Frequently asked questions
The spread between “incidence” and “mortality” apply to many other cancers, not just colorectal. The reasons for this disparity are well familiar to epidemiologists, oncologists, and pathologists:
A large number of cancer-related deaths are underreported because people don‘t die directly from cancer of the colon, rectum, or anus itself, but from its complications, such as intestinal obstruction, organ failure (kidney, liver, lungs), cardiac arrest, etc. These outcomes, not cancer, get reported on death certificates and become the “official statistics.”
The cause of death, such as “colon cancer” is likely to appear on the death certificate when a person passes away in the oncology wing of a hospital. If death happens at home or in a hospice, a nurse practitioner or physician called in to confirm it might not even know that the person was affected by colon cancer, and is likely to write “cardiac arrest” or “respiratory failure” instead.
People who get operated on and treated for colon cancer may succumb to other diseases related to age, complications, accidents, suicide, and other causes, rather than to complications directly related to cancer.
Surgical removal of the colon and/or rectum (colectomy), may extend the life of a colon cancer victim considerably — no question about it. Just like all other kinds of complex and expensive surgeries, that used to be restricted by age, money, and access, colectomies are now commonly accessible even in rural hospitals.
The under-reporting of cancer as the cause of death sits well with local, state, and federal health authorities, because a large number of cancer deaths poorly reflect on mortality statistics, particularly in comparison with other regions or countries.
Q. The trends show a small decrease in colon cancer incidence and death cited by Ms. Couric (5% for men and 4.5% for women). Do you think this decrease is related to screening colonoscopies?
According to the published stats, about half of Americans over age 50 undergo regular screening colonoscopies. If the actual reasons for having regular screenings originally cited by Ms. Couric — i.e. a 90% reduction in colon cancer death — have been true, we should have seen at least a 45% reduction in colon cancer death, not 5%.
The 5% decrease in mortality from year 2000 to 2007 cited by Ms. Couric amounts to 0.71% per year. This value falls within the so-called statistical “margin of error” and represents a chance happening, not a trend. Furthermore, the total number of deaths from colon cancer in any given year is neither meaningful nor reliable because of the facts outlined above.
Next, when the screening ‘net‘ is so wide — I am guessing 60 to 70 million colonoscopies have been performed from 2000 until present — you are bound to catch a small percentage of early cancers, and postpone (not reduce) mortality due to radical and aggressive treatment.
The actual data on the growth of colorectal cancer incidence — about 30,000 more cases in 2007 than in 2000 — supports my argument that screening colonoscopies and polypectomies are useless at best, or are partially behind this dramatic increase.
The other two less apparent reasons for the small reduction in the mortality rate from colorectal cancer aren't too encouraging either:
An increase in the death rate from other causes and a decrease in overall longevity, which means that many people die before developing colon cancer;
A substantial increase in the number of preventative proctocolectomies — the complete removal of the colon and/or rectum — in the cases of ulcerative colitis and Crohn‘s disease. This surgery reduces the risk of colon cancer by 80%, and they are performed in the hundreds of thousands.
Without a doubt, Ms. Couric‘s original pitch for colorectal cancer screenings, following her husband‘s tragic death, was sincere, heartfelt, and well intended. It is also apparent that someone (or more than one) oversold to her on the benefits of screening colonoscopies just as she later did to the American public.
I would not be surprised to find out, that most medical doctors past fifty, including board certified gastroenterologists (who must know better, right?), willingly submit themselves to conventional and virtual screenings. If these professionals are so easily duped, how could a vulnerable and hurt Ms. Couric have resisted the “miraculous” promises of regular colonoscopies?
Past her initial “euphoria” over the alleged benefits of colorectal cancer screening, corporate interests, including the interests of the GE Healthcare, embraced and skillfully manipulated her. This is apparent from the content of her prerecorded statements.
The claim of a 90% reduction in mortality due to regular screening was what people wanted to hear, not what Ms. Couric actually said. Her verbatim statement said: “In fact, it‘s [colon cancer] more than 90% curable — but only if you get tested in time.” [link]
This carefully worded legal speak — “but only...” — was intended to absolve Ms. Couric from all and any responsibility for her deceptive claims because what exactly “tested in time” meant — a week, a month, or a year — no one knows! And, as we have learned by now, the actual experiences of screened patients have demonstrated that detecting and removing polyps does not prevent the incidence of or mortality from colon cancer [link].
