Monday, March 12, 2012

Circumcision Does Not Prevent Prostate Cancer

By Danelle Frisbie © 2012

Male Anatomy



1. Bladder
2. Seminal vesicle
3. Prostate
4. Pubic bone
5. Erectile tissue
6. Urethra
7. Vas deferens
8. Epididymis
9. Glans
10. Prepuce ('Foreskin')
11. Testis
12. Rete testis
13. Efferent ductules
14. Seminiferous tubules
15. Anus






The prepuce, or 'foreskin,' is an organ located on the outside of the penis or clitoris and is present from birth in all mammals on earth. The prostate is a gland located deep inside the male pelvis at the base of the penis which surrounds the neck of the bladder. The two are located no where near each other and have little bearing on one another, except for the fact that both play important roles in male sexuality.

In reference to these two organs, an article published today by Reuters titled, Circumcision tied to lower prostate cancer risk, reports that "circumcised men may have a slightly lower risk of developing prostate cancer than those who still have their foreskin..." The article goes on to discuss research by Jonathan L. Wright who states that he, "Would not go out and advocate for widespread circumcision to prevent prostate cancer. We see an association, but it doesn't prove causality." (1)

As cringe worthy as some parts of the article are, it is a good thing that Wright notes the difference between correlation and causality because we know the two often have nothing to do with one another. For those not familiar with the difference: imagine for a moment the cities you know that host a lot of churches. We'll say City A has 100 churches, City B has 50 churches, and City C has just one church. We know (thanks to the fields of criminology and sociology) that City A also has the highest rate of aggravated crime, City B has much less, and City C sees almost no crime recorded in the local police log. Does this mean that building churches increases crime? If we tear those 100 churches down, will we see a decrease in City A's crime rate? Of course not. Because there are other variables at play, and the two are merely correlated. There are no direct causalities between a church and aggravated crime. In fact, the two are about as related as the foreskin and prostate cancer.

But, we've been here before - toying with the fairy tale of prostate cancer and foreskins. We've had a long list of illnesses (both real and imagined) that we've blamed on the foreskin -- masturbation, 'promiscuity,' epilepsy, convulsions, seizures, 'sin,' blindness, deafness, cancer, sexually transmitted illnesses (STIs) of various kinds, women's health issues, HIV... and now we are back to cancer again.

In their 1996 letter to the American Academy of Pediatrics, Drs. Heath and Shingleton (VPs on The American Cancer Society's board) stated that, "Perpetuating the mistaken belief that circumcision prevents cancer is inappropriate."

Not surprisingly, in their current review of risk factors for prostate cancer, The American Cancer Society does not list being intact among factors. Included are such things as age, ethnicity, family history, diet, obesity, and smoking.

In addition, The American Cancer Society makes this statement on early detection of prostate cancer and treatment:
Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment. The only test that can fully confirm the diagnosis of prostate cancer is a biopsy, the removal of small pieces of the prostate for microscopic examination. However, prior to a biopsy, less invasive testing can be conducted. [...] Screening men who are older or in poor health in order to find early prostate cancer is less likely to help them live longer. This is because most prostate cancers are slow-growing, and men who are older or sicker are likely to die from other causes before their prostate cancer grows enough to cause problems. (2)
Despite The American Cancer Society's position, those who are invested in pro-cutting measures today would assert that we should forgo early detection of prostate cancer via biopsy because it is 'too invasive,' but instead conduct an even more invasive and life-long, altering surgical procedure by amputating the prepuce organ from all healthy males. Is there logic in doing so? If there is any to be found, we would surely see it played out in statistics of prostate cancer between male populations that are circumcised at birth vs. those who are not.

Yet in reality, we find just the opposite to be true.

The World Health Organization's International Agency for Research on Cancer presented the 2008 findings of incidence and mortality of prostate cancer. Statistics clearly show that rates of prostate cancer are highest in nations with the highest populations of adult circumcised men, and rates of prostate cancer are consistently lowest in nations where male circumcision is unheard of. (3)

Diagram One shows the incidence of prostate cancer (red) and mortality rate of those inflicted with prostate dancer (blue). Keep in mind that North America has one of the highest populations of adult men who were circumcised at birth.


