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Prostate Cancer and the Engineer (Part 1)

Posted September 26, 2007 4:01 PM by Steve Melito
Pathfinder Tags: cancer engineers medicine

"I don't want to set myself up as a medical expert", explains Dick Leahy, but "my battle has been finding a doctor". Leahy, a retired aerospace engineer and 74-year old prostate cancer survivor, has been waging war on medical orthodoxy since 1999. During a recent telephone interview with CR4's Steve Melito (Moose), Leahy described how "from Day 1", he heard things from his doctors that he just didn't believe. Leahy also discussed his 2002 book, Prostate Cancer Survival Decisions: What you don't know CAN hurt you, a free publication that you can download by clicking here.

The Engineer as Patient

"In 34 years as an engineer," Leahy writes in Prostate Cancer Survival Decisions, "I had to overrule experts too many times to regard them as infallible". During a long career that included product design, project management, and aircraft accident investigations, the Michigan native learned to return to the data when "expert" conclusions didn't make sense. When he was diagnosed with prostate cancer eight years ago, Leahy applied this same methodology to his own treatment. His doctors, however, had different ideas. First, Leahy was told that "it was best to leave the tumor in" if the prostate cancer had spread to the lymph nodes. Second, Leahy learned of the medical profession's prevailing wisdom that "there was no proven survival benefit to early treatment" for prostate cancer.

The Difference Between Doctors and Engineers

Although Leahy's cancer had not spread to his lymph nodes, it had metastasized - spreading to his spine and other bones. Pathology samples missed this grim reality, however, and Leahy's doctor agreed to perform a prostatectomy. The surgery represented a victory in Dick Leahy's battle with cancer, but his war with medical orthodoxy would continue for years to come. In discarding his doctors' glossy brochures in favor of his own medical research, Leahy considered something very fundamental: the difference between how doctors and engineers think. Doctors, Leahy told CR4, use deductive reasoning to diagnose disease. Once a disease is diagnosed, however, medical personnel must follow "standard protocols" that provide licensing and liability protection, but offer "little flexibility" in terms of treatment.

Unlike doctors, Leahy explains, engineers are trained to "respond to a problem". They don't start by performing diagnostics, and aren't saddled with protocol-based constraints. In Leahy's case, his first step was to respond to the problem of conflicting reports. The solution was to apply what he learned during a 34 year engineer career: follow the data when the conclusions don't make sense.

Editor's Note: This is the first of a three-part story. Part 2 and Part 3 are now on CR4, too.

Steve Melito - The Y Files

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Power-User

Join Date: Jan 2007
Location: Los Angeles, CA
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#1

Re: Prostate Cancer and the Engineer (Part 1)

09/26/2007 8:45 PM

I think that the Medical system has a "Legal Network" set up that makes it OK to murder someone accidentally or just a little at a time.

Engineers have no such system.

My totally un-asked for and Un-Warranted opinion is that "If the Gov doesn't Get Cha, The food will, if that doesn't Get Cha the Medicals will.

My family eats natural home prepared foods and does not take Meds. When we visit a Doctor and answer "No" to all of those questions we get looks of disbelief.

I Dun know any answers, What do you get out of the system?

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#3
In reply to #1

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 1:52 AM

I couldn't agree more dbd. I always thought this would never come out in public but these people don't just murder, they assume they have a god given right to murder you, especially if you buck their precious system and don't do what they tell you to do. They lie mre easily than they tell the truth and if you want to see them especially vindictive, just accuse them of dangerous practices, like not washing their hands between patients. Basic stuff you would think? Yeah, right.

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#2

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 12:13 AM

The big difference between engineering and medicine is the huge amount of variability in the medical outcomes.

Apply a known force to two people of the same mass and they'll accelerate at the same rate. But give two sick people (of the same age/race/weight/fitness etc) the same treatment and one might live and the other die. So doctors usually give their advice based on statistics, for disease X, this treatment gives 35% of the people in your age group an extra 5 years. It's all they actually know is true.

Of course, when we get sick we cast around for anything that increases our odds. We'll turn to god/macrobiotics/yoga/coffee enemas etc and if we live we tell everyone that we cured ourselves, if we die we stop talking.

Leahy was told "there is no proven ..benefit.." That's what the numbers tell us. He had surgery and has presumably lived longer than expected. Great. But it doesn't tell us anything about the efficacy of the procedure since presumably others had early op's and died early.

Sorry to offend anyone, I know major sickness is a time of great stress. I've been close to a few people who had a terminal illness and witnessed the leaches gather round to offer unproven (but still expensive) treatments and prayers. Oddly enough they didn't help and the patients died at about the time the doctors had originally estimated. Each leach then said "If only I'd been called here sooner". ffej

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#15
In reply to #2

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 7:15 PM

Jeff:

Re: "The big difference between engineering and medicine is the huge amount of variability in the medical outcomes." To me, the difference doesn't end there. The engineer can't accept that variability and tell his/her boss that 65% of the product won't work. There has to be a reason for the variability, cause and effect, and understanding and addressing that reason is an everyday part of the engineer's job. The product has to be producible or there is no product .... and no employment for the engineer. I know of no counterpart for that process in the medical world.

