4 ms·

The alternative is death right? So give me some pills, knock me out, and go to town.

giancarlostoro 7y ago
Just when I was freaking the hell out I read this and realized, yeah, knock me the hell out. Don't even wake me up till long after. I'm wondering if it's just that the tool scrapes it out or something. As painful as it is to think about.
- Waterluvian 7y ago
  And then of course in this huge wild planet of ours there's people who get a kick out of doing that for fun.
  - giancarlostoro 7y ago
    Uhhhh just remembered hearing of such things. I have not been able to unsee certain things, but that one is one I am glad I have never looked at.
  - ryanmercer 7y ago
    So, I clear international freight through customs for a living. Maybe a decade ago we had this shipment from a now defunct website that was (I think, maybe it had the c) 'fuk.it'. In the package were various 'sexual toys'. Some sort of electronic shock device, some comically large anal 'toy' and a 'deep hole dick spreader' which was a urethral sound being marketed as a sex 'toy'. We had to go to the website to try and figure out how to classify the stuff with names like the above and 'colon snake' and not only did they sell these torture implements but they sold a variety of -caine local anesthetics. Humans never cease to amaze and confuse me.
    - giancarlostoro 7y ago
      I'm both disgusted and amused by this. Thank you for sharing. I love hearing stories like these on HN, random windows into the lives of people on HN.
- penagwin 7y ago
  Idk if they would knock you out or just give you anesthetic but keep you semi-aware. "Knocking people out" is generally avoided, but this obviously depends on the specific situation. Are there any medically experienced people that know if this could be more likely to be a full "knock them out" kind of procedure?
BurningFrog 7y ago
Prostate cancer is rarely lethal since it develops so slowly, and is often left untreated. That said, many cases are life threatening.
- ceejayoz 7y ago
  Not sure why you're getting downvotes. https://www.reuters.com/article/us-prostate-cancer/untreated-prostate-cancer-no-death-sentence-idUSTRE65H5MP20100618 https://www.reuters.com/article/us-prostate-cancer/untreated... > Even without treatment, only a small minority of men diagnosed with early-stage prostate cancer die from the disease, Swedish researchers reported Friday. Drawing from a national cancer register, they estimated that after 10 years prostate cancer would have killed less than three percent of these men. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60878-2/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... > Prostate cancer often has an indolent natural history, and patients are more likely to die with than to die from the disease. There is reliable evidence that PSA testing results in considerable overdiagnosis and overtreatment of men with prostate cancer, while associated potential harms include pain, fever, bleeding, infection, and transient urinary difficulties resulting from prostate biopsy, as well as erectile dysfunction, urinary incontinence, and bowel dysfunction. > On May 22, after reviewing the evidence on both benefits and harms of PSA testing, the US Preventive Services Task Force (USPSTF) concluded that the reduction in prostate cancer mortality after PSA testing was very small and that the benefits did not outweigh the harms. Their recommendations are against PSA-based screening for the general US population of men at any age.
- tompccs 7y ago
  This is factually true. There is some controversy regarding PSA screening programmes that they do not improve all-cause mortality. Making surgeries less invasive and less liable to complication, as well as improving screening, is likely to improve outcomes.
- fortran77 7y ago
  My father died from metastasized prostate cancer. While statistically your statement may be true (in that a large number of people die of something else before the prostate cancer kills them) it's still a lethal cancer that kills more men each year than breast cancer kills women.
HorizonXP 7y ago
If you're electing to have a prostatectomy (i.e. removal of your prostate), then yes, your alternative is likely death. I haven't read this paper, and it's been years since my Masters when I last kept up with this, but the patients at this stage are usually getting their prostates removed. The aggressiveness of the cancer is enough to threaten their life and well-being, so they elect for this procedure. It's usually followed up with radiation and chemotherapy to kill any residual tumour cells left behind, usually at the periphery, or if metastasis has occurred. So great, prostate and cancer's gone, everyone's happy right? Well, no. The surgery damages a lot of the surrounding tissues, so these men are left with sexual dysfunction (which sucks but you can somewhat handle since you are living) and incontinence. The urinary and bowel issues affect your quality of life immensely. If you're in your 60s, you might have another 10-20 years to live with this. But if you're in your 40s, which is a lot of the cases for aggressive cancer types, you're stuck this way for many decades. Hence why this ultrasound technique is so appealing because you can perform a minimally-invasive procedure that destroys only what you target, and spares the urethra and other tissues. Better outcomes, and better quality of life. Given that the gold standard is surgery, this new technique has to prove itself against that, by showing that it is actually successfully destroying the cancer. That's why these clinical trials are occurring. As an addendum, one study in Thailand looked at a sample size of dead men, and found that 1 in 7 had prostate cancer, but died of other causes. What that means is that many men get prostate cancer and may be asymptomatic because it is not aggressive. It can manifest as localized tumours/nodules within the prostate that you wouldn't be able to detect without good palpation and/or sensitive imaging. And because you're asymptomatic, you might not even seek diagnosis, and you'll probably die of other causes. It also means that many men get diagnosed with cancer and may seek premature treatment. Most good doctors will recommend a watchful waiting approach; regular checkups and PSA level checks to ensure that you're still in the asymptomatic area. There's other treatments that can occur before surgery. But if you end up down this path, your cancer could be very localized within the prostate. However, surgery is an all-or-nothing approach, there's no saving the prostate. Ultrasound ablation could be a good alternative and allow targeting. We're still far off from proving that though, but it's definitely viable. It's also why ultrasound ablation is being used for things like uterine fibroids, and breast cancer. There's even use cases for brain cancers. It's a very cool technology, and I'm very optimistic for it. But I left my Masters in 2012, and we're still conducting these clinical trials. This is exactly the pace it should be occurring at, since it needs to be ironclad. But I found it too slow for my liking, so I moved on in my career path.

