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Think Twice Before Getting Radiation Treatment For Prostate · Intellectual Medicine

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  We do treatments that are toxic and harmful to us so we don't
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  die from the disease we're trying to treat.
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  That's pretty fundamental. Radiation is a carcinogen.
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  It causes cancer that has to be weighed against whatever benefit
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  it may give us. You can't wash out the
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  radiation. It's permanent.
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  You see, doctors are motivated by not missing anything.
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  They're not thinking about you in three or five or ten years.
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  So radiation today doesn't worry them.
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  So you, you have to be the one that is absurd.
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  Think twice before getting radiation therapy.
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  Maybe it should be think three times or four times.
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  Let's not bury the headline, folks.
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  There's never been a placebo-controlled study
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  demonstrating that a radiating the prostate gland or the pelvis
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  does any good to prevent men from dying from prostate cancer.
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  And after all, isn't that what we're after?
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  We do treatments that are toxic and harmful to us so we don't
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  die from the disease we're trying to treat.
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  That's pretty fundamental. But you take something like
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  radiation, Here's what's unequivocal, settled science, No
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  debate. Radiation is a carcinogen.
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  It causes cancer, 100% risk that has to be weighed against
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  whatever benefit it may give us. So globally speaking, I'm of the
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  opinion that doctors radiate patients far too often.
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  We do this without regard to lifetime accumulation.
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  Folks, you can't wash out the radiation.
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  It's permanent. It is a cumulative toxicity.
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  Each X-ray gets a little worse than the last one.
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  Every X-ray counts. I haven't let my dentist X-ray
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  my teeth in 20 years. He hates me for that.
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  Well, probably didn't hate me. Said, what are you radiating him
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  for? He said, well, he might have a
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  cavity back in there. I might, but if I do, it's going
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  to let me know. So you you have to be the one
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  that is assertive when they want to irradiate you challenge them.
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  My wife had an accident. She was having trouble with her
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  chest pain. They want to do a plain X-ray.
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  OK, we could live with that. Then they want to do a CAT scan.
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  Well, so why? They said, well, she might have
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  a collapsed lung in there. OK.
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  If it's collapsed, she's going to have trouble breathing,
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  right? Yeah, we can.
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  We can wait and see if the symptom occurs.
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  You see, doctors are motivated by not missing anything.
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  They're not thinking about you in three or five or ten years.
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  So radiation today doesn't worry them.
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  Now let's get back to the issue at hand.
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  A man with prostate cancer. They want to irradiate your
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  prostate gland. Here's the bottom line.
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  Men. The Protect T trial compared men
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  who did nothing, men with prostate cancer who did
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  literally nothing. Compare them to men who had
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  irradiated their pelvis. That's not a trivial endeavour,
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  by the way. They irradiate your pelvis.
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  There are a lot of things that live really close to each other.
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  There is the rectum, the bladder and yes, sexual function.
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  So when you got a lot of potential harm to be done,
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  what's the upside? The Protect T trial after 15
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  years, the men who did nothing had a 2.7% rate of death from
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  prostate cancer. How about the guys who got it
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  radiated? Yeah, their death rate from
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  prostate cancer was 2.5%. Do not let them mislead and
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  misstate the outcome. Radiation therapy does not cure
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  cancer. When men are told we can cure
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  this cancer, I want to see the proof I have it.
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  It's disturbing to me. It'd be one thing if the
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  treatment was benign. This won't hurt you.
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  You're not going to lose sexual vitality if the treatment is
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  benign. We can tolerate an outcome
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  that's perhaps suboptimal or an outcome that's not ideal.
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  I mean, the perfect outcome is a treatment that eliminates the
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  disease and causes no harm. Radiation is the opposite.
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  It causes harm 100%. I don't care what they tell you,
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  folks, they're not really disclosing the extent of that
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  harm. They're looking at it through
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  their own lens. How do I know that?
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  Here's a study. They looked at men who had
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  radiation therapy, and in this study they were comparing
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  different levels of radiation. But the telling part of this had
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  to do with what they consider to be minor, acute, short term
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  outcome. Minor.
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  Minor by whose definition? We're looking at a 30% rate of
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  difficulty with sexual function, 20% rate of difficulty with
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  hormones, 10% rate of difficulty with rectal function.
