Writing as a man aged 66, you’d think I’d be concerned about prostate cancer, one of the current health hobby horses. In a way I am, but I also have an aversion to being told to worry about one thing after another, and my concerns also include the side-effects of treatment which are consistently overlooked in all sorts of contexts. I have seen what has happened to friends and relatives who have been diagnosed with prostate cancer.
When I watched a Hannah Fry Horizon documentary about her own cervical cancer experience, the side-effects of her treatment and the research she’d pursued, one of the most alarming points raised was that the risk of life-changing side effects from chemotherapy seemed to be somewhat higher than the risk from breast cancer. She asked “are we over-medicalising” cancer?
Now it seems that a major study running over 15 years has questioned the whole process of prostate cancer screening.
The Telegraph has the story:
Prostate cancer screening is likely to do more harm than good, experts have warned, after a 15-year trial showed one in six flagged cases was wrong.
The largest study to date investigating the PSA (Prostate-specific antigen) blood test, which is used as a screening tool in some European countries, found it had a small impact on reducing deaths, but also led to a worrying level of over-diagnosis.
In some cases, it missed early detection of some aggressive cancers.
Researchers from the universities of Bristol, Oxford and Cambridge, invited more than 400,000 men aged between 50-69 for screening, with just over half receiving a PSA test.
After following up for 15 years, nearly seven men out of every 1,000 in the group invited for screening had died from prostate cancer, compared to nearly eight men out of every 1,000 who had not been tested.
The results of the trial show that an estimated one in six cancers found by the single PSA screening were over-diagnosed leading to unnecessary treatment of tumours that would not have caused any harm in someone’s lifetime
The treatment of prostate cancer may cause physical side-effects including the possibility of infection following a biopsy, erectile dysfunction and bladder and bowel problems.
The key problems seem to involve missing the more aggressive cancers while subjecting other men given a positive diagnosis to treatment that may be unnecessary and causes more harm.
Dr. Neil Smith, GP for Cancer Research U.K. and GP Lead for Lancashire and South Cumbria Cancer Alliance, said: “With prostate cancer causing 12,000 deaths in the U.K. every year, we completely understand why men want to know if they have the disease, even when they don’t have symptoms.
“However, this research highlights that a PSA test for early detection can do more harm than good – it’s simply not accurate enough and can lead to some men having tests and treatment that they don’t need.”
Definitely worth reading in full.
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I am thankfully a complete ignoramus on all cancer matters. Here’s what I don’t understand. Someone here BTL will help me, I’m sure…
Cells divide and multiply. This is normal. Cancer is defined as this same behaviour, but “too fast”.
Who decides what is “too fast”?
Does cell division happen at the same rate in everyone, all the time, throughout a person’s life?
Does a tumour have to be present for a test for cancer to be positive? Are there any other circumstances which will return a positive result?
Aside from these questions, I am so far firmly of the opinion that before the abundance of cancer tests, people developed cancer and died many years later of something completely different.
Å gjoere noen en bjørnetjeneste…
I’m in no way an expert. But my understanding is that the whole process that kicks it off, relates very much to mitochondrial damage, which is usually as a consequence of metabolic disease. The mitochondria in our cells play an important role in the cells power system and this system is required for cells to be able to express themselves according to our DNA blueprint. For a cell to grow and divide according to the DNA instructions, it needs a significant amount of energy. That’s because making new proteins, replicating DNA, and the physical process of cell division (mitosis) are all energy-intensive tasks. Mitochondria also have roles in signaling, cellular differentiation (where cells develop into different types), and cell death (apoptosis), all of which are guided by the cell’s DNA.
When our cells mitochondria are damaged they end up unable to grow according to our DNA blueprint, and start to multiply like cells from epochal ancestors billions of years back before we had evolved our “advanced” design, hence they grow as a blob that is it increases in size disrupts more and more of the body. They still get their energy, but they get it via an ancient process known as fermentation (where the energy source is glucose) instead of anaerobic respiration.
There are a couple of aspects to this it is worth knowing about as a lay person.
Firstly metabolic disease is highly preventable. For a lay person it can be considered equivalent to insulin resistance, which comes from a lifetime of over-consuming sugars. We can reverse insulin resistance.
Secondly metabolic disease and mitochondrial damage are made worse by processed foods and hyper-processed foods. We have full control over that too.
Thirdly, read up on autophagy. It’s a process we enter into if we fast, which can be thought of as like a vacuum clean of the body, where the body cleans out damaged cells first, massively reducing potential sources of cancer.