Just when I was freaking the hell out I read this and realized, yeah, knock me the hell out. Don't even wake me up till long after. I'm wondering if it's just that the tool scrapes it out or something. As painful as it is to think about.

Waterluvian 7y ago
And then of course in this huge wild planet of ours there's people who get a kick out of doing that for fun.
- giancarlostoro 7y ago
  Uhhhh just remembered hearing of such things. I have not been able to unsee certain things, but that one is one I am glad I have never looked at.
- ryanmercer 7y ago
  So, I clear international freight through customs for a living. Maybe a decade ago we had this shipment from a now defunct website that was (I think, maybe it had the c) 'fuk.it'. In the package were various 'sexual toys'. Some sort of electronic shock device, some comically large anal 'toy' and a 'deep hole dick spreader' which was a urethral sound being marketed as a sex 'toy'. We had to go to the website to try and figure out how to classify the stuff with names like the above and 'colon snake' and not only did they sell these torture implements but they sold a variety of -caine local anesthetics. Humans never cease to amaze and confuse me.
  - giancarlostoro 7y ago
    I'm both disgusted and amused by this. Thank you for sharing. I love hearing stories like these on HN, random windows into the lives of people on HN.
penagwin 7y ago
Idk if they would knock you out or just give you anesthetic but keep you semi-aware. "Knocking people out" is generally avoided, but this obviously depends on the specific situation. Are there any medically experienced people that know if this could be more likely to be a full "knock them out" kind of procedure?

BurningFrog 7y ago

Prostate cancer is rarely lethal since it develops so slowly, and is often left untreated. That said, many cases are life threatening.

ceejayoz 7y ago
Not sure why you're getting downvotes. https://www.reuters.com/article/us-prostate-cancer/untreated-prostate-cancer-no-death-sentence-idUSTRE65H5MP20100618 https://www.reuters.com/article/us-prostate-cancer/untreated... > Even without treatment, only a small minority of men diagnosed with early-stage prostate cancer die from the disease, Swedish researchers reported Friday. Drawing from a national cancer register, they estimated that after 10 years prostate cancer would have killed less than three percent of these men. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60878-2/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... > Prostate cancer often has an indolent natural history, and patients are more likely to die with than to die from the disease. There is reliable evidence that PSA testing results in considerable overdiagnosis and overtreatment of men with prostate cancer, while associated potential harms include pain, fever, bleeding, infection, and transient urinary difficulties resulting from prostate biopsy, as well as erectile dysfunction, urinary incontinence, and bowel dysfunction. > On May 22, after reviewing the evidence on both benefits and harms of PSA testing, the US Preventive Services Task Force (USPSTF) concluded that the reduction in prostate cancer mortality after PSA testing was very small and that the benefits did not outweigh the harms. Their recommendations are against PSA-based screening for the general US population of men at any age.
tompccs 7y ago
This is factually true. There is some controversy regarding PSA screening programmes that they do not improve all-cause mortality. Making surgeries less invasive and less liable to complication, as well as improving screening, is likely to improve outcomes.
fortran77 7y ago
My father died from metastasized prostate cancer. While statistically your statement may be true (in that a large number of people die of something else before the prostate cancer kills them) it's still a lethal cancer that kills more men each year than breast cancer kills women.

HorizonXP 7y ago

If you're electing to have a prostatectomy (i.e. removal of your prostate), then yes, your alternative is likely death. I haven't read this paper, and it's been years since my Masters when I last kept up with this, but the patients at this stage are usually getting their prostates removed. The aggressiveness of the cancer is enough to threaten their life and well-being, so they elect for this procedure. It's usually followed up with radiation and chemotherapy to kill any residual tumour cells left behind, usually at the periphery, or if metastasis has occurred. So great, prostate and cancer's gone, everyone's happy right? Well, no. The surgery damages a lot of the surrounding tissues, so these men are left with sexual dysfunction (which sucks but you can somewhat handle since you are living) and incontinence. The urinary and bowel issues affect your quality of life immensely. If you're in your 60s, you might have another 10-20 years to live with this. But if you're in your 40s, which is a lot of the cases for aggressive cancer types, you're stuck this way for many decades. Hence why this ultrasound technique is so appealing because you can perform a minimally-invasive procedure that destroys only what you target, and spares the urethra and other tissues. Better outcomes, and better quality of life. Given that the gold standard is surgery, this new technique has to prove itself against that, by showing that it is actually successfully destroying the cancer. That's why these clinical trials are occurring. As an addendum, one study in Thailand looked at a sample size of dead men, and found that 1 in 7 had prostate cancer, but died of other causes. What that means is that many men get prostate cancer and may be asymptomatic because it is not aggressive. It can manifest as localized tumours/nodules within the prostate that you wouldn't be able to detect without good palpation and/or sensitive imaging. And because you're asymptomatic, you might not even seek diagnosis, and you'll probably die of other causes. It also means that many men get diagnosed with cancer and may seek premature treatment. Most good doctors will recommend a watchful waiting approach; regular checkups and PSA level checks to ensure that you're still in the asymptomatic area. There's other treatments that can occur before surgery. But if you end up down this path, your cancer could be very localized within the prostate. However, surgery is an all-or-nothing approach, there's no saving the prostate. Ultrasound ablation could be a good alternative and allow targeting. We're still far off from proving that though, but it's definitely viable. It's also why ultrasound ablation is being used for things like uterine fibroids, and breast cancer. There's even use cases for brain cancers. It's a very cool technology, and I'm very optimistic for it. But I left my Masters in 2012, and we're still conducting these clinical trials. This is exactly the pace it should be occurring at, since it needs to be ironclad. But I found it too slow for my liking, so I moved on in my career path.