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  And that's just the short term side effects.
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  They describe that as, you know, minor.
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  Not for me. If I'm the guy who's having
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  trouble with my bowels, I'm the guy who's having trouble with
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  erections. I'm the guy who's losing
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  hormonal vitality. Don't call that minor.
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  That's insulting to my sense of intelligence.
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  And on top of that, don't tell me you cured my cancer.
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  When you take a man who has early stage prostate cancer and
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  you tell him we're going to cure you with radiation, they're
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  giving you a treatment that's never been proven to work and
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  causes harm. The fact that most men don't die
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  from prostate cancer after being irradiated has probably very
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  little to do with the radiation and likely just their fate.
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  They weren't destined to die from it.
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  I understand it, man. It's tough.
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  It's tough to be told you have prostate cancer.
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  What can I do about that? Saith the man.
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  Well, we can take out your prostate, Glen.
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  It's a little bit harsh, don't you think?
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  I mean, most men in the early stage feel pretty darn good.
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  Strength is good, vitality is good.
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  Now they're whacking out the gland.
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  Then comes the difficulty with sexual function.
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  Then comes difficulty with bladder control.
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  For what gain? Again, we go back to the long
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  term trial. The PIVOT study looked at men
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  who had the gland removed versus men who did nothing, nothing.
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  And 20 years later, they had the same death rate from prostate
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  cancer. Think about that.
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  They take the gland out. Hey, we caught this early.
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  Isn't that great news? We're going to cut it out before
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  it spreads. Most cancers spread at an early
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  stage by cellular dissemination. So gross anatomy, we think we
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  got it all. Ain't the truth.
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  It escapes in a cellular level and those cells divide.
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  So be careful about how you are guided.
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  Be prepared to just say no, you don't have to get a biopsy.
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  In fact, in my opinion, they're pointless.
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  Now why do I say that? Because the information you gain
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  is going to guide you toward one of two conventional pathways,
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  surgical removal or radiation. Very good studies looking at
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  long term outcomes have not seen a benefit to either of these
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  treatments. I don't care how focal it is, I
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  don't care how fancy they make it seem.
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  I don't care how much they enhanced it.
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  In their mind, they've never proven the benefit against the
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  placebo and if anything the nearest thing to that, the
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  Protect T trial, 15 years, the nearest thing to that showed no
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  benefit at all. Radiation.
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  What about the harm? Increased rate of leukemia,
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  lymphoma, myelodysplasia, bone marrow damage can lead to
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  leukemias, Radiation proctitis, the late effect from radiation.
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  Now we all know that getting a sunburn is bad for us.
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  That's a spit compared to radiation.
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  Nevertheless, it's analogous. You get a sunburn, it hurts in
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  the moment. So too, radiation therapy.
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  The real harm comes 1015 years later when the skin cancer pops
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  up. That's how it works.
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  Guys with radiation to the pelvis, you'll feel not so good
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  when they do it. Diarrhea, fatigue, radiation is
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  poisonous. And then you're going to
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  recover. You're going to feel OK and
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  they're going to say, hey, it worked.
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  Your PSA went down. Much Ado about nothing.
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  I don't care about APSA number that much, I care about your
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  health and vitality. And there's way too much
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  interpretation placed on APSA number.
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  Did it go up? Did it go down?
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  Oh my goodness. Then comes the real harm, 5 and
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  10 years later. As always is the case with
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  radiation, the real harm is delayed radiation proctitis.
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  I've had men in my practice who had radiation done before.
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  They knew better. Now they're walking around
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  leaking stool. They can't control their poop.
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  How'd you like to live like that?
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  Did they tell you that when you signed the consent?
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  Oh, and if that's not enough? Radiation cystitis.
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  The bladder becomes friable, irritable.
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  It bleeds. You pee, blood.
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  The bladder itself becomes stiff.
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  Now they've developed barriers that they can put in to try to
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  reduce the amount of radiation hitting these vital organs.
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  What a joke. The difference is cellular.
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  These organs are flush up against one another.
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  Hey, here's what I'll believe when the day comes when they
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  say, you know what, this radiation is so safe.
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  I'm going to sit in the chair right next to you while you get
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  irradiated. No, they dodge out of the room.
