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Prostate Cancer: Over-Testing and Over-Treatment

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9 minute read

From the Brownstone Institute

By Bruce W. Davidson 

The excessive medical response to the Covid pandemic made one thing abundantly clear: Medical consumers really ought to do their own research into the health issues that impact them. Furthermore, it is no longer enough simply to seek out a “second opinion” or even a “third opinion” from doctors. They may well all be misinformed or biased. Furthermore, this problem appears to predate the Covid phenomenon.

A striking example of that can be found in the recent history of prostate cancer testing and treatment, which, for personal reasons, has become a subject of interest to me. In many ways, it strongly resembles the Covid calamity, where misuse of the PCR test resulted in harming the supposedly Covid-infected with destructive treatments.

Two excellent books on the subject illuminate the issues involved in prostate cancer. One is Invasion of the Prostate Snatchers by Dr. Mark Scholz and Ralph Blum. Dr. Scholtz is executive director of the Prostate Cancer Research Institute in California. The other is The Great Prostate Hoax by Richard Ablin and Ronald Piana. Richard Ablin is a pathologist who invented the PSA test but has become a vociferous critic of its widespread use as a diagnostic tool for prostate cancer.

Mandatory yearly PSA testing at many institutions opened up a gold mine for urologists, who were able to perform lucrative biopsies and prostatectomies on patients who had PSA test numbers above a certain level. However, Ablin has insisted that “routine PSA screening does far more harm to men than good.” Moreover, he maintains that the medical people involved in prostate screening and treatment represent “a self-perpetuating industry that has maimed millions of American men.”

Even during approval hearings for the PSA test, the FDA was well aware of the problems and dangers. For one thing, the test has a 78% false positive rate. An elevated PSA level can be caused by various factors besides cancer, so it is not really a test for prostate cancer. Moreover, a PSA test score can spur frightened men into getting unnecessary biopsies and harmful surgical procedures.

One person who understood the potential dangers of the test well was the chairman of the FDA’s committee, Dr. Harold Markovitz, who decided whether to approve it. He declared, “I’m afraid of this test. If it is approved, it comes out with the imprimatur of the committee…as pointed out, you can’t wash your hands of guilt. . .all this does is threaten a whole lot of men with prostate biopsy…it’s dangerous.”

In the end, the committee did not give unqualified approval to the PSA test but only approved it “with conditions.” However, subsequently, the conditions were ignored.

Nevertheless, the PSA test became celebrated as the route to salvation from prostate cancer. The Postal Service even circulated a stamp promoting yearly PSA tests in 1999. Quite a few people became wealthy and well-known at the Hybritech company, thanks to the Tandem-R PSA test, their most lucrative product.

In those days, the corrupting influence of the pharmaceutical companies on the medical device and drug approval process was already apparent. In an editorial for the Journal of the American Medical Association (quoted in Albin and Piana’s book), Dr. Marcia Angell wrote, “The pharmaceutical industry has gained unprecedented control over the evaluation of its products…there’s mounting evidence that they skew the research they sponsor to make their drugs look better and safer.” She also authored the book The Truth About the Drug Companies: How They Deceive Us and What to Do About It.

A cancer diagnosis often causes great anxiety, but in actuality, prostate cancer develops very slowly compared to other cancers and does not often pose an imminent threat to life. A chart featured in Scholz and Blum’s book compares the average length of life of people whose cancer returns after surgery. In the case of colon cancer, they live on average two more years, but prostate cancer patients live another 18.5 years.

In the overwhelming majority of cases, prostate cancer patients do not die from it but rather from something else, whether they are treated for it or not. In a 2023 article about this issue titled “To Treat or Not to Treat,” the author reports the results of a 15-year study of prostate cancer patients in the New England Journal of Medicine. Only 3% of the men in the study died of prostate cancer, and getting radiation or surgery for it did not seem to offer much statistical benefit over “active surveillance.”

Dr. Scholz confirms this, writing that “studies indicate that these treatments [radiation and surgery] reduce mortality in men with Low and Intermediate-Risk disease by only 1% to 2% and by less than 10% in men with High-Risk disease.”

