To treat or not to treat
Over-treatment is a common theme in mainstream medicine. In House Calls yesterday, I told you about our ever-increasing spending on back pain treatments—with more cases cropping up than ever.
Prostate cancer is something I've long said is over-treated. And now, the largest study done about this very issue has come out supporting my position.
There has been a debate raging behind closed doors for years: Treat tumors aggressively or take a wait-and-watch approach?
Of course, the mainstream media doesn't report on this debate. But I hear these types of arguments when I travel to medical conferences, where doctors loosen their collars and occasionally even let the fur fly.
According to this study, only 10 percent of the 9,000 participants who delayed or avoided treatment ended up dying of prostate cancer more than 10 years later. The other 90 percent were still living without any significant difference in their symptoms (or they ended up dying of something else entirely).
And that's something I've observed for years: many more men die WITH prostate cancer than FROM prostate cancer.
The lead researcher notes that most cases of prostate cancer are diagnosed in men over the age of 68, and those cases are usually early stage. Further, most men do well for a long time using the wait-and-watch approach.
A PSA above 4 usually results in a biopsy, which is how prostate cancers are diagnosed. Anywhere from six to 12 or more tissue samples are taken. Even with 12 or more samples, cancer can be missed, because biopsies cover a very small part of the prostate.
Even though the increase in PSA testing has led to more diagnoses of cancer, one of the problems with the test is that you can have a normal PSA and still have cancer. On the flip side, your PSA can be elevated with no cancer. For these reasons the value of PSA as a screening device continues to be debated by doctors, even though you may not hear much about it in the mainstream press.
Unnecessary treatment can involve painful biopsies, powerful drugs, and prostate removal surgeries that result in loss of bladder control, inability to achieve erection and emotional distress. So it's definitely not something to dive into blindly. If you have any suspicion that you're being rushed into an unnecessary biopsy and possible surgery, get a second opinion.
