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Prostate Biopsies: The Hidden Risk No One Told You About · Intellectual Medicine

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  I contend that a human being should be aspiring to live 120
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  years. I know that's a bold statement,
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  but it's not pure hyperbole. We need to be targeting
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  ourselves to stay vital. Nothing is ever achieved unless
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  you first conceive of it, men, and that includes going past 100
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  with your prostate gland in your body.
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  We need to figure out how to live with this instead of boxing
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  our way into an anxiety frenzy. It's just a horrible thing to do
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  to any man. I'm talking about a prostate
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  biopsy. The hidden risks.
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  Yeah, we'll talk about those, too.
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  But the obvious ones, it is painful.
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  I don't care what they tell you. It's not a simple, quick
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  procedure. Talk to the men who've had it
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  done. It hurts and the pain can
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  linger. Another potential risk
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  infection, no matter if they go through the perineum or through
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  the rectum. And this is a point of
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  differentiation that loses the main focus.
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  Whether they stick the needle through your butt or through the
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  skin between your rectum and your, your genitalia, the
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  perineum, it's not relevant to the fundamental reflection that
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  it shouldn't be done. No biopsies, ever.
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  Other hidden risks, erectile dysfunction, bladder
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  dysfunction, urinary flow issues.
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  You can't stick this trocar. It's not a little needle, guys.
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  It's a trocar. And they don't just go it's,
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  it's Machine Gun Kelly, baby. They're pumping 12 of those
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  suckers in there. Bad enough, right?
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  Infection, pain, bloody urine, potential obstruction.
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  Men have been hospitalized with Abscess infections, life
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  threatening level men have been hospitalized with in with
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  obstruction of urinary flow. These are horrible things.
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  Not that hidden but under emphasized.
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  That's no big deal. So many times I've heard the
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  story flow through some. One of my patients described it
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  as a biopsy annuity. And there's another hidden risk.
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  Now you're on the treadmill. If the biopsy comes back normal,
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  well, you know, we got to check it again.
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  Things could change. Another problem with biopsies.
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  Boy, do I I just. There is a critical study called
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  the Protect T trial that informs much of the reflection upon the
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  futility, uselessness and harm of prostate biopsies, which
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  we'll get to. But as far as the hidden risks,
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  the ones that they don't tell you about, they make it seem
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  like it's just like getting your car washed.
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  It's just a quickie in and out, in and out.
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  One of the biggest hidden risks is ambiguity.
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  There's nothing that is definitive about the result.
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  It comes back. There's not cancer.
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  Yeah, but it could be the reason they did the biopsy in the 1st
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  place. You had an elevated PSA.
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  Well, it's still going to be elevated.
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  You had an abnormal MRI. Well, it's still going to be
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  abnormal. And guess what, men, every year
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  we live, the likelihood of developing atypical dormant
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  cells, that's what I call sleeping cells within the
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  prostate gland. It increases so you're not out
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  of the woods. And if they show evidence of
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  cancer, it does not inform the decision about what comes next.
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  There is not a single screening test, not a blood test, not a
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  genetic test, not a biopsy that is correlated with a treatment
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  that is shown to actually prevent men from dying of
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  prostate cancer. None, none of these.
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  Everything is based on intuition, speculation, and hope
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  without evidence. Now, I don't mind a lack of
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  definitive evidence regarding an outcome, as long as they don't
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  have to hurt you to achieve that objective.
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  Biopsies hurt. And here's a big one folks.
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  I don't care what they tell you. You stick a trocar, you make a
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  bloody mess out of a cancer. Cellular escape can happen.
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  Cellular escape can scatter, can go to other organs, like
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  dandelion seeds blowing in the wind, planting themselves in the
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  bone, in the liver. They will tell you that there's
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  no evidence that that occurs, that it's a myth, that it's
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  unlikely to happen, all of which is not true.
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  There's no evidence that it has happened.
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  Technically, that's, I suppose, correct.
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  No evidence, proof. But they've never done the
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  study. They've never done a study to
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  see if it's actually making things worse.
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  I have borne witness to case studies where a man was
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  percolating along, gets a biopsy done, and all of a sudden his
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  PSA takes off. Coincidence.
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  There are research papers in the medical literature documenting a
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  correlation between needle trocar metastatic disease, over
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  90 of them in the last five years.
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  And some of those are related to prostate cancer.
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  There's a case report of a man who had prostate cancer
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  implanted into his rectum after a biopsy.
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  So this is not purely theoretical, guys.
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  It's real. So you've got a man.
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  Feels great. I feel fine.
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  Yeah, but your PSA is elevated. We better do a biopsy just to
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  see. Stop.
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  There are plenty of ways to look at that gland without sticking a
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  trocar, and I've talked to men that have had never felt the
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  same after the biopsy. This is a major trauma to a
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  vital gland that is central to our masculine well-being.
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  You don't trifle with it without compelling reason.
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  The biopsy gives us no upside merit.
