Welcome

CONTENTS

Biography  Acknowledgements

REFERENCES

 

Texte  Franšais

 

If  I  ever get a cancer in my prostate...

 

My personal views do not commit anyone but myself.  I will not give any advice nor prescription.

I am just reporting a flfty years personal experience with  sincerity : I would apply my own opinion to myself.

 

1

I refuse any biopsy before treatment  :

 

a) diagnostic can clearly be done by rectal palpation and  Prostatic Specific Antigen (PSA) blood level,  without any invasive surgery.

b) normal rectal palpation by itself  increases the PSA blood level

c) biopsy needles open blood vessels and release malignant cells into the circulation.

          New fashions advocate more and more numerous biopsies.  I do not agree.  I refuse my prostate being changed into a bloody sponge.

          There is no doubt that the moment of the first malignant dissemination  is very hard to assert.  Nevertheless  my  practical experience and my  survey  of an important file of a cancer hospital    let me believe that , in new cases,  this event is often contemporary of the first surgical  operation - biopsy or transurethral resection - that opened venous vessels.

          Numerous medical papers based on  supposed metastase free series are simply foolish :  there is no means of detecting  cancer on the beginnings.

         Bone scintigraphy  can accurately identify only  cellular bulks  that started their growing  from a few migrating cells about two years before  and that are already beyond cure therapy. 

 

 

2

I want that a  hormonal treatment be instaured the very day of diagnostic, without any delay.

 

a)   Why a hormonal treatment ? 

 

1) Death by prostate cancer is mostly due to bone metastasis of the spine.

I refuse such a   life's end,  overcome by such a pain that the unescapable  solution is euthanasia,  disguised as compassional treatment with morphine.

 

2) the only really working treatment of distant metastasis is hormonal.

-      Every urologist can recall  spines flooded by malignity  that unbelievably  recovered  an apparently normal aspect  by the effect of  oestrogens or antiandrogens.

 

-       The medically correct argumentation   on the subject still remains  the sixty years old survey  of the american veterans who were treated by diethylstilbestrol .

This huge investigation came to conclusions  that  diethylstilbestrol :

     - soothes bone pain

     - does not prolong lifespan

 

First, as do numerous colleagues,   I contest the second of these conclusions,  not only because analysis refinements  show clearly   that statistic samples have been distorted   but  above all because daily observation simply shows the contrary.

 

Then, instead of drawing the honest and simple conclusion that  giving  the drug for bone distant metastasis is justified,  the medical  authorities   spread the assertion   that  diethylstilbestrol could not be given but for  relief of bone pain.

I claim  that no one  can enact such a law  when the molecule  had not been tested  in any other  case but terminal  and beyond hope conditions.

----------------------------------------------

 

b)   Why a  primary hormonal treatment  ?    :

 

a)      - Only  scarse populations of malignant cells can be completely destroyed  by  hormonal therapy.  The typical feature of cancer is the disorder of genic deviance.    After the hormonal blast  a tiny percentage  of surviving cells still  makes a rather numerous population   whenever  the original bulk is  large  so that   independent  colonies can organize and expand.    This is not the case in scarse populations where the  few surviving cells can hardly  resist against  natural  defenses  because  the statistic chance of selecting resistent genomes is much lower and presumably because one cell alone can't stay alive.   The only hope of healing bone sites of metastasis lies in very early action against scanty cellular stuff.

Definitive stabilisation is no utopia.  As in breast cancer, a similar hormonodependent  tumor,  attaining recovery is not so rare.  I had the opportunity to assess it in my own family.

 

 b)      - Primary hormonal treatment does not impair any of other options.   On the contrary  it enhances their efficiency  by lowering  the tumoral mass.   I wish to emphasize  that in my personal experience  previous hormonal treatment never blurred the  histological  diagnosis on resection or biopsy material. 

 

c)    - Vascular risk linked to hormones falls  to almost nothing  when  rational  doses are given  under  small doses of  protective  antithrombotics.

 

3

Prostate cancer  and  sexual  philosophy

 

In western countries   prostate cancer is deeply  involved in  sexual  philosophy.

According to  christianity  Life is the highest of all values.  Yet,  facing  every day  concerns,  emotion often overcomes  good sense  and  set  male erection  at the  highest  level as being the leading  part of health.

If questioned about the sentence to be applied  to  children rapists and  murderers  a huge majority would choose life imprisonment  or even hanging  rather than  testicular pulpectomy.

Putting an end to the murderer's  erection seems much more  unbearable  to one's  conscience  than    putting an end to his  life.

Honourable men would rush to the front row  pleading  the lack of scientific proof.  These people are the same who,  for more than a century,  advocated  tobacco   arguing  that its harmfulness had no scientific  evidence.  Nobody hurries up to find the scientific harmfulness of  what he loves.

 

During african tribal wars I saw dozens of young men who had their genitals cut away.  I assert that  loss of testicular hormones  annihilates sex drive and  wish .  These poor fellows were not worried by  sexual impotence for the simple reason that  they  felt no deprivation.   Either they were pushed to  the consulting room   by  the  harassing  request of a  family waiting for descendants,  or  because section of the urethra  produced  a blocking stricture,  often complicated  by enormous  abcesses and water can perineum.

 

In the same manner  any debate  on  hormonal  drugs for prostate cancer is completely corrupted by the underlying  supremacy of male erection over  life itself.   Therefore  estrogens and antiandrogens must necessarily be given only to  desperate  cases in terminal  life.

 

I do not personnally adhere to that common mass philosophy.  I regard Life as the highest value.

Being a surgeon, I could accept the supremacy of Health  over  vegetative life.  But erection of the aged male is by no way  a  health function that could be  above  Life.

Let it be said -by the way- that the medical power is commonly detained by quinquagenarians  whose heat of passion  is proverbial,  bodily strength  intact  and  who are obviously unable to  pay any real-life attention to  the elderly.

 

 

 Personal  Opinions

 

About adenomectomies

On medical power

" You don't have any disease. You got it into your head..."