By Howard Wolinsky

Rick Davis, founder of the AnCan platform of support groups, has made major contributions to peer-support, especially for prostate cancer—though he often has followed a combative, scorched-earth policy. He’s no diplomat. Actually, I admire the fact that he stands on principle and speaks out without fear of pushback.

I proudly worked with him to form the successful virtual support group for Active Surveillance. (Meets the first four Wednesdays of each month at 8-9:30 pm Eastern.) I urge men, especially the newly diagnosed as well as AS vets, to attend these meetings for peer support. It was the first such group of its kind for AS, and it has filled a clear need. Other support groups in Canada and the U.K. have emulated it.

Not always smooth sailing

Over the years, Rick and I have butted heads more than once. He also has locked horns with many other advocates over matters large and small. He comes out swinging.

As a result, he sometimes has become persona non grata with groups such as ZERO Prostate Cancer, and the Prostate Cancer Impact Alliance (PCIA), a collaborative initiative focused on improving outcomes for men with prostate cancer, part of the American Urological Association (AUA).

(Disclosure: PCIA banned me, too, and even changed their bylaws to do it. I volunteered to work with their advocacy committee as an individual not representing any group. They said they only wanted group reps. I wanted to speak my mind. I got the boot, But in part, I don’t think they wanted a journalist—even one who is a PCa patient—sniffing around.)

The M.O.

Let’s get personal. Part of Rick’s M.O. is to go beyond the sterile facts and get personal. He’s a street fighter. I’m more of a street lover.

Rick and I descend from the same “stiff-necked people,” those stereotyped stubborn and haughty Jews, and more specifically the Litvaks, the Jews from Lithuania. The Litvaks are known for their intellectual focus and opposition to emotionalism and mysticism of some sects.

Meanwhile…

Rick is on the warpath for my running a post in The Active Surveillor on May 30 by the urologic heretic Bert Vorstman, MD, and investigative reporter Ron Piana.

Rick wrote in his newsletter (see below). that AnCan still “loves” me as an advisory board member but suggested that my journalistic instincts got the better of me in running the column by Vorstman and Piana, “What's The Truth About Prostate Cancer?” that takes on the whole uro-industrial complex and PCa.

The post was intended by the authors to be provocative. I support their right to express views out of step with mainstream thinking. In the introduction, I warned readers that the article was controversial and they should take no action before discussing it with their doctors.

Rick told me in an email that my warning “wasn’t enough.” I’m not sure how we can measure that.

The comments section of Substack is the place for discussion and debate, in effect letters to the editor. Rick and Bert had a knock-down verbal battle. It was out-of-hand.

Rick was unhappy with me. That’s nothing new. We have butted heads several times. See below.

A tale of biopsies

Early on in the AS support group, Rick was frustrated when he heard AS patients express reservations about biopsies, a routine fact-of-life for AS patients Serial biopsies, especially transrectal biopsies, as frequently as annually, were the bane of AS patients. Some men rightly were concerned about the risks for deadly sepsis and infection.

As the meeting closed, Rick said something to this effect: “What’s wrong with you AS guys, anyway. Why can’t you put on your big boy pants and get biopsies?”

Fighting words.

I blurted, “So you consider us crybabies?”

I explained that men on AS with low-risk prostate cancer were “climbing a different mountain” and had different concerns than those with more advanced cancer, like Rick.

To my shock, he shut off my microphone.

But to his credit, Rick has learned more about the AS mindset and wrote about my battle against transrectal (transfecal) biopsies that Norwegian researcher Dr. Truls E. Johansen estimates kills 2,000 American men a year—a number denied by many but not all U.S, urologists. (I’ll be writing an update on this soon in The Active Surveillor.)

Still, he needs to stop calling the AS approach “Pre-treatment Active Surveillance.”

When he shut me down, Rick reminded me of my old Hebrew school teacher, Rebbe Harry Venice. He was old school and ran the class like one in the 17th century in Poland. A Canadian, he deliberately left the windows open in the classroom. To keep us awake? Tufts of wiry ,white hair sprouting from his ears shocked us; we little expected that the day would come when we had those marks of older age. He was a strict disciplinarian, who shut down quickly when we felt we were rowdy. He’s say: “Shtok” (שתוק), Shut up. In a way, we loved the cranky old Hebrew school teacher, our own Yiddishe Mr. Chips. We’ll never forget him.