This, unfortunately, means that Ms. Couric became the willing “face” of a medical racket and large-scale consumer fraud. It is impossible to assume for even a fleeting moment that she is not aware of the mounting evidence about the futility of colon cancer screening, particularly past 2006.
It is also inconceivable — considering the rules of the tightly regulated TV broadcast networks and the corporate governance of public companies, such as the CBS Corporation, — that Ms. Couric, her producers, and corporate lawyers could have missed my letter from May 19, 2008 or my later post on her blog.
God only knows how many hundreds of billions of dollars have been “stolen” from the real medical needs of countless Americans, and how many tens of millions of Americans have been harmed between 2000 and now by conventional colonoscopies, or how many millions of people have been exposed to cancer-causing radiation by unnecessary CT scans.
If harming close to 200 people day after day with unnecessary colonoscopy screening and thousands more with radiation isn't a crime, what is?
No, I am not. First, it's reasonable to presume Ms. Couric benefited financially from the expansion of colonoscopy screening through the ownership of the General Electric (the owner of NBC Television) stock and stock options, favorable job reviews, and contract extensions, but without ever disclosing her affiliation with GE Healthcare — one of the world‘s largest manufacturers of the CT scanners used to administer virtual colonoscopies.
Second, Ms. Couric is a public person by choice. She is subject to the same scrutiny and, if necessary, criticism as all other public persons are. Furthermore, she has made “a show” from her husband‘s unfortunate death, consciously.
How many celebrities do you know that have turned their spouse‘s tragic death into ruthless self-promotion, on-going publicity stunt, and marketing ploy for GE Healthcare, radiologists and gastric endoscopists who enjoy the spoils of conveyer-style screenings.
Third, this “poor“ woman is also savoring the prestige of anchoring CBS Evening News along with her $15 million pay package. If Ms. Couric gave a hoot about your health and life, considering her enviable perch, she could have exposed the screening colonoscopy racket just as easily and vigorously as she had initiated it.
Finally, it is not my fault that Ms. Couric has made herself a willing spokesperson for the multibillion-dollar industry spawned by screening colonoscopies. Moreover, I am not out to get Ms. Couric, but am after stopping the deadly outcomes of needless colorectal cancer screenings.
Just like Ms. Couric, I am a messenger, albeit on the other side of the fence. So if anything, my message is not about getting this “poor woman,” but about saving your “poor ass.”
Except for actual “ringleaders,” most physicians — at least until they learn about the research behind this report — aren't. Rank-and-file medical doctors are very much like soldiers in the well-trained army, even though they may think about themselves otherwise.
Just like all good soldiers, physicians do what they are told to by the “higher authorities” in their respective specialties, and are easily manipulated by deceptive advertising, fabricated research, planted salutary articles in the medical journals, and continuous education courses embellished with all of the above.
The physicians who don't question the system are amply rewarded for their obedience and well insulated from liability because they follow “generally accepted clinical guidelines,” dead and injured be damned.
On the other hand, the mavericks who question the system or object too vigorously, risk losing their medical licenses and livelihood — a typical mafia-style arrangement. Therefore, if you are expecting your “middle-of-the-road” doctor to break the ometrá (the mafia code of silence), and advise you too vigorously against getting screened for colon cancer — good luck...
Ironically, doctors and their families are victimized by screening colonoscopies even more than the “meat” — a derogatory term reserved for patients under care — because of their unrestricted access to “state-of-the-art” preventative care, the intense peer pressure to “take good care” of their health, and the same basic dread of death and disease that haunts you and me.
These three Ds — the Dread of Death and Disease — give me a faint hope that the recommendations on this site will soon become mainstream, and you‘ll be spared from the unnecessary harm caused by harmful screening colonoscopies and the lack of appropriate colorectal cancer prevention.
