What is the Prostate? A quick primer on prostate health

Sometimes bigger isn’t better. Enlarged prostate is one of the most common health issues facing men today. But the prostate is also one of the most important parts of a man’s reproductive system. To understand what can go wrong and what to look out for, let’s first understand what the prostate does and why you want to take care of it.

What does the prostate do?

If you imagine the male reproductive tract as a subway with lots of interconnecting tubes, the prostrate would be grand central station. Normally, the connection between the bladder and the urethra (the main tube inside the penis) is open to allow urine to pass. This causes sperm and seminal fluid to build up in other passage ways, waiting like impatient commuters for the express line to the suburbs. Finally, the evening express comes. The prostate closes off the passage to the bladder and opens tiny doors allowing sperm to pile in. It then helps support the contractions during ejaculation to help propel sperm to the end of the line.

The prostate is also a factory that produces several key ingredients to protect and support sperm on their journey. Among these are a substance to increase alkalinity of semen (to combat acidity of the vagina), a proprietary blend of simple sugars, carbohydrates and antioxidants to keep sperm energized for the long swim ahead, and prostate specific antigen (PSA) that breaks down or liquefies) semen after it reaches the woman’s cervix.

What is PSA?

Prostate Specific Antigen (PSA) is an enzyme secreted by the prostate into semen that causes it to liquefy over time. Most PSA goes directly into semen but trace amounts leak into the blood. If PSA levels are heightened in a blood test it can signal that the prostate is overactive either due to inflammation (prostatitis), an enlarged prostate (BPH), or prostate cancer. Because prostate issues are relatively common as men age, most doctors recommend regular blood tests for PSA for early detection of prostate problems.

What causes the prostate to get enlarged?

The short answer is, no one really knows. An enlarged prostate, or benign prostatic hyperplasia (BPH), is a common ailment that impacts men as they age. In fact, BPH is listed as one of the top 10 most common and most costly diseases in men over age 50 in the United States. Because the prostate plays a critical role in urinary function, an enlarged prostate can cause major problems with a man’s ability to take a pee (which feels to me like one of those inalienable human rights). Because BPH, prostate cancer and low testosterone (hypogonadism) are common ailments that impact men as they age, a ton of research is ongoing to understand the relationship between testosterone, aging and prostate health to better inform risks and benefits of treatment options for these conditions. So far, the answer seems to be, “It’s complicated,” but here’s a quick summary of what we do know.

Dihydrotestosterone (DHT), a form of testosterone, is critical for growth and function of the prostate. Studies also consistently show that boys who have testicles removed due to poor testicular descent, injury, cancer or do not develop enlarged prostate later in life. As men age, testosterone levels naturally begin to drop. However, if testosterone drops too low, it can cause several other symptoms that can be hard to live with. Identifying optimal testosterone levels for men as they age is the subject of significant debate and ongoing research.

Interestingly, risk factors for low T and enlarged prostate are similar. Overwhelmingly, both conditions are age related – the older you are, the higher risk. They also seem to have higher risk in men who are less healthy. Diabetes, obesity, poor diet and smoking can all contribute to low T and poor prostate health. Taking care of yourself can help maintain healthy levels of testosterone and keep the prostate in check.

The key takeaway here is that doing what you can to live a healthy life (everything in moderation) will pay dividends in your quality of life as you age, and going in regularly for checkups can help identify issues before they become problems. Urologists are equipped with a great toolbox for keeping machinery below the belt in good working order and can be great partners for helping men optimize health over the course of their life.

What causes prostate cancer?

Prostate cancer is one of the most common cancers diagnosed in American men. According the American Cancer Society, 1 in 7 men will be diagnosed with prostate cancer in their lifetime. Like BPH, prostate cancer is most common in men over 40 and risk increases with age. There seems to be a genetic component as family history and race both contribute to risk. When caught early, prostate cancer is very treatable and therefore regular screening is recommended sometime after age 50 depending on other risk factors.

The most common screening tool used is a blood test to measure PSA levels in the blood. When the prostate is functioning properly, PSA levels should be relatively low. However, high PSA does not necessarily mean you have prostate cancer. As mentioned above, inflammation, infection, enlarged prostate or other issues can also cause elevated PSA. If PSA levels come back high, a physical exam of the prostate, imaging or biopsy may be recommended.

As with other issues of men’s health, overall good health seems to contribute to prostate health and may help to reduce risk of prostate cancer.

How do you keep your prostate healthy?

What’s good for your heart is good for your prostate. Healthy diet, keeping your waist a reasonable size and not over doing alcohol, marijuana or cigarettes can go a long way to keeping your prostate (and your sex life) in good shape as you get older. A bit of good news. A recent study followed a large cohort of men throughout their life found that frequent ejaculation (with a partner or solo) decreased the risk of prostate cancer. And that is something we can all get behind.

References

  1. Wikipedia articles: Prostate, Semen, Ejaculation, BPH, Prostate Cancer, PSA,
  2. Owen, D. H.; Katz, DF (2005). “A Review of the Physical and Chemical Properties of Human Semen and the Formulation of a Semen Simulant”. Journal of Andrology. 26 (4): 459- 69. PMID 15955884. doi:10.2164/jandrol.04104.
  3. Lee CH, Akin-Olugbade O, Kirschenbaum A. Overview of prostate anatomy, histology, and pathology. Endocrinol Metab Clin North Am. 2011 Sep;40(3):565-75, viii-ix. doi: 10.1016/j.ecl.2011.05.012.
  4. Warburton D, Hobaugh C, Wang G, Lin H, Wang R1. Testosterone replacement therapy and the risk of prostate cancer. Asian J Androl. 2015 Nov-Dec;17(6):878-81; discussion 880. doi: 10.4103/1008-682X.150841.
  5. Kang DY, Li HJ. The effect of testosterone replacement therapy on prostate-specific antigen (PSA) levels in men being treated for hypogonadism: a systematic review and meta-analysis. Medicine (Baltimore). 2015 Jan;94(3):e410. doi: 10.1097/MD.0000000000000410.
  6. Klotz L1. Testosterone therapy and prostate cancer–safety concerns are well founded. Nat Rev Urol. 2015 Jan;12(1):48-54. doi: 10.1038/nrurol.2014.338.
  7. Jarvis TR, Chughtai B1, Kaplan SA. Testosterone and benign prostatic hyperplasia. Asian J Androl. 2015 Mar-Apr;17(2):212-6. doi: 10.4103/1008-682X.140966.
  8. Rove KO1, Crawford ED2, Perachino M3, Morote J4, Klotz L5, Lange PH6, Andriole GL7, Matsumoto AM8, Taneja SS9, Eisenberger MA10, Reis LO11. Maximal testosterone suppression in prostate cancer–free vs total testosterone. Urology. 2014 Jun;83(6):1217-22. doi: 10.1016/j.urology.2014.02.001. Epub 2014 Apr 6.
  9. Fenter, TC (2006). “The cost of treating the 10 most prevalent diseases in men 50 years of age or older.”. Am J Manag Care. 12 (4 Suppl): S90-8. PMID 16551207.
  10. Rider JR1, Wilson KM2, Sinnott JA3, Kelly RS4, Mucci LA2, Giovannucci EL5. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up. Eur Urol. 2016 Dec;70(6):974-982. doi: 10.1016/j.eururo.2016.03.027. Epub 2016 Mar 28.
Sara SDx

Sara SDx

Editor of dontcookyourballs.com and co-founder of Trak Fertility. Interested in all research about men's health, sperm, balls & babymaking. Passionate that we can do better when it comes to male fertility and men's reproductive health.

