Why does breast cancer research receive more research funding than prostate cancer?

Carcinoma of the prostate

“Men’s Rights Activism” (MRA) is a dirty phrase in many circles.  The MRA movement is a fairly diverse beast ranging from claims of inequality in child custody cases to accusations of full-blown, societal-scale misandry typified by higher death rates in men and lower levels of social investment.  One claim in particular that the MRAs make is that breast cancer (a cancer that predominantly, though not entirely, affects women) receives substantially more money in terms of research funding than prostate cancer, despite similar numbers of people dying from each.  First I’ll review some of the specific claims made, I’ll look at the data on funding, then we can delve into a few stats on the impacts of these two cancer types (bear with me!).  I’ve also included some more detail on whether younger men are more at risk from prostate cancer as an appendix for those who are interested.

The Claims

Here are some verbatim examples of the claims:

The amazing advances that have been made in the treatment of Breast Cancer is stemmed from the amount of funding that the Breast Cancer Research program has received over the decades. The two forms of cancer seem to be as problematic as each other, however Breast Cancer Research receives at least 75% MORE funding than Prostate Cancer Research.

www.mens-rights.net

The number of men who contract prostate cancer is about the same as the number of women getting breast cancer.  The disparity in annual, government research funding between the two cancers is striking and discriminatory, illustrating yet again the institutionalized misandry existing in Western societies, in my opinion.

Ray Blumhorst, National Coalition for Men

This year [2007] 218,890 men in the U.S. will be diagnosed with prostate cancer, according to the American Cancer Society. By comparison, 178,480 new cases of breast cancer will be diagnosed in women. Not a huge difference, but a new report finds that for every prostate cancer drug on the market, there are seven used to treat breast cancer, and federal spending on breast cancer research outpaces prostate cancer spending by a ratio of nearly two to one.

Business Week, via the National Prostate Cancer Coalition

“…prostate cancer is just as deadly as breast cancer yet receives only a fraction of the funding and that the myth that prostate cancer only affects old men just isn’t true. It’s weird, but new studies show that younger men with certain aggressive forms of the disease are actually more prone to dying quicker.”

– Canadian Association for Equality promotional video

The specifics of the claim vary over time and between countries, but the similarities seem to be:

  1. Prostate cancer research receives less funding than breast cancer.
  2. Prostate cancer affects at least as many men as breast cancer affects women.

It is these claims that I will look at now.

Funding for breast and prostate cancer

There are certainly going to be international variations in the amount of funding given to different cancers.  I have chosen data from the UK and the US because those countries make their data available.  If anybody has a source for other countries, I would be happy to include it as an addendum.  The data for the UK is the expenditure by Cancer Research UK (specifically from this report), the world’s largest independent cancer charity, which (as the name suggests) conducts research on prevention, diagnosis and treatment of cancer.  The US data comes from the http://www.cancer.gov website (specifically here, supplemented with 2011 data from here).

As you can see, there is a substantial difference in the funding of prostate cancer and breast cancer research in both the UK and the US, and this gap doesn’t seem to be closing.  So maybe the MRAs have a point?

Incidence and mortality of prostate and breast cancers in the US

I’m going to look at two variables: incidence (the number of cases) and mortality (the number of deaths).  In each case, the numbers are from the US (because the US cancer stats are mostly easily accessible, from here) and are expressed as the number of cases or deaths per 100,000 population.  As you can see from the data, throughout the 1970s and most of the 1980s there were similar numbers of men suffering and dying from prostate cancer as there were women suffering and dying from breast cancer.  However, in the early 1990s the prostate cancer incidence spikes, along with the number of men dying from prostate cancer.  Following that spike, we see a levelling-out of cases with prostate cancer affecting about 20% more men than breast cancer affects women.  The good news is that the number of people dying from each seems to be falling year on year.  Again, the MRAs seem to be right: there are more cases of prostate cancer and the mortality rate is at least as high as for breast cancer.  So are they right to feel aggrieved?

The problem with the MRA argument is that the statistics hide the details of what is actually going on with the two diseases.  Yes, more men are suffering from prostate cancer, and yes, equal numbers are dying, but who are those men?  We can use the US data to take a closer look.

The following statistics look at the age distribution of the (i) the incidence, (ii) the population-level mortality (i.e. the number of people who are dying), and (iii) the individual-level mortality (i.e. the probability of dying if you contract the disease) for prostate and breast cancer.  The data are all from the same http://www.cancer.gov website that I cited above.  What you can see is that prostate cancer doesn’t affect men until their mid/late 40s (top graph).  Breast cancer, on the other hand, is affecting many more younger women.  Prostate cancer also kills relatively few men under the age of 70.  Bearing in mind that the average life expectancy for men in the US population was 75.9 in 2010 (source), that means that you have to almost reach the average life expectancy before this particular cancer will be much concern.  Note that breast cancer kills many women who are in middle-age (40-60 yrs old, middle graph).  These differences in population level mortality statistics stem from a difference in survival between the two cancers.  If you contract breast cancer at age 25, you have approximately a 10% chance of dying and  by age 50, this chance rises to 15%.  In contrast, mortality rates are very low (<5%) for prostate cancer until men pass 70 years of age.

Is prostate cancer more aggressive in younger men?

You might have noticed that there are two additional claims made in the fourth quote that I presented above, the first of which is “The statement that prostate cancer only affects old men isn’t true” – this is a straw man argument that misses the point.  The data is clear that younger men are affected, but these cases are rare compared to cases of breast cancer in younger women, and the probability of survival is very high.  The second statement, “new studies show that younger men with certain aggressive forms of the disease are actually more prone to dying quicker“, is a more detailed point backed up with actual scientific references so it deserves a closer look.  However, this is a detailed issue so I have put the discussion in an appendix at the foot of this post for those who are interested.  Basically, it seems to be a poorly supported theory that was common in the 1960s.

Summary

A few take home messages:

  • Breast cancer and prostate cancer affect different people, not only in terms of gender but also in terms of age.
  • Breast cancer kills young women and kills mothers while their children are young.  The reason for our fear (and, as a result, our funding) of breast cancer is that it can strike at almost any time and poses a considerable risk when women do suffer from it.
  • Prostate cancer, by and large, kills older men.  While no less of a tragedy, these men have lived long lives and are at greatly increased risk from a range of other ailments (heart disease among them).  The theory of more aggressive prostate cancers in younger (whatever that means) men is poorly supported.
  • The MRA movement cites statistics that do not reveal these important differences.
  • Finally, the priorities of funding agencies are not simply the number of people dying from a particular condition.  The funding landscape is complex, designed around current advances, where the best researchers are located, the best proposals for funding, political will, and a host of other variables.

Now, I am not saying that we should not research prostate cancer.  Indeed, Movember is coming up and I would encourage everyone to contribute or participate (you can also donate to Cancer Research UK).  However, when we have limited resources, we have to make difficult decisions about how to allocate those resources.  In this case, breast cancer has a greater societal impact through greater mortality at younger ages and that is why we can justifiable provide greater funding to breast cancer research.

________________________________________________________________

APPENDIX: Age and prostate cancer

The notes from the video point to the Cancer Research UK website that references these two studies.  First of all, the two studies are from 1994 and 2002, so they are not exactly new.  We’ll take them one by one:

Gronberg et al., 1994 – Gronberg and colleagues don’t demonstrate that prostate cancer is any more aggressive in younger men.  In fact, the article even states in the abstract “This finding does not support the view that tumors appearing in younger patients are more aggressive per se”.  The interpretation of their results that the MRAs adopt stems from a consideration of “loss of life expectancy” as the outcome, rather than death.  When a younger man dies, this is a greater number of potential life years lost than if an older man dies.  In this sense, prostate cancer is worse for younger men but the study said nothing about the disease itself affecting people differently (the survival rate was the same).

Merrill and Bird, 2002 – These authors did actually look at the survival of men in different age groups and did find a difference between ages.  They describe a lower survival in younger and older men, with a peak in survival at intermediate ages.

It is worth, however, putting these two studies into context, since there has been much research conducted since:

  • Freedland et al (2004) found that young men had more favourable outcomes after surgical radical prostatectomy (RP) than older men.
  • Herold et al (1998) found that age of the patients greater than 65 years was a significant predictor of distant metastases at 5 years.
  • Obek et al (1999) suggested that young age per se might be an independent favourable prognostic factor for disease recurrence after surgical radical prostatectomy.
  • Austin and Convery (1993) showed that younger white men survived better than older white men, but that younger black men survived less well than older black men.
  • Konski et al. (2006) show that men age ≤55 years who present with localized prostate cancer do not appear to have a worse prognosis.  They also note that “In the pre-PSA era, younger age was believed to convene a poorer prognosis because it potentially signified more virulent disease”, suggesting that this is in the past.  They cite Merrill and Bird as a study that shows this effect.
  • Hamstra et al. (2011) suggest that older men (defined as >70 years old) have better recovering after radiation therapy than younger men.
  • Wang et al. (2011) show that for a very rare form of prostate cancer (signet ring prostate carcinoma) there is lower survival in younger men.
  • Lin et al. (2009) find that younger men were more likely to… have better overall and equivalent cancer-specific survival at 10 years compared with older men.  However, they also note that high grade and locally advanced prostate cancer was associated with a worse prognosis in younger vs older men.  They cite a wide range of studies demonstrating that recovery is more likely and treatment complications are reduced in younger men.  They also raise the problem of defining “young” in the case of prostate cancer studies, since this can mean anything from less than 50 years to less than 60 years depending upon the study.  Neither of these corresponds to “young” in common parlance…

In summary, the picture is far from clear and most studies seem to suggest that younger men have a better prognosis than older men.  The example cited in the MRA literature (Merrill and Bird, 2002) appears to be the only convincing result in favour of their hypothesis, while many other studies contradict that result.  Also, the lack of a consistent definition of “young” (whatever is used in the studies tends to be considerably older than what most people would consider “young”) makes these studies difficult to interpret.

References

Austin JP, Convery K (1993) Age-race interaction in prostatic adenocarcinoma treated with external beam irradiation.  Am J Clin Oncol. 16(2):140-5.

Konski, A., Eisenberg, D., Horwitz, E., Hanlon, A., Pollack, A. and Hanks, G. (2006), Does age matter in the selection of treatment for men with early-stage prostate cancer?. Cancer, 106: 2598–2602.

Freedland SJ, Presti JC Jr, Kane CJ, Aronson WJ, Terris MK, Dorey F, Amling CL, SEARCH Database Study Group. (2004) Do younger men have better biochemical outcomes after radical prostatectomy? Urology, 63(3):518-22.

Gronberg, H., et al., Patient age as a prognostic factor in prostate cancer. J Urol, 1994. 152(3): p. 892-5.

Hamstra D.A. et al. (2011) Older Age Predicts Decreased Metastasis and Prostate Cancer-Specific Death for Men Treated With Radiation Therapy: Meta-Analysis of Radiation Therapy Oncology Group Trials, International Journal of Radiation Oncology * Biology * Physics, 81,(5): 1293-1301.

Herold DM, Hanlon AL, Movsas B, Hanks GE (1998) Age-related prostate cancer metastases. Urology,  51(6):985-90.

Lin, D. W., Porter, M. and Montgomery, B. (2009), Treatment and survival outcomes in young men diagnosed with prostate cancer. Cancer, 115: 2863–2871.

Merrill, R.M. and J.S. Bird, Effect of young age on prostate cancer survival: a population-based assessment (United States). Cancer Causes Control, 2002. 13(5): p. 435-43.

Obek C, Lai S, Sadek S, Civantos F, Soloway MS (1999) Age as a prognostic factor for disease recurrence after radical prostatectomy. Urology. 54(3):533-8.

Wang, J., Wang, F.W., and Hemstreet, III, G.P., (2011) Younger Age Is an Independent Predictor for Poor Survival in Patients with Signet Ring Prostate Carcinoma, Prostate Cancer, vol. 2011, Article ID 216169.

Prostate photo by Netha Hussain.  Graphs are all mine based on data cited.

Advertisements

84 thoughts on “Why does breast cancer research receive more research funding than prostate cancer?

  1. Is there any easy way of expressing those mortality numbers in terms of “total years of life lost”? (I don’t know how epidemiologists choose their stats, but that’s one I’ve seen).

    • Good question. The answer is yes and it goes like this: “potential years life lost” (PYLL) often takes 75 years as a baseline for these analyses. However, we know that life expectancy is 75.9 in US males and 80.7 in US females (as of 2009). Using these as the baseline and making some simplifying assumptions about the age brackets in the data (we don’t know what the distribution of people dying between the ages of 60 and 64, for example) we can make some calculations: prostate cancer causes PYLL[75.9]=1788 per 100,000 population, while breast cancer causes PYLL[80.7]=7967 per 100,000 population.

      We can also calculate “average years life lost” (AYLL) and express this as a percentage of the life expectancy which has been done for a range of cancer sites (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361853/). This which shows that breast cancer causes an average loss of 15.5% of a sufferer’s lifespan compared to prostate causing a loss of 5.5%. Whichever of these two statistics we use, they both make the case that breast cancer is more worthy of research because it robs more people of more of their lives.

      • 2 points. 1: your charts above aren’t “change in mortality/incidence….” – you are showing the true number, not the change (your numbers are more meaningful than the char title suggests). 2: If you are comparing PYLL, you can’t use a lower life expectancy for males – there lower life expectancy is likely part of the prostate cancer equation, so normalizing for that difference is lessening its effect. It’s similar to looking at the health benefits of a healthy diet, but normalizing for body weight……
        Either way, your data is great, and exactly what I was looking for – thanks for creating this web page!

    • You r old with cancer? Fuck you! Is that the kind of attitude we want to show to the new generation? This is a big problem, and life expectency would rise for men, if prostatecancer was reaserched as much as BC.

  2. I have heard claims that the money donated to Breast Cancer societies translates into a comparably small amount of research dollars (i.e., a relatively high amount goes into overhead and advertising). Do you know if there is any truth to this? And if so, is there any way of comparing the amount of “research dollars” obtained for each cancer?