A last point it is worth making is there is a Harvard professor (Thomas Seyfried) who has been doing work that appears to show, since cancer cells start getting their energy from sugars using the fermentation sugars process, instead of, ultimately, via the oxygen we get from breathing, you can kill cancer cells by radically cutting out sugars. This has been known for many years, but what wasn’t understood until recently, is that you have to work out which type of sugar the cancer cells for the cancer you have prefer. This professor’s work has been applied by many clinics and has evidently led to many successful outcomes. Since the pandemic has made me less trusting of the medical authorities, I became interested in this, and it does seem to be a treatment that is currently being denigrated and suppressed by the Pharmaceutical industry. All very positive signs in my book!
If you are interested in this check out:
https://youtu.be/7YbRCxeIVU0?si=427Vzg3W_kM4_lTp
and
https://youtu.be/pwhRskOPwVk?si=0GgT3ypdlQDrWLc8
Oh and BTW, apart from Glucose and Fructose themselves, actually the primary source of Sugar is the carbohydrate we consume. Carbohydrate is unerringly converted to sugar by our bodies. I have only been successful at sustaining weight loss ofter understanding this. In my case it was the bagels what dunnit.
Thank you, TheBasicMind. You haven’t answered my questions but you have given me a lot besides.
Ha ha, so true. I launched into it, then got carried away and by the end forgot about the questions
.I was going to say as far as I understand it there are too many factors relating to cell division to be able to reliably pin it down. It’s driven by loads of variables. So genetics, location in the body in relation to energy/blood supply, hormones, type of cancer, immune response (which probably doesn’t actually change the rate of cell division – but certainly changes the effective rate of multiplication of surviving cells). So my guess would be there are general expectations for the type of cancer and location and then they will need to actually measure the growth to be sure.
Re tests, there are different forms of imaging. And the there are indirect blood tests which test for factors that are indicative of cancer (I understand tumours release certain proteins – which is then of course indirect evidence). I could imagine the lack of such proteins doesn’t always rule out the possibility there is still cancer somewhere, but whether the presence of such proteins is determinative I have no idea.
Thank you TheBasicMind very very interesting, well written and educational.
So a good mitigation strategy is to enhance your cells’ ability to perform anaerobic respiration, i.e. exercise which increases stamina. Long distance sports.
What my grandmother taught me.
Cancer specialists I know strongly recommend regular, vigorous exercise as a highly-effective protection against cancer.
Yes. As regards diet, how do you understand “processed” and “unprocessed”?
How do they know? Slim, well exercised people I have known have died of or are suffering from cancer.
My Jewish grandmother taught me to keep eating no matter what. It doesn’t mean it’s true. She abhorred fasting. But fasting is clearly on trend and it’s worth considering what is behind the fasting which is becoming cult. Meanwhile I intend to keep eating, one of the joys of life
Good post.
Have you read Travis Christofferson’s book ‘Tripping over the Truth’? It sets out in layperson words the metabolic theory of cancer, including Professor Thomas Seyfried’s work. I found it a very interesting read indeed.
No I haven’t read it, but I do want to read up more on this area, so good tip thanks.
O/T I’m afraid, but we are still waiting for Toby to explain why comments were suddenly closed on the Melissa Kite article about Princess Kate. I think MAK said at the time that he had queried it and had an explanation.
As it doesn’t look like TY wants to share this with other (paying) commenters, would you be prepared to tell us?
Sorry to harp on about this but when the DS summarily shuts down comments without giving a reason, it leaves a bad taste
HPV virus does not exist (cervical cancer, see Christine Massey FOI on substack). Prostrate cancer does exist due to toxic poisoning – stabbinations, drugs, too much alcohol, white sugar etc.
I refuse all fake cancer screening regimes. Fake tests will give fake positives. Then come the drugs. Then I am ill. Then quack boy will say ‘told you, you have cancer’. Then more problems (colon cancer, esophagal cancer etc) and more drugs.
If I contract prostrate cancer I would like to know the provenance (the national death service does not have a clue on that). Then I will likely die. I will take the chance. It is a good bet – once you go into their system and regime your life expectancy collapses.
See Polio-AIDs-Rona for patterns and templates.
These results are counterintuitive. The average patient thinks that a simple test has to be better than risking cancer.
But a couple of decades ago, when I was disputing with a local urologist who was following the NHS line in NOT screening for Ca prostate, but WAS recommending it in his private practice, i found myself in e-mail correspondence with Sir Muir Gray, founder and then chief of the UK screening service.
Through him I received a crash course in screening epidemiology, which showed that there are very few cases in which mass screening is beneficial. His sceptical stance on PSA screening has now, it seems, been thoroughly vindicated, and those interminable consultations trying to impart some basic wisdom to patients “just wanting the test” were not entirely wasted.
Also, the knowledge stood me in good stead in quickly seeing through the nonsensical COVID screening policy, on which the now retired Muir Gray commented in the BMJ, but was entirely ignored by the profession and the government.