This doesn't need to be a taboo subject left in a closet, nor do men need to go through this alone. Education and community are key elements to improving health. Don't cook your balls is a space for us to share science and experience advance the state of male reproductive health care.
Sara SDx

5 Comments

  1. Prostate November 10, 2017 at 10:51 am - Reply

    Sweet site, super layout, rattling clean and use genial. http://www.3dprostatecure.com/

  2. JJ November 7, 2017 at 3:43 pm - Reply

    Men beware!
    Read the sad truth about prostate cancer over testing and treatment, dangers and exploitation for profit by predatory doctors.
    A prostate cancer survival guide by a patient and victim.
    Created January 8, 2016. Revised November 4, 2017

    The man who invented the PSA test, Dr. Richard Ablin now calls it: “the Great Prostate Mistake, Hoax and a Profit-Driven Public Health Disaster”.

    Your life or your quality of life may depend on reading this document.
    Prostate cancer dirty secrets, lies, exaggerations, deceptions and elder abuse.
    Men, avoid the over diagnosis and unnecessary treatment of prostate cancer.

    In my opinion:
    Read the hard facts about prostate cancer testing and treatment that no one will tell you about, even after it’s too late. This is information all men over 50 should have. Also, anyone concerned about cancer in general, dangers from clinical trials, injuries and deaths from medical mistakes, exploitation, elder abuse, HIPAA laws and privacy issues should read this document. Prostate cancer patients are often elderly, over treated, misinformed and exploited for huge profits by predatory doctors. The testing, treatment and well documented excessive over treatment for profit of prostate cancer often results in devastating and unnecessary side effects and sometimes death. At times profit vs. QOL (quality of life). Gleason 6 (3+3) is a pseudo-¬cancer mislabeled as a cancer; it does not need detection or treatment.

    Facts per some studies:
    1. Multiple studies have verified more harm and deaths caused from prostate cancer testing and treatment then from prostate cancer itself.
    2. Extensively documented unnecessary testing and treatment of prostate cancer for profit or poor judgment by some doctors in the USA.
    3. Medical mistakes are the third cause of deaths in the USA (over 251,000 deaths a year, over one million deaths in 4 years) more then suicide, firearms and motor vehicle accidents combined.
    4. About 1 man in 6 will be diagnosed with prostate cancer in his life.
    5. About 233,000 new cases per year of prostate cancer.
    6. 1 million dangerous prostate blind biopsies are performed per year in the USA.
    7. 6.9% hospitalization within 30 days from a prostate biopsy complication.
    8. About 1.3 to 3.5 deaths per 1,000 from prostate blind biopsies.
    9. .2% to 1.2% deaths as a result of prostate cancer surgery.
    10. A study of early-stage prostate cancer found no difference in surviving at 10 years whether men had surgery, radiation or monitoring (no treatment).
    11. Low risk Gleason 3+3=6 “cancer” lacks the hallmarks of a cancer yet it is often aggressively treated.
    12. Prostate cancer patients are at an increased risk for chronic fatigue, depression, suicide and heart attacks.
    13. Depression in prostate cancer patients is about 27% and 22% at 5 years, for advanced prostate cancer patient’s depression is even higher.
    14. 75% to 90% of oncologists would refuse chemotherapy if they had cancer.
    15. The National Cancer Institute says approximately 40 to 50% of men with low to moderate grade Prostate cancer will have a recurrence after treatment.
    16. 62% to 75% of bankruptcies in America are because of medical bills.

    Excuse the generally accurate humor and sarcasm. Its intent is to entertain and educate while reading this possibly laborious text.

    $Follow the money$: If a surgeon is financially responsible for a building lease, a large staff or an oncologist is also responsible for a lease on multimillions of dollars in radiation treatment equipment, do you think they would be more or less honest about the benefits and hazards of treatment? Do you think the profit margin would compromise some doctor’s ethics? Typically, what is the purpose in over testing and treating a cancer that often will not spread and the testing and treatment frequently causes lower QOL (quality of life), ED, incontinence, depression, fatigue, suicide, etc if it was not extremely profitable? The medical field is alluding to the fact that prostate cancer testing and treatment may do more harm then good. The U.S. Advisory Panel is now recommending for prostate cancer PSA testing and screening: for men 55 to 69 “letting men decide for themselves after talking with their doctors. For men over 70, no testing at all is recommended.” However this may not protect men from predatory doctors exploiting them. Patients usually follow a doctor’s recommendation. Do you think any regulatory agency will stop the exploitation of elderly men with a high PSA or prostate cancer or approve new treatments at the risk of financially bankrupting thousands of treatment facilities and jeopardizing thousands more jobs? Do you think any regulatory agency will set guidelines for testing and treatment at the risk of upsetting the doctors who are profiting from over treating? Some drugs and treatments for prostate cancer and ED are kept very expensive and newer or less expensive and effective drugs and treatments are seldom approved for maximum profit. Prostate cancer patients are often elderly and exploited for profit, the treatments offered has horrible side effects, and newer treatment options are either unavailable or not offered to patients or available outside the USA. Prostate cancer is often slow growing and of low risk and can just be monitored. Often no treatment is the best treatment. Over testing and treatment has been verified by numerous experts, studies and investigations, documentation, etc.

    A 12, 18 or 24 core blind biopsy, holey prostate! One million dangerous prostate blind biopsies are performed in the USA each year and they should be banned. Men with a high PSA tests result are often sent to an urologist for a blind biopsy. Men should be told about other options: Percent free PSA test, 4Kscore test, PCA3 urine test or a MRI, 3D color-Doppler test before receiving a blind biopsy. These tests can often or always eliminate the need for a more risky and invasive blind biopsy. Insertion of 12, 18 or 24 large holes through the rectum into a gland the size of a walnut, a blind Biopsy can result in (per studies) pain, prostate infections, a risk of permanent or temporary erectile dysfunction at about 24% (Biopsies cause about 240,000 cases of ED a year), urinary problems, hospitalization from infections and sometimes even death from sepsis (About 1.3 to 3.5 deaths per 1,000 from blind biopsies). There is also debate that a biopsy may spread cancer because of needle tracking. A blind biopsy can also increase PSA reading for several weeks or months, further frightening men into an unnecessary treatment. Blind biopsies are almost never performed on other organs. One very prestigious hospital biopsy information states “Notice that your semen has a red or rust-colored tint caused by a small amount of blood in your semen”. Another large prestigious hospital states “Blood, either red or reddish brown, may also be in your ejaculate.” These statements are often an extreme exaggeration (mostly lies). Very often after a biopsy a man’s semen will turn into jet black goo. This could be an unpleasant surprise for a man and especially for his unsuspecting partner. However if a biopsy is performed before Halloween or April Fools’ day this may be of some benefit to a few patients. If some very prestigious hospitals are not factual about the color of semen, what other facts are not being disclosed or misrepresented? Never submit to a blind biopsy.

