Friday , October 22 2021

Cutting out surgery for prostate cancer


Most men suffering from this disease should retain their prostatic glands, says the author of the book on the advancement and treatment of prostate cancer.


WHEN MEN RECEIVE A Prostate Cancer Diagnosis, their first reaction is often surgical thinking. This is mainly because the majority of prostate cancer doctors are surgeons who can more often recommend such treatment. But radical prostatectomy – removal of the prostate gland – is usually unnecessary and can cause irreversible side effects such as urinary incontinence and sexual dysfunction.

In total, 91.5% of men who were diagnosed with prostate cancer live normally and die from natural causes, not cancer. Thus, instead of rushing to treatment, men with prostate cancer can slow down and develop a general plan that takes into account both survival rate and quality of life. Treatment choices based on partial information often lead to permanent regret.

The path to optimal treatment is the proper determination of the severity – tumor size assessment, localization and dissemination, and then education. If people take time to do their homework, most will know that they can maintain their prostates, otherwise they cope with cancer and maintain a good quality of life.


Stageing provides insight into the severity of the disease, which can range from completely harmless to life-threatening. Apparently men must adjust the intensity of treatment to the aggressiveness of the disease. Mild cancers deserve mild treatment. Aggressive cancers require aggressive therapy. Suffering from side effects associated with treatment, such as urinary incontinence and sexual dysfunction, is unacceptable if the cancer is benign. On the other hand, for a potentially life-threatening disease, maintaining a higher risk of side effects associated with treatment can be justified.

The key to individualized treatment of prostate cancer is to know the stage of the disease and its severity. This reduces the number of therapeutic options, allowing men to bypass huge amounts of irrelevant information. This will help to focus on any research carried out on the Internet and facilitate interviews with doctors, enabling them to use the most commonly used methods of treatment at specific stages.


To understand the stage of prostate cancer, a man must provide some information that can be found on his medical card: tumor size; the results of the digital test from the anus; do the scans show that the cancer has spread beyond the prostate; malignancy grade, also known as Gleason score, which is an assessment of how healthy or abnormal cancer cells look under the microscope; and blood levels of a prostate specific antigen (PSA), an enzyme that tends to increase with increasing prostate cancer.

I have developed a short quiz that helps patients determine the stage of their prostate cancer and understand which therapies may be appropriate. It is available online on the website or, the website of the Prostate Cancer Research Institute, which I have set up. It is also published in my last book, "The key to prostate cancer: 30 experts explain 15 stages of prostate cancer." My quiz breaks the aggressiveness of prostate cancer with a system that I call five stages of blue, which assigns color at each stage:

• Sky – low risk.
• Turquoise – indirect risk.
• Azure – high risk.
• Indigo – recurrent disease.
• Royal – metastatic or hormonal disease.


After determining the prostate cancer stage, patients and doctors can determine how dangerous the disease is and calculate the most sensible treatment options. The treatment carries a gamut of active surveillance for low-risk tumors for various therapeutic combinations – perhaps immunotherapy, hormone therapy and / or radiotherapeutic seed implants – in the case of a more advanced or increased risk of disease. Surgery may be offered, but I think it is appropriate only in very exceptional cases, such as men with medium-risk or green, patients who have prostate glands that are too large for radiation.

Extensive information on the individual stages of treatment, presented in a patient-friendly language by various experts, is presented in my book. Reliable information is also available at

I urge men to arm themselves with as much information as possible and find a doctor who specializes in prostate cancer and better understand the complexity of this disease. Men who have been diagnosed with prostate cancer have plenty of time to explore all their abilities. If they can understand exactly what modern, state-of-the-art care offers, they will be happy to discover that there is almost no need for surgery.

MARK SCHOLZ, M.D., holds a diploma in the field of oncological surgery and internal medicine and specializes exclusively in prostate cancer. Scholz is the medical director of Prostate Oncology Specialists in Marina del Rey, California, as well as the Executive Director of the Prostate Cancer Research Institute. He wrote two books "Invasion of prostate snatchers" and "Key to prostate cancer: 30 experts explain 15 stages of prostate cancer".

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