Jumat, 23 Desember 2016

como se produce el cancer de colon

como se produce cancer de colon

como se produce el cancer de colon


i have a very special son and wish the best for him. one day he told me he had decided to become a catholic and to join opus dei. he had come acrossthe message of st josemarã­a i’m not catholic. who is st josemarã­a? i approached the tabernacle,

knelt down, and said: lord, if you don’t need my honour,what do i want it for? for you to offer god your ordinary work in a way that’s pleasing to him,do it better each day, with a more upright intention,with greater effort and affection, thinking not only of yourselfand your loved ones, but of the whole of society,of other people. you say it’s difficult, but i know it’s what youare doing since you have a big heart.

st josemarã­a escrivã¡ said: “many great things depend— don’t forget it — on whether you and i live our lives as god wants.” these are important words,they make you think. one could say that he was the saint of ordinary life how can we live if we are not in love? otherwise i don’t understand it.

i live because i’m in love. if not, life wouldn’t be worth living. i’m crazy. i’ve been called crazy more than once and i don’t care at all.they’re right. i agree with those who say i’m crazy. so: i want you to be crazy with love. my son started to change after becoming a member of opus dei.

the first change was that he tookan interest in others and was a lot more cheerful than before. we cannot live without love. you all have deep desires to do great thingsand to put your heart in those things. when i was at school, i used to think thatwe could change things by joining a group of people,people of my sort of age, who were politically active,extreme left-wing, and the methods to use

were organising marches, fighting the police, throwing stones,setting fire to cars, and sorting things out above all by violence,by bashing others, the law of the strongest. then i happened to watch a film of st josemarã­a escrivã¡,the founder of opus dei. it was in spanish.i don’t speak spanish. i didn’t understanda word he said – not a word.

but at the end of the film, miraculously, everything became clear. i was seeing beneath that cassock a heart which made him fly up to the heights, and i understood that my lifeto put it bluntly had been that of a farmyard animal. with open arms to embrace everyone: those on the right, those on the left,those in front and those behind. everyone, absolutely everyone!

we cannot close our arms to anyone. we cannot be wedded to one party. we cannot talk in terms of warring factions – warring is anti-christian. nor of disputes. we talk about getting on with one another. we talk about exchanging viewsso as to come to an agreement. but… fighting? hating one another? no! for me, the message of st josemarã­a

is something that unitesbecause it brings together people who can havethe most diverse ways of thinking but share one fundamental idea, which isconcern for the good of neighbour, and, building on that, one thing,which st josemarã­a always proclaimed: to serve our neighbour. god asks us to practisethe virtue of charity and so we love each other for the loveof jesus christ, for the love of the church, for the love of all people.we want to do good to everyone. we are not a little closed group:

we are open to all. i went towards the electricity generator and a flame burst out into my face and sent me flying several metres. my daughter got hold of me and took medirectly to the monkole hospital. i found a priest there who gave me some bookletson the life of st josemarã­a, and i began to see that the people therepractised that spirit of order, discipline and sanctity,the spirit that gave them

the strength with whichthey ran the institution. put your heart there and you will softenthe life of many people who are alone, helpless, who never receive an affectionate word,or a smile, or a loving glance. your heart! my son and i have always got on very well. when he joined opus dei, he opened his heart to god and that had an influenceon our communication.

now we are more united in the sense that we can feelthe love at all times. because we want peace,peace in the world, peace in our own country,peace in the family, peace with our conscience…we take up the struggle. peace is a consequence of war. i am always preaching the same thing. and when we have peace, we have joy, which is a christian gift.

we are here on earth for a reason, for something which is not our selfishness. it’s to live for our future happiness, being happy already down here. our aim is to have someone in each village, in each community, someone who is a good sonor daughter of god, someone committed, who encourages initiatives,both material and spiritual.

we had to be trained, educated. what for? to help themget a higher standard of living and place education at the heart of developmentin the face of poverty. you need to get people to do things: not just give them things,not just tell them things, but help them to do things themselves.