      • Shame is your article is just as wrong just as one sided as mra. The premise that either disease is worse or deserves this or that is the problem with humans. You wrote this article to show men are bad. Look at every commercial on tv, men are made to look stupid helpless while woman are made to look mean and short tempered. That sad fact is when you look at stats from an even position both cancer kill period. I always wonder how woman like you raise a male child. Do you care that men are told to suffer in silence. There are no tv shows or pep rally no one telling us it’s ok to die with dignity. That is the sad fact both sides miss. I could go on but it won’t change anything you will see me as a man then not listen. Look at the stats evenly not with an agenda. Look at how child support destroys good men and rewards bad woman. Sure it helps some and those are the ones we want to show a fake feel good world but it’s not reality. Look at child molesters new research shows a 51 to 49 % number of men to woman molest children and yet only men are made to be villains. Like I said I could go on but whats the point I know you already checked out as soon as I gave info that doesn’t fit the feminist narrative. Just like the wage gap myth, and you know it’s a myth especially when it comes to wage earners under 250,000 dollars. The sad fact is the despairity is at the top where come on be honest it just really doesn’t matter. Not in a way folks try to show it, the single mom leaving in a run down apartment as big bad men all drive BMW. Such bull. Fact is a single father make 50k struggles just as bad as a single mom. So we take from men and turn them into paychecks not fathers. But go on with you I am woman hear me roar no matter how much the divide grows.


        EDIT:

        Hi Lawrwnce – you commented on the third level of a comment thread so I can’t reply. Instead, I’ll tag this comment onto the end of your own. You make a lot of useful points. I agree entirely that there are equality issues for men as well as women. Our patriarchal society damages everyone. However, the post was about the statistics of two specific cancers and you have not really engaged with any of those points.

      • i am a senior in high school and what you said brought tears of joy to my eyes. I do not know how to formally express my emotions so bare with my here. About last month two girls in my math class said they overall hated me, when I asked why they said “because we are angry that the male society is unfair and oppressing us.” This made me very sad (although im not supposed to be sad/emotional in the views of society) I questioned my moral values and tried very hard to find out what i am doing wrong or why they dont like me. About a week after the event I thought i should take my mind off the subject and find an activity like a club, as i was scrolling through the club listing on my schools website i noticed 5 specific clubs that stood out to me “Women’s Athletics club,” “Women’s education club,” “Women’s Alliance club,” “Girls United,” and “Women empowerment club.” There wasn’t a single “male” only club, every other club was for example “The Ping Pong club!” no discrimination. Up untill the moment i saw your comment i felt like a piece of shit, i had bias facts thrown in my face all day unable to fight back. Thank you.

    • “reared its ugly head”? why does the word feminist sound so much righteous than chauvinist these days? Seems to me no one actually ones wants EQUALITY, just revenge and the conquering of past wrongdoings. Blaming today’s male population on discrimination from the past is like abusing Angela Merckel for the Nazi party.
      I believe we need to address female participation in the workforce, female positions in leadership for business but who is addressing the drop in school grades for men? Or the reason why male life expectancy is far shorter? Or custodial rights? No one. Because people are too afraid.
      Don’t worry, when the feminists finally take over it will be men that launch the counter-attack. We’re got at least 4000 years of experience with it so I’m not fussed.

    • So both breast and prostate cancers have about the same incidence and kill about the same number of men as women – but the female version receives 2x the research funding. The only rationale the author gives for this is because women get it younger, and they are mothers? I had to look it up separately, and yes average age women get breast cancer is 61 and average age men get prostate cancer is 66. Wait. So the 200% difference in funding is not sexism and gynocentrism – it’s ageism then? Well. There you have it. That’s totally justifiable and can be defended (sarc).

      • Fascinating how this post still gets the occasional drive-by, almost three years later. Did you actually *read* the post? Because if so, you would understand why average age of onset far from the only relevant statistic.

      • Hi S,
        You’ll see in one of my comments above I calculate PYLL, and that shows that the number of years of life lost per 100,000 population is 4x higher in the case of breast cancer than prostate cancer. As Steve says, the mean age doesn’t tell you much – it’s the distribution of ages that make the difference.

  3. If you look hard enough to get a bias you’ll always get one and that’s what’s happened.

    How dare men speak out about equality, going off the logic of the author them i’m sure she agrees with warren farrell on why men get paid more and the reasoning behind that, more likely to stay longer in work, more likely to die in work etc

  4. Maybe our cancer funding drives shouldn’t be so bloody openly sexist.

    Seriously, this entire article is trying to find a reason why one gender deserves to live more than the other, and not why donations are clearly sexist, as seen in the stats. The objectivity here is laughable – the article was written around the selective research chosen, with an all-too-easy justification of its results. Men were dehumanized from the onset as whiney MRA’s who stood to die anyways and, though dying in similar numbers somehow had it better, while women were young women and mothers who lost precious years (despite factually the vast majority that were indeed NOT young). The sickly biased and unfounded takeaway “Breast cancer kills young women and kills mothers while their children are young” deliberately leads the reader away from visibly different facts, none of which refer to parenting. Apparently, the fathers of young children don’t matter.

    I guess I’ll look elsewhere for objective journalism. I’ll come back here for FOX News. This sexist high-school propaganda should be removed from the net to prevent making matters worse.

    • I would be interested in seeing your statistics. Are you saying that there are equal numbers of young men and women dying from prostate and breast cancer? The statistics don’t support that. Or are you saying that age shouldn’t matter, and that (given limited funding) we should put the same effort into saving a 65 year old man as we do into saving a 30 year old woman? That is an ethical issue, as I explained above. It’s your decision to make, but I don’t think it is unreasonable to prioritise the young.

      As for “selective research”, I would be interested in seeing the alternative research. I thought I was pretty even-handed when I cited the literature (I’m not a cancer specialist, but I do have access to journals through a university). Maybe you could cite the studies that I have missed?

      Finally, what are the “visibly different facts” away from which I lead the reader? That was a bit enigmatic, and again I would be interested in seeing your statistics.

      • As you should know, one can find supportive documentation for pretty much any argument. In the end, if an argument doesn’t pass the sniff test, it is probably biased. In this case, several obvious things stood out as missing, several key supportive assumptions are made, and the language and flow of the argument seemed predetermined from the outset. I will not go to every point, but a few rich examples.

        First, your take “Breast cancer kills young women and kills mothers while their children are young” is unfounded by the info presented, yet is presented as a conclusion, and divides breast cancer from prostate cancer in ways not recognizing critical differences in how each is first discovered. It doesn’t kill young men? And young fathers? Breast cancer is commonly first self-detected as a lump that is easily felt by hand, whle prostate cancer requires a digital exam not even first run on a man until he is already middle aged – if ever, giving it plenty of time to metastasize, perhaps never to be discovered or identified as the primary cancer. So breast cancer stands readily to be identified as a primary cancer – and identified as such earlier in life – far more readily than prostate cancer. That said, the perception of breast cancer as being more lethal, however inaccurate it may or may not be, does presumably lend itself towards higher research attention, likely fueled by the powerful Pink Ribbon juggernaut.

        Secondly, and further to the above point, around the world, men are generally older than their brides, as they are expected within many cultures to have careers before becoming providers (a common fact). Therefore older men dying of cancer can also have young children.

        Third, the mortality of cancer is higher for men, yet this key number goes uncited and unexplained here; thus, it’s quite conceivable via the statistics that men are getting prostate cancer that goes undetected as such, and their deaths are being improperly categorized under some secondary cancer type, such as lung or liver. Men are also far more prone to suicide in their 30’s than women, masking what would include a portion dying by cancer, but opting an early out.

        Finally, the presupposition of the insignificance of the elderly suggests that somehow this means research-specified donations will somehow be fewer, but no mention of data is made to support this. In general, the wording and tack you use translates into “old men don’t matter as much as young women”, “mothers matter more than fathers” and “more women die of breast cancer than men from prostate cancer”, none of which prove why research funding is so much higher for breast cancer.

        Generally, your argument confuses discussion as to why breast cancer research deserves more funding with why it actually gets more funding. This allows a cross-breeding of opinion and fact, such as the above inclusion of children, from the perspective of a mother’s age, without giving fathers any significance. Further, it sidesteps any criticism of the existing funding bias, as if it should only be natural on the basis of the limited facts presented. In other words, it is literally, through exclusion, justifying the deaths of men, being essentially, at heart, an argument as to why women deserve funding. This point is brought home by your sentences:
        [“The reason for our fear (and, as a result, our funding) of breast cancer is that it can strike at almost any time and poses a considerable risk when women do suffer from it.”]
        [“Prostate cancer, by and large, kills older men. While no less of a tragedy, these men have lived long lives and are at greatly increased risk from a range of other ailments”]
        The use of “our” and “suffer” clearly shows a personal bias and intent to justify against the depersonalized and insensitive “these” and “having lived long lives”, not to mention that it’s somehow NOT suffering to be an old man dying a slow, painful death by cancer.
        [“…breast cancer has a greater societal impact through greater mortality at younger ages and that is why we can justifiable provide greater funding to breast cancer research.”]
        So again, we have a major conclusion that is not met out by the facts. The roles of the men dying of prostate cancer are not even considered. If they are the sole provider in a household full of kids, I’m sure it has a comparable impact, but then, reading this, I guess we’d never know.

        —————————————————————————-

        A few notes:

        According to the stats referred to here, more men die of cancer of any kind, so clearly, something is causing men to die of some kind of cancer in general:
        http://www.cancer.ca/canada-wide/about%20cancer/cancer%20statistics/stats%20at%20a%20glance/general%20cancer%20stats.aspx

        These stats demonstrate the ease at which one’s bias can enter citations and manipulate and distort the resulting conclusions. For example, if you look quickly at figures 3.2 and 3.3, young women die of cancer more than young men. But on closer inspection, we see that actual death numbers for young males is much higher than the percentage figures make it appear. So the stats can equally be used to point out higher numbers in cancer death rates for men by numbers, and for women by percentage.
        http://www.cancerresearchuk.org/cancer-info/cancerstats/mortality/age/uk-cancer-mortality-statistics-by-age

        Tumor burden is seen as a major cause in cancer-related death in both men and women. Neither women nor men are likely to die from breast or prostate cancer, rather from tumor burden, etc. So a missing argument is why there should be any gender division in the research funding at all.

  5. I’m not sure if you understand statistics as well as the author, friend. In your last linked website, in the age-group 25-49 the number of deaths from all cancers was approx. as follows:
    Men: 17% x 17,138 = 2,913
    Women: 39% x 9,956 = 3,883
    So women was quite a bit higher (970) .
    The ‘Children’ and ‘Teenager’ group is not really relevant to breast or prostate cancer.
    As for whether we should value a 30 year old woman or a 60 year old man more highly – that is a complex ethical question. However, “years of life lost” type studies is a common way to look at funding. If it costs $100 to save a 30 year old woman and a 60 year old man who both would have lived to 75 – then for the man this is $6.67 per year of life and $2.22 per year of life for the woman. Also as the woman would have a longer life expectancy, her number would come lower still.

    But I don’t think you really intend to reconsider your views no matter what anyone says.

    • Hi TAISN,

      Sorry for taking so long to respond – only just noticed this comment!

      – As you should know, one can find supportive documentation for pretty much any argument. In the end, if an argument doesn’t pass the sniff test, it is probably biased. In this case, several obvious things stood out as missing, several key supportive assumptions are made, and the language and flow of the argument seemed predetermined from the outset. I will not go to every point, but a few rich examples.

      By “sniff test” you mean “my subjective impression”. I cite science. Feel free to do the same.

      – First, your take “Breast cancer kills young women and kills mothers while their children are young” is unfounded by the info presented, yet is presented as a conclusion, and divides breast cancer from prostate cancer in ways not recognizing critical differences in how each is first discovered.

      No it doesn’t. First, it does kill young women (see the graph). Second, approximately 75% of women of child bearing age have children so those young women are likely to be mothers.

      – It doesn’t kill young men? And young fathers?

      I never said it didn’t, but men are dying a lot less than women of a similar age – that is the crux of the argument.

      – Breast cancer is commonly first self-detected as a lump that is easily felt by hand, whle prostate cancer requires a digital exam not even first run on a man until he is already middle aged – if ever, giving it plenty of time to metastasize, perhaps never to be discovered or identified as the primary cancer. So breast cancer stands readily to be identified as a primary cancer – and identified as such earlier in life – far more readily than prostate cancer. That said, the perception of breast cancer as being more lethal, however inaccurate it may or may not be, does presumably lend itself towards higher research attention, likely fueled by the powerful Pink Ribbon juggernaut.

      Do you have data on this variation in rates of detection? I’d be interested to see it.

      – Secondly, and further to the above point, around the world, men are generally older than their brides, as they are expected within many cultures to have careers before becoming providers (a common fact). Therefore older men dying of cancer can also have young children.

      I agree, but they die after having lived longer than women. The “father and mother” argument is tangential to the central issue of years of life lost.

      – Third, the mortality of cancer is higher for men, yet this key number goes uncited and unexplained here; thus, it’s quite conceivable via the statistics that men are getting prostate cancer that goes undetected as such, and their deaths are being improperly categorized under some secondary cancer type, such as lung or liver. Men are also far more prone to suicide in their 30′s than women, masking what would include a portion dying by cancer, but opting an early out.

      Male cancer deaths represent 52% of the total (http://www.cancerresearchuk.org/cancer-info/cancerstats/mortality/all-cancers-combined/). This is not huge, but you use it as a basis for wild speculation… I’m not saying you’re wrong, but do you have data on this? I’d be interested to see it.

      – Finally, the presupposition of the insignificance of the elderly suggests that somehow this means research-specified donations will somehow be fewer, but no mention of data is made to support this. In general, the wording and tack you use translates into “old men don’t matter as much as young women”, “mothers matter more than fathers” and “more women die of breast cancer than men from prostate cancer”, none of which prove why research funding is so much higher for breast cancer.

      I was never going to “prove” anything – this is simply one line of argument that can justify this situation. The issue of “young people are worth more than old people” is a complex ethical issue as highlighted above, but it is a rational response to a very difficult decision (all other things being equal). Also, you don’t seem to have read the piece – I state clearly that the same number of men and women die from prostate and breast cancer, respectively. The argument is based on relative AGE.

      – Generally, your argument confuses discussion as to why breast cancer research deserves more funding with why it actually gets more funding.

      The argument that I make is based on a potential justification for the funding difference. I would expect the justification to also be one of the reasons for the difference… I don’t really see what you are trying to say here.

      – This allows a cross-breeding of opinion and fact, such as the above inclusion of children, from the perspective of a mother’s age, without giving fathers any significance.
      I state the evidence plainly: there is negligible (though not zero) mortality due to prostate cancer in men under 55. The SEER data from the US National Cancer Institute doesn’t even have records for mortality from prostate cancer for the under 25s: http://seer.cancer.gov/csr/1975_2009_pops09/browse_csr.php?sectionSEL=23&pageSEL=sect_23_table.07.html.