    Bone scan scam: Prostate cancer patients are often sent for a bone scan. A bone scan has about a 13% chance of having a false positive and only 3 men in 1,000 have bone cancer who have a bone scan. Bone scans may often be unnecessary in lower risk prostate cancer patients.

    Low risk cancer patients or patients with advanced age are often sent for aggressive treatment by some doctors when monitoring is usually a better option. An extreme example of overtreatment is one SBRT radiation clinical trial. Prostate cancer patients (victims) where intentionally treated (fried) with a huge dose (50Gy total, 5 fractions) of radiation resulting in disastrous long term side effect for some of these men. The typical SBRT dose is 35 to 36.35 Gy, 5 fractions. A large percentage of prostate cancer patients in this clinical trial had low risk prostate cancer and did not require any treatment at all.

    Clinical trials may be hazardous to patients. The goal of a clinical trial is to gather information; the intent is not necessarily to help or cure patients. In a clinical trial, if someone is given a treatment that will harm them (as in the above example) or given a placebo in place of treatment or needed treatment is withheld, the patient may be deceived or harmed. Investigate before you participate in any clinical trial. Often drug company’s get your information from medical and pharmacy databases to lure people into clinical trials, soliciting people with letters and postcards. This is often a HIPAA violation. If you call about a clinical trial your phone conversation may be recorded “Calls may be recorded for training and quality purposes” including your medical and personal information. Even if you do get a safe and effective treatment, it may not be available to you after the clinical trial is over. If the trial is for a drug, you will not be told if you are getting a drug or a placebo until after the trial is over. Patients can be harmed by a clinical trial.

    Your privacy and confidentiality is just an illusion: You may have little privacy and confidentiality! Under the HIPAA law all access to your records is allegedly by a “Need to know” basis only. This is another exaggeration (lie). Prostate cancer patients are asked to fill out a series of EPIC questionnaires and other questioners. The EPIC questionnaire asks several intimate details about patient’s sex life, urinary and bowl function. By a prostate cancer patient completing an EPIC questionnaire may be able to assist his doctor, nurse, office workers or database track his progress or decline. By refusing to fill out these questioners and supplying other unnecessary information one can help insure his privacy, dignity and insure he do not unknowingly become part of a study or clinical trial or other collective survey or have his information forwarded to multiple databases. He may be told these questioners and records are “strictly confidential” (as stated in some EPIC questionnaires); this statement is misleading. Most of the time a patient has no idea who has access to medical records or why the records are being looked at. Who has access to your medical records? Probably everyone that works in a medical office or building has access to the records, except you (often you the patient may have limited or no access without a formal request). Access may include/however not limited to non-medical employees, office workers, bookkeepers, janitors, insurance companies, temporary high school or college interns, volunteers, etc. This may also include other medical facilities, programmers, hackers, researchers, etc. Usually records are placed on a Health Information Exchange (HIE) or servers. Dozens, sometimes even hundreds or thousands or more people may have access to medical records. Some major databases like SEER (Surveillance, Epidemiology and End Results) are linked to Medicare records to determine “end results” for researchers, studies, drug companies, clinical trial offers, etc. Servers, both government and privet are sharing information, AKA “health surveillance”. Health information may be shared and downloaded by millions of entities and servers all over the USA and the world to countries that do not have any regulations for privacy. Your prescription history can also be tracked. Records may be packaged with others and offered for sale, this does often happen on “the dark web”. If a doctor, patient or insurance company is involved in a criminal or civil case, medical records may become public court or law enforcement records. Your records can be acquired by insurance companies. If a patient has radiotherapy he may have a photo taken before treatment to verify identity. All patients should get a copy and read any confidentiality disclosures statements (HIPAA statements). Financial and medical Identity theft is a growing problem, often expensive and difficult to correct. Ransomware is also a growing problem. Under the HIPAA laws you are entitled to a copy of all your medical records, however if you try to obtain a copy of extensive records as in a hospital stay you may be met with resistance. I recently went to a new optometrist for glasses and I was given a form that asked details about my heritage, including my mother’s maiden name and a form for my complete medical history. Your records can also be accessed by anyone (trainees, volunteers, students, high school interns, minors and adolescent people as young as 16 years of age) “for training purposes” or any other reason, all without your consent. A high school interns can even watch your surgeries and other invasive procedures. This gives kids a chance to play doctor and nurse in a real doctor’s office with real patients. A list of what a high school intern is allowed to do to patients: “learning simple medical procedures, watching surgeries, shadowing doctors (including seeing patients, possibly you), working in hospitals, interacting with patients, and more.” They can also read all records about your prostate problems, your wife’s hemorrhoids and your daughters yeast infections or any files for any patient, all within the HIPAA guidelines. These people do not have to be employed by the facility or have a background check. My family doctors office has summer time high school interns with full access to all records. One high school intern signed me in, took my temperature, weight, blood pressure and logged it in my file. Would you like to have a high school or college student that possibly lives in your neighborhood or attends school with your children read over your extensive family member’s medical records and personal information? How much curiosity or self control does a high school or college student have? I also went to a hearing aid center in a department store to get a free hearing test and was given forms inquiring about personal information and my complete medical history. This is information I do not want filed in a department store. All patients should avoid supplying unnecessary information whenever possible. Supply relevant information only when filling out forms. In the USA identity theft is very common, growing problem and is often financial devastating. Medical forms can be a good source of information for thieves. Recently my friend with arthritis in her hips received a letter offering a clinical trial for a new medication; coincidently looking for patients with hip and knee arthritis. How did this company determine she and not her husband or other family member was a prime candidate for this new drug study without violating any HIPAA privacy laws? Numerous exceptions (loopholes) appear within the HIPAA laws regarding you privacy. Even without HIPAA privacy law violations, records can be accessed by multiple people and appear in multiple databases. Sometimes medical phone calls are recorded “Calls may be recorded for training and quality purposes”. Calls about a clinical trial, calls to a large clinic, toll free number, calls to drug companies and calls to insurance companies may be recorded. These conversations can include confidential or medical information. Some of the Obamacare goals sought to have everyone’s medical records on servers so they could be accessed by any medical facility or doctor. HIPAA laws are deficient and often will not protect your privacy. Your privacy and confidentiality is not that secure. I believe the medical field has little regard for our privacy, especially if it is in conflict with training, research, studies, profit or other objectives. If you’re a public figure, celebrity, rich or famous you may be subject to numerous people wanting to see your medical records. Also if you are known to or an acquaintance of anyone with access to your records (neighbor, co-workers spouse, etc) they would possibly (or probably) want to have a look at your medical records. On May 6, 2017 Dear Abby did an article on this subject, “Snooping into medical records”. You are naive if you believe otherwise or that your records are secure. The same also applies to pharmacies and your prescriptions, labs, etc.