Researchers hypothesize, test, obtain data and report statistics. The report only relates to the original hyphothesis. There is never provision for finding and attacking the reasons for failure. No development program. No chasing down new information that develops. Every report ends with the words; "More study is needed." Every report is a dead end, except for some statistics that are of limited usefulness. Every engineering assignment anticipates and addresses problems and provides complete solutions. The process frequently includes a development program that requires generating and testing theories. That's what I'm trying to do with my one guinea pig. THAT, to me, is the big difference between engineering and medicine.

Best regards,

Dick Leahy

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#16
In reply to #2

Re: Prostate Cancer and the Engineer (Part 1)

10/29/2007 9:27 PM

Hi Jeff:

"Leahy was told "there is no proven ..benefit.." That's what the numbers tell us."

That is NOT what the numbers tell us. That's my problem. There are two stories behind those words and the whole picture is pretty sad. Here's my interpretation of the relevant history:

1) There was a dream study in the sixties involving 14 VA hospitals and 2000 patients. The only problem was that the treatment under test, 5 mg/day of DES (diethylstilbestrol) was toxic. It did work and saved lives from prostate cancer. Unfortunately, it took as many lives through cardiovascular events. If it had been reported that way, by cause specific deaths, everything would have been fine. Unfortunately, they chose to mask the problem by totally scrambling the data and combining cancer "saves" with cardiovascular deaths to report that there was no OVERALL survival benefit for the treatment. The subject of cancer specific survival, which was impressive, was not reported. THAT'S why you have to go to the data, which another researcher referred to as "a train wreck", and ignore the stated conclusions. The researchers didn't lie, they just finessed the data and led to years of doctors advising patients to delay urgently needed treatment. That, in fact, was the advice that I was given ..... "no need to hurry", and that's what started me on this weird quest.

2) Finally, in 1999, the New England Journal of Medicine set the record straight. They published the excellent work of Dr. Messing, et al, showing a clear survival benefit for early treatment with a non-toxic agent. Unfortunately, in the same issue, they included what I considered a specious, non peer-reviewed editorial, co-authored by a famous physician, torpedoing the excellent work of Dr. Messing. That work trashed Dr. Messing's study, resulting in a continuation of the fatal "no hurry" standard practice to this day. I recently had an opportunity to discuss this with Dr. Messing and one of his co-authors and they didn't seem bitter, but people are still dying because of flawed timing policy. It's still wrong and well meaning doctors are providing fatal advice.

I'm only a layman, trying to learn as I go, and I got involved in this just to stay alive but, as I came across these things, I felt compelled to pass on my opinions. So far, I've managed to avoid "god/macrobiotics/yoga/coffee enemas etc" as treatment alternatives and I'm still here.

Best regards.

DickL

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#4

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 2:33 AM

Hi

with any medical tretment there is the problem that these are evaluated on a statistical basis and what is best for the mean is considered the best treatment,

But an individual patient is an individual case and may require quite a different treatment.

So we are obliged to get informed, to start a P2P (patient to physician) partnership.

We shall shall immediately leave any doc who is not willing to share this concept.

Concerning prostate cancer: there is a magnificent book, written by Strum and Pogliano, title is: A Primer on Prostate Cancer.

There is a vast amount of information, some is not fully approved by official people,
at the websites of PCRI and LEF.

And concerning cancer in general: there are no 2 identical cancers so differences in developing illness is quite common.

And: there are medical miracles occurring at a rate of near 1:30000 that final illness is cured by <we do not know>.

To help this fight it is very recommended to change food usage according to the proposals of Barry Sears.

Science is on the start to discover some of the problems with cancer and provided us with an ever increasing complexity of cell behaviour.

If anybody has some money to invest in upcoming treatments:

there is a magnificent new vaccine against adenocarcinomas, made by Immvarx.com

Have success

RR

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#5
In reply to #4

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 3:39 AM

I totally agree with your statement "But an individual ... may require quite a different treatment". The trouble is knowing what treatment that is.

We've all seen it happen. Someone gets terminally ill, the doctors say (based on a large sample, using the best known treatments) "X% of people with your condition die within Y years. I wish I could do more". The next step is to visit a practitioner of "alternative" therapies (ie things that have no tested proof of being effective), they're full of confidence "100% of my patients have been totally cured". (but of course, it'll be expensive). This confidence isn't based on lengthy double blind trials or peer reviewed, published papers but rather wishful thinking. If you disagree, then you must be part of the vast conspiracy to keep the simple truth from the public.