It is the same with breast cancer screening, and they actually warn you on your screening ‘invite’ that, essentially, screening can lead to false diagnosis. In addition to that the repeated application of radiation to the breasts is a cancer risk in itself, and the process can be painful and bruising depending on the shape of your breasts. I no longer do breast screening because of this (although I will shortly be ‘too old’ for it anyway. Although why someone can no longer be considered at risk because of age is a mystery, or perhaps it is not worth spending money on treating old farts).
I had treatment for prostate cancer 8 years ago. In my case the PSA test and personal examination followed a minor symptom, however the decision was made to monitor the PSA and only to take action is it was seen to be increasing over time.
A single absolute value can only be an indicator; the response is in the hands of the clinicians. As we know clinicians vary in quality and ability.
In my case there was no doubt about its seriousness. My inital test was repeated 6 months later to see if it had increased.
It had, and the specialist I was assigned to offered me the opportunity to take part in a trial of new treatment, in a group of about 20. As a consequence I was one of very few men who have seen a 3d model of their prostate tumour. This accurate computer model was the basis of planning its irradiation.
The treatment used a higher powered beam supplied by a source that followed a complex pre-planned orbit around me centred on the tumour. It requires considerably fewer visits to deliver the required lethal (to the tumour) dose.
The purpose of all this complex planning was to supply a powerful “zap” to the tumour whilst minimising damage to the surrounding tissue.
It was a success, as it was I am told for all the other trial participants.I still have annual follow-ups as part of the trial and my PSA has remained close to zero.
I have a close friend who had surgery for the same problem. He had a lengthy convalescence and permanent incontinence.
I know two plus two can now equal five, but I always thought eight was one more than seven. What’s going on?
Dunno – perhaps it indicated that the difference was statistically insignificant (no idea how to work out the p value between 7 and not quite 8 per 1000) hence screening didn’t improve mortality rates and wasn’t provably beneficial? Where’s the stats guy we have on DS?
Assuming that’s the case, what is not factored in is the morbidity of being told you have Cancer, and all the stress and physical damage from the treatment, form impotence to incontinence.
“…found it had a small impact on reducing deaths, but also led to a worrying level of over-diagnosis.”
So in other words, the harm of over-diagnoses and unnecessary treatments outweighed the tiny benefit in very slightly reducing deaths.
The study outcome (as reported at least) is that the chances of dying from prostate cancer is slightly reduced in those who are screened (compared with the unscreened).
But this prostate cancer reduced mortality is roughly balanced out by an increase in the chance of those screened dying from another cause other than prostate cancer (compared with the unscreened). Where unnecessary treatment for diagnosed prostate cancer has been undertaken for an individual the side affects of this treatment and all the stress and anxiety could have caused that individual in some cases to have died from another cause.
A link to the full study is available from the following article
https://www.bristol.ac.uk/news/2024/april/prostate-cancer.html
Only skimmed it at the moment but this all cause mortality chart (screened vs unscreened control) looks interesting for example as it suggests no significant net benefit or harm from the screening as the two lines visually overlap. But as I say I haven’t read it properly
It is a good study, but I don’t understand why this story is reported on DS. Doubting PSA tests for screening is not particularly sceptical. The value of PSA tests for screening has been debated for decades and it is NHS policy not to do PSA tests for screening because “it has not been proved that the benefits would outweigh the risks.”
I do sometimes wonder if MTF gets downticks just because, not as a result of his comments! He is correct.
https://www.nhs.uk/conditions/prostate-cancer/psa-testing/
Back in the day when I was involved in this sort of thing, there was a lamentable lack of advice regarding test prep, ie no sex for at least 24 hrs prior, no strenuous physical activity, etc (I’d also add in less alcohol and red meat as these can both affect PSA). I know of at least one chap who ended up having an unnecessary TURP resulting in impotence and occasional incontinence. At least they’re bothering to scan first these days.
Having seen the ridiculous extreme over testing of covid and the absurd pretence that the results meant something they clearly didn’t, I have naturally come to question the routine testing of other conditions. So this study doesn’t surprise me at all.
On the other hand, how convenient that testing for certain cancers is all of a sudden counterproductive. Just when the NHS so completely overwhelmed… and “assisted dying” is becoming a thing.
That pretty much sums up the post covid world for me. I don’t believe anything and don’t always know what to think.
how convenient that testing for certain cancers is all of a sudden counterproductive.
It is not “all of sudden”. As I wrote in this comment, it has been NHS policy not to do PSA screening for many years.
From NHS website https://www.nhs.uk/conditions/prostate-cancer/psa-testing/
“There’s currently no screening programme for prostate cancer in the UK. This is because it has not been proved that the benefits would outweigh the risks.”…”PSA tests are unreliable and can suggest prostate cancer when no cancer exists (a false-positive result).”
