Prostate Surgery failing to deliver survival benefits

PIVOT Study shows little survival benefit in Prostate surgery - but a lot of unwanted side-effects.

According to new research from America in the PIVOT Study - prostate surgery does not extend life!

Ten years ago, when CANCERactive first started up, we were puzzled by the research evidence from around the world which seemed to conflict with the way prostate cancer was treated in the West.

Firstly, there were several research studies like the one that analysed the prostates of males over age 50 killed in motoring accidents in Los Angeles. More than two thirds had been unknowingly living with prostate cancer. Several experts of the time explained that men were more likely to die with prostate cancer than of it.

Based on the various research studies at CANCERactive we came up with a clear view that, unless you were one of the 5 per cent diagnosed in your 40s when the cancer might well be aggressive, for the 95 per cent diagnosed after age 60 the strategy should be: DO NOTHING. OBSERVE; Watch and wait.

We coupled this with more research evidence: Namely, that the PSA test was notoriously inaccurate; and that prostate biopsies had a history of causing infection, and even heightened the risk of spread.

About 4 years later NICE and the Royal Marsden joined us when stating that in 50 per cent of cases of prostate cancer, the correct strategy should be ACTIVE SURVEILLANCE.

Why the rush?

Yet we continued to observe that prostate cancer patients,  especially those treated privately,  were being rushed to surgery. It might have spread, lets take it out! It hasn’t spread take it out to be safe!

We asked a Professor of Prostate cancer at a top hospital, Why? His reply was simple, Money. Surgeons get a good few for a private prostate operation.

More research; Embarrassing research

But now comes yet another research study a 12 year research study (The PIVOT Study) which followed a total of 731 men and compared those who had surgery with men who had none. The results show clearly that surgery did not extend life. Worse, of course, men who have surgery are more likely to suffer side-effects. Overall more that 50 per cent suffer impotence, and more than 10 per cent suffer incontinence. Readers should read our article from Christopher Eden on how the level of side-effects decreases the more experienced the surgeon.

The truth is that CANCERactive, by accurately reading research studies from around the world, has been consistently advising prostate patients correctly.

The next hurdles: honesty in prevention and a new status quo?

Eurocare 3 showed a 5-year survival for the UK of around 54 per cent, although by Eurocare 4 we had increased by more than 10 people per hundred. This still put the UK a long way behind the best countries in Europe, not to mention the USA. Cancer charities said this was because a conservatism amongst British men to seek early treatment. The PIVOT study shows that argument to be tosh.

More than a dozen studies have shown that prostate cancer is caused by aggressive oestrogen converting safe testosterone into aggressive DHT. One study showed that this oestrogen did not have to be human oestrogen, yet could be any one of up to 13 chemicals which could replicate the action of oestrogen once in the body. Other studies show the link between cows’ dairy consumption and prostate cancer risk. Other studies in Cancer Watch show there is a link between Triglyceride levels and prostrate cancer aggression. Vitamin D clearly plays an important preventative role but, again, cancer charities have been giving poor advice for ten years telling people to stay out of the sun.

The fact is that we will not curb the incidence of 37,000 men a year and rising being diagnosed with prostate cancer in the UK until we come clean certain chemicals should be banned from everyday usage, an hour in the sunshine needs to be encouraged or vitamin D supplementation become a National ethos, and the links to cows’ dairy need to be publicised just as they have been in the USA.

But more than that, modern medicine has to ask itself why it also uses anti-testosterone arguments and treatments that give men oestrogen. We asked a top UK prostate cancer expert why he prescribed oestrogen and his answer was, because it works. When we challenged him that it only controlled testosterone production for a very few years, he conceded that oestrogen merely extended life by a couple of years. After oestrogen treatment, prostate oncologists have little left to offer; and they may even have made matters worse. 

Prostate cancer treatment in the UK needs a complete rethink

One option is ready and waiting in the wings it is localised hyperthermia, or HIFU. And a variation, now being increasingly used in the USA, called the Nanoknife. 

The problem is that these emerging treatments will greatly upset the status quo. But it’s a status quo that clearly needs upsetting.

April - June Cancer Watch 2012
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