    A patient’s dignity (or lack of dignity): Prostate cancer testing and treatment is stressful, degrading, demoralizing and often unnecessary. EPIC questionnaires can be counterproductive impact a patient’s dignity, privacy, confidentiality and self image. EPIC questionnaires have an increased potential and greater impact on patients for privacy violations because of its format, nature and personal content (potential for HIPAA privacy law violations). Patients may mistakenly believe the EPIC questionnaire is a requirement to be filled out. Also the term “strictly confidential” can be misleading and ambiguous. One patient posted he filled out and turned in his “strictly confidential” EPIC questioners only to have every female office staff member read it and ogle him. Resulting in him not filling out any more EPIC forms or any other forms and he stated that he became very uncomfortable and evasive with the entire office staff. The drawbacks of this form seem to outweigh any potential benefit for some patients. Medical tests and procedures can be degrading and embarrassing for both men and women. Many women prefer or will only see female doctors or gynecologists, about 50% to 70%. Over half of men prefer a male doctor. (Per some respected doctors: “Men stay away from medical care in large numbers because of privacy and dignity. Many men still avoid medical care because of embarrassment. Honest answers will often not be given if asked by a female doctor or nurse.”) Per surveys: nurses and medical staff often laugh at and ridicule patients. What percent of men will feel comfortable consulting a female doctor, nurse or office worker about his prostate problems, ED, etc or would want an invasive test or procedure performed by a female?

    LDR Brachytherapy is permanent radioactive seed implant, a bizarre treatment option. This procedure implants about 60 to 120 radioactive seeds in the prostate, sometimes resulting in urinary problems. The patient will literally become radioactive for months and up to 2 years. The patient may set off radiation alarm at airports, seaports and border security checkpoints. He will also be required to use a condom, have no close contact with pregnant women, infants, children and young pets for months or longer. Occasionally he may even eject dangerous radioactive seeds during sexual activity or urination. The patient will become like a walking Chernobyl, having radioactive scrap metal and emitting hazardous radiation from his crotch. He will also be required to carry a card in his wallet stating he is radioactive. After treatment, if he dies cremation may be a problem. The videos of this procedure is disturbing and bizarre. A catheter will also be required. Brachytherapy has a high possibility for ED.

    ADT Hormone therapy, big profits, devastating side effects: Lupron injections is one of the most common. Men are prescribed hormone therapy (ADT therapy), AKA chemical castration as an additional or only treatment. Hormone (ADT) therapy is sometimes over prescribed for profit, per some studies. Hormone therapy is often very expensive (Profitable for doctors if provided at the doctor’s office and not a pharmacy) and can have horrible, strange and devastating side effects, feminization, hot flashes, fatigue, weight gain, long term or permanent ED, depression, etc. His penis could shrink and his testicles can completely disappear, he may grow breasts. This treatment can have so many mind and body altering side effects that doctors will often not inform patients about all of them. One man stated that ADT therapy turned him into an old menopausal woman. Men are sometimes actually castrated (orchiectomy) as a cancer treatment to reduce testosterone; I just can’t imagine a more barbaric and primitive treatment. Amnesty International calls chemical castration “inhuman”. ADT therapy is often used in sex reassignment surgery, male-to-female transsexuals. Studies (Medicare and financial) have documented doctors do over prescribe ADT therapy for profit (depending on Insurance payout rates/profit margin). When insurance payment reimbursement for ADT decreased so did the number of patients being prescribed ADT therapy! Per Wikipedia: “in patients with localized prostate cancer, confined to the prostate, ADT has demonstrated no survival advantage, and significant harm, such as impotence, diabetes and bone loss. Even so, 80% of American doctors provide ADT to patients with localized prostate cancer.” Overtreatment with ADT is extremely profitable, unfortunate and avoidable.

    Nerve sparing Robotic-assisted DaVinci surgery is touted as being a better treatment and having fewer side effects, this is usually an exaggeration. The nerves can not always be spared. Robotic surgery can result in a faster initial recovery. Long term risk of incontinence, fatigue, ED, depression, some men will ejaculate urine, shorter penis, etc is about the same and sometimes worse then conventional surgery. Patients undergoing surgery are at a very small risk of developing post traumatic stress disorder (PTSD) and about a 22% chance of long term or permanent fatigue. A catheter will be required. Also .2% to 1.2% risk of deaths as a result of prostate cancer surgery or medical mistakes. Patients can have unrealistic expectations about the results and regret the surgery option. The ED rates and other side effects are often understated to patients. Men are left limp and leaking after this surgery.

    Patients should not be naive: Medical mistakes are the third cause of deaths in the USA (over one million deaths in 4 years). Medical mistakes cause more deaths then suicide, firearms and motor vehicle accidents combined. Countless other patients have been harmed by medical mistakes. If you are having surgery, biopsy or a procedure take precautions if possible. Have someone qualified or knowledgeable monitor you and your medications, etc. Doctors, nurses and technicians can be profit motivated, use obsolete procedures, be lazy, incompetent, make mistakes and be apathetic or rushed. Occasionally harm can be done or not prevented with intent. Drug abuse is often a problem with some medical workers because of easy access. Doctor’s offices and clinics can see many patients in a relatively short amount of time. This may be a disadvantage to patients, empathy and quality of care can sometimes be compromised. Sometimes a nurse, medical assistant or an office staff member may be the person that overseeing much of a patient’s care. I personally know of or have had contact with at least 14 nurses and other medical staff that I would consider dangerous: incompetent, dishonest, lazy, abusive, mentally disturbed, sadistic, drug abusers that work in doctor’s offices, labs and hospitals. Most of these people did not have a name tag and supplied me with a first name only when asked for a name. I am now sure modern medicine protects the guilty and incompetent, also victimizes the naive patients. I now understand why medical mistakes are the third leading cause of deaths in the USA. I now believe some or most of the deaths and injuries are preventable or intentional. Medical workers can know everything about a patient, hide behind anonymity and do patients irreversible harm or death. The patient may not even know his or her first name. TV and sometimes the public seem to idolize doctors, nurses and caregivers; however the health care profession has about the same amount of abusive or incompetent workers as other occupations. I have also had excellent doctors and nurses. However this may not protect you from the bad ones. What are the main reasons nurses get fired: 1. Prescription drug abuse (because of easy access to drugs). 2. Too many mistakes. 3. Code of conduct and privacy violations. 3. Bad attitude. 4. No proper licenses 5. Abuse of patients. Patients should be aware that sometimes QOL (quality of life) may be secondary or an absent goal in treatment. Sometimes overtreatment for profit or to prevent an unlikely death or metastization from low risk cancer may be the primary or the only goals of prostate cancer treatment.

    A blind biopsy or treatments are often worse then the disease: Testing and treatment often resulting in Chronic/permanent fatigue, incontinence, depression, sexual dysfunction and sometimes death. Hormone therapy does have an extensive list of side effects that can be devastating for men. Biopsies and treatment are degrading, stressful and often unnecessary. Many men may not be prepared or have unrealistic expectations about the outcome, physical and psychological impact of testing and treatment.

    Depression in prostate cancer patients is common, about 22% at 5 years (per some studies) and for advanced prostate cancer patient’s depression is even higher. Prostate cancer patients are at an increased risk of suicide. Men are seldom screened for depression after prostate cancer.

    The risk of long term chronic and permanent fatigue (that can result in depression) is almost always understated if mentioned at all too many patients. Per some studies and depending on your treatment; the risk of long term or permanent fatigue is about 25% to 60%. Radiation with Hormone therapy has a high risk of fatigue. Long term fatigue also increases the risk of clinical depression and suicide.