Nowadays prostate surgery is a dangerous treatment choice, but it is still widely recommended by doctors, especially in Japan. Sadly, it also seems to be unnecessary. One study cited in Ablin and Piana’s book concluded that “PSA mass screening resulted in a huge increase in the number of radical prostatectomies. There is little evidence for improved survival outcomes in the recent years…”

However, a number of urologists urge their patients not to wait to get prostate surgery, threatening them with imminent death if they do not. Ralph Blum, a prostate cancer patient, was told by one urologist, “Without surgery you’ll be dead in two years.” Many will recall that similar death threats were also a common feature of Covid mRNA-injection promotion.

Weighing against prostate surgery are various risks, including death and long-term impairment, since it is a very difficult procedure, even with newer robotic technology. According to Dr. Scholz, about 1 in 600 prostate surgeries result in the death of the patient. Much higher percentages suffer from incontinence (15% to 20%) and impotence after surgery. The psychological impact of these side effects is not a minor problem for many men.

In light of the significant risks and little proven benefit of treatment, Dr. Scholz censures “the urology world’s persistent overtreatment mindset.” Clearly, excessive PSA screening led to inflicting unnecessary suffering on many men. More recently, the Covid phenomenon has been an even more dramatic case of medical overkill.

Ablin and Piana’s book makes an observation that also sheds a harsh light on the Covid medical response: “Isn’t cutting edge innovation that brings new medical technology to the market a good thing for health-care consumers? The answer is yes, but only if new technologies entering the market have proven benefit over the ones they replace.”

That last point especially applies to Japan right now, where people are being urged to receive the next-generation mRNA innovation–the self-amplifying mRNA Covid vaccine. Thankfully, a number seem to be resisting this time.

Author

Bruce Davidson is professor of humanities at Hokusei Gakuen University in Sapporo, Japan.

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US plastic surgeons’ group challenges ‘consensus’ on ‘gender transitions’ for minors

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From LifeSiteNews

By Alliance Defending Freedom

The American Society of Plastic Surgeons argued that ‘genital surgical interventions’ have not been proven an effective solution to adolescent gender dysphoria, adding that current ‘research’ backing medical intervention is of ‘low quality/low certainty.’

One of the most effective weapons that proponents of radical gender ideology have wielded in support of their cause has been “consensus.”

When pressed to explain how blocking a young boy’s puberty or removing a teenage girl’s healthy breasts provide any medical or mental benefit, they often cite “experts” or refer to a “consensus” of medical organizations and government agencies.

But there’s a problem with that strategy.

Recent research has shown the glaring flaws in the argument that transition drugs and procedures are appropriate or helpful for minors. European countries that had once embraced “gender affirming care” for minors, including the U.K., have begun to reverse these policies.

While American medical organizations and governments have been slow to respond, recent developments indicate that may be changing.

Earlier this year, City Journal reported that the American Society of Plastic Surgeons (ASPS) had not signed on to “any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.”

ASPS added that there is “considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions” and that “the existing evidence base is viewed as low quality/low certainty.”

More recently, the president of that organization, Dr. Steven Williams, told a local media outlet, “I don’t perform gender-affirming care in adolescents, and the reason why is because I don’t think the data supports it.”

Prominent plastic surgeon Dr. Sheila Nazarian echoed that sentiment. “I think some physicians and some medical associations have been overtaken by a vocal minority and they are politicized,” she said. “This is 100 percent an American political issue. If we look at Europe, very progressive governments have backed off of these procedures in minors because they’re just analyzing the data – as we should with every procedure. Why is it that for this procedure, in this patient population, we just have to shut up?”

In addition, whistleblowers have come forward to reveal the damage being done to children. Evidence now shows that the World Professional Association for Transgender Health (WPATH) has exerted pressure on researchers. In fact, leaked files from WPATH show that some doctors understood many of the concerns about pushing such drugs and procedures on minors – but did so anyway.

landmark review of the available research on the effect of these drugs and procedures by Dr. Hilary Cass “demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.”

The Cass review, commissioned by the U.K. National Health Service, noted that “[t]he strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate.”