      – Further, it sidesteps any criticism of the existing funding bias, as if it should only be natural on the basis of the limited facts presented. In other words, it is literally, through exclusion, justifying the deaths of men, being essentially, at heart, an argument as to why women deserve funding. This point is brought home by your sentences:
      [“The reason for our fear (and, as a result, our funding) of breast cancer is that it can strike at almost any time and poses a considerable risk when women do suffer from it.”]
      [“Prostate cancer, by and large, kills older men. While no less of a tragedy, these men have lived long lives and are at greatly increased risk from a range of other ailments”]
      The use of “our” and “suffer” clearly shows a personal bias and intent to justify against the depersonalized and insensitive “these” and “having lived long lives”, not to mention that it’s somehow NOT suffering to be an old man dying a slow, painful death by cancer.

      You’re inferring a great deal from my choice of words. I think we as a society are afraid of breast cancer, aren’t we? And people do suffer from cancer! You dodge the issue of an increase in all-cause mortality in older populations, which makes treating cancer aggressively less appealing for medical practitioners. I agree that I probably do have a bias (we all do), although I don’t have a horse in this particular race so I can’t understand what drives it. However, I can be biased and still be right 😉

      – [“…breast cancer has a greater societal impact through greater mortality at younger ages and that is why we can justifiable provide greater funding to breast cancer research.”]
      So again, we have a major conclusion that is not met out by the facts. The roles of the men dying of prostate cancer are not even considered. If they are the sole provider in a household full of kids, I’m sure it has a comparable impact, but then, reading this, I guess we’d never know.

      Do you have data on this? I’d be interested to see it. I agree that the loss of money will have an impact, but will that have the same impact as the loss of a person? Strange that you should argue this, having accused me of dehumanising men…

  6. So, how many 70 year old men’s lives are worth a 50 year old women’s life ? Because that’s pretty much what you are saying.

  7. Thank you for a very informative blog post, and as someone who do think that the MRA brings up fair points, this is an area where they seem to be just wrong. I would also (reluctantly) have to agree that saving a young person is preferable to saving an old person, but the massive discrepancy in funding between breast and prostate cancer is a bit too glaring to me.

    This is especially since the breast cancer research also pulls in massive amounts of non-grant and non-federal funding money, while no one wears the “blue ribbon”. I would argue that this is because of our cultural tendency to put women first, but that is for another day.. I would like to instead out the thumbscrews on companies collecting money for the pink ribbon, so that not these huge amunts of money would be lost in the overhead. If this can be done, I can absolutely support a decrease in federal funding for breast cancer (and an increase in prostate cancer) research, since it would receive well over what prostate cancer research gets in private funding anyway. This would possibly eliminate a lot of the most glaring inequalitites.

    • Hi Jakke, thanks for commenting. I wanted to provide the data so people could make up their own minds. Obviously some readers disagree with me, and that’s fine. I do think it is a valid argument. The issue of charity and public profile is an important one, especially because of the stigma attached to prostate cancer, and the importance of early detection.

  8. Well written. This is the first reasonable post I’ve seen on why there is a difference between funding for breast cancer and prostate cancer. It is well written well researched and properly documented. The one type of post that I like more than ones that support my opinions are the ones that change my mind. So, good job on that.

    • Hi GNL – glad to hear you found the evidence useful. It’s one way of looking at things, and I’m not saying the situation is perfect. However, a years-of-life-lost approach does seem reasonable…

  9. I read your article which I take as accurate and yet I come away with different conclusions.

    Indeed it seems the MRAs by your account have a fair point, and are not going overboard as they emphasize it. And while you can conclude it is better to save the lives of younger women, that is mostly just a value judgment, your value judgment, and it is rightfully noted as sexist even as you believe you can rationalize it in economic terms.

    Indeed when you write:

    ” While no less of a tragedy, these men have lived long lives and are at greatly increased risk from a range of other ailments (heart disease among them).”

    It makes me wonder if you understand the meaning of the phrase “no less” because while you claim it is “no less” a tragedy, you immediately explain why it is a lesser tragedy!

    Weird.

    However, though I come to a different conclusion, and think your data and analysis buttresses MRA claims, I truly do thank you for a clear post with clear understandable graphics, it does help illuminate the similarities and differences of these diseases and the points in the various arguments pro and con.

    • Jacques, thanks for commenting. I’m glad you appreciate the data. I completely understand that some people will disagree with my opinions, and they are well within their rights to do so. The years-of-life-lost metric is a terrible thing to use but when we have limited funds and have to (effectively) decide who lives and who dies, these are the tools that we have available to us. What is the solution? Equal money for both? On what basis do you make that choice?

  10. So basically, since prostate cancer affects men later than breast cancer does women, that’s why funding for breast cancer research is more important? I’d call you a sexist piece of human filth, but even that seems to smell better than you.

  11. Have been looking into this a bit today and was pleased to find this well written and researched post. What would be interesting is to see the percentages for the sources of funding for each cancer. For example, it’s a different issue if the state is providing a vastly disproportionate amount of funding for breast cancer than prostate cancer. Another interesting thing would be to compare the disparity between other kinds of gender specific cancers (Testicular and Cervical spring to mind.) Though breast cancer may have a “friendlier” image that people can get behind more, a comparison with these other cancers should give some insight as to whether there is an overall gender bias in cancer funding.

    Thanks

    • I agree – that’s a great idea. You would predict that the overall funding of cancer would be related to the YLL, and that there would be no systematic variation between cancers predominantly affecting one sex. Are you volunteering to do the work? 😉

  12. Article starts with accusing all Men’s Rights Activists of, for want of better words, indecency and unfairness.
    Can’t continue to read.
    Sometimes I feel that I’m the only one who wants actually equality, fuck chauvinists and fuck feminists.

  13. Bigoted Sexist Bullshit. Here is an interesting point for you. At birth men make up 53% the population, by a man’s retirement age of 65 (compared to a woman’s 60) men make up only 39% of the population. Men work longer hours in more dangerous jobs, pay the vast majority of income tax despite the fact women control most of domestic spending and after a lifetimes servitude they are basically told thanks for all your service and tax money, now fuck off and die early because a sexist society riddled with gynocentric brainwashing has finished exploiting you.

    Ps
    Breast cancer research receives more than double the funding than any other form of cancer,
    including the number one killer, lung cancer.

    http://www.aleksandreia.com/2012/02/25/the-unfairness-in-cancer-research-funding/

    • Hi there – apologies for the delay, but you were buried in a pile of spam that I have only just had a chance to clear.

      Worth noting that much of this is changing. Retirement age doesn’t exist anymore, and the pensionable age will equalise by 2018. I agree that this current state of affairs is outmoded and I’m pleased to see it shifting (in the UK, at least – I don’t know about elsewhere). I also agree that men work in more dangerous jobs – safety at work is an issue that MRAs are right about, although it shouldn’t be a men’s issue but a general issue. Men certainly pay most of the income tax as well, but a part of that is due to the gender wage gap and discrimination against women at higher levels of employment. If you see your domestic situation as one of such abject servitude, then I feel sorry for you – maybe you should get out?

      It is important to note that you haven’t mentioned any of the positive sides of being a man. You can find a short list here: http://amptoons.com/blog/the-male-privilege-checklist/. You can try to paint men as long suffering oxen yolked under female oppression if you like, but that simply isn’t an accurate representation of the situation.

      Finally, 86% of cases of lung cancer are linked to smoking (http://www.cancerresearchuk.org/cancer-help/type/lung-cancer/about/lung-cancer-risks-and-causes). This means that we know how to reduce lung cancer, and it isn’t necessarily treatment of existing cancers. The smoking cessation investment by public bodies is unique to lung cancer and involves a huge amount of money – there is no equivalent for other cancers because there is no clear causal link. I haven’t been able to find stats on the gross spend on smoking cessation as the figures are frequently expressed as QALYs (quality-adjusted life years – precisely the argument I put forward in the original blog post – but you can find some data here: http://www.bmj.com/rapid-response/2011/10/28/smoking-cessation-services-top-return-investment).

      All that said, I have never claimed that we shouldn’t be investing more in research into other cancers. Prostate cancer in particular is going to increase in prominence as men live longer and so there is a definite reason to increase investment in treatment and diagnosis.

      • Uh-0h! loss off credibility alert! Wage gap? Seriously? Discrimination against women at the CEO level? Oh me, oh MY!

        This has been disproven about…a DOZEN times already?

  14. This is the best analysis I have seen to date on the issue of cancer research spending for the different genders. I congratulate you on that.

    I refer to you comment above: ” Men certainly pay most of the income tax as well, but a part of that is due to the gender wage gap and discrimination against women at higher levels of employment.”

    I have come across this comment by the USA Department of Labour on a CONSAD Research Corporationon document titled: “An Analysis of the Reasons for the Disparity in Wages between Men and Women”:

    “There are observable differences in the attributes of men and women that account for most of the wage gap. Statistical analysis that includes those variables has produced results that
    collectively account for between 65.1 and 76.4 percent of a raw gender wage gap of 20.4 percent, and thereby leave an adjusted gender wage gap that is between 4.8 and 7.1 percent.
    These variables include
    :
    A greater percentage of women than men tend to work part-time. Part-time work tends to
    pay less than full-time work.

    A greater percentage of women than men tend to leave the labor force for child birth, child
    care and elder care. Some of the wage gap is explained by the percentage of women who
    were not in the labor force during previous years, the age of women, and the number of child
    ren in the home.

    Women, especially working mothers, tend to value “family friendly” workplace policies more than men. Some of the wage gap is explained by industry and occupation, particularly
    the percentage of women who work in the industry and occupation.

    Research also suggests that differences not incorporated into the model due to data limitations may account for part of the remaining gap. Specifically, CONSAD’s model and much of the literature, including the Bureau of Labor Statistics Highlights of Women’s Earnings, focus on wages rather than total compensation. Research indicates that women may value non-wage benefits more than men do, and as a result prefer to take a greater portion of their compensation in the form of health insurance and other fringe benefits.”

    “Although additional research in this area is clearly needed, this study leads to the unambiguous conclusion that the differences in the compensation of men and women are the result of a multitude of factors and that the raw wage gap should not be used as the basis to justify corrective action. Indeed, there may be nothing to correct. The differences in raw wages may be almost entirely the result of the individual choices being made by both male and female workers.”

    I am aware that you are a biologist and scientist and that health issues are closer to your field of interest than labour issues. However, given your statement that I quote above, have you got any additional research that confirms or confounds the opinion in 2009 of the US Department of Labour (or Labor as they say in the USA)?

    :