    Prostate cancer testing and treatment, quackery and butchery! Castration, ADT hormone therapy (chemical castration), LDR Brachytherapy (radiation seed implant), cryotherapy, radiotherapy, surgery, chemotherapy and blind biopsies are dangerous, psychically and emotionally brutal, traumatic and disturbing. These types of treatments are primitive and almost beyond belief in today’s world of advanced technology. It seems all of the best treatments for prostate cancer have not been approved and some are only available outside the USA. Newer treatments like, HIFU, hyperthermia, Conexus, IRE Therapy, Boron Neutron capture therapy, Gold Nanoparticles, PARP Inhibitors, Platinum, focal Ablation (only treating the cancer and not the entire prostate) and orphan drugs (dichloroacetate, etc.) should be approved and used when appropriate. Biopsies should be limited to selective MRI guided samples only; blind biopsies should never be performed. Per some studies vitamin D3 may help control PSA and prevent prostate cancer from becoming aggressive.

    Lipstick on a pig: Approved advances in prostate cancer treatment mostly consisting of newer, faster and more accurate radiation treatments, robotic surgery and new drugs. These advances sound like greater strides have been made. However most of these approved advances are of limited benefit to prostate cancer patients and still have about the same amount of long term side effects. Compared to other technologies, computers, communications, electronics, aviation, etc, cancer treatment approved advances have been dismal. The National Cancer Institute wastes about 3 billion dollars a year on PSA screening that can be used for research and true cures. QOL (quality of life) issues have not been adequately addressed. Profit often outweighs QOL.

    Prostate Radiotherapy (EBRT-external beam radiation therapy) for cancer treatment. New technology consists of: IMRT, SBRT, IGRT, VMAT, TrueBeam, Cyberknife, etc. This newer, faster, more accurate and easer to setup radiation equipment is of much benefit for doctors, staff and a good selling point to patient’s. However as far as reducing long term side effects, only small gains have been made with the newer radiotherapy equipment. A patient should be skeptical if exaggerated claims are made about reduced long term side effects, especially fatigue and ED rates. Radiotherapy can cause hip and bone problems later in life. About 25% of radiotherapy patients can expect an alarming temporary “bounce” (spike) in the PSA value after treatment. Patients should inquire as to the treatment plan: Gy dose and fractions, margins, testicular dose, constraints and age of radiotherapy equipment to insure excessive radiation exposure treatment is not given that can result in additional side effects. Patients should be aware that pelvic shaving, permanent tattoo markers, fiducial marker (small seeds) are sometimes placed in the prostate, MRI, CT scan, photographs, catheters and other procedures may or may not a be required. Radiotherapy can also occasionally result in secondary cancers and damage to “organs at risk” (organs close to the prostate). Radiation has a high probability of sexual dysfunction and fatigue, just as high and sometimes higher with the newer equipment. ED rates estimated at 35% to 75% or higher, 93% at 15 years. Sometimes radiation can also cause bowel and urinary problems. Per some studies radiotherapy causes moderate-to-severe gastrointestinal effects in 17%. A 5 day SBRT radiation treatment is now commonly available with about the same results and side effects as a 9 week radiation treatment. A doctor with a multimillion dollar lease and maintenance agreement on radiotherapy equipment and a large staff may or may not be influenced by his or her financial obligations when deciding to recommend over testing and treatment.

    Fried nuts, two-: Prostate radiotherapy (EBRT) can sometimes result in a 5% to 30% temporary or permanent drop in testosterone levels, excluding hormone therapy. This drop is determined by the testicular radiation dose (treatment equipment and planning). A below normal drop in testosterone can result in fatigue, depression, sexual dysfunction and other symptoms. Always ask for a printout of testicle dose and constraints before and after prostate EBRT to insure your testicles are not over radiated, also include the CT scan exposures. Have your testosterone levels tested before and months after EBRT treatment.

    Chemotherapy can be extremely toxic and sometimes deadly: Any cancer patient (man or woman) who are being offered chemotherapy should be particularly cautious. Without genomic testing or proof of the effectiveness of the specific drug being used on the exact cancer type being treated, chemotherapy can often be more toxic to the patient then to the cancer. Chemotherapy may be extremely expensive, profitable for some doctors (if dispensed by the doctor and not by a third party) and can be misused or overused, often for profit. The “chemotherapy concession”: A doctor may purchase a quantity of chemo drugs for $10,000 and charge a patient $20,000. A doctor can also receive a percent kickback from the drug company for prescribing the drug. What is the motive for some doctors to perform Genomic testing and giving a patient a different and more effective treatment at an unknown or no profit versus a guaranteed profit with a probable worthless or harmful treatment? This is a well documented and common practice. 75% to 90% of oncologists would refuse chemotherapy if they had cancer. Chemotherapy fails upwards of 93 and 98% percent of the time depending on which study you look at. One Michigan oncologist who committed fraud and gave $35 million in needless chemotherapy (for profit) to patients, some who did not even have cancer is now in jail for 45 years. He was running his own in-house pharmacy. The nursing staff was indifferent and the state regulatory agency initially cleared him of any wrongdoing (a cover up). Many or most chemo drugs are considered a biohazard.

    Long term care consists of regular PSA testing for years. Long term care for side effects is often lacking or exploitive or ineffective. Often complaints of side effects are disregarded by nurses, doctors and sometimes referred out to other doctors. The patient is sometimes left to figure out what to do about his side effects with the resources available to him. Long term side effects often consist of fatigue, bowel or urinary problems, sexual dysfunction, depression and other symptoms. Patients with complaints of chronic fatigue are often told to exercise, get plenty of sleep, pace your self and eat a healthy diet; this advice is of limited help for chronic fatigue. Often treatments for long term side effects are embarrassing, degrading, unavailable, nonexistent, costly, not effective, not offered or bothersome. Prostate cancer treatment often results in fatigue, depression, isolation and sometimes suicide. Billions of dollars are profited from ED drug and other ED products, catheters, pads and diapers, drugs for depression or pain or insomnia or incontinence, additional treatments and surgeries for side effects. Also treatments for the multiple and bizarre side effects from hormone ADT therapy (chemical castration) is sometimes required.

    Men, ageing, exploitation and elder abuse: If any man lives long enough it is very likely he will have a prostate problem, low testosterones or some form of sexual dysfunction. In my opinion modern medicine often has been exploitive, abusive and has provided substandard care for older men in general due to all of the explanation given in this text. I believe much of the attitudes toward older Americans need improvement and they are sometimes viewed as being subhuman and exploitable by various groups and individuals. If documented cases of unnecessary surgery and radiotherapy or blind biopsies on children by doctors for profit were released, the vast majority of Americans would be outraged and this practice would quickly end. However for older men it dose not seems to be of great concern! As defined by some or all state laws, exploitation of elderly men by overprescribing treatment for profit is a crime or an offence of various guidelines and regulations. It is extremely unlikely any doctor will ever be prosecuted or have a medical license suspended for this common and extensively documented abuse or crime. It is well documented that all forms abuse do occur to the elderly and disabled in nursing homes and other facilities including neglect, theft, starvation, torture, harassment, sexual assault, etc. Elderly are being exploited in many ways (Also scams for profit). One patient after recovering from a brain injury testified that he was repeatedly abused, slapped and hit, forced to drink boiling hot tea by multiple caregivers and sexually assaulted by one female caregiver. I personally know of an elderly lady that is living in an expensive assisted living home that has had all of her possessions (radio, clothes, underwear, shoes) repeatedly stolen and replaced by her family including the sheets off of her bed, even after the sheets where marked with her name using a larger permanent marker pen. Guardian scam: If you are declared incompetent by strangers, they can become your guardian (Guardianships and Conservatorships). You can be forced to move into a nursing home and your property can be sold and your assets can be seized by them. In other words-they can steal your assets and incarcerate you. Some people are becoming very wealthy by using this exploitation method. Make sure you have an estate trust, executor, etc.