Same with Rebbe Rick, my prostate rabbi.

The column in question

I ran a column by urologic heretic Bert Vorstman, MD, and Ron Piana, co-author of “The Great Prostate Hoax.” This column resulted in a virtual shouting match between Bert and Rick. I was exhausted and tried to switch it off. It was over the top and I tried to shut it down.

(Rick Davis, founder of AnCan—top—vs uro-heretic Dr. Bert Vorstman)

In the end, Rick demanded in an email that I take the column down or the consequences would “not be pretty.”

I have been a journalist for 52 years. And yes, as Rick says, I still have those journalistic instincts. Like telling me to remove a column—not necessarily one I totally agree with—only makes me want to dig in and protect the authors, rally behind the endangered First Amendment and not give into censorship, a growing concern in the media in America in these times.

So in the AnCan Reminder newsletters, Rick criticized my journalistic instincts to print the Vorstman/Piana column, which he fears will confuse patients. I think the reluctant brotherhood can handle this,

Gnarly, dude.

(Gnarly wave.)

I laughed when Rick said: “AnCan loves Howard the way you love that gnarly old uncle who pinches your cheek while sticking a buck in your pocket. He's truly a treasured member of AnCan's Advisory Board, and occasional Active Surveillance Moderator.”

Gnarly is a loaded word that can be used to describe something in a positive or negative way, depending on the context and the specific meaning being used. It can mean "very good," "impressive," or "cool,"—especially in the surfer subculture that is in awe of gnarly waves, but it can also mean "bad,” or "very difficult.”

I’m going with the surfer definition.

Rick, get with it: Beloved Uncle Howard stuffs Alexander Hamiltons and Andrew Jacksons into the fists of his nephews and nieces—inflation you know in the time of tariffs.

Journalistic instincts

Guilty as charged. I do try to share all sides of a story—though these days some view this as evil “bothsideism.” In other words, journos need to define the truth and not include another side that supports an opposing view. I get it. But I like to consider all sides. Call me old school.

Maybe I’m selfish, too. When Vorstman writes for The Active Surveillor, readership doubles and even quadruples.

One of the top patient advocates in the U.S.- told me: “Vorstman? I love that guy. He really tells the urologists what they need to know.”

On the other hand, a top urologist, CEO of a major private-practice group, told me in an email: “Have your urologist prostate cancer heretic put this in his pipe and smoke it. Those of us who take care of men dying horrible deaths from prostate cancer have a totally different perspective and experience than your guy.”

(Note: Rick and AnCan oppose urologists managing advanced cases, like that of former President Biden. Rick said: “Why the heck is a urologist treating him for metastatic disease. Didn't anyone mention a GU med onc should be running his care?” A strong statement from a layman—albeit a well-informed patient. Some experts bristle such Monday morning quarterbacking. But here at The ACtive SUrveillor we’re OK with that.

(Should I not have shared Rick’s position on Biden in this newsletter?)

Rick put it in the Reminder: “Everyone is entitled to an opinion, in fact many of you have heard the expression, ‘Opinions are like a**holes, everyone has one!; And I'll add, some people confuse what comes out of one with what comes out of the other.

”That said, we don't have to provide a soap box for opinions that confuse our core audience, and even discourage them from maintaining best medical practices to address their condition.”

That’s just like your opinion, man, as the Big Lebowski out it. And I support your right to express it.

Please read the article

Ironically, Rick’s critique could draw more people reading the column, “What's The Truth About Prostate Cancer?Is the cure worse than the disease? (Be prepared. Get a snack—the article is long.) Click.

What's The Truth About Prostate Cancer?

Howard Wolinsky

·

May 30

(Editor’s note: Dr. Bert Vorstman and author/investigative reporter Ron Piana like to, as Dr. B. says, “to rattle the cages.” They’ve written three of the top 10 most-read articles that have appeared in The Active Surveillor over the past three years. They’re back again here with this commentary on prostate cancer in the aftermath of the case of Presid…

Read full story

I think Rick was particularly miffed by the subhead, and I understand that. “Is the cure worse than the disease?” Bert and Ron wrote their headlines. I hesitated when I read it, but decided to go with it. I’s a common idiom with literal but also metaphoric meaning.