  15. Katatrepsis.com “Why does breast cancer research receive more research funding than prostate cancer?”

    Tudor Wright

    I have only just read your most interesting essay of 30 October 2012 and as a 74 years old prostate cancer patient (living in the UK) I would like to make a few comments.
    Clearly, there is a wide funding gap not just between research into breast and prostate cancers but in screening and treatment funding for these cancers, in research, scanning and treatment for all gender specific cancers (and medical conditions, as here in the UK it has been estimated that the Department of Health spends eight times as much money on specific female health issues as on male ones even excluding maternity care (‘Guardian‘ 8 January 2001)) and also for all common cancers. In fact, the Dept. of Health spends four times more money on breast cancer than on the far more common lung and bowel cancers despite lung and bowel cancers accounting for four times more deaths (of these three most common cancers, breast cancer accounts for 19 per cent of deaths yet receives 78 per cent of funding). Furthermore, a report by Cancer Research UK in 2009 tells us that men diagnosed with cancer are far more likely to die from the disease than women – due to a higher initial risk and later detection. “Men are 40 per cent more likely to die from cancer than women overall, and 16 per cent more likely to get the disease. [But with] cancers that affected both men and women, the difference was even more striking. Men were 60 per cent more likely to get cancer than women, and 70 per cent more likely to die from it.” Professor David Foreman, who helped carry out this research for Cancer UK, said he was “surprised” by the results as there are no known biological reasons why men should be at greater risk for many forms of cancer. No wonder then that so many people get exercised by what appears to be quite unjustified disparities in cancer research funding!
    However, just looking at the funding gap between breast and prostate cancer research and treatment, you make the good point that spending more money on breast cancer is justified as this disease affects more young women (who are of child-rearing age) than young men. I think one of your respondents makes the point that older men (who are therefore at risk of prostate cancer) are still fertile while older women are not – but against this, older men will have fewer ‘potential years life lost’ compared to younger women although not necessarily fewer ‘quality adjusted life years ‘if they become fathers in later life, but of course their number will be relatively small.
    However, your conclusion is somewhat undermined by your own evidence, for the graph “Age variation in cancer mortality” shows that the number of young women and of child-rearing age who die from breast cancer are not significant relative to women of all ages and whose numbers increase steadily from middle age through old age ( as do those of men with prostate cancer), and your graph “Age variation in cancer incidence” shows that the number of women under 40 are also not significant relative to women of all ages and whose numbers increase steadily from middle age and then steadily decrease in old age ( as do those of men with prostate cancer). While your graph “Variation in chance of dying” shows that women at most ages are at greater risk of dying from breast cancer than men from prostate cancer, it does not take into account that prostate cancer – which is slow-growing – usually metastasizes into other fast-growing cancers which can then become the cause of death.
    Nevertheless, one takes the point that there are more women of a young age who contract breast cancer as compared with young men who contract prostate cancer and this therefore justifies some higher funding of breast cancer research than of prostate cancer research. But how much more? Is the present balance about right? Or should even more money be spent on breast cancer research – or more on prostate cancer research and less on breast cancer research?
    But before trying to answer these questions let us examine the reasons and causes for the gender funding gap. Your conclusion is that the disparity in funding is “a result” of society’s fear of breast cancer killing young women and young mothers while their children are young (even though women who have children are at a reduced risk compared to women who have not), but you provide no evidence for this conclusion. It would be nice to think that such rational and moral reasoning does operate, but in the real world there are more mundane causes. So for Professor Karol Sikora, Medical Director of Cancer Partners UK and a former chief to the World Health Organisation’s Cancer Programmes, the cause of the greater funding for breast cancer has been that of political opportunism.
    “The fact is,” he writes, “politicians, eager to court the female vote, have long presided over a huge disparity in funding and treatment of female cancer patients at the expense of their male counterparts. Take breast cancer. I became a consultant in 1979, the same year that Margaret Thatcher introduced a controversial nationwide breast-screening programme. The evidence that this would be effective was very weak but, aware that most floating voters are women, Mrs Thatcher and her advisers pressed ahead regardless. Since then, the screening programme has saved many women. But it has come at a phenomenal cost – equivalent to around £1million per life saved [and] we have to ask whether that money could have saved even more lives if it had been spent in other areas of medicine. I believe it could. “(Mail Online 15 June 2009).
    Since 1979, screening programmes have also been introduced in the UK for cervical and ovarian cancers, but there are still no screening programmes for prostate and testicular cancers. A point to bear in mind is that because of their extremely high cost, screening programmes are only viable if sub-groups can be identified who are at a greater risk; here the sub-group most at risk of prostate cancer is men aged 50 and over (and particularly black men as they are at twice the risk of contracting and dying of prostate cancer than white men) and this is much smaller than the sub-group of women at greater risk of breast cancer (those aged 35 and over), and yet men are not screened whereas women are – and we know that screening is effective, for it is estimated that the UK national breast screening programme reduces by 25 per cent the number of deaths in the age group 50 to 64 eligible for screening (and a survey in Sweden showed a 29 per cent reduction in mortality among women aged 50 to 69).
    Apart from political opportunism, I would suggest there are two other major causes for the funding disparity between breast and prostate cancers. One is that feminism and the ideology of patriarchy have become the dominant narrative of gender relations in our society: which is that basically women are victims – of men if not of their own bodies – and so clearly deserve more of our support and help just as men – who represent a dominant masculinity – deserve or need less of our support and help. The other cause is that the female breast is totemic – being the primary symbol in our society of femininity, sexual allure and sex itself – and so is to be protected at all costs. But no similar glamour is attached to the prostate (where and what exactly is a prostate?) or compassion bestowed upon its male owners.
    So is too much funding being given to breast cancer research, bearing in mind that resources are finite? Professor Sikora has argued this is the case, and so have many others, including Iona Heath, a former president of the Royal College of General Practitioners and a doctor for 35 years, who published a paper in October 2014 in the ‘British Medical Journal’ suggesting that screening – including tests for breast cancer – should not be routinely performed. “Breast cancer screening”, she says, “undoubtedly harms more people than the number of lives it prolongs”, and she claims that for every one cancer discovered, ten women are “over treated” unnecessarily with surgery, chemo or radiotherapy.
    So bearing in mind there is no nationwide screening programme for prostate cancer in the UK, should more money be diverted to it? Even though the numbers of men affected are only significant from the age of 50 onwards, reducing the risk of death from prostate cancer will mean men having an average life expectancy at age 50 of, say, another 33 years, at 60 another 25 years, at 70 another 17 years, at 80 another 10 years, and so on. Untreated prostate cancer may be slow-growing but it is eventually fatal if it has not already metastasized into fast-growing and painful conditions such as bladder and bowel cancers, or the man has not died from another illness.
    At present, unfortunately, diagnosis of prostate cancer is practically and scientifically more difficult than of breast cancer. The practical problems, from my own personal experience, include a great reluctance from health professionals to provide early examination and testing and, as a result, my own prostate cancer remained undetected for several years longer than it should. (According to the National Cancer Experience Survey 2012, 24 per cent of men with prostate cancer have to visit their doctor at least three times before their disease is identified, compared with only eight per cent of women with breast cancer).
    The scientific difficulties include a prostate specific antigen (PSA) blood test which has drawbacks in that it can give false positives (worrying, and resulting in unnecessary and invasive procedures) and false negatives (potentially fatal, and the National Health Service test form tells us: “A normal PSA does not exclude prostatic cancer”). A digital rectal examination can detect cancer but can also produce false negatives as only the back and lower part of the prostate gland can be palpated. Similarly, a standard trans-rectal ultra-sound (‘TRUS’) guided biopsy can only detect cancer in the back and lower part of the prostate and so give a false negative when cancer is present in the top or front of the gland.
    What could serve as an effective screening tool is multi-parametric magnetic resonance imaging (‘MP-MRI’) which, with a skilled radiologist, provides clear and accurate images of the whole prostate and any lesions. The procedure takes 30 – 40 minutes and so is longer than the usual 15 minutes for a mammogram (breast cancer test) and is therefore more costly – but will enable earlier and more appropriate treatment than from the other existing detection methods. (At present there is a pan-European research study which hopefully will result in widespread MRI testing; this is called PROMIS: Prostate MRI Imaging Study). So with political will and a reasonable increase in funding there could be a nationwide MP-MRI screening programme for prostate cancer that gives accurate diagnoses and so provides men with options for treatment that improves and prolongs their lives by many years.
    To sum up. Your overall conclusion that “breast cancer has a greater societal impact through greater mortality at younger ages and that is why we can justifiably provide greater funding to breast cancer research” is true but needs to be qualified, for while you have persuasively argued that more funding can be justified for breast cancer research than for prostate cancer research, there is good evidence that in a situation of finite resources the present funding level on breast cancer should be reduced and that of prostate cancer increased.

    *

    Your last respondent, Jorge, raises the question of the gender pay gap, and he quotes the reasons for this cited by the US Dept of Labor in a CONSAD study. These largely hold true for the UK too, although here there is no longer a gender pay gap among the under 40s and already among the 20s in full-time work women are on average paid slightly more than men (Equality and Human Rights Commission Report 2014). Overall, though, national pay rates in 2015 for all ages and all types of work show that women are paid on average 19 per cent less than men (Chartered Institute of Personnel and Development: CIPD), but this is due to more women than men being in part-time work (at the end of 2014, 42 per cent of all women’s jobs were part-time compared with only 17 per cent of all men’s jobs) and to a pay gap amongst the over 40s which is the result of the tradition (which is disappearing) of men and women doing different types of work – a tradition which has not always favoured men, however, as in full-time jobs men work on average five hours longer than women (Office for National Statistics : ONS) and 11 hours when overtime is taken into account (CIPD).
    For men and women in full-time work the gender pay gap in 2014 was 9.4 per cent and is on a downward trend (ONS: Annual Survey of Hours and Earnings), partly due to the reasons in the CONSAD report which include women here being generally far less attracted to working in the highest paid sectors of commerce such as insurance, banking and financial and commodity trading. (In this sector there were £15billion of bonuses paid out in 2014 representing 30 per cent of total pay, this £15 billion being 36 per cent of all bonuses in Britain, and it even excludes deferred bonuses (ONS). This difference in aspiration skews overall pay distribution away from women, although in full-time employment there is considerable variation with women in schools and hospitals, for example, generally having higher paid positions than men, and overall overt pay discrimination is no longer a problem.
    The main problem with pay and employment as it relates to gender is not actually that of pay discrimination. It is that in full-time jobs men on average work considerably longer hours than women, the work tends to be more onerous and also insecure. (According to a study of 500,000 people in the US, Europe and Australia published in ‘The Lancet’ (20/8/15), the risk of a heart attack or stroke is increased by 10 per cent for an extra hour a day worked and by 33 per cent for three extra hours). But unemployment is an even greater risk to health from stress, anxiety and depression and in recent years 16 per cent more men than women have been unemployed (ONS). More alarmingly, for the under 25s in 2015, 30 per cent more men than women are unemployed (it is perhaps no coincidence that overall men aged 20 to 24 are now three times more likely to die than young women).
    Only a few days ago, our right-wing government was forced to reveal (Department of Work and Pensions (DWP) report ‘Mortality Statistics’ 27 August 2015) that over the 27 months to February 2014 there was an excess mortality rate of 67 deaths per day (or 470 per week) among claimants of incapacity benefits, as compared to the previous 11 months. Over the whole 38 months period, 92,740 claimants (all of working age) died, and we can fairly assume that the great majority of these were men. Of these claimants, 9,580 had been told they were presently or shortly fit for work – although obviously, barring accidents, none of them should have died. Some commentators have suggested that these deaths have been due to the DWP’s increasingly harsh treatment of claimants which includes a stringent ‘Work Capability Assessment’ (WCA), with 40,680 claimants of unemployment benefit (i.e. those already fit for work) dying within a year of a WCA. More significantly, 2,380 claimants classified as unfit for work died within two weeks of a WCA decision that they would have to seek work – and because of these deaths the United Nations Committee on the Rights of Persons with Disabilities is now formally investigating whether the Conservative government’s welfare reforms are now violating the human rights of disabled people. (There were also a further 270 claimants classified as incapacitated or severely disabled who died within six weeks of a WCA decision that they were “fit for work”).
    A DWP internal review of 49 of these benefits-related deaths shows that at least 40 were suicides (‘Guardian’ 28/8/15). We know that stress and anxiety lower one’s immune system and ability to fight cardiovascular diseases and cancers, and depression is a contributory cause of suicide. (Men are three times as likely to commit suicide as women, with young men in 2015 being five times more likely to kill themselves as young women – and suicide is now the major cause of death of all men under the age of 50).
    Partly due to the stress from both employment and unemployment, and partly due to less healthy life-styles, men also develop heart disease 10 years earlier than women, with over 60 per cent more men than women suffering from heart disease, heart attacks and heart failure; similarly, nearly 60 per cent more men than women suffer strokes (including my father who died of stroke in his 50s after losing his job). And when we look at cancer we find that although more males than females are dying from cancer every year, men diagnosed with cancer are far more likely to die from the disease than women – due to a higher initial risk and later detection. But this is where I came in…..

    • Tudor, having read this article and your response I just wanted to thank you for adding a lot more colour to what was a superficial and black/white piece written from a feminist perspective. I note with interest that unlike other posts the author has not responded to you.

      I was going to add a post identifying that in the UK the NHS has extended Breast cancer screening to women aged over 70 so no longer having the social value of younger women if we agree with the author of this piece. But spending yet more scarce resources on women specific cancers when men don’t even have a screening process at all.

      The author skates over this – basically men don’t have the luxury of being screened for this cancer and often we find out when it’s too late. In other words it is a constant concern to a greater or lesser degree to all men, whereas women who have that concern have a screening program to alleviate it.

      You have said it with far more eloquence and knowledge than I could and your reply to me clearly adds more weight to the theory that we live in a gynocentric society in the U.K. and supports the old adage that men are disposable whilst women are not.

      Once again, Tudor, thank you for tak No the time to write your post, superb.

      • Hi Serge,

        Thanks for your comment. I try to approve anything that isn’t spam, so what you see on the blog is everything that isn’t adverts for Chinese stuffed toy manufacturers. However, Tudor and I actually had an exchange by email, where I apologised for a delay in approving his post (it got lost in the junk). Here is the text of the email that I sent to Tudor on 19th September 2015 (I will not repost Tudor’s response without his/her permission):

        ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

        Hi Tudor,

        Sorry, there was a comment that popped up at the same time that you emailed me, but it must have been someone else. I see now that that other comment was posted on 8th September. I dug through my spam folder and found your comment (I think your thorough and elegant writing style convinced the system that it couldn’t be a blog comment!). It should be live on the blog now. There is a lot of really interesting information in there and you clearly have a very informed and nuanced view of the situation. You might be interested in a paper published in 2012 (which I reference on a slightly later comment): http://www.ncbi.nlm.nih.gov/pubmed/22800364. This paper does the analysis that I performed, but for a wide array of cancers. There is clearly a disparity in funding across different cancer types, and when you look at the proportion of funding allotted to prostate cancer, it seems that this too is “over-funded” (although these are US data, I believe).

        There is clearly a very important conversation to be had about where funding goes, and where research priorities lie. I think a point that is very relevant to your comment is that everybody is living longer today. This means that there is a fairly rapid increase in years of life lost per prostate cancer case. I do not know what consequence that has for these kinds of calculations, but I expect that prostate cancer will have increased in importance relative to other types of cancer.

        Best wishes,

        Chris
        ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

        I suggest you check out the link that I posted in my response to Tudor. That paper points out that prostate cancer, too, is massively over-funded compared to the risk of the disease. There are far more dangerous cancers that are not sex-specific and which are not funded to the same level.

        Now on to your argument. We do not have a prostate cancer screening programme because it has not been demonstrated that the costs outweigh the benefits. Tests for prostate cancer throw up a lot of false positives, for instance. You state that it is “a constant concern to a greater or lesser degree to all men”, which is nonsense. It is an extremely rare disease in young men, and so is not a concern in all men. That is the entire point of the post, but you seem not to have appreciated the figures.

        Further, your suggestion that we live in a “gynocentric society” where men are expendable must be increasingly difficult to hold, given that the most significant breakthrough in recent cancer research has been in prostate cancer treatment: https://www.theguardian.com/society/2016/dec/20/prostate-cancer-laser-treatment-could-be-game-changer-for-men.

      • Hi Chris,

        Thank you for the quick and unexpected response!

        I found your original article interesting and for me it was only spoilt by your comments about the MRA movement at the beginning of your article – I’m unclear as to why arguing for men’s rights should be regarded in such a way. After all men are human being too and anybody who is in favour of human rights should also be in favour of men’s rights surely?

        I accept there are elements of the MRA who are as bad as radical third wave feminists but the MRA is not a single homogenous group, no more than feminists are.

        Anyway I digress – in my view women and girls have issues but so do men and boys and equality is not a competition. It’s a pity it is seen as such when men’s rights are brought up. There is, certainly in the U.K. (And probably the USA from what I have read), a ready ear for women’s issues but that is not the case for men’s issues.

        I note with interest the link you provided about the new prostrate treatment, which is actually what brought me to your post in the first place as I was looking at comparative funding for a simple Facebook post.

        What’s interesting about this new and very welcome approach though is:
        It is for treatment after the cancer has been diagnosed, and is suitable for early stage cancer. The problem here of course is that there is no successful screening for the condition so many cases will not be suitable as it will be too late and the cancer will already have spread to other areas of the body.

        I wonder why there is not a more successful screening test available for this condition as catching it early seems to be critical. Or maybe it’s just not a priority? Of course we can argue all day about the priority for health spend but I imagine it will be a brave politician that dares to suggest cutting Breast cancer funding – but it would also be a brave politician who suggests increasing spend on prostrate cancer research.

        I am particularly interested in the lack of successful screening as several members of my family have died from the disease – it was found too late- and obviously I wonder if I will be next.

        The second interesting thing is that the new technique you mention came out of Israel rather than the UK or USA. This is despite having one of the best funded cancer research bodies (Cancer Research) in the world, as you point out. My comment about living in a gynocentric society applies of course to the UK and not Israel. I do not know enough about the culture of Israel but if it is like the rest of the Middle East it is unlikely to be gynocentric. I stand to be corrected on that of course.

        We may have to accept our difference of opinions on the reality or not of the UK being a gynocentric society. From my view it very much is and is evident across education, university attendance, homelessness, suicide rate, the criminal law, family law, NEET, and more beside. My view is based on far wider society and policy issues than just gender based cancer research.

        For example, I find it interesting that the press were recently all over stats that indicated more women than men attempt suicide but failed to mention that around four times more men than women are actually successful.