There's a lot of self delusion out there. Me, I prefer to live in the real world. ffej

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#6
In reply to #5

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 8:30 AM

ffej:

The "real world" that a patient sees may be different than you expect. It was for this patient. Certainly there is no place for the peddlers of laetrile or coffee enemas, but they can be very persuasive. Quack Watch can help there.

Fortunately, there are also published, peer reviewed reports. That's where I turned for answers to the questions of completing a prostatectomy if metastasis has occurred and early hormone therapy for metastatic cancer. I had to make those decisions quickly, (remove the prostate with its large tumor mass and start therapy immediately) based on intuition, but I followed up with review of every relevant study that I could find and prepared the graph in Figure 8 on page 103 of my book. (Moose has provided a link for free access to the book PDF.) That graph was prepared by this layman using the 5 and 10 year points of the published Kaplan-Meier anlyses, but I've never had anyone come up with a convincing, objective denial. Following standard practice (leave the tumor and delay treatment) will place a patient on the bottom line of the graph. I, personally, received both recommendations. I'd certainly be glad to receive any comments because I realize that I can be wrong, but that result reinforced my perception that "Standard Practice" needs some work.

The graph and the book were just the beginning. In trying to define what I considered to be the most effective treatment approach in subsequent years, some of the problems for me have been:

1) No one has performed the test that I'm interested in

2) I don't feel that the data support the conclusions

3) The "industry" has ignored the study (sometimes for a very poor reason)

4) The study was performed incorrectly

5) People ignore glaring differences in studies performed at different institutions

6) Medications that are in common use in other countries or have been through enough (Phase I and Phase II) testing to demonstrate safety and efficacy are denied to the people of this country by the FDA and by understandable reluctance on the part of doctors to be innovative.

7) Prostate cancer is usually very slow growing with typical doubling times of 3-4 years and has developed that reputation, and a ho-hum attitude, on the part of medical people. They aren't mathematicians and don't understand how my 10 day doubling time might affect my sense of urgency. Somehow, though, 30,000 people a year are dying.

I'll step down from my soapbox for now, but, as a patient whose hypotheses have maintained life into the ninth year with a very aggressive cancer, I'm trying very hard to continue to test them.

Best regards,

Dick Leahy

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#7
In reply to #4

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 11:23 AM

RR:

Right On!! I have found PCRI (Prostate Cancer Research Institute) very useful and, more recently, I've spent some time with LEF, particularly their criticism of FDA's blockage of needed, new and/or foreign medications while people are dying. PCRI has an excellent paper on the use of HDK (High Dose Ketoconazole). If I'd paid more attention to it, I probably wouldn't have developed the ulcer.

I took some interest in nutrients, Lycopene and Green Tea, in the beginning, because of published papers on small studies, but, in the end, they didn't contribute much. I pretty much stayed with an unconventional sequence of standard medications for most years, but most of them have failed now, as they always do, and I'm trying to use meds that are still in test or are only used in other countries.

I'm not interested in placebo controlled studies because you have a 50% chance of not being treated. I think there has to be a better way than that.

Best regards

Dick Leahy

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Anonymous Poster
#8
In reply to #7

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 12:02 PM

There are a lot of things that force Doctors to behave differently than scientists or engineers. One difference is that most doctors educations is biology based, so they do not think the way a physicist or chemist might about addressing a problem. Second, they get sued a lot even when they make good valid justified recommendations, this changes the amount of risk they are willing to take to save a life or buck standardized practices. Third, they practice on a person not a project where they have a high level of control over function and utilization. Trying get a person to stop drinking coffee is less predictable than trying to control the materials used on a project or the way people use the project. Fourth, they get paid much more not to think about the data and just trust what they are told, and saving lives is becoming something doctors aren't paid to do. With insurance and lawyers overlooking everything they do and specifying the types of procedure for protection of life, they are very limited. They are finding their pay scales for the most highly educated doctors whose jobs are to save lives falling, while their relatively uneducated staff support wage scale rises above theirs. All the while the doctors who make a good wage are paid to do breast augmentations and liposuctions. In our current society, brain surgeons and rocket scientists, common euphanisms for the best and brightest in our society, have high liability for their knowledge and are getting paid very poorly for their work relative to the education and training they must obtain, while real estate agents, produce brokers and car salesmen make much more and have no real liability. Why spend all that time learning something and spend years working hard you will just get sued or on the news for having knowledge about the subject matter and habing an adverse results, when you can commit fraud with no liability by just playing dumb, hardly working and selling stuff.