In short, the “consensus” that our media, doctors, activists, and politicians rely upon is no consensus at all. It’s based not on proven science but on a commitment to ideology.

These cracks in the façade that advocates of gender ideology use as a shield provide hope to those who have long been advocating for the truth – in the courtroom and in the culture:

  • The truth that no amount of cross-sex hormones or permanently damaging surgery can change a person’s sex.
  • The truth that doctors have a duty to “do no harm,” and that includes being honest with patients about the facts regarding procedures that are mischaracterized as “gender affirming.”

It’s heartening to see prominent doctors from at least one major medical association speak the truth about the harm being done to so many children.

In the wake of Donald Trump’s election, we are hopeful that the new administration will follow through on promises to protect boys and girls from gender ideology.

And the issue of gender transition efforts for children has reached the U.S. Supreme Court too. On December 4, the court heard arguments in United States of America v. Skrmetti, in which the state of Tennessee is defending its law protecting children from these harmful and unnecessary procedures.

But we know that regardless of what happens in Washington, D.C., we will continue to face challenges in statehouses, government agencies, and school districts across the country.

The fight for truth isn’t over yet – but this is a big step toward achieving a lasting victory.

Reprinted with permission from the Alliance Defending Freedom.

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You wouldn’t believe how complicated distributing public money can get

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The Audit

 David Clinton

Veteran Affairs: the Big Picture

While researching posts for The Audit, I’ll often confront massive datasets representing the operations of agencies with which I’m not in the least familiar. Getting to the point where all the raw numbers turn into a useful picture can take considerable effort, but it’s a satisfying process.

But my first attempts to understand Veteran Affairs Canada (VAC) felt a bit different. I wasn’t just looking at funding and costs, but at the frustrations and suffering of people who, to a greater or lesser degree, were harmed through their service to the country. Here, I hope, is part of their story.

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Veterans Affairs Funding

There are currently more than 460,000 living veterans of the Canadian military. The estimated 2024-25 spending allocation for Veteran Affairs Canada – whose mandate is to serve that population – is around $4.8 billion. The department employs less than four thousand people, which is actually around eight percent fewer than in 2010. Having said that, employment at the distinct Veterans Review and Appeal Board has grown from zero to 161 since 2017.

Besides VAC, the Office of Infrastructure of Canada will spend around $16.5 million on their Veteran Homelessness Program, and Department of National Defence has another $1.6 million budgeted for Community Support for Sexual Misconduct Survivors Program – something for which veterans will also be eligible.

In addition, nearly $2.5 million in grants from various government agencies (including Canada Mortgage and Housing Corporation) was given in 2023 to the Homes for Heroes Foundation, which provides housing and support for at-risk veterans.

Non-government agencies also work to support veterans. In 2023, for instance, the War Amps reported spending $2.7 million on “Service Bureau and Advocacy” and around $700,000 on “Veterans Issues – Special”. The Royal Canadian Legion Dominion Command spent around $1.15 million on veterans services in 2022.

The True Patriot Love Foundation is also a big player in this area, channeling nearly $2.7 million in 2024 to other charities working for veterans. At the same time, more than 30 percent of their own budget came from government sources.

One example of such flow-through funding was the $360,000 given by True Patriot Love to Veterans Transition Network in 2024. In 2023, Veterans Transition Network themselves received another $2.2 million from government along with a total of $1.7 million from other charities.

These kinds of ultra-complex relationships are common in Canada’s charitable sector. The complexity may provide benefits that outsiders can’t easily see. At the same time, knowing whether moving funds through multiple organizations leads to unnecessary inefficiencies and waste is something that would probably require a serious forensic audit.

Veterans Affairs Spending

The largest line items in this year’s VAC spending include $1.6 billion for pain and suffering compensation, $1.34 billion for the Income Replacement Benefit, and $990 million for pensions for disability and death.

In 2023, VAC awarded $41.6 million in external contracts. The largest of those was worth $13.8 million and went to 674725 ONTARIO LTD for “Other Business services not Elsewhere Specified”. 674725 Ontario Ltd. appears to be closely associated with a company called Agilec which, in turn, is a part of Excellence CanadaHere’s how Excellence Canada describes itself:

“Founded in 1992 by Industry Canada as the National Quality Institute (NQI), then rebranded as Excellence Canada in 2011, we are an independent, not-for-profit corporation that is dedicated to advancing organizational performance across Canada.”