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  Hide behind the lead curtain. So should you get radiation
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  therapy, think twice. I'm strongly of the opinion that
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  it has no value based upon the research I've observed and the
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  outcomes I have seen. Now another problem.
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  They'll say if you get your prostate removed.
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  Here's another null study. They looked at men who had the
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  prostate gland removed. OK, so that's a bad thing in the
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  first place. Then they have two different
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  kinds of radiation. They're going to offer these men
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  adjuvant, which means immediately take out the the the
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  prostate and, you know, wait for recovery and then we're going to
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  radiate you. Then they compared those men to
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  the men who didn't do radiation. And they waited and they waited.
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  And when the PSA level started to go up again, they irradiated
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  them. They call that salvage
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  radiation. I have a lot of problems with
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  these definitions, folks. First, APSA level going up is
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  not justification in my opinion, for severe toxic therapy, be it
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  radiation or castration. I don't think you should do
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  either just because the PSA goes up.
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  It's premature and their definition of a biochemical
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  recurrence, if it goes up two points above the baseline, that
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  ain't much. I've seen people go up two
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  points after a long bike ride, so you got to be very careful
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  about the path that is being pointed toward you.
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  The idea of adjuvant radiation therapy versus salvage, There
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  was no difference in outcomes whether they did radiation right
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  away or they waited sometimes up to 8 years.
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  Why was there no difference? Because it doesn't work and it
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  didn't work adjuvant and it doesn't work long term.
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  I'm still waiting for evidence of benefit.
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  But you know, we're up against a multibillion dollar juggernaut.
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  That's one variable. We're up against doctors who
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  sincerely believe that they're helping you.
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  And their belief is reinforced by the correlation between their
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  therapy and a lack of cancer coming back, in which case the
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  cancer probably going to come back anyhow.
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  When the man comes in, he's saying, you know, Doc, I'm
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  leaking stool, I can't get an erection.
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  I feel awful. The doctor says, yeah, but
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  you're not dead. And the guy nods accordingly.
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  Yeah, you're right. You're right.
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  I've heard this story too much. Talked to a man just the other
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  day. She told me about his dad.
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  He said he remember the last 10 years of his life, he had
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  prostatectomy. He said all I remember was how
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  sad he was the last 10 years of his life before he died.
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  Or unpleasant, depressing. This man is no way to live.
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  Fighting cancer like a man. It's an option you can embrace.
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  It gives you the opportunity to hold on to vitality.
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  Does it guarantee you're not going to die from cancer?
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  No, doesn't guarantee that. It guarantees you're not going
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  to be harmed by all these aggressive therapies.
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  And it guarantees you you're not going to sit on your hands and
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  just hope. This is what we need to do.
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  We need to have another pathway opened up in front of us.
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  Radiation, not now, not later, not ever.
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  There is one niche for radiation.
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  When or if the cancer goes to your bone and there's a targeted
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  area that they can hit with radiation, it can reduce pain.
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  In some cases it can help prevent a pathological fracture
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  from happening. So I'm talking about pelvic
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  radiation. That's the one that I think has
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  zero merit. Targeted radiation late in the
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  disease when you have metastatic to the bone can alleviate pain
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  and I think that that's a legitimate use.
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  That's one of the few spots. But now we're talking comfort at
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  the tail end of life. We're not worried so much about
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  a five year issue. When you're young, you got to
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  think twice, think three times. How do you want to live?
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  Ask that question. And do you have to do radiation?
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  Of course you don't. Do you have alternatives?
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  Yeah. And that's why you're tuning in
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  this podcast, so we can learn about them together.
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  Well, thanks for taking some time.
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  I want you to take your time. Think hard.
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  It's your life. It's your body.
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  It's your choice. You have time, Then this cancer
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  moves slowly. Don't let anybody shuffle you
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  into a treatment until you're absolutely ready.
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  And if you choose radiation, do so with a clear mind, with good
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  research, and with confidence in the path you chose because it
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  suits your philosophy. It's not what I would choose.
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  I would never do it. Nope, never.
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  I'm thinking. Not a circumstance I can think
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  of with regard to prostate cancer that I would allow them
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  to light me up. Nope.
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  I'm going to keep my vitality. All right, guys, till next time
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  we'll continue the conversation.