to

men as breast cancer is to women, I'd say take a look at this URL comparing

PC to BC: http://www.prostateman.org/diet/fatstats.html

You will learn that prostate cancer claims almost as many men as breast

cancer does women throughout the world. Are you going to say that breast

cancer is a trivial disease as well as PC ? I don't think so !

The alarming thing is that breast cancer receives x10 as much research money

as PC, and enjoys national screening programmes in many countries. I believe

this unfair bias is a real issue we should address, and I have been in touch

with the UK National Screening Committee about this recently. The Director

Muir Gray replied to the comments in my paper regarding PC statistics and

screening for PC. [ I sent him a copy and he actually read it, to his

credit.] Muir Gray did not challenge my statements such as the one you

chose to single out:

<SNIP> Prostate cancer is one of the biggest killers of men in the western

world, yet it is oddly thought of as a pussycat disease.<SNIP>

... because it is TRUE ! That is the whole point. There is a problem of

perception here, because PC is a paradoxical disease !

I won't labour the point. I'll just add that my paper attempts to lay bare

WHY there is this paradox about PC, and WHAT men can do about it for

themselves. I certainly do not recommend jumping on an operating table as a

first option. I hope that at least eases your mind. You might wish to review

the paper yourself at some stage.

Cheers,

Sammy.

Mortality rate for PCa

I have been away from home for the past three weeks, so have missed out on

much of the discussion of late. I did however get one of Sammy Bates’ mails

(Header: Unusual Language) stating that he was <snip> ‘relaunching’ EPCEL

<snip> and giving the URL as http://www.prostateman.org/#0

<http://www.prostateman.org/#0>

I went along to see what it was all about and was somewhat surprised to see

this statement:

<SNIP> Prostate cancer is one of the biggest killers of men in the western

world, yet it is oddly thought of as a pussycat disease.<SNIP>

Given that we are trying to help men through the process of diagnosis and

treatment choice, should we not be giving them information that is as

factual as possible? All the data I have seen published puts prostate cancer

as one of the lesser killers of men – most data shows less than 3% of male

deaths from this cause, compared with, say, heart conditions which normally

account for over 30% of male deaths, or lung cancer, typically at about 25%

of male deaths. Those are the biggest killers of men in the western world.

There is also the autopsy data demonstrating the prevalence of prostate

cancer cells in the bodies of men of all ages, but increasing significantly

with age until, some hold, by the time men reach the age of 80, the

substantial majority, if not all of them, will have these cells in their

prostate. Yet the disease only kills relatively few of these men – that is

why it is referred to as in indolent disease in many cases, or to use

Sammy’s terminology, a pussycat disease.

In saying this, of course I recognise that prostate cancer can be a killer

disease and it should never be ignored. Any diagnosis needs to be carefully

assessed and the most appropriate action taken, but as the small ongoing

studies in a number of places are showing, there are men who do not need to

have immediate invasive treatment following a diagnosis of PCa.

I think it is important for all newly diagnosed men to understand that.

All the best

Terry Herbert

in sunny Kalk Bay, South Africa

Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. June

04: PSA 8.35:fPSA 42% TURP

My site is at www.prostatecancerwatchfulwaiting.co.za

It is a tragedy of the world that no one knows what he doesn’t know, and the

less a man knows, the more sure he is that he knows everything. Joyce

Carey

August 10, 2004

Sammy,

I don't think Terry has ever suggested that Pca is a 'trivial' disease as you say:

<<Are you going to say that breast cancer is a trivial disease as well as PC ? I don't think so !>>

Anyone who has read his book 'A strange Place' will see that he doesn't consider it as such. What I think we are all agreed on is that Pca is an overtreated disease as far as radical treatment is concerned.

I think Pca is very closely linked to breast cancer in a lot of respects. Many women diagnosed with breast cancer have in fact DCIS - Ductal Carcinoma In Situ - an early form of breast cancer confined within the milk ducts. Doctors don't know when, or if, DCIS may develop and spread, and for that reason 'offer' women a mastectomy. I say 'offer' but in reality these women are given little choice. I believe the same is true of Pca. More research needs to be done into the behaviour of cancer cells to distinguish between the 'Tiger' and the 'Pussy cat'. Of all women screened annually and found to have breast cancer, some 20 per cent have DCIS. But the fact is we never hear about DCIS.

One woman says " Part of me wonders: 'Did I lose my breast for nothing?' 'You can have a mastectomy in three weeks' said the doctor simply, as a nurse looked on with a benign expression. I'd just been diagnosed with DCIS, yet the doctor wanted to mutilate me - alter me irrevocably as a woman. All my instincts told me it was wrong"

Yet this scene is repeated every day for men newly diagnosed with Pca. Invariably they are fast-tracked into radical treatment which more often than not destroys their manhood for no good reason other than to boost the uro's strike rate. Why else would my uro say in my notes: "He has unfortunately gained a great deal of information from the internet and has read extensively on the subject of prostate cancer" The only thing that was 'unfortunate' is that I didn't read up on the subject of Pca until after I had opted for radical treatment. But that is the reason the uro's fast-track us into treatment before we gain that 'unfortunate' knowledge. Had it not been for people like yourself and Terry , and the internet, I would still be believing that the 'good doctor' 'saved my life' when the reverse is true in that he destroyed my QOL. We cannot expect the newly diagnosed to take this overtreatment on board because they are innocent enough to believe that their doctor has only their interest at heart, the rare doctor does, but the majority, in my view, are subject to head counting dogma that now prevails our medical establishments.

So to the newly diagnosed we are called 'nutters' etc. You are right when you say that Pca has become one of the biggest killers of men. It recently overtook lung cancer to become the most commonly diagnosed cancer in UK men, with more than 27,000 new cases a year. But does that mean there are more cases than before, or that more cases are being detected? I suspect the latter. In which case I suspect more indolent cases of Pca will be fast tracked to aggressive treatment to improve the Government's 'cure rate'. And so it goes. I think the truth lies somewhere between the Squarfian Index and a 'Strange Place' :0)

Regards

Hi Terry,

Interesting take ! I agree with your statement: "there are men who do not

need to have immediate invasive treatment following a diagnosis of PCa ". I