19/03/2013 00:00
TW
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Gerry Mulligan's comprehensive article on detecting prostate cancer touched on two major problems. The first is the reluctance of men to “bother” the doctor. A Scandinavian study implied it could be genetic. It showed men who produced daughters rather than sons appeared to be much more liable to prostate cancer. It transpired that men who produced daughters rather than sons were much more liable to be diagnosed with prostate cancer. The actual frequency of the disease was the same between the 2 groups, it was just that the second group hadn't checked. The difference was due to daughters prodding their dads to the surgery more than sons did. The second problem is that medical opinion is increasingly suggesting that just like breast cancer in women, prostate cancer in men is being over diagnosed – in plain English miss diagnosed. His experience with his urologist was typical - because he had a PSA of over 4 a biopsy was recommended. If that had proved positive he would have been directed to immediate treatment typically surgery or radiation. He highlights that even a well performed biopsy can miss the cancer (15%). I should also point out that 12% of positive biopsies are plain wrong. With radical prostatectomy the removed gland can be completely examined and 1 in 8 is found to have no trace of cancer.

The operation carried out on the patient, with all the risks of the horrendous side effects of incontinence, impotency and sterility, having been completely unnecessary. Only through the strength of his own research did he delay the tide of medical opinion until the hiccup in his PSA dropped to an acceptable level (to him but still not the medic). His perseverance is not common. Most doctors pressure their panicked patients into often premature and occasionally unnecessary treatment. Much more relevant than an individual PSA reading is a series of measurements when a trend may be detected and the cancer rated aggressive or not. If over say a 24 month period a sixty year old has a PSA increasing from 4 to 5 the trend at this rate is not particularly dangerous and certainly this alone would not necessitate an operation. Prostate cancer is very prevalent in older men but in fact more die with the decease than from it! When treatment occurs and is later judged unsucessfull pomegranate juice can slow and sometimes reverse a PSA trend. This “medicine” is pooh-poohed by doctors as folkloric but is backed up by studies at UCLA over many years involving both breast and prostate cancer sufferers. As well as native to our islands it tastes nice! Mike Lillico
Playa de Palma