we need to go out and give such training to that group of people,because it’s not just one person, but each village,it’s 35 or 50 people, and then your workhas a multiplier effect, because it doesn’t just affectone person but many. and who should we thank for that? st josemarã­a. you shouldn’t look at a person from just one point of view, but overall, as a whole,

and the message of st josemarã­a allows me to put all my resources, both human and spiritual, at the service of others. this message allows one to use all worthy means for dealingwith the control of hiv. so that’s the joy i have: to see many souls all round the world, of all races, of all tongues,

who feel like you, who look with clean eyes, who know how to forgive, how to excuse others,how to live together with everyone. i had an idea of politicsas an exercise of power, but after i met josemarã­a i learnt that, right from the start, work is meant to be sanctified, and that politics should aim at the proper redistributionof the benefits of work.

the great michelangelo used to say: “i am still learning,” and i had that phrase put up in my own studio to remind me of this idea of continuingto grow in formation and in research. i found the same sentiment in st josemarã­a, that although we are very small, nevertheless with the help of god and our own humility

we can do great things,just as michelangelo succeeded in doing. you will look after all the detailsfor the sake of love. it’s wonderful that the simplestand most beautiful message that st josemarã­a gave us was that we could find beautyand therefore god, in little things. it’s mind-blowing – it’s like giving a nameto this search of mine, which is the longing for god which everyone has within them.

because in opus dei any kind of work can be sanctified. any honest work can be sanctifiable and sanctified and a means of sanctity. it’s the same whether it’s manual workor intellectual work. it’s the same! the work with greatest value is the onecarried out with the greatest love. do things with a lot of love and your workwill be of greater value than anyone else’s.

it’s a message that gives meaning to our life. think: why are we working all the time and why are we trying to improveall the time? for ourselves?that seems pretty empty to me. you will lose your motivation after a month,or even after a week. if you do it for love,it lasts your whole life… when my son joined opus dei,many people were surprised because they thought it was an organisation

full of rules; but my son followed his wayby listening to his heart. god is in our daily life. in our moments of each day, today, tomorrow, yesterday,the day before, and the day after tomorrow. he is in our lunch and our dinner. in our conversations and our tears and our smiles. he is in everything. god is a father.

if we want to go to him,we can find him at any moment. he is so close to you that he is within you, giving supernatural life, height, colour and taste, interest and joy, to your life. god is there. i want to be a son of god,i want to talk to god, i want to act as a man who knows he has an eternal destiny,

and besides… spend his lifedoing as much good as he can: understanding others, excusing them,forgiving them, getting on with them. were i to get discouraged at the outset,i couldn’t encourage them to keep going on. the strength i have comes preciselyfrom the teachings of st josemarã­a, and with this effort which we shouldalways put into our work to accompany people – all of that gives me a bit of a boost. but sometimes people are already at worn outby the difficulties we are facing in our country. despite that i alwaysencourage them, telling them

that even if they don’t understandthese things we’re undergoing, it’s all going to work out well,that we are children of god, that we always have to fight to carry onand we will win through in the end. ever since my son joined opus dei, my conversations with him have made me think about the meaning of life. i think that the teachings of the church

enriched my life making it possibleto understand the great questions life poses. questions which we oftendon’t have good answers to, like the meaning of life. if you call on an individual heart, if you knock hard at an individual heart, it sometimes sounds hard,but that’s because it’s made of bronze, a heart of bronze which melts into tearsif placed close to the fire. many people are confused

about st josemarã­a’s idea of suffering. i am open to understanding the true meaning of suffering. god is not an abstract idea. he is not a far-off being. he is better than a good mother. he does not rejoice in our misfortune but in our good. when you take a knifeout of the hands of your

little child, or some matcheshe is playing with, because you’re afraid he’ll hurt himself, and the little child complains, he complains becauseyou’re treating him badly, taking away his toy. we have a vision basedon this world, and therefore we only see the tapestry from behind, where it’s all full of knots. and we don’t understand

that happiness comes later, that this passes away,like water through our fingers. all this is very short. “tempus breve est”says the holy spirit, the time for loving is very short. i’ve been through a long illness, a cancer of the colon – it’s in the difficult moments when your neighbour,

that “other person” or your spouseor your friend show the love they have for you, that is, by helping you or giving you some simple advice or coming to provide you with something you lack, it’s then that i think that love truly shows itself in times of suffering. tell them

that god in heaven is their father, and that the time for loving is short, that they should show their love here and that love is shown in suffering. i’ve been greatly helped by being able to offer this suffering for my husband’s conversion. today i’m happy because he understandsand sometimes he wakes me up and tells me it’s time for the rosaryand usually we pray it.