        Likewise a recent TV news article on the apparent growth in numbers of young women suffering depression because of what is said on their Social Media. They highlighted the need for mental health services to respond to these depressed young women but completely failed to mention the gender disparity in suicide rates, nor that successive governments have not spent one penny on researching why men are far more likely to commit suicide ( source Nursing Times).

        I wrote to ITV news asking when they were going to cover male mental health and suicide but they didn’t even bother replying. Anecdotal I know but finding it newsworthy that young women suffer depression from their social media feed but not the fact around suicide being the main cause of death for men aged under 50, or are four times more likely to commit suicide than women? I wonder why this is not newsworthy?

        Anyway, no doubt we have different views on this but I repeat both men and women have issues and it is time that governments, the media and academia acknowledged that.

        Once again thank you for your reply, and indeed the original article. I found Tudors response very articulate and researched, far more than mine is I know!

        You don’t come across as a third wave feminist, so I am happy to wish you a merry Christmas, and good luck with your blog 🙂

        Kind regards,

        Steve

        Get Outlook for iOS

  16. While I appreciate the scientific data I do believe there is gender discrimination in the way cancer research funding is allocated. Once you account for variables such as age of diagnosis, mortality rates, economic rationalism, etc etc, there is still a greater proportion of funds going to breast and cervical and ovarian cancer than male types of cancers. Perhaps gender discrimination is the culprit here.

    • Hi Adam, It’s possible that there could still be some imbalance when everything else is taken into account. However, I don’t think it is a male-female cancer issue. This paper: http://www.ncbi.nlm.nih.gov/pubmed/22800364 suggests that both breast and prostate cancer are over-funded, while non-sex-specific cancers (bladder, esophageal, liver, oral, pancreatic, stomach) are underfunded.

  17. i have often wondered about this same question. your research and explinations are well organized and supported effectively. thank you.

  18. Re: More Feminazist Rhetoric. It always amazes me how a movement can rationalize why they are right. And I always think about the Nazi movement when I read a feminazist article since the tactics used are so similar and their goals are the same. Both are moving towards the master race and gender. They can play with this stat and that stat but men are dying at much higher rates than women. I am surrounded in this neighborhood by widows. Why is a white woman so much more superior than other race/genders?

  19. […] any other case that is connected to well-beings. Now here is the twist, there is this article: Why does breast cancer research receive more research funding than prostate cancer? | Katatrepsis It's about trying to rationalise why females are given a multiple times the health fund than male, […]

  20. Honestly, if you can’t see the relevance of prostate cancer funding vs. breast cancer as something more complex than a simple age metric, you must be blind. It is germane to the same issue as to why men are 95% of workplace deaths and incarcerated for longer sentences for similar crimes than women… and why male so suicide is 400% higher. It is because society doesn’t value men, or men’s issues in the way it does women’s issues. The ‘cancer’ debate is part of larger gender debate, and your attempts to aint it as solely and age metric are highly disingenuous.

    • Hi ITP – thanks for commenting. I agree that there are men’s issues that require action, particularly around mental health and crime. However, men also enjoy systematic advantages in other areas of life. In the particular case of prostate vs breast cancer funding, both are funded far more than they should be (see https://www.ncbi.nlm.nih.gov/pubmed/22800364) but in comparison with one another, the two are funded roughly proportionately to the years of life lost. If you want to broaden the discussion to encompass the whole field of human experience, it is very difficult to argue that men have it harder than women.

  21. “However, men also enjoy systematic advantages in other areas of life.”

    Please could you tell us what other areas of life men, as a class (i.e. All men), enjoy systematic advantages? I’m talking about the UK or at least western 1st world society.

    “If you want to broaden the discussion to encompass the whole field of human experience, it is very difficult to argue that men have it harder than women.”

    Interesting comment, are you saying that women have it harder then men in western society? If not I presume you are saying that women (as a class) have it harder then men in some area of human experience – specifically which areas are they, again limiting your thinking to first world western societies especially the UK.

    Thanks in advance.

  22. Hi Serge – thanks for commenting.

    Men enjoy systematic biases in hiring (http://psycnet.apa.org/psycinfo/2014-21414-001/), pay (http://journals.sagepub.com/doi/abs/10.1177/0003122416683393), impacts of child care (http://www.thirdway.org/report/the-fatherhood-bonus-and-the-motherhood-penalty-parenthood-and-the-gender-gap-in-pay), and lower rates of sexual assault (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214970/sexual-offending-overview-jan-2013.pdf), among others.

    I didn’t say definitively that women have it harder than men in Western society – that is a very strong position to take that would require a large number of value judgements that would be difficult (but not, potentially, impossible) to support using high-quality evidence. I said that it is hard to argue that men have it harder than women. Globally, men probably have it far better (the probably is there because I have run out of steam on this response and don’t have the energy to look up global, experimental approaches to gender bias, but we can probably agree that on average the world is male-biased?). The fact that you limit your questions to Western society seems to be a tacit admission that globally there is gender inequality? In Western society, my feeling (and my interpretation of the evidence) is that the balance is still tipped in the favour of men, but that the data suggest that gaps are closing and effects are more insidious than conspicuous.

    My response to your “in which areas of human experience do women have it worse” question is contained above, I think, as it is the inverse of the “men have it better” position in most cases where there is a significant difference between sexes. Do you disagree with me when I say that there are cases in which men enjoy advantages over women (generally or with a restricted geographical scope)? Do you think that women enjoy a net systemic benefit over men (generally or with a restricted geographical scope)?

    I do want to reiterate again that I acknowledge the fact that there are many issues in men’s health and wellbeing that need attention, and that the discrimination against men in cases of mental health and crime is just as reprehensible as any discrimination against women in hiring and pay. We should aim to resolve all such issues. Of course, this is all getting a bit away from a statistical analysis of survival, investment and disease 🙂

  23. Thanks for the post. You’ve changed my thinking on the issue, and I’m revising my position correspondingly. I only wish you hadn’t framed the issue in Feminist v. MRA politics. I think in doing so, you’ve courted fanaticism in your comments and repelled a portion of a would-be audience who will go without seeing a reasoned argument.

    You’ve identified reasons for funding breast cancer research at a higher rate than prostate cancer research that are consonant with my values. However, I don’t think your reasoning has much to do with the justification of the people donating the money. In that sense, the MRAs that use these funding data to identify a societal sexual bias are probably getting some purchase on reality.

    • Hi Tim – thanks for the comment. I agree that the framing could have been more positive. The piece was written in frustration and that has polarised the comments more than I would have liked… I also agree that the justification I present likely doesn’t feature highly in the actual decision-making. There are many social and political forces at work that drive funding priorities. You only have to look at the variation in funding across other cancers in comparison to their severity to see that the argument does not hold across all cancer types.

  24. Just a note, from the chart, I’d say that prostrate cancer infection actually tends to start in the mid to late 30’s, not the 40’s.

  25. The conclusion still doesn’t explain in my opinion the huge difference in funding. I am sure if you did a survey you would find that majority of people don’t have a clue that prostate cancer statistic is this bad.

    Women have many advantages while constantly claiming that they are the victims of the imaginary oppressive patriarchy. Every advantage that women have is clearly measurable (death rates, child custody, work related injuries, better college enrolment rates etc…) while there always has to be “systematic” and implicit male advantages, i.e. women are not expected to provide data, they just have to start crying.

    • Yes, this is a key problem with the article. It says (paraphrasing): “prostate and breast cancers have similar mortality rates overall but majorly disproportionately affects younger women and older men. It’s pragmatic to focus health funding on the younger than the older”. However, while that (controversially) might justify a funding gap, it doesn’t necessarily explain it (or even justify the size of the gap). And there is no evidence presented to suggest it does.

      To compare the age of the patients like this, it would be interesting to compare breast cancer funding with that for young children suffering serious illnesses. Far more evidence is needed to connect the dots between age of cancer sufferers and level of funding.

      It would be interesting to see what historical impact the funding has had on detection and survival rates for each cancer. One would think that funding is there for the help it can bring rather than the severity of the problem that is there. There is a subtle difference.

      The calculation of “years lost” is very interesting because it could be applied to so many other situations too. If a man expects to die at 80 and is killed by cancer at 75, that’s “5 years lost”. But if a woman is expected to die at 85 but dies at 78, that’s “7 years lost”. Yet she’s lived a longer life than the man. She’s also probably worked far less years (part time work and earlier retirement). So you could also count “hours lived outside of work” and compare that to the expected number. That would be a real eye-opener!

      And there are other ways to play with these numbers. If a man lives 75 years, compared to a woman’s 80, that means an hour of a man’s life is a higher percentage than an hour of a woman’s life. So an hour is more valuable to a man than a woman. So maybe he should be paid 6% more than a woman for the same work!? The fact that men have had to retire later than women even though they die earlier is quite revealing in what we expect of men in our societies. It would make more sense for women to retire later, yet why is no one is asking for that?

      Overall I liked the article, and learned something from it. However, the article does not come across as particularly objective. It’s pushing back on claims of men being treated unfairly (which, by itself, is reasonable to do so) but does not offer the same scrutiny for females being treated favorably. A common example of a socially-acceptable reluctance to see men as victims.

  26. suffragettes were mocked; are you any better in this write up. They raised up due to inequality; there is a reason there is a men’s movement.

    As a man please explain to me why my life and my sons is worth less than my wife’s or daughters in medical spending.

    We all have sons daughters wife’s and fathers; I see the spending as sexist and predetermined worth of life.

    If this spending was reversed there would be uproar in the women’s groups; men have no voice.

  27. [ED: I’ve approved this comment because it is well referenced, but I’d rather the original poster summarised things so people might read it!]

    Men beware!

    Read the sad truth about prostate cancer over testing and treatment, dangers and exploitation for profit by predatory doctors.
    A prostate cancer survival guide by a patient and victim.
    January 8, 2016. Updated December 12, 2017 (With references)

    The man that invented the PSA test, Dr. Richard Ablin now calls it: “the Great Prostate Mistake, Hoax and a Profit-Driven Public Health Disaster” [1].

    Your life or your quality of life may depend on reading this document.
    Prostate cancer dirty secrets, lies, exaggerations, deceptions and elder abuse.

    In my opinion:
    Read the hard facts about prostate cancer testing and treatment that no one will tell you about, even after it’s too late. Any man over 50 or anyone concerned about cancer in general, dangers from clinical trials, injuries and deaths from medical mistakes, Quality prescriptions at a huge discount from Canada, exploitation and elder abuse, HIPAA laws and privacy issues should read this document. Prostate cancer patients are often elderly, over treated, misinformed and exploited for huge profits by predatory doctors [1, 9, 10, 25]. The testing, treatment and well documented excessive over treatment for profit of prostate cancer often results in devastating and unnecessary side effects and sometimes death. At times profit vs. QOL (quality of life). Low risk Gleason 6 (3+3) is a pseudo-¬cancer mislabeled as a cancer, it does not need detection or treatment [1, 2, 9].

    Facts per some studies:
    1. Multiple studies have verified more harm and deaths caused from prostate cancer testing and treatment then from prostate cancer itself [1, 9, 10, 25].
    2. Extensively documented unnecessary testing and treatment of prostate cancer for profit or poor judgment by some doctors in the USA [1, 5, 9, 10, 25].
    3. Medical mistakes are the third cause of deaths in the USA (over 251,000 deaths a year, over one million deaths in 4 years) more then suicide, firearms and motor vehicle accidents combined [13].
    4. About 1 man in 6 will be diagnosed with prostate cancer in his life.
    5. About 233,000 new cases per year of prostate cancer.
    6. 1 million dangerous prostate blind biopsies are performed per year in the USA [5, 11, 22, 23].
    7. 6.9% hospitalization within 30 days from a prostate biopsy complication[11].
    8. About 1.3 to 3.5 deaths per 1,000 from prostate blind biopsies [5].
    9. 0.5% died and 20.4% had one or more complications within 30 days of radical prostatectomy [15].
    10. A study of early-stage prostate cancer found no difference in surviving at 10 years whether men had surgery, radiation or monitoring (no treatment) [12].
    11. Low risk Gleason 3+3=6 “cancer” lacks the hallmarks of a cancer yet it is often aggressively over treated [1, 2, 9].
    12. Prostate cancer patients are at an increased risk for chronic fatigue, depression, suicide and heart attacks.
    13. Depression in prostate cancer patients is about 27% and 22% at 5 years, for advanced prostate cancer patient’s depression is even higher [6].
    14. 75% to 90% of oncologists would refuse chemotherapy if they had cancer.
    15. The National Cancer Institute says approximately 40 to 50% of men with low to moderate grade Prostate cancer will have a recurrence after treatment.
    16. 62% to 75% of bankruptcies in America are because of medical bills.
    17. Breast cancer receives much more research funding, publicity than prostate cancer despite similar number of victims.

    Excuse the generally accurate humor and sarcasm. Its intent is to entertain and educate while reading this possibly laborious text.

    $Follow the money$: If a surgeon is financially responsible for operating expenses, a large staff or an oncologist is also responsible for a lease on multimillions of dollars in radiation treatment equipment, do you think they would be more or less honest about the benefits and hazards of treatment? Do you think the profit margin would compromise some doctor’s ethics? Typically, what is the purpose in over testing and treating a cancer that often will not spread and the testing and treatment frequently causes lower QOL (quality of life), ED, incontinence, depression, fatigue, etc if it was not extremely profitable? The medical field is alluding to the fact that prostate cancer testing and treatment may do more harm then good. The U.S. Advisory Panel is now recommending for prostate cancer PSA testing and screening: for men 55 to 69 “letting men decide for themselves after talking with their doctors. For men over 70, no testing at all is recommended.” However this may not protect men from predatory doctors exploiting them. Patients usually follow a doctor’s recommendation. Do you think any regulatory agency will set guidelines for testing and treatment or stop the exploitation of elderly men with a high PSA or prostate cancer or approve new treatments at the risk of financially bankrupting thousands of treatment facilities and jeopardizing thousands more jobs? Prostate cancer patients are often elderly and exploited for profit, the treatments offered has horrible side effects, and newer treatment options are either unavailable or not offered to patients or available outside the USA. Prostate cancer is often slow growing and of low risk and can just be monitored. Often no treatment is the best treatment. Over testing and treatment has been verified by numerous experts, studies and investigations, documentation, etc. [1, 9, 10, 25]

    A 12, 18 or 24 core blind biopsy, holey prostate! One million dangerous prostate blind biopsies are performed in the USA each year and they should be banned. Men with a high PSA tests result are often sent to an urologist for a blind biopsy. Men should be told about other options; Percent free PSA test, 4Kscore test, PCA3 urine test or a MRI, 3D color-Doppler test before receiving a any biopsy. These tests can often eliminate the need for a more risky and invasive blind biopsy. Insertion of 12, 18 or 24 large holes through the rectum into a gland the size of a walnut, a blind Biopsy can result in pain, infections. A high risk of permanent or temporary erectile dysfunction, 22.3% mild ED, 15.5% mild-to-moderate ED, 10% moderate ED, and 13.6% severe ED [22, 23]. Biopsies can cause urinary problems, 6.9% hospitalization within 30 days from a complication[11], sometimes even death from sepsis (About 1.3 to 3.5 deaths per 1,000)[5]. There is also debate that a biopsy may spread cancer because of needle tracking. A blind biopsy can also increase PSA reading for several weeks or months, further frightening men into an unnecessary treatment. Blind biopsies are almost never performed on other organs. One very prestigious hospital biopsy information states “Notice that your semen has a red or rust-colored tint caused by a small amount of blood in your semen”. Another large prestigious hospital states “Blood, either red or reddish brown, may also be in your ejaculate.” These statements are often an extreme exaggeration (mostly lies). Very often after a biopsy a man’s semen will turn into jet black goo. This could be an unpleasant surprise for a man and especially for his unsuspecting partner. However if a biopsy is performed before Halloween or April Fools’ day this may be of some benefit to a few patients. If some very prestigious hospitals are not factual about the color of semen, what other facts are not being disclosed or misrepresented? Never submit to a blind biopsy [5, 11, 22, 23].