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  And here's one of the biggest features, one of the biggest
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  reasons I don't like the biopsy. You take a totally healthy man,
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  you biopsy him, you label him, you now have prostate cancer in
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  almost every circumstance. I would say that's a gross
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  exaggeration. We're confusing atypical dormant
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  cells, which have some potential to progress with actual cancer.
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  Those are two very separate things.
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  You take a totally healthy man, you tell me as cancer we better
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  take out your gland. Don't you want us to cut out the
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  cancer? Good Lord, the anxiety levels.
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  These poor men are in panic. You poor men are in panic.
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  First thing, stop. Breathe.
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  Do nothing. Do nothing.
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  You owe it to yourself, to your partner, wife, spouse, friend,
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  family to maintain your temperance and to really gather
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  information. What we know.
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  So the Protect T trial was published in 2023.
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  That study looked at men who had prostate cancer and they divided
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  them into three groups. These are all men that had
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  biopsies, which, by the way, I recommend you never do.
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  But for the sake of the study, it's informative.
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  And it is really, in my view, the most important study
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  regarding prostate cancer yet published.
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  It should have been a Seminole moment of dramatic change in how
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  we approach this process, but it hasn't been.
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  It's been largely set aside. Tomorrow some poor son of a gun
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  is getting at a biopsy. Tomorrow some poor man is going
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  to stare into the eyes of his urologist and tell him we have
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  to do something before this cancer gets spread.
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  All right, so here are the facts, guys.
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  The protect T trial, three groups, one group did active
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  monitoring. That's Med speak for nothing.
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  You have prostate cancer. We biopsy proven that, but we're
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  not going to do anything. We're just going to biopsy
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  periodically and kind of see what happens.
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  Another group got radiation therapy and a third group had
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  the gland removed. They compared the three groups.
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  The goal Does surgery or radiation decrease the death
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  rate from prostate cancer compared to doing nothing 10
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  years later? No difference in the death rate
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  from prostate cancer in all three groups.
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  None that was curious. So they said, you know what,
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  let's push it out to 15 years. We think at 15 years will be a
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  point of separation. 15 years go by, no difference guys. 0 none,
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  nada. Get the Glen removed.
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  A lifetime erectile difficulty, urinary leakage, but no decrease
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  in your risk of dying of prostate cancer.
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  What gives? I give a lot of credit to Doctor
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  Hamdi and the others who conceived of and put forth the
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  study. And when I read the study, I
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  looked for who sponsored it. I always do that.
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  Not shockingly, I didn't see any drug companies behind it.
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  It's in their interest to foment anxiety in order to propel, in
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  my view, a lot of harmful and ultimately counterproductive
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  therapy. There's a hidden biopsy, hidden
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  biopsy risk. You think a perfectly healthy
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  man feels great one day. Now you label him with cancer.
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  You have cancer. It colors his life.
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  It shouldn't. Here's another fact fact
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  research based from the Protect T trial, the 15 year survival
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  from prostate cancer. Now the men in this study were
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  not all early, early stage. Based upon the analysis of the
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  study, 30% of them, well they were all early stage, but 30% of
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  them had moderate level risk disease.
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  So these weren't all categorized as the utmost simplest forms.
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  Anyhow, 15 years later, the survival rate from all forms of
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  prostate cancer, those that enter without metastatic
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  disease. Mind you, we're not talking
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  about men who show up day one with cancer in the bone. 97%
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  survival rate after 15 years, 97% including the men who did
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  nothing. So take your time.
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  When they tell you this is an emergency, it's not.
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  When they tell you you have to get the gland out before it
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  spreads, that's misleading. In fact, in 30% of the men who
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  had the gland removed, there was already evidence of extension
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  beyond the gland itself. This gentleman is a cellular
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  disease. The hidden risk of the biopsy,
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  in addition to all the trauma, all the infections, all the
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  pain, all the misery, days out of work, days you're not going
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  to fish, days you're not going to have sex with your partner.
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  All those things are relevant. Life is precious.
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  It's short. Each day matters.
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  I want you to spend a day suffering needlessly because of
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  a robotic, methodical, intuitive treatment pathway that has
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  evolved over decades without evidence of benefit.
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  It's powerful. I understand what I'm saying.
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  I understand the implication. That's why we've developed the
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  Pederuti protocol. My protocol does not evolve
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  biopsies. It does not involve castration.
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  It does not involve blocking your hormones.
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  It does not involve radiation surgery.
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  The body, our bodies have a remarkable capacity for self
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  healing. Your body is actively fighting
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  cancer every day, does it every day quite successfully.
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  Because we know that cancer is cellular and we know that these
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  atypical dormant cells reside within the prostate gland behind
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  a capsule. Do not Pierce the capsule.
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  Do not stick trocars in there. Listen, guys, if you've already
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  had that done, I do not want to amplify your anxiety.
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  This is a real consequence of the biopsy process.
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  Not only the biopsy, but the way it's interpreted to men, the
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  PSA, the way that's interpreted to men, your PS as relevant.