The fear-mongering and promotion of colon cancer screening serves the financial interests of a narrow group of endoscopists, radiologists, and radiology equipment manufacturers who benefit financially from administering this procedure, not patients. Most likely not even patients in a high-risk group.
The shortage of qualified endoscopists has been producing the proliferation of radiology clinics which specialize in virtual colonoscopy. Some of these clinics are co-owned by the same gastroenterologists who profit from regular colonoscopies. To maximize profits, some of the electronic CT scans are routinely outsourced to radiologists in low-cost countries, such as India or Pakistan.
So I wasn‘t at all that surprised, that despite increased risk of cancer from radiation, new screening guidelines were released on March 6, 2008 by the American Cancer Society and American College of Radiology, which in addition to colonoscopy, insist on performing double-contrast barium enema x-rays or a virtual colonoscopy every five years [link].
So, the answer to the question above: virtual colonoscopies are permitted and encouraged because they are a source of windfall profit to entities who promote them. If they really cared about your health, they would have told you to avoid them like the plague, or, at the very least, advised you that a single abdominal CT scan is just as cancer-prone as smoking your entire life or making your living by mining asbestos.
Still in doubt? If these CT scanners were indeed safe and harmless, why would doctors and nurses ensconce themselves behind leaded walls, wear protective shields, and carry personal radiation monitors?
I don‘t believe Ms. Couric started campaigning for colon cancer screening with dollar signs on her mind, and I said that much in my report, prior answers, and elsewhere on this site. Also, I doubt that anyone ever said to her: “Katie, we are going to make a killing out of this...”
They didn't have to... Ms. Couric was employed by the NBC Corporation, a subsidiary of General Electric. Just like any other senior employee of any major American public company, she was (I presume with 99% certainty) receiving stock options, 401K, and other financial incentives related to her ratings, advertising revenues, and overall performance of GE stock.
After Ms. Couric took a strong public position on colonoscopy, and particularly after her televised colonoscopy, her show's rating, public stature, popularity, and name recognition skyrocketed, and, inevitably, yielded her even greater financial gain, larger compensation, larger speaking and endorsement fees (if any), opportunities for fat book advances, and so on.
Finally, when CBS hired Ms. Couric to anchor the evening news, she was offered, reportedly, a $15 million annual salary, the highest among her peers even today. According to press reports, NBC had counter-offered her $20 million, but she declined because, apparently, the extra $5 millions weren't worth missing out on her social life “denied” by an early — up at 3-4 am — morning schedule.
Obviously, this huge salary and counter-offer weren't related to Ms. Couric‘s “hard news” journalistic credentials, but to her celebrity status, and ratings cemented earlier with her high profile work on colon cancer advocacy and public sympathy over her husband‘s tragic death. That is also why, despite the mounting evidence about the futility and dangers of colonoscopy screening, she continued to milk this subject at CBS, albeit with much less intensity and enthusiasm than at NBC.
Well, in this day-and-age anything is possible, especially when you are confronting an 800 lb gorilla in a sheep's disguise. That said, the odds of Ms. Couric going this route are slim for several well-known reasons:
(1) Ms. Couric had ample opportunity to address all of the issues raised in my original letter in private, and fess up to the American public, but she decided not to. I am sure she consulted with her lawyers and bosses before making this reckless decision. Apparently, as was the case with Ford Pinto, tobacco, and countless others, they decided to gamble on this one. So what else is new? Are you shocked and surprised about this corporate hubris, arrogance, and malfeasance? After the Madoff affair? After the implosion of Wall Street? Give me a break...
(2) There isn't anything in my report, books, or web site that even remotely defames Ms. Couric. Pointing out that someone is 'lying' based on the presented facts isn't defamation, but the expression of one's educated opinion. At this point, the burden of proof that screening colonoscopy is a safe and effective procedure delivering a “90% cure” of colon cancer is on Ms. Couric and her collaborators, not me.
(3) The American legal system isn't receptive to super-rich celebrities abusing First Amendment privileges under the disguise of defamation. Good luck finding a court to take her case, claiming that Mr. Monastyrsky “knowingly and recklessly made false statements about Ms. Couric that caused personal or professional injury to her reputation.”
