This story by investment blogger Mish Shedlock about a prostate cancer diagnosis illustrates the bias of doctors toward dangerous expensive treatments:
The biopsy showed I had cancer. My “Gleason Score” was 6. The surgeon who performed the biopsy strongly recommended surgery. He gave me a cost of $20,000.
Bad recommendation. Shedlock got rid of his cancer, as measured by PSA (Prostate Specific Antigen) tests, without surgery or any other expensive or dangerous treatment.
The surgeon said something else also highly misleading. He told Shedlock he was “10% cancerous”. When Shedlock repeated this to his oncologist,
The oncologist replied “That’s not correct. Of the 12 samples, only one had cancer and one was questionable. The cancerous sample was 10% cancerous.” Now that is a hell of a lot different than being 10% overall cancerous.
His oncologist seemed unfamiliar with data:
I informed the oncologist that I was going to have a PSA test every month. He commented something along the lines of “Why do you want to do that? Every six months is sufficient. The tests are not that reliable.” . . . [I thought:] The more unreliable a test is, the more tests one should take to weed out erroneous outlier results.
This reminds me of the dermatologist I had in graduate school. After I tested the two medicines he had prescribed for my acne, and found that one of them didn’t work, and told him this, he said, “Why did you do that?” Haha.
The oncologist predicted that the cocktail that cured Shedlock “would not do [him] any good”.
I am sorry Shedlock does not name the doctors involved, as I did in a similar situation. I too avoided recommended surgery and my surgeon made highly misleading statements. Shedlock wrote about bad health care more generally here.
Thanks to Steve Hansen.
Great story. I think he neglected one possibility, though: he had “cancer,” as currently defined, but it went away on its own and would have even if he had never known about it in the first place. It seems clear this happens, maybe a lot. Until the biology and natural history of cancer are understood a lot better this raises questions about the wisdom of screening for “cancer.”
Another possibility is that he still has “cancer,” which may or may not ever hurt him, but the latest biopsy samples didn’t happen to see it. My sense is that especially as men get older if you only look hard enough (more biopsy samples) almost all of us may have “cancer.” Autopsy studies support this idea. If you look less hard, fewer of us do. Same may be true of other cancers, including breast and thyroid. What a mess.
Reminds me of that Upton Sinclair quote : “It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”
I was Googling some of the supplements the author mentions in the linked post to see what benefits they have in general, and actually came across another interesting site where people with a different prostate disorder report their personal experimentation with various nutritional approaches.
https://www.prostatitis.org/itworksforme.html
Most people do not realize what an evil scam is perpetuated by Doctors and how men are actually checked for prostate cancer. Samples of a mans prostate are taken. Then live Cancer cells are put on the man’s healthy tissue samples. If the Cancer cells grow in the Petri dish or start to eat the man’s healthy sample, the evil Doctors tell the man he has Cancer! Then they proceed to kill the healthy man with deadly radiation, poisonous and/or radioactive drugs or surgery.
Since Doctors admit that they do not know how to cure Cancer, why in the world would people trust them at all? There is a Natural cure for everything! You wouldn’t go to a person to fix the transmission on your car if the person admitted they couldn’t fix it!
The lab technitions put Cancer cells on your cells and then say you have prostate Cancer! That’s outrageous! If a man’s prostate hurts, it’s probably from ejaculating too often. Avoid sex and masturbation for a few days. In addition, two saw palmetto capsules taken with two thistle capsules once a day if you are hurting plus sitting down when urinating until you’re back to normal will be extremely helpful in most cases.
understatement: “misaligned incentives that reimburse more for treating rather than monitoring”