Diagram Two shows the age-standardized incidence of prostate cancer per 100,000 men across the globe. Again, we see that the highest prevalence of prostate cancer exists in nations that also have the highest number of adult circumcised males. The lowest rates of prostate cancer are found in nations where men are almost exclusively intact.


In fact, if we didn't know better [remember correlation versus causation] we'd venture to guess that being intact serves as protection from prostate cancer! We know very little at this point within the fields of human sexuality, health, and urology about the immunological protection that is achieved by the sub-preputial (within the prepuce) flora, immunoglobulins and lytic secretions coming from within the human male body. Physicians and researchers alike have suggested that these protective properties may lend explanation to the fact that we consistently find results as those portrayed in the graphs above - men who keep their full and functioning prepuce (which serves, in part, as an immunological organ) tend to see less, not more, genital related illnesses and infection of all kinds. (4, 5, 6).

What was first debunked in the 1940s after Abraham Ravich (7) invented the mythological notion that the foreskin was to blame for prostate and cervical cancers, seems to have resurfaced in pro-cutting circles today. Maybe enough time has past that we will not recall the roots of these tall tales and will tragically fall victim to them again... And maybe enough money (unnecessary surgeries, the sale of foreskins for research and cosmetics, job opportunities) will incite even the well researched professional to cut healthy organs from healthy human beings. But in the midst of the mess, one thing is for certain: circumcision does not protect against prostate cancer.

While discussing the subject among advocates today, Kira Dawn remarked, "It never ceases to amaze me how much money and time is spent by 'researchers' hell-bent on proving that a normal human body part is the biggest threat known to mankind." Much in agreement and bewildered at today's headlines, Australian native, James Mac, noted, "These increasingly desperate and hysterical claims will only hasten the demise of forced circumcision." Let's hope that he is correct. It's high time for Americans to wise up and and put an end to such laughable nonsense.


References

1) Reuters' "Circumcision tied to lower cancer rates" at: http://www.reuters.com/article/2012/03/12/us-circumcision-cancer-idUSBRE82B08G20120312?feedType=RSS

2) American Cancer Society: Prostate Cancer at: http://www.cancer.org/Cancer/ProstateCancer/MoreInformation/ProstateCancerEarlyDetection/prostate-cancer-early-detection-toc

3) World Health Organization International Agency for Research on Cancer: Globocan 2008 at: http://globocan.iarc.fr/factsheets/cancers/prostate.asp

4) Bowen JM, Tobin N, Simpson RB, Ley WB & Ansari MM. Effects of washing on the bacterial flora of the stallion's penis. Journal of Reproductive Fertility, 1982; 32:41-45.

5) Fleiss, Paul M. & Hodges, Frederick M. (2002). What Your Doctor May Not Tell You About Circumcision. Warner Books, New York.

6) Wallerstein, Edward (1980). Circumcision: An American Health Fallacy. Springer Publishing Company, New York.

7) Ravich, Abraham. “The Relationship of Circumcision to Cancer of the Prostate” Journal of Urology, Vol. 48, 1942:298‑299.

Related reading in addition to above references:

1) Gollaher, David, L. (2000). Circumcision: A History of the World's Most Controversial Surgery. Basic Books, New York.

2) Ritter, Thomas & Denniston, George (2002). Doctors Re-examine Circumcision. Third Millennium Publishing Company, Seattle, WA.

3) Romberg, Rosemary, The Painful Dilemma, Chapter 14: The Question of Prostate Cancer at: http://circumcisionthepainfuldilemma.wordpress.com/table-of-contents/chapter-14/

4) Circumcision Information Research Pages: Penile Cancer at: http://www.cirp.org/library/disease/cancer/

5) Joseph Lewis' Latest Pro-Circumcision Canard: 'Circumcision Prevents Prostate Cancer'.

6) Hugh, of Circumstitions.org response: http://www.circumstitions.com/news/news44.html#prostate

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