(4) Any lawsuit of this kind will only attract even more attention to Ms. Couric's persona, and in an extremely negative light.
And, what exactly is Ms. Couric going to win from filing a defamation lawsuit? She doesn't need any more money. It will take years to litigate. Throughout the process she‘ll be an emotional and physical wreck, because she has been too sheltered for far too long to deal with this kind of stress, adversity, negative press, discovery proceedings, and so on.
My attorneys will also have an opportunity to depose her going back to 2000, and discover even more compromising facts about her role in this charade, including financial gains. All of that will be discussed in the open court, including the court of public opinion, and, court permitting, on my blog and the rest of the media.
Above all, her suit isn't going to bring back her goody-two-shoes reputation, or make screening colonoscopies any safer, more effective, or necessary for the majority of Americans.
Finally, if every American writer, journalist, and public activist was to be scared of celebrities or corporate wrath, this would be the Soviet Union, not America! Thank God, I left that awful place 30 years ago, and never looked back.
And even if she does, so what? It will only mean that even more Americans will learn about the dangers of colonoscopy screening, which was my primary objective to start with.
Q. Doctors used colonoscopy to diagnose my mother‘s colon cancer! This saved her life. It's very frustrating and confusing to watch your report...
I understand the frustration and angst of people who have been affected by colorectal cancer, either themselves, or through the suffering of their loved ones. My mother passed away in January of 2003 from a misdiagnosed and mistreated ovarian cancer, and we fought for 16 arduous months to keep her alive despite an array of gross medical errors.
All along, and in spite of her incredible survival feat, we (my wife and I) were treated with contempt and indifference by her doctors. Just to keep her safe from harm, we hired an attendant to “guard” and properly nourish her throughout the day while in the hospital.
In retrospect, she could still have been alive, if we had gone for treatment to a local oncologist instead of taking her to presumably one of the best oncology centers in the world — the Memorial Sloan-Kettering Cancer Center in New York City. When we brought her in for the very first time with severe ascites, she wasn‘t even tested for CA-125 — a basic blood test for ovarian cancer.
Instead, and after a month-long delay, she was scheduled for a biopsy to determine the source of her ascites on the presumption that women of her age — 80 at the time — do not get ovarian cancer. No surprise here: Medicare pays tens of thousands of dollars for biopsy, and next to nothing for CA-125. With hands in the honey pot, why bother with mere crumbs?
That unnecessary biopsy caused a severe infection that required massive abdominal surgery to remove the abscess along with several liters of pus, and the scars from that surgery eliminated the possibility of removing her ovaries.
That left her with just one option — chemotherapy, which stopped working after the tenth round. Unable to ingest nutrients because of an ensuing intestinal obstruction, she passed away several months later in our house and in her own bed.
In the process of caring for her, I learned a great deal about critical care nutrition. Thanks to these insights, my mother enjoyed relative normalcy throughout her ordeal. Even chemo treatments were mainly non-events — no usual nausea, no fatigue, no throwing up, no constipation, no depression, no bed sores, no blood clots, no circulatory problems, or any other serious quality-of-life issues that plague so badly people half her age.
In the end, Medicare paid an estimated $300,000 to the Memorial Sloan-Kettering Cancer Center. The more damage they caused, the more they were paid to fix it! Badly shaken, we ignored our attorney advice to file malpractice lawsuit, so we could erase these events from memory and return to normalcy — a very common happening among grieving relatives.
Depressed, grief-stricken, and guilt-ridden, I had a hard time resuming my work on the talk radio in New York. It took me almost two years to get back “on track.” Consequentially, the sales of my Russian-language books tanked, and we almost lost our publishing business. As skilled and proficient as I am in these matters when it concerns others, I failed to recognize and address post-traumatic stress syndrome while dealing with it myself.
Also, as I mentioned in the Death By Colonoscopy report, Tatyana‘s dad survived a bout with late stage colon cancer in 2003, even though he wasn‘t given much time by his doctors. The experience gained from my mom‘s ordeal helped him to survive the surgery and fully recover. Because of his advanced age — 80 at that time — and poor prognosis, he was spared of chemotherapy, and that decision turned into a blessing. Tatyana and I convalesced him back to normalcy, and, all things considered, he is doing great eight years later (page updated on November 15, 2011).