i’m filled with admiration to see you all, everywhere in the world. people have kicked awaythe lord’s teaching and his seed. it’s been kicked everywhere,to all lands and races, and everywhere it has taken root. so yes, i am filled with admiration.it seems i am looking at – how shall i put it? –a wonderful, charming film, full of bright colours. nothing is lost. i have to do better

where i am, with the little that i have. what i have learnt from st josemarã­a is to aim high, and to say, “think how it depends on you, leave a mark, don’t let your lifebe a barren one, you can change the rules of the game, either on your own or together with othersbut you first of all.” sow peace and joy everywhere. don’t say a hurtful word to anyone.

go arm in arm with those who think differently from you. never mistreat anyone. be brothers and sisters of everyone, sowers of peace and joy. i am very grateful to god because my faith gives meaningto everything i do in my life, because it gives me joy and peace, and because i can pass it on to others.

as a mother i can see, hear and feel that my son is happy. happy in his lifeand happy in his choice. and that’s whyi am happy with his choice.

como se produce cancer de colon

Mesoth.net - the united mexican states or mexicois located in southern north america. its capital is mexico city, which is one of the largest citieson earth. mexico is the 6th largest countryin the americas and the 15th largest in the world. it has a population ofabout 106 million, and, therefore, isthe 11th most populous country. this beautiful country hasmany listings as unesco world heritage sites,both cultural and natural.
as cultural listings mexico boasts: the ancient maya city of calakmul,el-tajin – a pre-hispanic city and the rock paintings ofthe sierra de san francisco; to name but a few. natural unesco listings include: the islands and protected areasof the gulf of california and the whale sanctuaryof el vizcaino. for almost three thousand years, mexico was the site of severaladvanced amerindian civilizations –
the mesoamerican cultures – such as the olmec,the maya and the aztecs. today, mexico hosts a wealthof unique cultures; every region hostsa distinct culture and language. in recent years, mexico has become more proactive in its efforts toprotect the environment including the urgent issue ofglobal warming. in 2008, mexico was lauded bya world bank’s report,
“less carbon: latin america faced withthe challenge of climate change,” for its nationalclimate change strategy to reduce millions of tonsof carbon emissions. to inform the public aboutthe gravity of global warming and its solutions, government officialsof the state of veracruz had hosted severalclimate change conferences in which supreme master ching haiwas invited as
the special guest of honor. during these conferences, supreme master ching haigraciously shared her insight and the message of the singlemost effective and immediate solution to mitigate global warming –the vegan diet. we now invite you to join us forpart 1 of the videoconference with supreme master ching hai titled “sos – a quick actionto stop global warming” on november 16, 2009,in orizaba, veracruz, mexico.
sos - a quick actionto stop global warming november 16, 2009orizaba, veracruz, mexico part i good afternoon, esteemed leaders,distinguished guests, supportive viewers ofsupreme master television and friends. a heartfelt welcometo our conference on climate change entitled here in orizaba, veracruz, mexico. we feel very encouraged
and truly appreciateyour participation today. this conference is beingbroadcast worldwide, live, on supreme master television via14 satellite platforms, iptv, as well as internet on in addition, it is being airedon live radio in mexico, on xetq – 850 amorizaba veracruz; xeov – 1240 am orizaba; xhpg fm cordoba; xedz - 580 am cã³rdoba, veracruz;
and radio orizaba s.a. orizaba means“region of the high mountains.” with the magnificentcitlaltã©petl mountain – the highest in mexico – and the health-sustainingmineral springs nearby, we are humbled and ever grateful for how much god has indeed lovedand blessed beautiful mexico. to begin, we have some good newsto share with you about some major stepsthe mexican government
has been taking to protectthis precious country. in the face of the most seriousdrought in 69 years, in october 2009, his excellency presidentfelipe calderã³n inaugurated a nearly us$20 millioncampaign entitled “water is like your family,protect it!” all mexican citizens are beingencouraged to take special care to preservethis precious resource. in fact, president calderã³n isvery committed to