    Bone scan scam: Prostate cancer patients are often sent for a bone scan. A bone scan has about a 13% chance of having a false positive and only 3 men in 1,000 have bone cancer who have a bone scan. Bone scans may often be unnecessary in lower risk prostate cancer patients.

    Low risk cancer patients or patients with advanced age are often sent for aggressive treatment by some doctors when monitoring is usually a better option. An extreme example of overtreatment is one SBRT radiation clinical trial. Prostate cancer patients (victims?) where intentionally treated (fried?) with a huge dose (50Gy total, 5 fractions) of radiation resulting in disastrous long term side effect for some of these men. The typical SBRT dose is 35 to 36.35 Gy, 5 fractions. A large percentage of prostate cancer patients in this clinical trial had low risk prostate cancer and probably did not require any treatment at all [4].

    Clinical trials may (or may not) be hazardous to patients. The goal of a clinical trial is to gather information; the intent is not necessarily to help or cure patients. In a clinical trial, if someone is given a treatment that will harm them (as in the above example) or given a placebo in place of treatment or needed treatment is withheld, the patient may be deceived or harmed. Investigate before you participate in any clinical trial. Even if you do get a safe and effective treatment, it may not be available to you after the clinical trial is over. If the trial is for a drug, you will not be told if you are getting a drug or a placebo until after the trial is over.

    Your privacy and confidentiality is just an illusion: You may have little or no privacy and confidentiality! Under the HIPAA law all access to your records is allegedly by a “Need to know” basis only. This is another exaggeration (lie). Prostate cancer patients are asked to fill out a series of EPIC questionnaires and other questioners. The EPIC questionnaire asks several intimate details about patient’s sex life, urinary and bowl function. By a prostate cancer patient completing an EPIC questionnaire may be able to assist his doctor, nurse, office workers or database track his progress or decline. By refusing to fill out these questioners and supplying other unnecessary information one can help insure his privacy, dignity and insure he do not unknowingly become part of a study or clinical trial or other collective survey or have his information forwarded to multiple databases. Most of the time a patient has no idea who has access to medical records or why the records are being looked at. Who has access to your medical records? Probably everyone that works in a medical office or building has access to the records, except you (often you the patient may have limited or no access without a formal request). File access may include/however not limited to non-medical employees, office workers, bookkeepers, janitors, insurance companies, temporary high school or college interns, volunteers, etc. This may also include other medical facilities, programmers, hackers, researchers, etc. Usually records are placed on a Health Information Exchange (HIE) or servers. Dozens, sometimes even hundreds or thousands or more people may have access to medical records. Some major databases like SEER (Surveillance, Epidemiology and End Results) are linked to Medicare records to determine “end results” for researchers, studies, drug companies, clinical trial offers, etc. Servers, both government and privet are sharing information, AKA “health surveillance”. Health information may be shared and downloaded by millions of entities and servers all over the USA and the world to countries that do not have any regulations for privacy. Records may be packaged with others and offered for sale, this does often happen on “the dark web”. If a doctor, patient or insurance company is involved in a criminal or civil case, medical records may become public court or law enforcement records. A patient may have a photo taken before treatment. Financial and medical Identity theft is a growing problem, often expensive and difficult to correct. Ransomware is also a growing problem. Your records can also be accessed by anyone (trainees, volunteers, students, high school interns, minors and adolescent people as young as 16 years of age) “for training purposes” or any other reason, all without your consent. A list of what a high school intern is allowed to do to patients: “learning simple medical procedures, watching surgeries or procedures, shadowing doctors (including seeing patients), working in hospitals, interacting with patients, and more.” They can also read all records about your prostate problems, your wife’s hemorrhoids and your daughters yeast infections or any files for any patient, all within the HIPAA guidelines. These people do not have to be employed by the facility or have a background check. Would you like to have a high school or college student that possibly lives in your neighborhood or attends school with your children read over your extensive family member’s medical records and personal information? How much curiosity or self control does a high school or college student have? All patients should avoid supplying unnecessary information whenever possible. Supply relevant information only when filling out forms. In the USA identity theft is very common, growing problem and is often financial devastating. Medical forms can be a good source of information for thieves. Drug companies use major databases to solicit people for clinical trials. Numerous exceptions (loopholes) appear within the HIPAA laws regarding you privacy. Even without HIPAA violations, records can be accessed by multiple people and appear in multiple databases. Sometimes medical phone calls are recorded “Calls may be recorded for training and quality purposes”. Calls about a clinical trial, calls to a large clinic, toll free number, calls to drug companies and calls to insurance companies may be recorded. HIPAA laws are deficient and often will not protect your privacy. I believe the medical field has little regard for our privacy, especially if it is in conflict with training, research, studies, profit or other objectives. If you’re a public figure, celebrity, rich or famous you may be subject to numerous people wanting to see your medical records. Also if you are known to or an acquaintance of anyone with access to your records (neighbor, co-workers spouse, etc) they would possibly (or probably) want to have a look at your medical records. On May 6, 2017 Dear Abby did an article on this subject, “Snooping into medical records”. You are naive if you believe otherwise or that your records are secure. The same also applies to pharmacies and labs, etc.

    A patient’s dignity (or lack of dignity): Prostate cancer testing and treatment is stressful, degrading, demoralizing and embarrassing. After his surgery one patient stated both his prostate and his dignity was both removed and discarded. EPIC questionnaires can be counterproductive impact a patient’s dignity, privacy, confidentiality and self image. EPIC questionnaires have an increased potential and greater impact on patients for privacy violations because of its format, nature and personal content. Patients may mistakenly believe the EPIC questionnaire is a requirement to be filled out. Also the term “strictly confidential” can be misleading and ambiguous. One patient posted he filled out and turned in his “strictly confidential” EPIC questioners only to have every female office staff member read it and ogle him. Resulting in him not filling out any more EPIC forms or any other forms and he stated that he became very uncomfortable and evasive with the entire office staff. The drawbacks of this form seem to outweigh any potential benefit for some patients. Medical tests and procedures can be degrading and embarrassing for both men and women. Many women prefer or will only see female doctors or gynecologists. Over half of men prefer a male doctor. (Per some respected doctors: “Men stay away from medical care in large numbers because of privacy and dignity. Many men still avoid medical care because of embarrassment. Honest answers will often not be given if asked by a female doctor or nurse.”) Per surveys: nurses and medical staff often laugh at and ridicule patients. What percent of men will feel comfortable consulting a female doctor, nurse or office worker about his prostate problems, ED, etc or would want an invasive test or procedure performed by a female?

    Becoming radioactive, a bizarre treatment option: LDR Brachytherapy (permanent radioactive seed implant). This procedure implants about 60 to 120 radioactive seeds in the prostate, sometimes resulting in urinary problems. The patient will literally become radioactive for months and up to 2 years. The patient may set off radiation alarm at airports, seaports and border security checkpoints. He will also be required to use a condom, have no close contact with pregnant women, infants, children and young pets for months or longer. Occasionally he may even eject dangerous radioactive seeds during sexual activity or urination. The patient will become like a walking Chernobyl, having radioactive scrap metal and emitting hazardous radiation from his crotch. He will also be required to carry a card in his wallet stating he is radioactive. If he dies cremation may be a big problem. The videos of this procedure are disturbing and bizarre. A catheter will also be required. Brachytherapy has a high possibility for ED.

    ADT Hormone therapy, big profits and devastating side effects: Lupron injections are one of the most common. Men are prescribed hormone therapy (ADT therapy), AKA chemical castration as an additional or only treatment. Hormone (ADT) therapy is sometimes over prescribed for profit, per some studies. Hormone therapy is often very expensive (Profitable for doctors if provided at the doctor’s office and not a pharmacy) and can have horrible, strange and devastating side effects, feminization, hot flashes, fatigue, weight gain, long term or permanent ED, depression, etc. His penis could shrink and his testicles can completely disappear, he may grow breasts. This treatment can have so many mind and body altering side effects that doctors will often not inform patients about all of them. One man stated that ADT therapy turned him into an old menopausal woman. Men are sometimes actually castrated (orchiectomy) as a cancer treatment to reduce testosterone; I just can’t imagine a more barbaric and primitive treatment. Amnesty International calls chemical castration “inhuman”. ADT therapy is often used in sex reassignment surgery, male-to-female transsexuals. Studies (Medicare and financial) have documented doctors do over prescribe ADT therapy for profit (depending on Insurance payout rates/profit margin). When insurance payment reimbursement for ADT decreased so did the number of patients being prescribed ADT therapy! [17, 18] Per Wikipedia: “in patients with localized prostate cancer, confined to the prostate, ADT has demonstrated no survival advantage, and significant harm, such as impotence, diabetes and bone loss. Even so, 80% of American doctors provide ADT to patients with localized prostate cancer.” Overtreatment with ADT is extremely profitable, unfortunate and avoidable.

    Major surgery, major side effects: Nerve sparing Robotic surgery is touted as being a better treatment and having fewer side effects, this is usually an extreme exaggeration. The nerves can not always be spared. Robotic surgery can result in a faster initial recovery. Long term risk of incontinence, fatigue, ED, depression, some men will ejaculate urine, shorter penis; etc is about the same as conventional surgery [1, 2, 3, 6, 14]. Patients undergoing surgery are at about a 22% chance of long term or permanent fatigue. A catheter will be required. 0.5% died and 20.4% had one or more complications within 30 days of radical prostatectomy [15]. Patients can have unrealistic expectations about the results. Per some studies radical prostatectomy was associated with more regrets than other treatment options. The ED rates and other side effects are often understated to patients. Men are left limp and leaking after this surgery [1, 2, 3, 14].

    Patients should not be naive: Medical mistakes are the third cause of deaths in the USA (over one million deaths in 4 years) [13]. Medical mistakes cause more deaths then suicide, firearms and motor vehicle accidents combined. Countless other patients have been harmed by medical mistakes. If you are having surgery, biopsy or a procedure take precautions if possible. Have someone qualified or knowledgeable monitor you and your medications, etc. Doctors, nurses and technicians can be profit motivated, use obsolete procedures, be lazy, incompetent, make mistakes and be apathetic or rushed. Occasionally harm can be done or not prevented with intent or for profit. Drug abuse is often a problem with some medical workers because of easy access. Doctor’s offices and clinics can see many patients in a relatively short amount of time. This may be a disadvantage to patients, empathy and quality of care can sometimes be compromised. Sometimes a nurse, medical assistant or an office staff member may be the person that overseeing much of a patient’s care. I personally know of or have had contact with at least 12 doctors, nurses and other medical staff that I would consider dangerous; incompetent, dishonest, lazy, abusive, mentally disturbed, sadistic, drug abusers that work in doctor’s offices, labs and hospitals. Most of these people did not have a name tag and supplied me with a first name only when asked for a name. I am now sure modern medicine protects the guilty and incompetent, also victimizes the naive patients. I now understand why medical mistakes are the third leading cause of deaths in the USA. I now believe some or most of the deaths and injuries are preventable or intentional. Medical workers can know everything about a patient, hide behind anonymity and do patients irreversible harm or death. The patient may not even know his or her first name. TV and sometimes the public seem to idolize doctors, nurses and caregivers; however the health care profession has about the same amount of abusive or incompetent workers as other occupations. I have also had excellent doctors and nurses, however this may not protect you from the bad ones. What are the main reasons nurses get fired: 1. Prescription drug abuse (because of easy access to drugs). 2. Too many mistakes. 3. Code of conduct and privacy violations. 3. Bad attitude. 4. No proper licenses 5. Abuse of patients. Often the bad health care workers can just get another job if they get fired, without any repercussions. Patients should be aware that sometimes QOL (quality of life) may be secondary or an absent goal in treatment. Sometimes overtreatment for profit or to prevent an unlikely death or metastization from low risk cancer may be the primary or the only goals of prostate cancer treatment. Many men may not be prepared for or have unrealistic expectations about the outcome, physical and psychological impact of testing and treatment.

    Depression in prostate cancer patients is common, 27% and 22% at 5 years [6] and for advanced prostate cancer patient’s depression is even higher. Prostate cancer patients are at an increased risk of suicide. Men are seldom screened for depression after prostate cancer.

    The risk of long term chronic and permanent fatigue (that can result in depression) is almost always understated if mentioned at all to many patients. Per some studies and depending on your treatment; the risk of long term or permanent fatigue is about 25% to 60%. Radiation with Hormone therapy has a high risk of fatigue. Long term fatigue also increases the risk of clinical depression and suicide.

    Prostate cancer testing and treatment. Quackery and butchery? Castration, ADT hormone therapy (chemical castration), Brachytherapy, cryotherapy, radiotherapy, surgery, chemotherapy and blind biopsies are dangerous, psychically and emotionally brutal, traumatic and disturbing. These types of treatments are primitive and almost beyond belief in today’s world of advanced technology. It seems all of the best treatments for prostate cancer have not been approved and some are only available outside the USA. Newer treatments like, HIFU, hyperthermia, Conexus, IRE Therapy, Boron Neutron capture therapy, Gold Nanoparticles, PARP Inhibitors, Platinum, focal Ablation (only treating the cancer and not the entire prostate) and orphan drugs (dichloroacetate, etc.) should be approved and used when appropriate. Biopsies should be limited to selective MRI guided samples only; blind biopsies should never be performed. Per some studies vitamin D3 may help control PSA and prevent prostate cancer from becoming aggressive [16].