So, if anyone thinks that I don‘t know first hand what it is like watching a loved one withering away from terminal cancer, or taking care of a parent, affected by colorectal cancer, they‘re badly mistaken. And, to tell you the truth, without that painful and costly experience and insights, I wouldn‘t have had the gumption to touch this unpleasant and scary subject with certainty and conviction.
Past aside, my work isn‘t about people getting affected by colorectal cancer, but about making sure that healthy people (a) don‘t get killed or injured in the name of “cancer prevention” that doesn‘t deliver, and (b) teaching people that most cancers, including colorectal, aren‘t a mystical plague that strike only the unlucky, but a predictable, preventable, and avoidable disease.
I do realize that my work flies in the face of conventional (and supremely profitable) thinking, and that it is very polarizing, especially for people outside of cancer research and academia (this bunch is much more humble and open minded). No surprise there: just two generations ago people were told by their very doctors that smoking is perfectly safe, even healthy, and anyone who begged to differ was labeled a freak, so what‘s new?
Now, lets get back to the “colonoscopy saved my mother‘s life” argument. There is a sea of a difference between a life-saving diagnostic colonoscopy for people already affected with cancer, and a screening colonoscopy for healthy people that‘s not only not preventing anything, but may also cause death, injury, and contribute to other cancers.
When the patient is brought to ER with colorectal bleeding, unrelenting pain, or obstruction – colonoscopy is what doctors do to discover the source of the problem, and this is what they should do! And if they detect colon cancer, and save one‘s life, God bless the doctors and the patient, and I am all for that. But, as I said, this situation has nothing to do with bringing healthy and asymptomatic people to the same hospital, and making some of them sick or dead in the name of non-existent and non-attainable prevention.
Thus, in this particular situation, the proper question should be:
— Konstantin, would screening colonoscopy a year or two before my mother was diagnosed with colon cancer have prevented it?
To that, I can only restate what has already been established by mainstream clinical research and published in the leading medical journals:
● First, when people ask me this question, what they often mean to ask is this: “Will my parents' bad genes kill me too if I fail to get screened more often?” Unlikely, because only 3% of all colorectal cancers are hereditary, and they usually kill people in their early forties. Besides, you only need a single blood test to screen out genetic risks, not a colonoscopy.
● Second, screening colonoscopy can‘t detect 40% of all precancerous lesions and polyps located in the right (ascending) colon;
● Third, it misses up to 30% of polyps located in the left (descending) colon even in the hands of the most experienced and attentive endoscopists;
● Fourth, not all colorectal cancers are preceded by detectable polyps;
● And, finally, fifth, even when all of the polyps are detected and removed during screening colonoscopy, most patients develop cancers in-between the screenings anyway.
In other words, screening colonoscopy is a crapshoot, not the life-saving diagnostic procedure with a 90% cure rate as it was presented by the sly and vested “Dr. Couric.” And it is precisely that — lying about screening colonoscopies‘ alleged benefits — is what I am adamantly opposed to.
If you still don‘t get it, get screened as often as you like, or as often as your insurance will pay for it! In turn, I'll pray for some good doctors to stop this travesty well before you get yourself killed or injured in the process!
Many people have this question on their minds, but aren't likely to ask them for fear of embarrassing me or themselves. Actually, I find these concerns absolutely legit, and deserving detailed, explicit answers:
Medical training. First, I went to a medical school that was also attended by future doctors, and received a similar base medical education from the same professors, in the same lecture halls, in the same morgue, and using the same lancet to dissect corpses.
To a large extent, the specialized curriculum of a pharmacist is closer to what I do now — analyzing the connections between foods and diseases — than the ‘clinical sciences’ that are taught to medical doctors. In other words, I don‘t need to know a vagina‘s anatomy and physiology in the same minutiae as a gynecologist does in order to become a better lover.
Interpreting facts isn't science. Second, I do not make science, but report it. My analysis of screening colonoscopies or other medical controversies is based entirely on the fundamental academic and clinical research emanating from the medical doctors themselves, including those directly involved in colonoscopy screenings.