In that context, it’s interesting that in 2022, VAC awarded a $159 million contract to a joint venture between WCG International Consultants Ltd. and March of Dimes Canada for “Other Health Services not Specified Elsewhere”.

What makes that interesting? Well, WCG also shows up on an Innovation, Science and Economic Development Canada (ISED) page related to compliance with the Investment Canada Act (ICA). The ICA exists to provide transparency relating to foreign investments in the interest of maintaining a fair and competitive marketplace

This particular page identifies a “U.S.” company called Ancora BidCo Pty Ltd as the new owners of a number of businesses under contract with the federal government. Those businesses include 674725 Ontario Ltd. and WCG International Consultants Ltd.

In fact, Ancora isn’t really a U.S. company at all. They’re actually Australian (as the Pty designation suggests). But their parent company – the private equity firm Madison Dearborn Partners, LLC – indeed operates in Chicago.

There’s no direct evidence to suggest there’s anything dark and nefarious happening here. But it is strange that so many discrete contracts turn out to be awarded to what now amounts to a single foreign for-profit company.

External Contracting Patterns

Has VAC been increasing their reliance on external contracts in recent years? Well, as you can see from this graphic, it’s complicated:

I don’t know what policy changes drove those two huge spikes in 2014 ($933 million) and 2021 ($2.25 billion). But I can tell you which specific vendors are responsible for most of the increase.

In 2014, three contracts worth a total of $803 million went to Medavie Inc for “Other Business services not Elsewhere Specified”. That was 86 percent of the sum of all VAC contracts from that year.

An eye-popping 98 percent of 2021’s external spending went to just six contracts worth $2.2 billion. Medavie Inc received one of those contracts – worth $228 million. But the other five (worth a total of $1.99 billion) were all joint ventures involving WCG International Consultants Ltd.

Lifemark Health Corp. (currently owned by Loblaw) partnered with WCG for three of those contracts, and March of Dimes Canada had the other two dance slots.

What Is Medavie?

Medavie Inc. is the owner of:

  • Medavie Blue Cross
  • Medavie EMS Inc.
  • Medavie health Services New Brunswick Inc.
  • Emergency Medical Care Inc.

Between them, those companies provide health insurance, healthcare training, and emergency management services. They also provide public health program administration – which would probably account for the majority of those contract amounts.

What’s not clear to me is why there’s no record of Medavie receiving any federal contracts of any sort since 2021 – despite the fact that the VAC website tells us that they’re still actively engaged in service provision through Partners in Canadian Veterans Rehabilitation Services (PCVRS).

What Is WCG International Consultants Ltd?

As we’ve seen, WCG is now owned by an American private equity firm and is most certainly no longer not-for-profit. Their website tells us that they’re part of the APM Group, which is an Australian company providing “services in early childhood, youth, employment, insurance, justice, veterans, health, disability, and aged care”.

You’re correct to assume the APM Group is more or less synonymous with Ancora BidCo Pty Ltd. More specifically: all of APM’s publicly-traded shares were bought out in the past couple of months on behalf of Madison Dearborn Partners.

Just one more detail: according to WCG’s website, they’re:

“Partners in Canadian Veterans Rehabilitation Services (PCVRS) coordinates and administers the Rehabilitation Services and Vocational Assistance Program on behalf of Veterans Affairs Canada (VAC).”

Curious about PCVRS? Since late 2022, they’ve been tasked with administering all medical, psycho-social and vocational assistance services on behalf of VAC. However, reports suggest that not everyone has been happy with either accessibility or responsiveness under the new system.

None of this is necessarily inappropriate. And if you’re willing to work at it, you’ll be able to use public information sources to uncover a wealth of related relationships and details. But the vast amounts of money involved, along with the operational complexity make abuse possible. Which means external oversight is a good thing.

Besides all that logistical stuff, what really matters is whether veterans themselves are receiving the support and services they deserve. And that’s a question only they can answer.

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