Doctors sell prostate cancer patients on surgery as the only way to treat the disease once and for all, but evidence is mounting that, in a high percentage of surgery cases, the cancer soon comes back.
As smoking has declined, prostate cancer has overtaken lung cancer as the biggest cancer killer of men in the Western world. One in 12 will develop a clinically significant prostate disease in their lifetime. Each year, some 10,000 men in the UK and more than 40,000 in the USA die of the disease.
The scandal of prostate cancer is not just the burgeoning incidence of the disease, suggesting that something in the Western lifestyle is proving deadly to the male constitution, but also the ruinous way in which modern medicine treats it.
In the vast majority of cases, the so-called ‘treatment’ leaves the patient worse off than having the disease - incontinent, impotent and likely, in 40 per cent of cases, to have the cancer return.
Doctors have been using the same treatment methods for over 30 years. Despite this, a recent Lancet review candidly admits that 'the optimal treatment for localised prostate cancer is still not known' (Lancet, 1997; 349: 906-10).
The conventional therapy is the traditional trio of surgery, radiation and drugs. The most common surgical technique is transurethral prostatectomy, or TURPS, in which the prostate is cut or burned away by an instrument inserted down the penis. Surgery is recommended for both prostate cancer and benign prostatic hyperplasia (BPH), non-life-threatening age-related enlargement of the prostate.
The side-effects of surgery are both severe and debilitating. In addition to possible prolonged bleeding from the prostate itself, many men are rendered permanently incontinent. Furthermore, a staggering 80 per cent will be made impotent as well (J Natl Cancer Inst, 2000; 92: 1582-92). There is considerable anecdotal evidence that doctors choose to withhold this devastating information from their patients before they operate.
New surgical techniques such as cryotherapy (freezing) and so-called ‘nerve-sparing surgery’ don’t appear to appreciably reduce these side-effects either (J Urol, 1996; 156: 115-21; JAMA, 2000; 283: 354-60).
Although doctors often suggest otherwise, surgery is not guaranteed to solve the problem of prostate enlargement. Worse, there is a significant risk of recurrence of both BPH and cancer.
A study by the Mayo Clinic in the US showed that prostate cancer returned within a year in more than 8 per cent of the men they treated. This rate of recurrence rose to 40 per cent 10 years after the surgery (US National Cancer Institute Statement, July 2001).
Radiotherapy has an equally unimpressive record. This treatment is applied either externally by X-rays or internally with the use of radioactive implants (also called brachytherapy).
Radiation is frequently called upon to solve the recurrence problem after surgery, but a recent analysis has shown this to be of 'limited efficacy' (Int J Radiat Oncol Biol Phys, 2002; 53: 269-76). And, of course, it comes with a host of side-effects, including bowel and urinary problems as well as impotence.
The conventional drug treatment for prostate cancer is not the standard cancer chemotherapy (which is believed to be largely ineffective), but uses drugs that block male hormones, principally testosterone. This is because prostate cancer is thought to need testosterone in order to grow.