Anyone telling you otherwise — that all of this is just Mr. Monastyrsky's opinion, — is being coy with the facts. In other words, no one can watch my video or read my books, and claim with a straight face that I make science. I don‘t, nor do I pretend that I do, and I have no interest in doing this.
All I do is read the available and up-to-date research, think it over, analyze my thinking, and report my conclusions. Any unbiased investigator doing the same will come up with similar conclusions.
When all is said, done, and delivered on a silver platter, it sure looks simple. Third, I work with what I have — medical textbooks, journals, and references, and address what I can — basic human physiology, evolutionary anthropology, forensic nutrition, and common sense. Then, I wrap up my findings in accessible language, and work hard to make it fun by using irony, humor, and occasionally indignation. And there isn‘t anything easy or simple about it.
Anyone confusing the apparent simplicity of my writings with “simplicity of mind” must be an imbecile! Describing complex medical or scientific concepts in accessible language is ten times more difficult than writing in “medicalese.” This “scientific” lingo is inaccessible to an average reader not because the people who use it are great scientists or good doctors, but because they are bad writers and terrible communicators.
Here is a representative example of some doctor-speak that deals with the exact same subject as my investigative report:
“The rate of colonoscopy in matched controls did not vary by site of primary CRC (9.7%, 9.9%, and 9.8% of controls matched to case patients with left-sided cancer, right-sided cancer, and unknown site of cancer, respectively). The inverse association of death from left-sided CRC with colonoscopy was substantial for attempted colonoscopy (OR, 0.39 [CI, 0.34 to 0.45]) and complete colonoscopy (OR, 0.33 [CI, 0.28 to 0.39]). Colonoscopy was not associated with death from right-sided CRC (OR from any attempted colonoscopy, 1.07 [CI 0.94 to 1.21]; OR from complete colonoscopy, 0.99 [CI, 0.86 to 1.14])” [link]
Do you understand any of it? Is it because the author is a genius, and you are stupid? No, it is because the author can‘t write in plain English. Unfortunately, this style of writing is not only tolerated, but encouraged, so it looks “scientific” and intimidating to pumpkins like you and me.
The whole purpose of science is to make one‘s findings accessible and clearly understood. The sole purpose of the above pseudo-science is to make the writer appear smart (and the reader — stupid), or to obscure the findings, or to make the trivial appear significant.
Independent investigator. Fourth, to be fair to medical doctors, I am not a part of their guild, so there is no peer pressure to conform to the prevailing groupthink or fear professional ostracism for “paddling” against the current. Nor do I need to be concerned over a professional reprimand for questioning the prevailing wisdom or fear losing my license and livelihood for breaking down profitable rackets. I also discuss these underlying issues in the following sections:
Looking at the big picture. Fifth, As a broad generalist and independent investigator, I have a substantial advantage over narrowly-focused specialists. Each of them looks only at their own very limited field of research, and is doing his/her best to solve their individual ‘puzzle.’ I, on the other hand, look at the whole picture, take advantage of all available findings, and put the entire puzzle together.
Here is a good example of a very simple jigsaw puzzle, just 108 shuffled pieces. Do you have a clue what this puzzle represents?
Actually, this is my portrait from the Biography page. A medical doctor investigating a certain aspect of colonoscopy screening may only see 10-15 random pieces out of 108 in this picture. Can you expect that doctor to guess what‘s behind those limited pieces when you have just failed to figure out what was behind the entire set?
And that is what I do — deliberately collect all of the jigsaw puzzle pieces, and take time to put them together. When the final picture is finally assembled and explained, it looks so darn simple: look, guys, this is that Russian dude!
Alas, it isn‘t that simple, and even if it was, medical doctors aren‘t paid for putting together puzzles or writing in Pulitzer-style prose. And that is why I, not them, came up first with this information about colorectal screening.
And if this still bothers you, then do what any well-trained scientist does in a similar situation – bring this information to an unbiased person with a background in medical research, and ask his or her opinion. Hopefully, that will put your mind at ease...