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  We must do a biopsy. Absolutely not.
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  Mark yourself absent. Be mentally prepared.
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  Your primary care doc says my PSA, Your PSA is elevated.
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  I don't even think you'd go see a urologist.
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  You know what they're going to say.
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  Like most of them are going to play the same note on the piano.
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  It's what they were trained to do, right?
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  It is entrenched. It's really, really hard to get
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  doctors to change their pattern of doing something.
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  It's been said that if you want a doctor to understand his
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  position is wrong and yours is correct, wait for him to die.
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  They're going to be hard to move.
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  They're going to be hard to move.
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  But this evidence, it's there. It's irrefutable.
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  It's tangible, what I'm sharing with you.
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  Yeah, it's my opinion, but it's research informed, no biopsy,
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  hidden risk anxiety. So in the study, the Protect T
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  trial, some of the men in the active surveillance flipped into
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  treatment. Why?
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  They flipped by and large, because of anxiety.
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  This is a horrible mental consequence to tell a man, yeah,
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  we think you have prostate cancer.
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  Next question, Doc, What can I do about that?
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  Well, we can irradiate you. A ghastly thing you should never
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  do. I don't care if they put seeds,
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  targeted radiation. It's all nonsense, it's all
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  harmful. It's all playing upon your fear
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  and the hope that somehow they can target it.
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  No, these are cells. They're cells.
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  They can't target the radiation to cells.
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  Anyhow, you don't want to have that anxiety because what
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  happened to the men in the study, A lot of them said, I
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  can't put up with this, but just take it out.
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  Just take it out. If you're that mentally
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  duressed, it may be a reasonable decision, but give yourself
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  time. After one year, the men in the
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  active surveillance of men who did nothing, the anxiety levels
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  tended to go down and they tended to go down because men
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  started to realize I'm not dying, nothing awful is
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  happening. I can stay the course.
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  I can maintain my health and avoid all the consequences that
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  befall the following the bread crumbs down the path of the
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  biopsy. Don't you want to know if you
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  have cancer or not? Yeah, probably.
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  Probably like to know that. But most importantly, what
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  action can be taken and do you need to dig at the tissue to get
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  the answer? Absolutely not.
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  We can make this diagnosis to a reasonable degree of certainty
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  without causing you harm. PS AM RI clinical history.
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  And most importantly, get to a health supportive pathway with
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  collateral benefit to well-being without doing harm.
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  So the hidden risk of a biopsy More numerous than I can count,
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  but I think a big part of this is a psychological duress.
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  I get it. It's an existential horror,
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  right? Someday we're going to die.
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  I like to not think about that. I like to perceive myself as
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  being, well, like kind of immortal.
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  I don't think it's likely to happen.
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  That is, I do believe that at some point, odds are, based upon
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  my research and clinical experience, that I might die,
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  although I contend that a human being should be aspiring to live
• 17:21
  120 years. I know that's a bold statement,
• 17:24
  but it's not pure hyperbole. We need to be targeting
• 17:28
  ourselves to stay vital. Nothing is ever achieved unless
• 17:33
  you first conceive of it, men, and that includes going past 100
• 17:38
  with your prostate gland in your body.
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  We need to figure out how to live with this instead of boxing
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  our way into an anxiety frenzy and see if there's anything else
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  hidden. I can think about prostate
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  biopsies other than the treadmill of misery, The
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  recurrence, sequential biopsying to see what's going on is
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  absolutely silly. We know what's going on.
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  Your prostate's enlarged. The MRI shows us you have
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  nodules. OK, let's look at it again in a
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  year, see what it looks like. We got time.
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  You have time. There is no evidence that
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  supports early intervention with any conventional treatment such
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  that it'll prevent you or delay the onset of metastatic disease
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  to the bone or death from prostate cancer.
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  In fact, even when the cancer, if the cancer becomes
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  metastatic, which in some cases it will do to some people, the
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  majority will never get to that level.
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  But if you get to that level, it's not a death sentence.
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  The majority of men with metastatic prostate cancer to
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  the bone don't actually die from it.
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  There's lots that can be done. So my message to you is, in
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  addition to the futility of the treatment pathway that the
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  biopsy leads you towards, the procedure itself is harmful and
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  inducing of false urgency. Now I get it, y'all got to live
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  with yourselves. So my opinion should resonate
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  with some of you and if it gives you the confidence to depart
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  from the conventional stream of automaticity, good.
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  On the other hand, if it doesn't and you're comforted by going
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  down that pathway, that's most important.
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  What I most hope for you men is that you have choices.
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  How you want to live, how you choose to manage your life
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  should be giving you flexibility, should never be
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  forced or told emotionally coerced or otherwise misguided
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  based upon false anxiety. All right, so biopsies, No, why
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  not? I think we've cleared.
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  I think we've covered that. All right.
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  Listen guys, thanks for your time.
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  We'll talk again soon. See you then.