    ED, no bathtub included: Almost all prostate cancer treatments usually result a high percentage of erectile dysfunction. Loss of libido estimated at about 45%. Excluding hormone therapy, lower libido is almost never disclosed as a treatment side effect and sometimes it is completely denied as a problem. Blind biopsies can often cause temporary or permanent ED. Often claims of prompt effective treatment for ED or other side effects if they occur after treatment are often misleading. Statistics for ED percentages from treatment are usually quoted after treatment with Viagra, Muse or other ED treatments, therefore most statistics are very misleading. ED rated at 5 years may be as high as 50% to 80% or higher for most treatments. ED rated at 15 years may be as high as 90% or higher for most treatments. For cryotherapy, ED rates are extremely high. The cost for ED drugs like Levitra, Cialis, Viagra and Muse are deliberately kept very expensive by drug companies, about $10 to $45 per 1 pill or dose. At these prices Lilly could consider including a free bathtub featured in its advertisements for Cialis. The cost of a 30 day supply of Cialis is usually well over $320 and the cost of an inexpensive bathtub is about $200. Generic PDE5I ED drugs in Canada and other parts of the world sell for about $0.50 to $2 a pill. Many insurance companies will not pay for ED drugs or treatment. Less expensive generic drugs are usually unavailable in the US. Some ED drugs should have already become available in a generic (in the USA) form for about $1 a pill. This is further exploitation by the drug companies of men in general. Men are also exploited by counterfeit mail order ED drug sales. ED drugs are not always effective and may have side effects. ED treatments can also be embarrassing, not offered, not practical, painful, expensive/not covered by insurance. Men will often not seek treatment because or these reasons.

    The numbers game, you lose: More exaggerations and lies. A doctor may state a patients chances of ED is about 35% with EBRT radiotherapy (or some other treatment). A patient may think, 35% is not too bad and if I do get ED I can always take Viagra. What a doctor may not tell a patient is that the ED rate is 35% at 1 or 2 years for a patient under 65 years old and with an ED drug treatment option. For a patient over 3 years, over 65 years old and no ED drugs the ED rate may be about 75% or higher, after age 70 your chances of ED is over 85% or higher. Obviously, a man is more likely to refuse treatment at a 75% ED rate verses a 35% ED rate. Some side effects may not be disclosed at all. If side effects (low libido, chronic fatigue, depression, increased suicide risk, etc) are not disclosed, no percentages will usually need to be quoted. Results are often worse for a surgery option, the main difference in ED results between surgery and radiotherapy is; with surgery ED will start out bad and may or may not get better with time, however with radiotherapy ED will get worse over time. With both treatments together or with ADT hormones also you’re in real trouble with ED percentages. Cure rates are often quoted at the 5 years mark for most treatments. 5 years is not a magic number, anyone can have a treatment failure before or after 5 years. A cure rate for a treatment at 5 years may be quoted at 85%; however the cure rate at 7 to 10 years may be only 70% and 50%. The 85% at 5 year rate was quoted to me. I was never told about my 50% at 10 year cure rate. Always ask what is the “biochemical recurrence” (AKA rising PSA or treatment failure) rate for well beyond 5 years with your computer software simulation and Partin tables. Ask your urologist or radiation oncologist for a 10-year cure Rate. If the physician is unable to provide one, consider finding another doctor. Studies and clinical trials results, side effects percentage claims, etc can be biased. Watch out for terms like “age adjusted” or ambiguous or excluded facts as given in the above examples. ED rates for radiotherapy are usually quoted at under 1 or 2 years and for surgery over 1 or 2 year to give the appearance of a more positive result. I have read and have been given some extremely exaggerated claims (mostly lies) concerning cure rated, side effects, etc.

    Prostate cancer patients are sometimes elderly and exploited for profit (per documented studies). A blind biopsy is unsafe and newer test methods should be used. The treatments offered have horrible side effects. Some doctors are treating patients with low risk cancer or advanced age when monitoring is often a better option. Patients with low risk cancer or advanced age should often be offered “watchful waiting” or “active surveillance” instead of treatment. Aftercare for long term side effects is frequently ineffective, expensive, not offered, degrading or nonexistent. Prostate cancer patients are seldom told about chronic fatigue, depression and the true risk of side effects are usually understated. Modern medicine often fails and victimizes prostate cancer patients.

    Often few good choices exist for treatment: A prostate cancer patient treatment choice often ends up being the least worst choice or the choice with the side effects a patient thinks he can tolerate. If a patient has intermediate or high risk prostate cancer and dose not have advanced age he may need treatment. He should consider genomic testing and look into other advanced treatments if available. Also he should try and avoid hormone therapy if possible because of the multiple side effects especially if the cancer is organ confined. If laser or other advanced treatments are not available a 5 day SBRT radiation treatment may be considered (In my opinion SBRT could be the least worst of the bad choices, still a poor option). SBRT seems to be fast, least invasive or traumatic. ED and fatigue is still a high long term risk. Radiation with hormone therapy has a higher risk of ED and long term fatigue. However, I now believe conventional prostate cancer testing and treatment is a mistake for most men.