Rick and I urge readers to share your opinions in an email to me at howard.wolinsky@gmail.com I’ll probably run a follow-up column sharing your opinions—pro and con. I graduated from journalism school in the 1960s at the University of Illinois, at the height of Vietnam War. We learned how public opinion is formed. I was heavily influenced by the idea that conflicting views would be published and eventually the truth will out.

I don’t necessarily agree with everything Vorstman and Piana wrote. They are critical of PSA testing—I think it’s a necessary evil for lack of something better.

The experts say that PSA is the best test they have to screen for prostate cancer.

Best? A leading British urologist noted recently: 15% of men with high-risk cancers have low PSA scores. And 75% of men with a raised PSA score will not have cancer.

Starting in the 1990s, PSA screening caused all kinds of overdiagnosis and overteatment for low-risk patients like me. It also missed advanced cancers. We need better testing.

Vortsman doesn’t like Active Surveillance. He wrote that it just puts lipstick on the pig: “AS seems to acknowledge the fact that most prostate cancers can be outlived and that our treatments are harmful BUT, many men get tired of being hurt during AS, tired of living with a cancer label, tired of scare-tactics, and often want something done to put it behind them.”

I view AS as better than unnecessary, aggressive treatment that too many of us still undergo. I was diagnosed 15 years ago—I started the so-called journey to AS in June 2010 with a rising PSA—and I am convinced if I was starting today, if I saw the right doctors, they would not have diagnosed me. AS is not exactly a free ride, emotionally, financially, or otherwise, but I think it’s better than the alternative. Better testing is needed to help us men with low-risk PCa avoid getting on the AS train to begin with.

Here’s Rick Davis’ take in his Reminder newsletter on the Vorstman/Piana column in The Active Surveillor. Share your opinions.

Spot the Hoax!

" PSA is a barefaced lie as the PSA is not specific for the prostate or for prostate cancer "

" most published medical research is false and healthcare is largely financially driven"

"...messaging by prostate cancer support groups and foundations lacks all credibility because they receive significant sponsorship and support from Big Tech and those in the business of prostate cancer."

When Bert Vorstman MD chose the byline Is the cure worse than the disease? in his recent The Active Surveillor article discussing his perceived truth about prostate cancer, it raised a huge red flag for us at AnCan. If you live with anything more than Gleason 3+3 disease, there is no cure. And doctors who speak about cure will invariably backtrack and agree that they should be speaking about a durable and continuing remission, a phrase coined by the late Dr. Snuffy Myers.

Vorstman is correct in saying that PSA is not specific to the prostate gland - the salivary glands produce it too, but it's no 'barefaced lie' and raises another red flag - that further tests are needed to find out why PSA is elevated.

I am loathe to use the title Dr. when this MD claims that most published medical evidence is false. I can't pretend to imagine the standard of his medical education in New Zealnd. But I can agree with Vorstman and his Ablin sidekick, Ron Piana, that some 3+3 prostate cancer should not be named cancer and calls for surveillance rather than surgery or radiation.

That's about all we do agree on. Both fail to appreciate AnCan's position that the PSA test is about information, not treatment. So discouraging PSA testing throws the baby out with the bathwater. Where are we supposed to source this headsup information elsewhere? Despite repeated request in the comments, that I urge you to read, nothing is suggested.

I had a PCP who didn't believe in PSA testing. My PSA leapt from 2 to 10 in 2 years and had it not been for my uroogist, who I was seeing for a kidney cyst, I would now be the wrong side of the grass with no AnCan. There are many, many men like me - ask the minions of de novo metastatic men showing up in our support group weekly.
Is the cure worse than the disease? is ignorant. It patently fails to acknowledge that many men with prostate cancer require treatment to avoid a prolonged and painful death.

You decide if AnCan provides a distorted message and if the prostate cancer world is one big, distorted financial scheme. Is that 'The Great Prostate Hoax' (Ablin & Piana) or are they the hoaxsters?

What concerns us equally at AnCan is how The Active Surveillor can publish this nonsense, followed only days later by this headline "Don’t miss your PSA screening—your life may depend upon it".

