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Dr. Bert Vorstman skeptical of any Pc treatment. What do you think?

Posted by quaddick @quaddick, 3 days ago

I watched this video 11 days prior to my prostatectomy. Gave me second thoughts briefly. However, after more research, I'm skeptical of his skepticism.
Dr. Vorstman's points:
- there’s no scientific evidence that the Prostate Cancer Awareness and Active Surveillance programs save significant numbers of lives

- countless men are injured in the process of prostate cancer testing and treatment without benefit

- the prostate cancer narrative exploits false hope and false promises by recycling misinformation

- the claims about the benefits of prostate cancer screening and treatment are untrue

A link to his video: https://www.youtube.com/watch
I went from no cancer detected to 2 tumors, one a 3+4 and a 3+3, and a decipher score of .85 in just a year. Seems to me pretty aggressive with a chance of metastasis. Doing nothing as he suggests seems reckless to me.
What do you guys think of his ideas?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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wwsmith | @wwsmith | 3 hours ago
In reply to @quaddick "@wwsmith Yeah, I was prepared to switch to CMRT if SBRT proved unsuitable. I was surprised..." + (show)
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@wwsmith
Yeah, I was prepared to switch to CMRT if SBRT proved unsuitable. I was surprised to have both tests come back high risk. I definitely preferred RT over surgery. I toyed with the idea of disregarding the results and doing RT regardless. It's a new test that's not yet standard of care. But if I did have serious problems as predicted by the test, I'm sure that I would regret ignoring it.

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@quaddick Well, we all have to play the cards we are dealt. With all the good modern testing we can at least see most of our cards. Being vulnerable to radiation toxicity is a handicap but you probably had better luck on other issues like not having BRCA2, for example.

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brianjarvis | @brianjarvis | 2 hours ago
In reply to @carbcounter "@brianjarvis you give such amazing answers I'm wearing out the like and helpful buttons, I hope..." + (show)
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@brianjarvis you give such amazing answers I'm wearing out the like and helpful buttons, I hope that's OK with you! I have a trendy question maybe you've run across answers for. When you talk about Gleason scores being expert opinion of images in a microscope - what might you (or others) have heard about AI system evaluations of these biopsy images?

Medical image analysis is something they've been working AI systems with since the 1980s (maybe longer), it seems to be everywhere, so I imagine there are people out there working on it? Thanks.

OK, I should also Google it myself, right? And here's the AI conclusion on this AI question:

Current Status & Future

AI algorithms are reaching pathologist-level performance and are becoming mature for clinical use.

Integration into clinical workflows is ongoing, with AI acting as a "digital colleague" to support diagnosis and prognosis.

Research continues to compare commercial vs. research-based AI and validate performance in diverse real-world settings.

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@carbcounter I’m sure that ever since Dr. Gleason identified different patterns in prostate cancer cells in the 1960s, that continued improvements in technology have enhanced those abilities. That will continue to improve going forward with AI (as long as funding for clinical trials continues).

Even with MRIs, initially there were 1T MRIs, then 2T, 2.5T, and 3T MRIs (which most of us get these days). Several research hospitals have 7T MRIs; there’s even an 11T MRI now.

Technology continues to advance. AI will no doubt be part of that advancement.

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juanmoczo | @juanmoczo | 1 hour ago
In reply to @jeffmarc "@copyman The problem is people do die of prostate cancer. My father died of it in..." + (show)
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@copyman
The problem is people do die of prostate cancer.

My father died of it in 2008 at 88 years old. The last few weeks were pretty terrible, He was on morphine and couldn’t communicate he was in so much pain.

I remember when he told me Lupron stopped working and there wasn’t anything else for treatment.

He started off with radiation as his initial treatment.

Some people do go into long-term remission. I don’t know about cure.

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@jeffmarc Thanks for a very honest and realistic portrayal of what dying of prostate cancer can be. I was treated for a Gleason 4+3 with EBRT and 18 months of ADT. The ADT was stopped at 18 months because the urologist taking over my case noticed how brutal the side effects were. On the plus side, my cancer is in remission and I am slowly going back to normal as I knew. Certainly not perfect, but so far, so good. By the way, an article that Dr. Bert Vorstman wrote on Medium (https://bvorstman.medium.com/why-some-cures-are-worse-than-the-disease-61a99ba7152c) is dedicated to ANTHONY HORAN, MD, who died of prostate cancer, of all causes.

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juanmoczo | @juanmoczo | 1 hour ago

Dr. Bert Vorstman published an article on Medium (https://bvorstman.medium.com/why-some-cures-are-worse-than-the-disease-61a99ba7152c) back in June 2025. The article includes a dedication to ANTHONY HORAN, MD, who died, of all things, prostate cancer. I wonder if Dr. ANTHONY HORAN, MD, would have agreed with his colleague on the topic of prostate cancer treatment.

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pesquallie | @pesquallie | 1 hour ago
In reply to @jimbo12 "1. I am an outlier. 2. I feel bound, however, to comment. 3. I know NOTHING..." + (show)
Profile picture for jimbo12 @jimbo12

1. I am an outlier.
2. I feel bound, however, to comment.
3. I know NOTHING about medicine.
4. I am now 88.
5. In 2010 a bit of prostate cancer appeared on some test.
6. I was offered watchful waiting or radiation.
7. I chose a month's radiation.
8. I then forgot about the matter after the radiation. My PSA was ok.
9. In about 2021, my primary care doctor told me my PSA was high.
10. I took a test. No cancer.
11. They then offered a super expensive test. If I failed to show up, I would have to pay for the test.
12. They discovered some cancer in my lymph nodes.
13. I was offered watchful waiting, hormone therapy, or radiation.
14. I --in 100% ignorance -- chose hormone therapy.
15. It was Lupron.
16. Being really stupid, I had no idea that lack of testosterone would -- in my case -- take away my muscle mass.
17. I stopped Lupron in 2022 (after only 2 shots).
18. This is 2026. My previous muscle mass still has not returned (probably because I am so old).
19. For three years, I have not dared to walk even around my neighborhood.

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@jimbo12

I was diagnosed at age 83 with stage 3b prostate cancer, had 44 radiation treatments and 4 months of Lupron. Lupron was killing me, and I had to quit because of severe headaches and constant profuse sweating. Now 6 months after ending Lupron I still have the same bad effects but at maybe 50% of the prior level. However, 2 months ago I started having muscle and joint pain. This has made it very difficult to exercise and stay in good health. There is growing evidence that ADT's may be doing more harm than good and Duke Health's initial AI work actually indicates that normal testosterone levels may be better for aggressive prostate cancer.

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