    Lipstick on a pig: Approved advances in prostate cancer treatment mostly consisting of newer, faster and more accurate radiation treatments, robotic surgery and new drugs. These advances sound like greater strides have been made. However most of these approved advances are of limited benefit to prostate cancer patients and still have about the same amount of long term side effects. Compared to other technologies, computers, communications, electronics, aviation, etc, cancer treatment approved advances have been dismal. The National Cancer Institute wastes about 3 billion dollars a year on PSA screening that can be used for research and true cures. QOL (quality of life) issues have not been adequately addressed. Profit often outweighs QOL.

    Prostate Radiotherapy (EBRT-external beam radiation therapy) for cancer treatment. New technology consists of: IMRT, SBRT, IGRT, VMAT, TrueBeam, Cyberknife, etc. This newer, faster, more accurate and easer to setup radiation equipment is of much benefit for doctors, staff and a good selling point to patient’s. However as far as reducing long term side effects, only small gains have been made with the newer radiotherapy equipment. A patient should be skeptical if exaggerated claims are made about reduced long term side effects, especially fatigue and ED rates. Radiotherapy can cause hip and bone problems later in life. 44% decreased orgasm intensity and multiple forms of sexual dysfunction [8, 21]. Patients should inquire as to the treatment plan: Gy dose and fractions, margins, testicular dose, constraints and age of radiotherapy equipment to insure excessive radiation exposure treatment is not given that can result in additional side effects. Patients should be aware that pelvic shaving, permanent tattoo markers, fiducial marker (small seeds) are sometimes placed in the prostate, MRI, CT scan, photographs, catheters and other procedures may or may not a be required. Radiotherapy can also occasionally result in secondary cancers and damage to “organs at risk” (organs close to the prostate). Radiation has a high probability of sexual dysfunction and fatigue, just as high and sometimes higher with the newer equipment. ED rates estimated at 35% to 75% or higher, 93% at 15 years [8,14, 21]. Sometimes radiation can also cause bowel and urinary problems. Per some studies radiotherapy causes moderate-to-severe gastrointestinal effects in 17%. A 5 day SBRT radiation treatment is now commonly available with about the same results and side effects as a 9 week radiation treatment. A doctor with a multimillion dollar lease and maintenance agreement on radiotherapy equipment and a large staff may or may not be influenced by his or her financial obligations when deciding to recommend over testing and treatment.

    Fried nuts, two-: Prostate radiotherapy (EBRT/SBRT) can sometimes result in a 5% to 30% temporary or permanent drop in testosterone levels, excluding hormone therapy. This drop is determined by the testicular radiation dose (treatment equipment and planning) [19, 20]. A below normal drop in testosterone can result in fatigue, depression, sexual dysfunction and other symptoms. Always ask for a printout of testicle dose and constraints before and after prostate radiotherapy to insure your testicles are not over radiated, also include the CT scan exposures. Have your testosterone levels tested before and months after EBRT treatment.

    Chemotherapy can be extremely toxic and sometimes deadly: Any cancer patient (man or woman) who are being offered chemotherapy should be particularly cautious. Without genomic testing or proof of the effectiveness of the specific drug being used on the exact cancer type being treated, chemotherapy can often be more toxic to the patient then to the cancer. Chemotherapy may be extremely expensive, profitable for some doctors (if dispensed by the doctor and not by a third party) and can be misused or overused, often for profit. The “chemotherapy concession”: A doctor may purchase a quantity of chemo drugs for $10,000 and charge a patient $20,000. A doctor can also receive a percent kickback from the drug company for prescribing the drug. What is the motive for some doctors to perform Genomic testing and giving a patient a different and more effective treatment at an unknown or no profit versus a guaranteed profit with a probable worthless or harmful treatment? This is a well documented and common practice. 75% to 90% of oncologists would refuse chemotherapy if they had cancer. Chemotherapy fails upwards of 93 and 98% percent per some studies. One Michigan oncologist who committed fraud and gave $35 million in needless chemotherapy (for profit) to patients, some who did not even have cancer is now in jail for 45 years. He was running his own in-house pharmacy. The nursing staff was indifferent and the state regulatory agency initially cleared him of any wrongdoing (a cover up). Many or most chemo drugs are considered a biohazard.

    Long term care consists of regular PSA testing for years. Long term care for side effects is often lacking or exploitive or ineffective. Often complaints of side effects are disregarded by nurses, doctors and sometimes referred out to other doctors. The patient is sometimes left to figure out what to do about his side effects with the resources available to him. Long term side effects (devastation) often consist of fatigue, bowel or urinary problems, sexual dysfunction, depression, isolation and sometimes suicide. Patients with complaints of chronic fatigue are often told to exercise, get plenty of sleep, pace your self and eat a healthy diet; this advice is of limited help for chronic fatigue. Often treatments for long term side effects are embarrassing, degrading, unavailable, nonexistent, costly, not effective, not offered or bothersome. Billions of dollars are profited from ED drug and other ED products, catheters, pads and diapers, drugs for depression or pain or insomnia or incontinence, additional treatments and surgeries for side effects. Also treatments for the multiple and bizarre side effects from hormone ADT therapy (chemical castration) is sometimes required.

    Men, ageing, exploitation and elder abuse: If any man lives long enough it is very likely he will have a prostate problem, low testosterones or some form of sexual dysfunction. In my opinion modern medicine often has been exploitive, abusive and has provided substandard care for older men in general due to all of the explanation given in this text. I believe much of the attitudes toward older Americans need improvement and they are sometimes viewed as being subhuman and exploitable by various groups and individuals. If documented cases of unnecessary surgery and radiotherapy or blind biopsies on children by doctors for profit were released, the vast majority of Americans would be outraged and this practice would quickly end. However for older men it dose not seems to be of great concern! As defined by some or all state laws, exploitation of elderly men by overprescribing treatment for profit is a crime or an offence of various guidelines and regulations. It is extremely unlikely any doctor will ever be prosecuted or has a medical license suspended for this common and extensively documented abuse or crime. It is well documented that all forms abuse do occur to the elderly and disabled in nursing homes and other facilities including neglect, theft, starvation, torture, harassment, sexual assault, etc. Elderly are being exploited in many ways (Also scams for profit). One patient after recovering from a brain injury testified that he was repeatedly abused, slapped and hit, forced to drink boiling hot tea by multiple caregivers and sexually assaulted by one female caregiver. I personally know of an elderly lady that is living in an expensive assisted living home that has had all of her possessions (radio, clothes, underwear, shoes, bed sheets) repeatedly stolen and replaced by her family. Guardian scam; If you are declared incompetent by strangers, they can become your guardian (Guardianships and Conservatorships). You can be forced to move into a nursing home and your property can be sold and your assets can be seized by them. In other words-they can steal your assets and incarcerate you. Some people are becoming very wealthy by using this exploitation method. Make sure you have an estate trust, executor, etc [24].

    Drug company rip Off!, no bathtub included: More exploitation of men! Almost all prostate cancer treatments usually result a high percentage of erectile dysfunction. Often claims of prompt effective treatment for ED or other side effects if they occur after treatment are often misleading. Statistics for ED percentages from treatment are usually quoted after treatment with Viagra, Muse or other ED treatments, therefore most statistics are very misleading. ED rated at 5 years may be as high as 50% to 80% or higher for most treatments. ED rated at 15 years may be as high as 90% or higher for most treatments. For cryotherapy, ED rates are extremely high. The cost for ED drugs like Levitra, Cialis, Viagra and Muse are deliberately kept very expensive by drug companies, about $10 to $60 per 1 pill or dose. At these prices Lilly could consider including a free bathtub featured in its advertisements for Cialis. The cost of a 30 day supply of Cialis is usually well over $340 and the cost of an inexpensive bathtub is about $200. Generic PDE5I ED drugs in Canada and other parts of the world sell for about $0.50 to $2 a pill. Many insurance companies will not pay for ED drugs or treatment. Less expensive generic drugs are usually unavailable in the US. Some ED drugs should have already become available in a generic (in the USA) form for about $1 a pill. This is further exploitation by the drug companies of men in general. Men are also exploited by counterfeit mail order ED drug sales. ED drugs are not always effective and may have side effects. ED treatments can also be embarrassing, not offered, not practical, painful, expensive/not covered by insurance. Men will often not seek treatment because or these reasons. You can get safe inexpensive quality generic and brand name drugs from Canada. Just get a prescription from your doctor and make sure the pharmacy is CIPA licensed. Generic or bran name Cialis, Viagra for about $0.50 to $3 a pill and other drugs. Go to https://www.cipa.com/certified-safe-online-pharmacies/ for a list of trusted CIPA Canadian pharmacies. Stop getting ripped off by American drug companies.

    The numbers game, you lose: More exaggerations and lies. A doctor may state a patients chances of ED is about 35% with EBRT radiotherapy (or some other treatment). A patient may think, 35% is not too bad and if I do get ED I can always take Viagra. What a doctor may not tell a patient is that the ED rate is 35% at 1 or 2 years for a patient under 65 years old and with an ED drug treatment option. For a patient over 4 years, over 65 years old and no ED drugs the ED rate may be about 75% or higher. After age 70 your chances of ED is over 85% or higher.[8] Obviously, a man is more likely to refuse treatment at a 75% ED rate verses a 35% ED rate. Some side effects may not be disclosed at all. If side effects (low libido, chronic fatigue, depression, increased suicide risk, etc) are not disclosed, no percentages will usually need to be quoted. Results are often worse for a surgery option, the main difference in ED results between surgery and radiotherapy is; with surgery ED will start out bad and may or may not get better with time, however with radiotherapy ED will get worse over time. With both treatments together or with ADT hormones also you’re in real trouble with ED percentages. Cure rates are often quoted at the 5 years mark for most treatments. 5 years is not a magic number, anyone can have a treatment failure before or after 5 years. A cure rate for a treatment at 5 years may be quoted at 85%; however the cure rate at 7 to 10 years may be only 70% and 50%. The 85% at 5 year rate was quoted to me. I was never told about my 50% at 10 year cure rate. Always ask what is the “biochemical recurrence” (AKA rising PSA or treatment failure) rate for well beyond 5 years with your computer software simulation and Partin tables. Ask your urologist or radiation oncologist for a 10-year cure Rate. If the physician is unable to provide one, consider finding another doctor. Studies and clinical trials results, side effects percentage claims, etc can be biased. Watch out for terms like “age adjusted” or ambiguous or excluded facts as given in the above examples. ED rates for radiotherapy are usually quoted at under 1 or 2 years and for surgery over 1 or 2 year to give the appearance of a more positive result. I have read and have been given some extremely exaggerated claims (mostly lies) concerning cure rated, side effects, etc.

    The walking dead: Patients are often left impotent, incontinent, fatigued, exploited, embarrassed, demoralized, depressed and sometimes also feminized/ castrated or suicidal. Loss of libido estimated at about 45%. Excluding hormone therapy, lower libido is almost never disclosed as a treatment side effect and sometimes it is completely denied as a problem. After testing and treatment your life may be very deferent. Prostate cancer patients are often elderly and exploited for profit [1, 5, 9, 10, 25]. Aftercare for long term side effects is frequently ineffective, expensive, not offered, degrading or nonexistent. Prostate cancer patients are seldom told about chronic fatigue, depression, loss of libido and the true risk of side effects are usually understated. Modern medicine often fails and victimizes prostate cancer patients.

    Often few good choices exist for treatment: A prostate cancer patient treatment choice often ends up being the least worst choice or the choice with the side effects a patient thinks he can tolerate. If a patient has intermediate or high risk prostate cancer and dose not have advanced age he may need treatment. He should consider genomic testing and look into other advanced treatments if available. Also he should try and avoid hormone therapy if possible because of the multiple side effects especially if the cancer is organ confined. If laser or other advanced treatments are not available a 5 day SBRT radiation treatment may be considered (In my opinion SBRT could be the least worst of the bad choices, still a poor option). SBRT seems to be fast, least invasive or traumatic. ED and fatigue is still a high long term risk. Radiation with hormone therapy has a higher risk of ED and long term fatigue. However, I now believe conventional prostate cancer testing and treatment is a big mistake for most men.

    The short version of my story: I was referred to an urologist by my family doctor after a high PSA test. I will refer to the urologist as Doctor “A”; he used old and dangerous testing technology (18 core blind biopsies), his nurse seemed to have a mental defect exhibiting arrogant, rude, strange, abusive behavior and was intent on inflicting psychological harm to me. Shortly after my Dr. “A” visits ended, his nurse was no longer employed at his office and no person in that office would refer to her employment or her existence. I now believe this nurse was high because of drug abuse being common among nurses (easy access to drugs). I was diagnosed with prostate cancer by Dr. “A”. I refused his surgery and hormone therapy recommendation because of the imminent side effects and his unprofessional nurse behavior, so Dr. “A” referred me to Dr “T”. Dr. “T” was outside of my insurance network; however his office manager stated she was willing to work with my insurance, offered me a doctor consultation and would accept any insurance payment as a full payment. When I arrived in his office the waiting room was empty. Dr “T” also had a large staff. Dr. “T” used older conventional technology, offered me overtreatment, hormone therapy, bone scan (unnecessary procedures and testes). One week after my consultation with Dr. “T” I received an $850 bill, in conflict with what was agreed upon with his office manager. After a recommendation from a friend, I called clinic “O” and met with the nurse. She offered me treatments with a verbal guarantee of “no side effects from the radiation”. However this nurse could not answer any of my basic questions, lacked any credibility and sounded like an unscrupulous used car salesmen. Most of these office visits caused me multiple problems with offices workers processing paperwork for tests, insurance forms and billing, etc. Two of these doctors offered me an unnecessary bone scan. Two of these doctors recommended unnecessary hormone therapy ADT (overtreatment) for my organ confined cancer. After I absolutely and utterly refused hormone therapy, both doctors admitted it probably would not help me in my final outcome because of the computer estimate run on me with my organ confined cancer, PSA, biopsy report, etc. Having no advance treatments (laser, etc) available to me at that time, I decided on SBRT treatment with Dr. “K”, he could answer my questions and had new equipment. Before my treatment could start I was referred to “W” lab for an MRI. “W” lab had a trainee assisting and it took over 2 hours to complete my MRI. 2 days later after receiving a copy of my MRI report, I examined the MRI report; it had my name and some other patient history information. I wasted 2 more days verifying it was the correct MRI of me and not some other prostate patient MRI before my treatment could start. I did receive treatment from Dr. “K”. I did have a relatively fast and noninvasive treatment (SBRT), resulting in several months of fatigue, a large PSA bounce 18 mothers later and some other short term side effects. At this time I am doing okay, however I’m not sure what the future will bring? I also no longer trust modern medicine, doctors, nurses, etc. Modern medicine seems to be more of a gamble then a science. I have wasted hundreds of hours and thousands of dollars. I feel modern medicine has abused and failed me (and others) due to the lack of guidelines and regulation, still approved obsolete technology, better unapproved treatments, exploitation, greed, apathy and incompetence. Hindsight is 20/20. I was never offered Genomic testing. If I could do it over again, I would also consider no PSA testing and treatment or traveling for advanced treatments from a competent provider if practical and available. I believe if I did take the two doctors recommendations and received unnecessary hormone therapy in addition to the radiotherapy my quality of life (QOL) would have been severely impacted for years or permanently and could possibly have resulting in my early death. I did seem to have a lot of bad luck in picking providers or is this just the new standard in medical care?