Everyone is entitled to an opinion, in fact many of you have heard the expression, "Opinions are like a**holes, everyone has one!" And I'll add, some people confuse what comes out of one with what comes out of the other.

That said, we don't have to provide a soap box for opinions that confuse our core audience, and even discourage them from maintaining best medical practices to address their condition. Howard Wolinsky publishes The Active Surveillor - AnCan loves Howard the way you love that gnarly old uncle who pinches your cheek while sticking a buck in your pocket. He's truly a treasured member of AnCan's Advisory Board, and occasional Active Surveillance Moderator.

Raising this post in various AnCan Groups has educated me to understand that Howard's journalist instinct encourages him to publish all sides of an issue. AnCan's postion is that anything discouraging men from PSA testing inhibits efforts to fight prostate cancer. We are not just critical of HW; we suggest it seriously questions his credibility when he then encourages men to get tested a coupleof days later. What to believe? Don't be an enabler.
What do you think? In the Vorstman/Piana post, Howard encorages you to let him know - please do!howard.wolinsky@gmail.com

ESPN’s Jay Harris set for prostate surgery

By Howard Wolinsky

ESPN "SportsCenter" anchor Jay Harris told Good Morning America on Thursday that he is undergoing a radical prostatectomy on June 10."

ESPN's Jay Harris speaks with Michael Strahan on "Good Morning America" on June 5, 2025. (ABC News)

"My doctor is quite optimistic," Harris said. "Per my last scan, nothing has spread, so once we take out the prostate, hopefully that will be it. That's the goal."

He said he will be off air for about a month as he recovers.

Harris said his father and other relatives have had PCa.

Last year, then-ESPN NBA Insider Adrian “Woj” Wojnarowski shared his story of being on Active Surveillance for low-risk prostate cancer. It was a rare case where a high-profile patient revealing he is on AS.

Breaking news! Former ESPN star reporter 'Woj' reveals he has low-risk prostate cancer

December 5, 2024

By Howard Wolinsky

Read full story

ASPI webinar June 28: Cracking the Code on Pathology Reports—Helping Patients Navigate Medicalese to Get Better Health Results

Most patients have a hard time deciphering pathology reports they get after prostate biopsies. At the same time, many are puzzled with their Gleason score.

Cathryn J. Lapedis, MD, MPH, a Clinical Assistant Professor of Pathology at Michigan Medicine in Ann Arbor, has found in her research that patient-centered reports can help patients understand the reports.

She will be the featured speaker at the ASPI webinar from noon to 1:30 p.m. on Saturday, June 28.

Please register for the meeting here.

Lapedis was the lead author of a recent study in JAMA that found a 93% comprehension of patient-centered pathology reports compared with 39% of those who read a report from the University of Michigan and 56% reading a pathology report from the Veterans Administration.

She also looked at how these patients interpreted Gleason scores: 84% reading specially prepared patient-centric reports understood their scores vs 48% for the university group and 40% for the VA group.

She has fellowship training in medical renal and gastrointestinal pathology. Her research centers on rethinking the way pathology results are communicated to patients and the healthcare system. She completed an in-depth analysis of key stakeholders’ attitudes towards patient-pathologist interactions, and is currently piloting early interventions in patient-centered pathology communications.

Please send questions in advance to: contactus@aspatients.org

PCa doesn’t stop this marathoner

By Howard Wolinsky

We hear that exercise is great in slowing and preventing prostate cancer. Is more better?

A British runner has taken marathons to heart.

Cornwall dentist Mark Maidwell-Smith, 67, finished the Tokyo marathon, fulfilling his ambition of achieving the 6 Star World Marathon Majors award.

Maidwell-Smith won this honor despite being diagnosed with prostate cancer.

The honor requires runners to complete marathons in London, Berlin, Tokyo, New York, Boston, and Chicago.

"Running is something I’ve always loved and while I’ve proved to myself that I can do it whilst living with prostate cancer, I do wish I’d got checked sooner."

The university dental clinic teacher is now using his experience to motivate men to get checked for the condition.

He said: "As well as promoting to the public, I’m a dentist and teach at the University of Plymouth’s dental clinic in Truro and I am really keen to share with students the value of work/life balance.