    The short version of my story: I was referred to an urologist by my family doctor after a high PSA test. I will refer to the urologist as Doctor “A”; he used old and dangerous testing technology (18 core blind biopsies), his nurse seemed to have a mental defect exhibiting arrogant, rude, strange, abusive behavior and was intent on inflicting psychological harm to me. Shortly after my Dr. “A” visits ended, his nurse was no longer employed at his office and no person in that office would refer to her employment or her existence. I now believe this nurse was high because of drug abuse being common among nurses (easy access to drugs). I was diagnosed with prostate cancer by Dr. “A”. I refused his surgery and hormone therapy recommendation because of the imminent side effects and his unprofessional nurse behavior, so Dr. “A” referred me to Dr “T”. Dr. “T” was outside of my insurance network; however his office manager stated she was willing to work with my insurance, offered me a doctor consultation and would accept any insurance payment as a full payment. When I arrived in his office the waiting room was empty. He also had a large staff. Dr. “T” used older conventional technology, offered me overtreatment, hormone therapy, unnecessary procedures and testes. One week after my consultation with Dr. “T” I received an $850 bill, in conflict with what was agreed upon with his office manager. After a recommendation from a friend, I called clinic “O” and met with the nurse. She offered me treatments with a verbal guarantee of “no side effects from the radiation”. However this nurse could not answer any of my basic questions, lacked any credibility and sounded like an unscrupulous used car salesmen. Most of these office visits caused me multiple problems with offices workers processing paperwork for tests, insurance forms and billing, etc. Two of these doctors offered me an unnecessary bone scan. Two of these doctors recommended unnecessary hormone therapy ADT (overtreatment) for my organ confined cancer. After I absolutely and utterly refused hormone therapy, both doctors admitted it probably would not help me in my final outcome because of the computer estimate run on me with my organ confined cancer, PSA, biopsy report, etc. Having no advance treatments (laser, etc) available to me at that time, I decided on SBRT treatment with Dr. “K”, he could answer my questions and had new equipment. Before my treatment could start I was referred to “W” lab for an MRI. “W” lab had a trainee assisting and it took over 2 hours to complete my MRI. 2 days later after receiving a copy of my MRI report, I examined the MRI report; it had my name and some other patient history information. I wasted 2 more days verifying it was the correct MRI of me and not some other prostate patient MRI before my treatment could start. I did receive treatment from Dr. “K”. I did have a relatively fast and noninvasive treatment (SBRT), resulting in several months of fatigue, a large PSA bounce 18 mothers later and some other short term side effects. At this time I am doing okay, however I’m not sure what the future will bring? I also no longer trust modern medicine, doctors, nurses, etc. Modern medicine seems to be more of a gamble then a science. I have wasted hundreds of hours and thousands of dollars. I feel modern medicine has abused and failed me (and others) due to the lack of guidelines and regulation, still approved obsolete technology, better unapproved treatments, exploitation, greed, apathy and incompetence. Hindsight is 20/20. I was never offered Genomic testing. If I could do it over again, I would also consider no PSA testing and treatment or traveling for advanced treatments from a competent provider if practical and available. I believe if I did take the two doctors recommendations and received unnecessary hormone therapy in addition to the radiotherapy my quality of life (QOL) would have been severely impacted for years or permanently and could possibly have resulting in my early death. I did seem to have a lot of bad luck in picking providers or is this just the new standard in medical care?

    “Do no harm”, unless you can make a lot of money and get away with it: I was harmed physically and verbally by Dr. “A” 18 core blind biopsy and verbally abused by his nurse. I was potentially exploited and financially harmed ($850) by Dr. “T” and offered unnecessary testing and overtreatment. Clinic “O” nurse attempted to misinform and deceive me about the treatment outcome of “no long term side effects”. I was harmed by “W” lab by mistakes and incompetence. I did also have numerous other billing and paperwork problems probably due to mistakes and apathy. A few of the office staff were incapable of completing some very simple tasks like filling out lab work request or insurance forms. At least 40% (probably substantially more, 50% to 60%) of the health care workers I came into contact with did or attempted to do some form of harm to me or provide substandard care, attempted excessive testing and treatment, mistakes, billing overcharges, blind biopsy, false statements, deception, misinformation, apathy and abusive behavior¬¬¬, as explained in this text. I have also observed several medical facilities do not require workers to wear name tags and when asked for a name most will give a first name only; this may also be a factor in health care workers not acting in an ethical manner. To me, it seems that this prostate cancer nightmare maze was intended for maximum physical, psychological, financial harm and to be of questionable benefit and maximum profit for doctors. My prostate cancer experience has been one of the worst events that has happened to me in my lifetime. Also seeking testing and treatment is one of the biggest mistakes I have ever made. I specifically blame modern medicine for not protecting patients from predatory doctors, substandard technology and a lack of regulations that would protect patients. I would have been much better off going to a Voodoo or witch doctor. I would have saved thousands of dollars, time, had no side effects, no paperwork, more confidentiality and privacy, and probably received better advice. I could have received a nice amulet or a good luck charm to protect against sorcery or magic (PSA testing, blind biopsies and treatment) and evil medicine men (predatory doctors).

    My treatment choice: I feel LDR Brachytherapy and hormone therapy (AKA chemical castration) seemed to be completely degrading, disturbing and bizarre. Hormone therapy would not have been an effective treatment for me. Surgery and Brachytherapy are to invasive. Surgery has an imminent danger of incontinence and ED. 9 week EBRT radiotherapy was just too long and laborious. Because castration (orchiectomy), ADT hormone therapy (chemical castration), surgery, Chemotherapy, LDR Brachytherapy and blind biopsies are what I consider “Frankenstein medicine” (Harmful, strange, bizarre, brutal, twisted, degrading or a perverted nightmare) I would avoid all of them. Unfortunately, I was deceived and misguided into having a blind biopsy. I do not believe other conventional treatments like radiotherapy are good or great choices either, just not as horrific. The choice I made was a 5 day SBRT radiotherapy. A 5 day SBRT also has numerous drawbacks and side effects, about the same as a 9 week EBRT radiotherapy. I also had no advanced treatment options available to me. As I have stated above, If I could do it over again I would also consider either no PSA testing and treatment or traveling for advanced treatments from a competent provider if practical and available. I am now sure I made the wrong choice by receiving conventional testing and treatment. With prostate cancer, the testing or treatment is often worse then the disease. I am not implying anyone should make the same choices as I did. I am only giving the motives for my decisions. I was also the victim of profit motivated and substandard providers. 3 years later I now believe my prostate cancer testing and treatment greatly accelerated my ageing (through the stress, testing, treatments and physically from the radiation and was also a financial burden). Per a new SBRT studies my 4+3 Gleason score is considered “unfavorable”. I now have about a 50% chance of a treatment failure in 8 to 10 years. My previous long term cure rate was originally quoted at 85% before my treatment started. I am also sure prostate cancer testing and treatment is mostly smoke and mirrors (lies). The man who invented the PSA test, Dr. Richard Ablin now calls it “the Great Prostate Mistake, Hoax and a Profit-Driven Public Health Disaster”. When asked: “How did you live so long?” A 99 year old woman stated “stay away from doctors and don’t take anything they prescribe for you”. With some exceptions, I now believe this advice to be mostly true.

    Always protect yourself: It should not be up to a patient to protect himself or herself from harm from doctors, however the new or common standard in medical care seems to be substandard. Do not let the sterile, friendly and professional environment of a doctor’s office detour you from protecting yourself from overtreatment or any unnecessary life changing tests and treatments. If you are concerned about misuse or privacy issues, refuse to fill out EPIC questioners and limit the information given to relevant information only. If you have a high PSA or prostate cancer, educate yourself. A patient should be extremely skeptical if exaggerated claims are made about minimal long term side effects from conventional treatments or blind biopsies. Also exaggerated cure rates or the need for immediate treatment. Bring someone educated or astute with you to your consultations and appointments. Insist on Genomic or advanced testing if you have prostate cancer. Avoid doctors that are mostly profit motivated. Do not submit to a prostate blind biopsy. Get a second or third opinion if you are being offered treatment with low risk prostate cancer. Learn about all your treatment options, testing and side effects. Verify everything you are told. Under the HIPAA law you are entitle to a copy of all your medical records and bills. Always ask the name of the person assisting you. If they refuse the request for a name leave immediately (you may or may not be in extreme danger). Be very cautious if you are ever refused a copy of your records; demand a copy of your records and a reason for any denial and seek other advice. Get a copy and keep a file of your test results, biopsy report, Gleason score, PSA, MRI report, treatment plan, bills, insurance payouts, etc. Carefully monitor your PSA. Expect a temporary increase (for weeks or months) in PSA after some procedures. Verify the accuracy of paperwork. If treatment is necessary talk to your doctor in advance about side effect management, chronic fatigue, ED, etc. Doctors that provide treatments often have computer software to predict the outcome using test results and different treatment options. Ask to see your computer predicted cure rate outcome with your treatment options if available. This may give you some insight to your options, cure rate and also to avoid overtreatment. Always ask what is the “biochemical recurrence” (AKA rising PSA or treatment failure) rate for well beyond 5 years, 5 years is not a magic number. For help contact a good prostate cancer support group without a conflict of interest. A wise man once told me “you need to learn to think like your doctors and nurses (or other providers)”. What are the motives of your providers, place them in order that you observe at your doctors office: to profit, to cure, to get high on the backroom drug supply, to do less work, to take an extra long lunch or get off work early, to help people, to cover up their incompetents, etc? This exercise may give you some insight into the care you may receive.

