Health
Prostate Cancer: Over-Testing and Over-Treatment
From the Brownstone Institute
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.
From the Brownstone Institute
This article was co-authored with Mary Beth Pfieffer.
In a seismic political shift, Republicans have laid claim to an issue that Democrats left in the gutter—the declining health of Americans. True, it took a Democrat with a famous name to ask why so many people are chronically ill, disabled, and dying younger than in 47 other countries. But the message resonated with the GOP.
We have a proposal in this unfolding milieu. Let’s have a serious, nuanced discussion. Let’s retire labels that have been weaponized against Robert F. Kennedy, Jr., nominated for Health and Human Services Secretary, and many people like him.
Start with discarding threadbare words like “conspiracy theory,” “anti-vax,” and the ever-changing “misinformation.”
These linguistic sleights of hand have been deployed—by government, media, and vested interests—to dismiss policy critics and thwart debate. If post-election developments tell us anything, it is that such scorn may no longer work for a population skeptical of government overreach.
Although RFK has been lambasted for months in the press, he just scored a 47 percent approval rating in a CBS poll.
Americans are asking: Is RFK on to something?
Perhaps, as he contends, a 1986 law that all but absolved vaccine manufacturers from liability has spawned an industry driven more by profit than protection.
Maybe Americans agree with RFK that the FDA, which gets 69 percent of its budget from pharmaceutical companies, is potentially compromised. Maybe Big Pharma, similarly, gets a free pass from the television news media that it generously supports. The US and New Zealand, incidentally, are the only nations on earth that allow “direct-to-consumer” TV ads.
Finally, just maybe there’s a straight line from this unhealthy alliance to the growing list of 80 childhood shots, inevitably approved after cursory industry studies with no placebo controls. The Hepatitis B vaccine trial, for one, monitored the effects on newborns for just five days. Babies are given three doses of this questionably necessary product—intended to prevent a disease spread through sex and drug use.
Pointing out such conflicts and flaws earns critics a label: “anti-vaxxer.”
Misinformation?
If RFK is accused of being extreme or misdirected, consider the Covid-19 axioms that Americans were told by their government.
The first: The pandemic started in animals in Wuhan, China. To think otherwise, Wikipedia states, is a “conspiracy theory,” fueled by “misplaced suspicion” and “anti-Chinese racism.”
Not so fast. In a new 520-page report, a Congressional subcommittee linked the outbreak to risky US-supported virus research at a Wuhan lab at the pandemic epicenter. After 25 hearings, the subcommittee found no evidence of “natural origin.”
Is the report a slam dunk? Maybe not. But neither is an outright dismissal of a lab leak.
The same goes for other pandemic dogma, including the utility of (ineffective) masks, (harmful) lockdowns, (arbitrary) six-foot spacing, and, most prominently, vaccines that millions were coerced to take and that harmed some.
Americans were told, wrongly, that two shots would prevent Covid and stop the spread. Natural immunity from previous infection was ignored to maximize vaccine uptake.
Yet there was scant scientific support for vaccinating babies with little risk, which few other countries did; pregnant women (whose deaths soared 40 percent after the rollout), and healthy adolescents, including some who suffered a heart injury called myocarditis. The CDC calls the condition “rare;” but a new study found 223 times more cases in 2021 than the average for all vaccines in the previous 30 years.
Truth Muzzled?
Beyond this, pandemic decrees were not open to question. Millions of social media posts were removed at the behest of the White House. The ranks grew both of well-funded fact-checkers and retractions of countervailing science.
The FDA, meantime, created a popular and false storyline that the Nobel Prize-winning early-treatment drug ivermectin was for horses, not people, and might cause coma and death. Under pressure from a federal court, the FDA removed its infamous webpage, but not before it cleared the way for unapproved vaccines, possible under the law only if no alternative was available.
An emergency situation can spawn official missteps. But they become insidious when dissent is suppressed and truth is molded to fit a narrative.
The government’s failures of transparency and oversight are why we are at this juncture today. RFK—should he overcome powerful opposition—may have the last word.
The conversation he proposes won’t mean the end of vaccines or of respect for science. It will mean accountability for what happened in Covid and reform of a dysfunctional system that made it possible.
