The Cure Is Castration

[Guest guest]

On page 50 of today's Daily Mail under the heading 'The Cure Is Castration' a urologists tells his story of his treatment choice. This is just another example of the double standards of these money grabbing uros. He says" <SNIP>The cancer, the size of a grape, seemed not to have gone beyond the prostate. But it was not in a good position to operate. '<SNIP> You could bet your bottom dollar that if he had a patient whose cancer was confined to the prostate he would have been recommending surgery.

By what he says about Casodex it underpins Dr Bob Leibowitz's theory that very often a dose of Casodex can 'kill' the cancer off for a very long spell, if not for good.

I just wonder how much Dr Offen considered his own patients QOL when putting them under the knife?

Because the article cannot be accessed on the Daily Mail website I have scanned and pasted the whole article.

The Cure Is Castration

Retired surgeon Nigel Offen ought to have known something was not right when he started having urinary problems. For years he had operated on patients with urological cancers,

but when it came to spotting his , own, he was, by his own admission, decidedly slow.

His, he says, is a cautionary tale warning all men over 50 to keep an eye on their prostate and seek help the minute they suspect something is wrong. He wants men to try to identify bodily changes in much the same way as women look out for breast cancer.And, he says, they also have to become more involved in deciding what sort of treatment they have. Because they do have options.

Too often, he says, men are left impotent, a result of aggressive treatment of the cancer, either by surgery or through drugs.

Prostate cancer claims the lives of 10,000 British men each year and yet Nigel, 61, a divorced father of two from Colchester, Essex, thought he was merely suffering from prostatitis, an inflammation of the prostate gland, which can disappear by itself.

He says: 'I was still busy working for the NHS, so it got pushed to one side. It was six months before I went to my GP. I was having symptoms of wanting to go to the toilet a lot, particularly at night. 'Prostatitis can occur in people who have had a vasectomy, and I'd had one.

I went to my GP for a PSA (prostate-specific antigen) test. This looks for what are known as "markers" in the blood that show cancer could be present.' Nigel's PSA reading was significantly higher than normal. It was clear something might be wrong.

'My GP sent me to see a specialist. The first consultant I saw believed it was cancer and wanted to use Zoladex, a drug that blocks production of testosterone ( which feeds the cancer). 'It would stop the disease but render me impotent — it is chemical castration. Instinctively, that was not something I wanted.' Nigel discovered that treating his cancer less aggressively was almost as good in terms of survival as the more radical approach.

'So I got myself referred to one of the best consultants in this area of medicine, Mr Kirby at St 's Hospital in London. 'I saw Mr Kirby for an MRI (magnetic resonance imaging) scan, my urine flow was tested, and I had a slightly painful biopsy of my prostate. The scan, and an ultrasound examination, confirmed it was cancer.

'It came as something of a shock. As a urological surgeon myself, I didn't do the sensible thing, which was to get screened earlier. "The worst thing about it is that I was at higher risk than average because my father died from prostate cancer when he was over 80. I should have been having regular PSA checks for years.'

NIGEL admits that, although it was bad news, it could have been worse. The cancer, the size of a grape, seemed not to have gone beyond the prostate. But it was not in a good position to operate. 'With surgery ruled out, I had two choices: radiotherapy, followed by "chemical" castration. Or 1 could have radiotherapy and then be treated with a drug that preserved my sexual capability. Although I'm divorced'with two grown-up sons, I wasn't prepared to trade in my sex life just yet. "Men who have surgical or chemical castration are more likely to survive longer, but

you have to weigh up quality-of-life issues.' It was decided Nigel would try radiotherapy plus a hormonal drug called Casodex, which reduces the production of testosterone but doesn't stop it. 'One of the things that tipped ne away from castration was an article in the British Medical Journal, where patients were

surveyed and said they would prefer quality of life over increased survival.' Before Nigel started radiotherapy, he was put on Casodex for two months. 'It had a

dramatic effect. My PSA level — which tells doctors how active a tumour is — came down from 44 to ten. From what Mr Kirby can see, my tumour has either goneor is very tiny.'

Nigel now has a check-up every six months. I still hope to meet someone again. Impotence is not something most men could cope with. I know from my experience as a surgeon that patients want to find out about their treatent, and to have a say in what is decided.

I'm so glad I didn't take the first treatment offered to me.' Nigel says that taking Casodex has allowed him to get on with his life, but admits

there are some side effects. it leaves you incredibly tired, and causes male breast enlargement But I'm still prepared to live with these side-effects than have my sex life taken away,'he says. " Kirby says he will always encourage patients to look at their options. " I think it is vitally important that ' people are fully aware there can be different choices.'