    A medical holocaust: Multiple studies have verified more deaths caused from prostate cancer testing and treatment then from prostate cancer itself. Medical mistakes are the third leading cause of deaths in the USA, over 251,000 deaths a year or over one million four thousand (1,004,000) deaths in 4 years. More then suicide, firearms and motor vehicle accidents combined. These statistics do not include many more people that have had their lives destroyed or shortened by modern medicine or a reduction in QOL (quality of life). Per the FDA, 106,000 deaths per year (Over one million people in 10 years) from prescription drugs. Very often men are not told about all of the true risks and side effects or they are downplayed for both a blind biopsy and treatments. I personally know of 2 patients killed from medical mistakes, one got hepatitis from a colonoscopy and the other death from an upset ER nurse forcing a tube down his throat causing lethal damage.

    Strict guidelines for cancer testing and treatment need to be created and enforced because of the extensive and documented abuses of prostate cancer patients: 1. Blind biopsies should be banned. 2. Strict standards and gridlines for testing and treatment need to be created. 3. Full mandatory industry standard disclosure forms need to be created for tests and treatment to include realistic risk factor disclosure. 4. Newer testing and treatments need to be created and approved. 5. Dignity, privacy and confidentiality need to be standardized and enforced in addition to the HIPAA laws. 6. Aftercare needs to be available, standardized and regulated. 7. The cost for drugs needs to be regulated to end financial exploitation by drug companies. 8. Medical workers should be identifiable and be required to wear name tags with first, last names and job title. 9. A new standard “Ethical Code of Conduct” needs to be created and enforced to end patient exploitation and abuse. 10. Genomic or genetic testing should be required before any patient is sent for treatment to avoid overtreatment and insure the correct treatment. 11. A truthful and accurate standardized educational book or PDF needs to be created and distributed to all high PSA and prostate cancer patients. 12. Ban for profit ADT therapy and the “chemotherapy concession”. It is unlikely any of the above recommendations will be implemented unless prostate cancer affected a larger percent of the population or enough prominent people are affected. Prostate cancer patients must protect themselves as the only alternative!

    Clarification: This text may probably anger and upset some people for various reasons. The intent of this document is not to imply all doctors are dishonest or to condemn all medical providers. The intent is to educate men of the consequences and dangers that may await them so they can take appropriate action and to inform patients of real world, typical or worst case scenarios. I have also tried to include most scenarios a prostate cancer patient should be cautious of. Would some health care providers harm a patient for profit or by accident or some other reason? Yes, absolutely! We just don’t know who or what percent would. Shockingly, for me it was will over 40% (probably 50% to 60%) that intended to do me some form of harm or provided substandard care as explained in my story. Are some other doctors and nurses exceptional? Yes! I have also had excellent doctors and nurses, however this may not protect you or I from the bad ones. Differences in opinion, variations in semantics do not invalidate this document or its intent. The information in this document is a sum of my experience, other patient’s experiences and hundreds of videos, documents, books, conversations, clinical trial, peer reviews, blogs, studies, articles, etc.

    Recommended reading. Investigate for yourself:
    1. Hardcover book, The Great Prostate Hoax: How Big Medicine Hijacked the PSA Test and Caused a Public Health Disaster. by Richard J. Ablin (Inventor of the PSA test).
    2. https://urologyweb.com/prostate-cancer-treatment-the-disturbing-facts/
    3. Internet search or Google: prostate cancer overtreatment or scam or hoax, useless PSA, Prostate biopsy sepsis or dangers. Medical mistakes, etc.

    Often prostate cancer testing and treatment is harmful and a big scam for profit! The evidence is overwhelming.

    Disclaimer: I have no conflict of interest. I do not represent any support group or other organizations. I am not a doctor. I do not prevent, treat, diagnose, cure or advise on medical matters. The information in this document is for educational purposes only. If you need treatment or medical advice, consult a competent and trustworthy medical doctor.

    Anyone may copy, email or distribute parts of or this entire document without changing or modifying it.

    I have been extensively criticized by some for creating this document and its blunt content. In order to insure my privacy and avoid any potential reprisals, further abuse or exploitation, I will remain Anonymous.

  3. Kavin August 1, 2017 at 2:41 pm - Reply

    Hello Sara,
    My wife has done Prolactin test when she was in her 4th week of pregnancy, and the result was (76.04 ng/mL), is it normal ?
    I know I’m out of the topic, but I really trust you opinion, Thank you dear…

  4. Dalla73 July 3, 2017 at 9:08 pm - Reply

    Hi, my long-time partner and I have recently made the decision to try to conceive within the next year. He is 40 and I am 36. I have children from a previous marriage and he has none- in fact he’s never had a pregnancy scare/expectation. As a result, he does not truly believe we will conceive without intervention.

    My question is this: Should we be concerned about his prostate and testicular health due to somewhat rough and non-mainstream activities we share in the bedroom? Specifically genital bondage, stretching, striking, pegging, etc.? He has been a participant most of his adult life.

    He is not quite ready to bring this up with his doctor or have an exam/semen testing. He does have other factors weighing against conception such as smoking and diet, but we’ve started making changes to help mitigate them.

    Any insight and advice would be much appreciated. Thank you!

    • Sara SDx August 15, 2017 at 9:54 pm - Reply

      Hi, sorry for the delay. I have been traveling and had limited access to internet.

      Here are a few thoughts on your concerns.

      1. It’s a good idea to think about this ahead of starting to try because it can be stressful if there is an issue. So good on you for being proactive.
      2. Rough sex generally is not too concerning unless you actually injure yourselves. I’ve talked to a fair number of urologists who have had cases of actual physical damage that they have needed to treat. The potential to have minor damage could contribute as a risk factor so I think it’s reasonable to be concerned. But major injury causes significant pain for long periods so I feel like in general, the risk of actually damage testicular tissue is probably low. However, while trying to conceive, you might want to take it a little easier.
      3. Smoking and diet can have a material impact on semen quality. Studies have pretty solidly connected both of these things to subfertility in men, so it could be a good idea to start taking steps now to improve on these fronts.

      I worked to help found a start-up called Trak that is designed to support men with reproductive health. It is a complete system that includes a home test and a companion app that provides personalized guidance based on scientific literature and feedback from urologists. It might be a good fit to where you guys are at… I’d love feedback to hear what you think of it.

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