Republished from RealClearHealth
Author
From the Brownstone Institute
The only way to restore public trust in vaccination – which has taken a big hit since the lies attending the rollout of the Covid-19 vaccine – is to put a well-known vaccine skeptic in charge of the vaccine research agenda. The ideal person for this is Robert F. Kennedy, Jr., who has been nominated to lead the Department of Health and Human Services.
At the same time, we must put rigorous scientists with a proven track record of evidence-based medicine in charge of determining the type of study designs to use. Two ideal scientists for this are Dr. Jay Bhattacharya and Dr. Marty Makary, who have been nominated to lead the NIH and FDA, respectively.
Vaccines are – along with antibiotics, anesthesia, and sanitation – one of the most significant health inventions in history. First conceived in 1774 by Benjamin Jesty, a farmer in Dorsetshire, England, the smallpox vaccine alone has saved millions of lives. Operation Warp Speed, which rapidly developed the Covid vaccines, saved many older Americans. Despite this, we have seen a sharp increase in general vaccine hesitancy. Vaccine scientists and public health officials who did not conduct properly randomized trials made false claims about vaccine efficacy and safety and established vaccine mandates for people who did not need the vaccines, sowing suspicion and damaging public trust in vaccination.
What went wrong? The purpose of the Covid vaccines was to reduce mortality and hospitalization, but the randomized trials were only designed to demonstrate short-term reduction in Covid symptoms, which is not of great public health importance. Since the placebo groups were promptly vaccinated after the emergency approval, they also failed to provide reliable information about adverse reactions. Despite these flaws, it was falsely claimed that vaccine-induced immunity is superior to natural infection-acquired immunity and that the vaccines would prevent infection and transmission.
Governments and universities then mandated the vaccines for people with superior natural immunity and for young people with very low mortality risk. These mandates were not only unscientific but with a limited vaccine supply, it was unethical to vaccinate low-mortality-risk people when the vaccines were needed by older high-risk people around the world.
Since government and pharmaceutical companies lied about the Covid vaccine, are they also lying about other vaccines? Skepticism has now spread to tried-and-true vaccines that are proven to work.
And there are real, unanswered vaccine safety questions. Seminal work from Denmark has shown that vaccines can have both positive and negative non-specific effects on non-targeted diseases, and that is something that must be explored in greater depth. Vaccine Safety Datalink (VSD) scientists studying asthma and aluminum-containing vaccines concluded that while their “findings do not constitute strong evidence for questioning the safety of aluminum in vaccines…additional examination of this hypothesis appears warranted.”
While VSD and other scientists should continue to do observational studies, we should also conduct randomized placebo-controlled vaccine trials, as RFK has advocated. Since we have herd immunity for many diseases, such as measles, trials can be ethically conducted by randomizing the age of vaccination to, for example, one versus three years old, while spreading the trial over a large geographical area so that the unvaccinated are not all living close to each other.
I am confident that most vaccines will continue to be found safe and effective. While some problems may be found, that is more likely to increase rather than decrease vaccine confidence. For instance, it was found that the measles-mumps-rubella-varicella (MMRV) vaccine causes excess febrile seizures in 12- to 23-month-old children. MMRV is now only given as a second dose to older children, while the younger kids get separate MMR and varicella vaccines, resulting in fewer vaccine-induced seizures that scare parents. Although safety studies were inconclusive, it was also wise to remove mercury from vaccines. Even if we end up with fewer vaccines in the recommended vaccine schedule, that’s not necessarily a terrible thing. Scandinavia has a very healthy population with fewer vaccines in their schedules.
We won’t restore vaccine confidence by preaching to the choir. After the Covid debacle, Kennedy’s stated goal is to return to evidence-based medicine free from conflicts of interest. Letting him do that is the only way that skeptics will trust vaccines again, and those of us who trust vaccines have no reason to be afraid of that.
Attempts by the public health and pharma establishments to derail the nominations of RFK, Bhattacharya, and Makary are the surest way to further increase vaccine hesitancy in America. The choice is stark. We cannot let lopsided “pro-vaccine scientists” who clamp their hands over their ears at the mildest questions do any more harm to vaccine confidence. As a pro-vaccine scientist, and in fact, the only person ever being fired by the CDC for being too pro-vaccine, the choice is clear in my mind. To restore vaccine confidence to previous levels, we must support the nominations of Kennedy, Bhattacharya, and Makary.
Republished from RealClearPolitics
Author
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