This has been debunked for generations, much like orgone. People have gone to JAIL for suggesting that you can use electricity to cure diseases such as cancer.
Prostate cancer could be treated by destroying tumors with electric currents
101–110 of 115 posts
Re: Prostate cancer could be treated by destroying tumors with electric currents
#102Earlier quoted context omitted.
I read its effective at treating lung and liver cancers too. Early diagnosis is key to survival.
Your second sentence merits millions of upvotes. Many health care provision systems don't invest in screening tests or other early-detection schemes, or they do make them available, but don't invest in raising awareness of their availability. I'm actually now at the age where I should start thinking about "What new periodic tests/checkups should you introduce within the next 5 years?" ... and at this point I'm still…
I don't know about "should", it's a conversation you should have without your doctor (at age 55-69) as it's not without risks (2/3 false positives, if you need a biopsy literature is 3% infection rate requiring hospitalization. Although the advent of prostate MRI may obviate some biopsies, it's still center specific. This will probably change but we don't have enough evidence yet to support this as screening (or to not do a random biopsy if the MRI is negative for clinically significant cancer). In any case most prostate cancers detected this way are low grade and watched with active surveillance anyway.
There is medium evidence that PSA screening does not improve overall mortality, strong evidence of harms and moderate evidence to support early detection for overall weak recommendations (grade C) to consider screening in 55-69 (50 in US and EU) for patients who decide they want it after shared decision making[0-3].
I definitely would not say that everyone should, it's a personal decision after a discussion. As a physician I personally wouldn't.
Note the guidelines differ for carriers of certain genetic mutations or are high risk.
> Many health care provision systems don't invest in screening tests or other early-detection schemes, or they do make them available, but don't invest in raising awareness of their availability.
This is a stretch, I'm not sure where you're living but this is not true in US, to a minimal extent in Canada (we still require GPs to send requisitions for mammograms in patients age 40-49 but the screening program covers 50 in spite of newer guidelines but we definitely provide age-approriate screening oral), and should not be in major European countries based on their own guidelines.
The reason no one is pushing PSA screening on you is because most physicians don't believe it and the recommendations themselves are very weak, only in patients who themselves desire it.
[0]https://www.auanet.org/guidelines-and-quality/guidelines/pro...
[1]https://www.uspreventiveservicestaskforce.org/uspstf/recomme...
[2]https://www.cua.org/system/files/Guideline-Files/7851_v6_1.p...
[3]https://uroweb.org/guidelines/prostate-cancer/chapter/diagno...
Re: Prostate cancer could be treated by destroying tumors with electric currents
#103Earlier quoted context omitted.
It's more likely that you die with prostate cancer than because of prostate cancer. Yes, cancer is never good but for most men prostate cancer develops late and is usually growing very slowly and doesn't spread.
The stats are still pretty bad. Prostate cancer kills more people than breast cancer (though it's usually men in their 80s, so the QALYS is not as bad). A prostate cancer diagnosis is not terrible (since it's so damn common) and aggressive treatment and overly-aggressive screening might be a bad idea in most cases (since it's often best to not worry too much - over-treatment and even over-testing has its costs) but t…
Not sure where you're getting your stats from. In both US and Canada this isn't true.
There are an estimated 43,780 deaths attributable to breast cancer and 34,500 to prostate cancer in the US for 2022[0] and 5555 vs 4600 respectively in Canada. This is spite of aggressive screening and early treatment vs not really for prostate cancer.
Re: Prostate cancer could be treated by destroying tumors with electric currents
#104Earlier quoted context omitted.
The stats are still pretty bad. Prostate cancer kills more people than breast cancer (though it's usually men in their 80s, so the QALYS is not as bad). A prostate cancer diagnosis is not terrible (since it's so damn common) and aggressive treatment and overly-aggressive screening might be a bad idea in most cases (since it's often best to not worry too much - over-treatment and even over-testing has its costs) but t…
But, curiously, they stop testing at 70 (or was it 72?). That's what my urologist told me last year when I had my exam. Ever since my father had prostate cancer, I've had a yearly PSA and exam by a urologist (thinking that a urologist will be better at detecting tumors than a GP/PCP).
There is weak evidence to support testing over 70 due to increasing risks of biopsy/treatment and no evidence to support improved overall mortality.
Some guidelines suggest that it's reasonable to continue in patients with >10-15 year life expectancy if the patient desires, but there is no strong recommendation or evidence to support this recommendation or screening in this age group.
Some guidelines actually have a strong recommendation to stop screening men with Even less evidence for a DRE. PSA by a GP is sufficient if you desire screening.
Re: Prostate cancer could be treated by destroying tumors with electric currents
#105Is there anything about this that is specific to the prostate? Wouldn't this exact same treatment work on other accessible tumors, for example breast or skin?
I read its effective at treating lung and liver cancers too. Early diagnosis is key to survival.
Be careful with this statement, early diagnosis is key to survival for certain conditions. In many cases it has not resulted in improved mortality, prostate cancer being one of them.