The Telegraph article says “used as a screening tool in some European countries” …not in the UK it seems
Maybe it’s counterproductive.
Or maybe when the NHS is so overwhelmed, it’s a case of women and children first.
Somehow, I think they’d struggle to get away with abolishing breast cancer screenings. The uproar would be heard around the world
Men generally tend to take it and move on.
Brilliant: Screening does more harm than good so we must find a way to do better screening. That’s proper science, that is.
Screening does more harm than good so we must find a way to do better screening
What is wrong with that argument? Prostate cancer is very common and your chances of surviving it are greatly improved if it is detected early. We don’t have a good screening test – let’s try and find one.
The article points out
However, in the UK there is a bowel cancer screening program introduced in 2006. So presumably it is clear that the benefits of this screening outweigh the harms.
In considering any benefits, allowance must be made for lead time bias; where, for example, screening detects the condition 5 years earlier than would otherwise have been the case, treatment therefore starts 5 years earlier, and the patient survives 5 years longer after diagnosis. I would hope and expect that credible estimates to correct for this bias were made as part of the decision to introduce bowel cancer screening for the over 60s in 2006.
As we get older, we’re more likely to die of cancer. We’re also more likely to die of other things. If we look at the rates of bowel cancer as a percentage of all causes of death we find that it becomes less likely in older age groups
Great progress has been made in reducing deaths caused by some types of bowel cancer. The chart below shows age-standardised death rates from 1994 to 2020 for the two main types: C18=Colon and C19-21=Rectal/Anus.
Deaths from C18 have declined since 1994 (I only have data going back to 1994; the decline may have started earlier) but deaths from C19-21 have remained almost level.
In more recent years the decline in death rate seems to have levelled off.
The dotted trend lines in the chart show the trends from 1994-2006 projected to 2020. Death rates are consistently above the pre-screening trend.
In 2006 the NHS introduced bowel cancer screening for the over 60s.
It appears that there has not been as great a reduction in death rate associated with bowel cancer since the introduction of screening in 2006 as compared with the improvement from 1994 to 2006 (the death rate is improving, but not improving as fast as it did before screening was introduced).
Screening undoubtedly causes harms – the question is whether it brings benefits which outweigh the harms. Yes, better, more accurate screening, and treatments would be welcome but not at the expense of our humanity. It may be better to improve end-of-life care.
This analysis focusses on death as an outcome. Survival of cancer to die of something else at a later time may well appeal to many, but personally I fear dying of dementia more than dying of cancer.
But most prostate cancer (numerically speaking) is not a cause of death, hence the adage that old men usually dies with, but not of, prostate cancer. Screening may become worthwhile if better screening tests were to be found that would predict actual outcomes better.
ZINC is the answer.
“The human prostate gland contains extremely high zinc levels; which is due to the specialized zinc-accumulating acinar epithelial of the peripheral zone.”
“The implications of zinc in the development and progression of prostate cancer are described, which is the most consistent hallmark characteristic of prostate cancer. ”
“In the current absence of an efficacious chemotherapy for advanced prostate cancer, and for prevention of early development of malignancy; a zinc treatment regimen is a plausible approach that should be pursued.”
A comprehensive review of the role of zinc in normal prostate function and metabolism; and its implications in prostate cancer – PMC (nih.gov)
Here is a global map (Figure 1) showing the countries with the lowest incidence of prostate cancer, including India & China, which also have high production levels of zinc-rich pumpkin seeds, which is why Chinese men eat a lot of pumpkin seeds.
Trends of Prostate Cancer Morbidity in Low-Incidence Countries from 1990–2019 | Cancer Epidemiology, Biomarkers & Prevention | American Association for Cancer Research (aacrjournals.org)
And as you know, red meat also is a good source of zinc.
Another Globalist reason for trying to force everyone to be vegans?
Two years ago in Feruary2022 – I had what I thought was a water infection ( most men don’t often get these problems but I’ve had a few) went – to see a doctor and after a dip test was given a prescription for antibiotics – which I took as per instructions.
I also has a PSA test taken – I’m now 71 – and my PSA was above the “safe” level for my age.
I went for the results at my surgery and asked for the results of my test – the receptionist told me my kidneys were ok – no mention of my prostate – so I had another test done and it came back lower the the first one – but still above my age related level.
Any way
I had a MRI scan which was noisy but ok
Something was noticed and a biopsy recommended. So I went along with the biopsy – I now know what a cervical smear test must be like – they took at least 12 x 1 inch long thin samples – I still feel the consequences “down there” which isn’t pleasant but I managed.
After which I was out in 6 monthly follow ups.
Only then did I do what I should have done at the outset – watch a video of the “doctor who invented the PSA test” – his summary was – it does more harm than good – as stated in the article – well worth a watch just search for the quoted search in YouTube.