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#11
In reply to #8

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 1:13 PM

As a member of a family containing 4 physiscians in widely varying medical specialties (and including 2 PhD cancer researchers) the subject of remuneration of different specialties comes up frequently in conversation. There is no question that the legal involvement and insurance company profit motive has seriously swayed the medical specialties sought after by the best and brightest MDs. At this juncture, I am told that in general the podiatrists and dermatologists are paid substantially more handsomely than areas such as cardiology, psychiatry, pediatrics where risk is greater for medical failure.

When are we as a society going to get real about medical care in the USA and get rid of the legal and insurance entanglements? Medical costs in the US didn't start to become exhorbitant (thereby starting to make health care unaffordable) until the 1960's when these two groups got into the fray. Eliminating their input to the equation could go far towards improving medical care here.
At this point because of the costs, a number of insurance companies and HMOs are sending patients to South East Asia and India for operations that could well be performed here in the USA. This raises another question: what about legal representation when an operation/care is botched during an operation say in India. What recourse does a patient have?

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#12
In reply to #11

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 3:32 PM

Doctors are like mechanics some are good and others are not.

As with mechanics it's better to go to a specialist in that area of expertise unfortunately doctors are reluctant to admit they don't know it all.

I have been through the system and found you have to be your own best advocate or you ,WILL receive ,substandard treatment.

I had to go to my HMO primary doctor and throw an ugly tantrum to finally be sent to a specialist, who said "I bet that hurts" and finally got correct treatment .

People are too trusting of doctors and believe the myth they are supreme beings when in fact there is ample reason to believe they care more for your money than anything else.

Thanks for everyones information on the topic I plan to learn all I can to prepare for the day I may have to face this issue.

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#10
In reply to #7

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 12:45 PM

For the record, the NIH has a website section that allows information on what type of clinical trials are underway for various drugs and procedures. The various trials are searchable via computer.

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#13
In reply to #7

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 3:48 PM

Hi DickL,

I tried selenium and came to a surprising result: I need 600 micrograms per day - this is not recommended anywhere! Decision making was only on working ability and endurance.

And I suspect that my natural appetite towards red and blue and black fruit: grapes and cranberries and red wine has some relation to resveratrol. Did you try this?

A magnificent search machine for medical data and publications (PubMed) is available at QUOSA.

The no-cost part of the program will do good for private use.

Did you decide on boron?

Good luck

RR

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#14
In reply to #13

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 4:07 PM

RR:

I'm taking 200 mcg/day of selenium, but only because I found the recommendation in several places. I can't associate it with any particular response. I'm not doing the other things, but I am taking 680 mg/day of strontium as citrate. I have an excellent reason for that.

I was given Zometa in 2004-5 without being advised of the potential predisposition for osteonecrosis. Once I learned of that, I rejected biophosphonates and started the strontium. It has been studied for many years, mostly as ranelate, mostly in Europe, and found to do a good job of building bone mass and strength in people at risk for osteoporosis. It's reasonably priced, which may account for the lack of interest in this country. I rarely find anyone else who's even heard of it. Thanks for your comments. I'm always trying to learn.

Dick Leahy

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#9

Re: Prostate Cancer and the Engineer (Part 1)

09/27/2007 12:22 PM

Cancer is a very unique disease because we are very unique different from one another, what may work wonders for one person may perform poorly for another, a reason why protocols based on statistics are not worth a penny. Cancer treatment is expensive, yet the patient does not get his or her money's worth because they are pushed into a protocol instead of being treated as an individual with very unique and special characteristics.

I agree and understand Dick's position, as engineers we are thought to think beyond the box, to find solutions, doctors on the other hand have been thought not to rock the boat, to stay within protocols that have been approved and if these protocols failed, oh well, the patient did not respond well and die, their "hands" clean and free from the ever watchful eye of lawyers lurking to make another buck.

Not all patients have the education and experience of Dick and so they end up with a doctor that places them in a box called "protocols".

I am in charge of our cancer centers (www.oncoamerica.net) thank God our centers are outside the United States and we do not have to be afraid to try new things, new procedures and yes we do also follow protocols but we compensate by providing other great services for our patients, such as individualize nutrition, psychological help for the patient and the family, immunology help, and whatever other known and well studied medications.

Many of you perhaps believe than anything not approved by the FDA belongs in the quack's list. Many products have been so well studied that I always wonder why the FDA has kept them away from the public. Case in point is a product called "Graviola". This product has been well studied by Purdue University and universities in Japan with great results, why is this product still not being offered to the public? It is natural, no patent, you make your conclusions.

DMSO, another great product. We use it as an adjuvant for patients with breast cancer. It is the best product that I have seen to dissolve breast fibroids.

MSM with 5% DMSO, a great adjuvant product for head and neck cancer.

We had lots of problems with patients developing skins problems after the 15th session; we started using Witch Hazel Hydrosol to protect their skin. Problem solved. We look for solutions. We do not box ourselves for fear of the lawyers. Our responsibility is called "Help the Patient".

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