This is so well known we have terms to describe the phenomenon. https://en.wikipedia.org/wiki/Length_time_bias
Re: Prostate cancer could be treated by destroying tumors with electric currents
#106Sample size n=1, but my dad was on the research or clinical trial of this exact treatment in Sydney, it worked for his prostate cancer, he's still clear from PSA tests (and possibly had biopsy also. No side effects. Previously he'd had the radioactive beads treatment which failed, the only other option was removal. Both these options have potentially unpleasant side effects. Happy to ask him questions if anyone wants…
May I ask how this was discovered in your dad's case? I feel like prostate cancer is the single most dangerous cancer for men in the late 30s, 40s, and 50s. So it's a subject I'm trying to pay attention to.
No way, colorectal and lung (even if you're a non-smoker, worse prognosis) are both relatively very common and will kill you quickly.
We're seeing a lot of early presentations in both contributing to the lower screening start by the USPTF, evidence still coming in on lung and what to do.
Re: Prostate cancer could be treated by destroying tumors with electric currents
#107Earlier quoted context omitted.
May I ask how this was discovered in your dad's case? I feel like prostate cancer is the single most dangerous cancer for men in the late 30s, 40s, and 50s. So it's a subject I'm trying to pay attention to.
I was diagnosed with prostate cancer when I was about 57. I had had somewhat regular "finger up the butt" exams prior to that, since I was about 45, which were all negative. Then a PSA blood test test came back positive and I then had a biopsy done (no fun, trust me). Because I was still in my 50's I needed to do something beyond just continuing to monitor it. Between radiation treatment and a prostatectomy I chose t…
I don't think you can conclude that from one patient, that's not how medicine works.
Whether to actively surveil vs treat depends on individual patient characteristics and grade (generally Gleason 7+) and the fact that you didn't have a complication does not mean they're not sufficiently high. On a population level analysis the evidence clearly support that there is no improved mortality with prostate cancer screening.
Re: Prostate cancer could be treated by destroying tumors with electric currents
#108Earlier quoted context omitted.
But, curiously, they stop testing at 70 (or was it 72?). That's what my urologist told me last year when I had my exam. Ever since my father had prostate cancer, I've had a yearly PSA and exam by a urologist (thinking that a urologist will be better at detecting tumors than a GP/PCP).
There is weak evidence to support testing over 70 due to increasing risks of biopsy/treatment and no evidence to support improved overall mortality. Some guidelines suggest that it's reasonable to continue in patients with >10-15 year life expectancy if the patient desires, but there is no strong recommendation or evidence to support this recommendation or screening in this age group. Some guidelines actually have a…
> Even less evidence for a DRE. PSA by a GP is sufficient if you desire screening.
I believe my father's prostate cancer was found via DRE and not PSA. That is, PSA was in the normal range. That is what made me get a DRE from a urologist once a year (since then).
Re: Prostate cancer could be treated by destroying tumors with electric currents
#109Earlier quoted context omitted.
There is weak evidence to support testing over 70 due to increasing risks of biopsy/treatment and no evidence to support improved overall mortality. Some guidelines suggest that it's reasonable to continue in patients with >10-15 year life expectancy if the patient desires, but there is no strong recommendation or evidence to support this recommendation or screening in this age group. Some guidelines actually have a…
> Even less evidence for a DRE. PSA by a GP is sufficient if you desire screening. I believe my father's prostate cancer was found via DRE and not PSA. That is, PSA was in the normal range. That is what made me get a DRE from a urologist once a year (since then).
It’s hard to comment accurately as prostate cancer isn’t a single disease.
PSA cutoff trades sensitivity and specificity. It isn’t a binary positive/negative.
There are certain highly aggressive but very rare subtypes (e.g. neuroendocrine) that will present with low PSA levels. Rarely an aggressive adenocarcinoma (Gleason 8+) will present with low PSA. Screen detected prostate cancers with low PSA are most likely clinically insignificant [0].
If you are known to have a first degree relative with a rare subtype then routine screening guidelines don’t apply to your circumstance.
Important points to keep in mind:
Just because a prostate cancer is “found” it doesn’t mean it needs to be treated.
There is no survival benefit when comparing treating early prostate adenocarcinoma (conventional and most common type representing 99% of prostate cancers) at very low PSA vs using 4ng/mL as a cutoff.
There are verifiable and proven harms with over treatment of low grade prostate cancer, workup of a “nodule” felt on DRE in the context of normal PSA is more likely to harm a patient than benefit them even if cancerous which forms the basis of current guidelines.
All forms of cancer screening will have edge cases that are missed. Even in your father’s case only the peripheral zone is palpable by DRE (would miss transitional zone or 20% of cancers). When considering recommendations to make at a population level harms vs benefits have to be carefully weighed, in the case of prostate the evidence strongly suggests against DRE, and weakly against prostate cancer screening in general.
Looking towards the future, there is probably a role for prostate MRI somewhere which is good at detecting clinically significant (Gleason 7+) cancers but this is still being actively studied and we don’t have enough evidence at this time to support screening.
[0] https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.11...
Re: Prostate cancer could be treated by destroying tumors with electric currents
#110Oddly enough I've just been looking into a veterinary treatment method for superficial tumours based around cytostatica in combination with electric pulses - delivered by a pulse generator controlled by a Raspberry Pi - which are supposed to increase the efficacy of the cytostatica by 'electroporation' [1]. I'm mostly looking into this because the glossy site and the presentation given at my wife's vet clinic have a…
Please for the love of god tell me you're not testing this on animals and if you are, you have actual medical training?