    “Do no harm”, unless you can make a lot of money and get away with it: I was harmed physically and verbally by Dr. “A” 18 core blind biopsy and verbally abused by his nurse. I was potentially exploited and financially harmed ($850) by Dr. “T” and offered unnecessary testing and overtreatment. Clinic “O” nurse attempted to misinform and deceive me about the treatment outcome of “no long term side effects”. I was harmed by “W” lab by mistakes and incompetence. I did also have numerous other billing and paperwork problems probably due to mistakes and apathy. A few of the office staff were incapable of completing some very simple tasks like filling out lab work request or insurance forms. At least 40% (probably substantially more, 50% to 60%) of the health care workers I came into contact with did or attempted to do some form of harm to me or provide substandard care, attempted excessive testing and treatment, mistakes, billing overcharges, blind biopsy, false statements, deception, misinformation, apathy and abusive behavior¬¬¬, as explained in this text. I have also observed several medical facilities do not require workers to wear name tags and when asked for a name most will give a first name only; this may also be a factor in health care workers not acting in an ethical manner. To me, it seems that this prostate cancer nightmare maze was intended for maximum physical, psychological, financial harm and to be of questionable benefit and maximum profit for doctors. My prostate cancer experience has been one of the worst events that has happened to me in my lifetime. Also seeking testing and treatment is one of the biggest mistakes I have ever made. I specifically blame modern medicine for not protecting patients from predatory doctors, substandard technology and a lack of regulations that would protect patients. I would have been much better off going to a Voodoo or witch doctor. I would have saved thousands of dollars, time, had no side effects, no paperwork, more confidentiality and privacy. Also I probably would have received better advice. I could have received a nice amulet or a good luck charm to protect against sorcery or magic (PSA testing and treatment) and evil medicine men (predatory doctors).

    My treatment choice: I feel LDR Brachytherapy and hormone therapy (AKA chemical castration) seemed to be completely degrading, disturbing and bizarre. Hormone therapy would not have been an effective treatment for me. Surgery and Brachytherapy are to invasive. Surgery has an imminent danger of incontinence and ED. 9 week EBRT radiotherapy was just too long and laborious. Because castration (orchiectomy), ADT therapy (chemical castration), surgery, Chemotherapy, LDR Brachytherapy and blind biopsies are what I consider “Frankenstein medicine” (outdated, harmful, strange, bizarre, brutal, twisted, degrading or a perverted nightmare) I would avoid all of them. Unfortunately, I was deceived and misguided into having a blind biopsy. I do not believe other conventional treatments like radiotherapy are good or great choices either, just not as horrific. The choice I made was a 5 day SBRT radiotherapy. A 5 day SBRT also has numerous drawbacks and side effects, about the same as a 9 week EBRT radiotherapy. I also had no advanced treatment options available to me. As I have stated above, If I could do it over again I would also consider either no PSA testing and treatment or traveling for advanced treatments from a competent provider if practical and available. I am now sure I made the wrong choice by receiving conventional testing and treatment. With prostate cancer, the testing or treatment is often worse then the disease. I am not implying anyone should make the same choices as I did. I am only giving the motives for my decisions. I was also the victim of profit motivated and substandard providers. 3 years later I now believe my prostate cancer testing and treatment greatly accelerated my ageing (through the stress, testing, treatments and physically from the radiation and was also a financial burden). Per a new SBRT studies my 4+3 Gleason score is considered “unfavorable” [7]. I now have about a 50% chance of a treatment failure in 8 to 10 years. My previous long term cure rate was originally quoted at 85% before my treatment started. I am also sure prostate cancer testing and treatment is mostly smoke and mirrors (lies). The man who invented the PSA test, Dr. Richard Ablin now calls it “the Great Prostate Mistake, Hoax and a Profit-Driven Public Health Disaster”[1]. When asked: “How did you live so long?” A 99 year old woman stated “stay away from doctors and don’t take anything they prescribe for you”. With some exceptions, I now believe this advice to be mostly true.

    Always protect yourself: With prostate cancer the common standard in medical care seems to be substandard. Do not let the sterile, friendly and professional environment of a doctor’s office detour you from protecting yourself from overtreatment or any unnecessary life changing tests and treatments. If you are concerned about misuse or privacy issues, refuse to fill out EPIC questioners and limit the information given to relevant information only. If you have a high PSA or prostate cancer, educate yourself. A patient should be extremely skeptical if exaggerated claims are made about minimal long term side effects from conventional treatments or blind biopsies, exaggerated cure rates or the need for immediate treatment. Also claims of effective prompt treatments for side effects. Bring someone educated or astute with you to your consultations and appointments. Insist on Genomic or advanced testing if you have prostate cancer. Avoid doctors that are mostly profit motivated. Do not submit to a prostate blind biopsy. Get a second or third opinion if you are being offered treatment with low risk prostate cancer. Learn about all your treatment options, testing and side effects. Verify everything you are told. Under the HIPAA law you are entitle to a copy of all your medical records and bills. Always ask the name of the person assisting you. Get a copy and keep a file of your test results, biopsy report, Gleason score, PSA, MRI report, treatment plan, bills, insurance payouts, etc. Carefully monitor your PSA. Expect a temporary increase (for weeks or months) in PSA after some procedures. Verify the accuracy of paperwork. If treatment is necessary talk to your doctor in advance about side effect management, chronic fatigue, ED, etc. Doctors that provide treatments often have computer software to predict the outcome using test results and different treatment options. Ask to see your computer predicted cure rate outcome with your treatment options if available. This may give you some insight to your options, cure rate and also to avoid overtreatment. Always ask what is the “biochemical recurrence” (AKA rising PSA or treatment failure) rate for well beyond 5 years, 5 years is not a magic number. For help contact a good prostate cancer support group without a conflict of interest. A wise man once told me “you need to learn to think like your doctors (nurses or other providers)”. What are the motives of your providers?

    A medical holocaust: Multiple studies have verified more deaths and harm caused from prostate cancer testing and treatment then from prostate cancer itself. Medical mistakes are the third leading cause of deaths in the USA, over 251,000 deaths a year or over one million four thousand (1,004,000) deaths in 4 years. More then suicide, firearms and motor vehicle accidents combined [13]. These statistics do not include many more people that have had their lives destroyed or shortened by modern medicine or a reduction in QOL (quality of life). Per the FDA, 106,000 deaths per year (Over one million people in 10 years) from prescription drugs. Very often men are not told about all of the true risks and side effects or they are downplayed for both a blind biopsy and treatments. I personally know of 2 patients killed from medical mistakes, one got hepatitis from a colonoscopy and the other death from an upset ER nurse forcing a tube down his throat causing lethal damage.

    No national guidelines: Strict guidelines for cancer testing and treatment need to be created and enforced because of the extensive and documented abuses of prostate cancer patients: 1. Blind biopsies should be banned. 2. Strict standards and gridlines for testing and treatment need to be created. 3. Full mandatory industry standard disclosure need to be created for tests and treatment to include realistic risk factors. 4. Newer testing and treatments need to be created and approved. 5. Dignity, privacy and confidentiality need to be standardized and enforced in addition to the HIPAA laws. 6. Mandatory aftercare needs to be available, standardized and regulated. 7. The cost for drugs needs to be regulated to end financial exploitation by drug companies. 8. Medical workers should be identifiable and be required to wear name tags with first, last names and job title. 9. A new standard “Ethical Code of Conduct” needs to be created and enforced to end patient exploitation and abuse. 10. Genomic or genetic testing should be required before any patient is sent for treatment to avoid overtreatment and insure the correct treatment. 11. A truthful and accurate standardized educational book or PDF needs to be created and distributed to all high PSA and prostate cancer patients. 12. Ban for profit ADT therapy and the “chemotherapy concession”. 13. A database needs to be created to track and ban dangerous or incompetent health care workers to break the cycle of abuse. It is unlikely any of the above recommendations will be implemented unless prostate cancer affected a larger percent of the population or enough prominent people are affected. Prostate cancer patients must protect themselves as the only alternative!

    Clarification: This text may anger and upset some people for various reasons. The intent of this document is not to imply all doctors are dishonest or to condemn all medical providers. The intent is to educate men of the consequences and dangers that may await them so they can take appropriate action and to inform patients of real world, typical or worst case scenarios. I have also tried to include most scenarios a prostate cancer patient should be cautious of. Would some health care providers harm a patient for profit or by accident or some other reason? Yes, absolutely! Shockingly, for me it was will over 40% (probably 50% to 60%) that intended to do me some form of harm or provided substandard care as explained in my story. Are some other doctors and nurses exceptional? Yes! I have also had excellent doctors and nurses, however this may not protect you or I from the bad ones.

    Disclaimer: I have no conflict of interest. I do not represent any support group or other organizations. I am not a doctor. I do not prevent, treat, diagnose, cure or advise on medical matters. The information in this document is for educational purposes only. If you need treatment or medical advice, consult a competent and trustworthy medical doctor.

    Anyone may copy, email or distribute parts of or this entire document without changing or modifying it.

    I have been extensively criticized by some for creating this document and its blunt content. In order to insure my privacy and avoid any potential reprisals, further abuse or exploitation, I will remain Anonymous.

    References:
    1. Hardcover book, The Great Prostate Hoax: How Big Medicine Hijacked the PSA Test and Caused a Public Health Disaster. by Richard J. Ablin (Inventor of the PSA test).
    2. https://urologyweb.com/prostate-cancer-treatment-the-disturbing-facts/
    3. World J Mens Health. 2017 Apr; 35(1): 1–13. Published online 2017 Apr 26. Orgasmic Dysfunction after Radical Prostatectomy. Paolo Capogrosso.
    4. R. Timmerman. Phase I dose-escalation study of stereotactic body radiation therapy for low- and intermediate-risk prostate cancer. J Clin Oncol. 2011 May 20;29(15):2020-6.
    10.1200/JCO.2010.31.4377. Epub 2011 Apr 4.
    5. Medscape Urology WebMD: Mortality Risk With Prostate Biopsy Raises Concern – Medscape – Jun 17, 2013.
    6. British Journal of Cancer (2006) 94, 1093 – 1098 & 2006 Cancer Research UK. Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up.
    7. Alan Katz. Original research published: 08 July 2016. 2016.00168. Predicting Biochemical Disease-Free survival after Prostate stereotactic Body radiotherapy: risk-stratification and Patterns of Failure.
    8. C. KING. doi:10.1016/j.ijrobp.2009.07.1748. SEXUAL FUNCTION AFTER STEREOTACTIC BODY RADIOTHERAPY FOR PROSTATE CANCER: RESULTS OF A PROSPECTIVE CLINICAL TRIAL.
    9. L. Klotz. Curr Opin Endocrinol Diabetes Obes. 2013 Jun;20(3):204-9. Prostate cancer overdiagnosis and overtreatment.
    10. Loeb, S. Eur Urol. 2014 Jun; 65(6): 1046–1055. Overdiagnosis and Overtreatment of Prostate Cancer.
    11. Loeb, S. J Urol. 2013 Mar; 189(3): 867–870. Is Repeat Prostate Biopsy Associated with a Greater Risk of Hospitalization? Data from SEER-Medicare.
    12. The new England journal of medicine. October 13, 2016 vol. 375 no. 15. 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer.
    13. BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2139 (Published 03 May 2016) Cite this as: BMJ 2016;353:i2139. Medical error—the third leading cause of death in the US.
    14. Matthew J. Resnick. N Engl J Med 2013; 368:436-445 January 31, 2013 Long-Term Functional Outcomes after Treatment for Localized Prostate Cancer
    15. JNCI: Journal of the National Cancer Institute, Volume 97, Issue 20, 19 October 2005, Pages 1525–1532. 30-Day Mortality and Major Complications after Radical Prostatectomy: Influence of Age and Comorbidity.
    16. Rev Urol. 2004 Spring; 6(2): 95–97. Vitamin D for the Management of Prostate Cancer
    Masood A Khan.
    17. Reimbursement Policy and Androgen-Deprivation Therapy for Prostate Cancer Vahakn B. Shahinian, M.D., Yong-Fang Kuo, Ph.D., and Scott M. Gilbert, M.D. N Engl J Med 2010; 363:1822-1832November 4, 2010
    18. Medicare Reimbursement and Prescribing Hormone Therapy for Prostate Cancer Nancy L. Keating. JNCI: Journal of the National Cancer Institute, Volume 102, Issue 24, 15 December 2010, Pages 1814–1815.
    19. Testicular Dose in Prostate Cancer Radiotherapy. Article in Strahlentherapie und Onkologie • April 2005.
    20. J Hematol Oncol. 2011; 4: 12. 2011 Mar 27. Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer.
    21. International Society for Sexual Medicine. Prevalence and Predicting Factors for Commonly Neglected Sexual Side Effects to External-Beam Radiation Therapy for Prostate Cancer. Anders Frey.
    22. Murray KS and Thrasher JB. “Have We Underestimated Erectile Dysfunction after Prostate Biopsy?” AUANews. 2015; 20(12): 11.
    23. BJUI. A prospective study of erectile function after transrectal ultrasonography-guided prostate biopsy. Katie S. Murray, Volume 116, Issue 2 August 2015 Pages 190–195.
    24. How seniors can prevent the legal seizure of all their assets. Business Insider. Áine Cain10/9/2017
    25 Epidemic of overtreatment of prostate cancer must stop By Otis Brawley, CNN Contributor. Updated 3:02 PM ET, Fri July 18, 2014

    Internet search or Google: prostate cancer overtreatment or dangers or scam or hoax. Prostate biopsy sepsis or ED or dangers. Medical mistakes, etc, etc. The evidence and references are to massive and overwhelming too list them all in this document.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s