taking action to curb global warming. his excellency has pledged todecrease greenhouse gas emissions by 50 million tons per year until 2012. also, in april of 2009, the “u.s.-mexico bilateral frameworkon clean energy and climate change” was released. this document outlinesthe collaboration between mexico and the usain the areas of sustainable energy, protection of forests,low carbon energy technology,
and more. this shows that mexicois seriously searching for solutions to safeguard our world and is willing totake the necessary action. the state of veracruz, so rich in natural beautyand resources, is at the forefront of the effortsto protect the environment. a vivid sign of this commitment isthe presence of a number of mayors from citiesthroughout the state,
and we would like to extenda warm welcome to them today and introduce themto our local and global audience. first, our host city of orizaba,honorable juan manuel diaz francos. we would now like to recognizethe honorable nelson votte ramos, mayor of ixczoquitlan, whose development projects benefitmany people in the community. the honorable angel sanchez rincon,mayor of fortin de las flores, has been very active in providingthe necessary help to regions affectedby recent heavy rains.
the honorable juan antoniolevin torres, mayor of cordoba; his efforts in improving educationhave helped many students to continue their studies. the honorable luis flores trujillo,mayor of zongolica. mayor trujillo has undertaken the taskto meet the needs of citizens who have just moved to the city. the honorable octavio misaellorenzo morales, mayor of atzacan; the honorable raul vera aguilar,mayor of rio blanco; the honorable dulce mariaromero aquino,
mayor of camerino, z. mendoza. mayor romero aquinohas been very active in improving literacy in her city. the honorable miguel romero retana,mayor of nogales. similar to mayor romero aquino, improving the citizens’ literacyand enhancing the education system is one of his priorities. we are also very pleased to welcome the honorable fidel kuri grajales,federal deputy of the 15th district;
the honorable alfonso torrez gonzales,mayor of mariano escobedo. we are very honored tohave the presence of distinguished guests such asdr. eva campos solano, head of the sanitary jurisdictionof orizaba; ms. lucina chua gonzales, general secretary of the unionof workers of orizaba; dr. emilio filly de bernardi,director of the association of friends and neighborsof the environment; the honorable edgar cury grajales,syndicate of the city council;
and mr. cuahutemoc alfaro bustos,technical secretary of the union of workers ofthe social insurance. thank you all dignitariesand participants for your very much valued attendanceat this conference. we have come togetherto find the most effective way to save our planet,as time is running out. according to experts, global warming is happening ata much faster rate than earlier scientific predictions.
important findings such as thatreleased by the worldwatch institute tell us that the livestock industryis responsible for over 50% ofgreenhouse gas emissions. and this is thought to bea conservative estimate, and reports withnewly discovered facts are constantly increasingthis percentage. thus, the fastest way to reducegreenhouse gas emissions is to stop its # 1 source:livestock breeding. besides her natural beauty,
mexico is also the cradle ofa number of glorious civilizations. we know that among thesesplendid cultures of the past, the mayans faced declinebecause of over-exploitation of natural resources. today, even as we reach the end ofthe mayan calendar, humanity facesenvironmental catastrophes that the mayans predicted. species are disappearing every day, the dead zones in our oceansare increasing in size,
and the latest swine flu epidemicis spreading quickly. today’s environmental crisis isno longer the problem of any one culture or country. ladies and gentlemen, let us watch this short videoon climate change, which addresses the urgencyof our current situation and proposes a practical solution. global unitytogether in saving lives fungi were the first organismsthat came to land.
1.3 billion years ago, fungi marched onto landfrom the oceans; plants followed severalhundred million years later. they were the gateway speciesand they led the way, and in the trail of myceliumthat they created, plant and animal communities thenmarched forward upon the mantel of mycelium. every day up to 270 speciesare erased from existence. one-third of all animal specieshave been lost since the 1970s.
it is our behavior thatcaused so much the loss of our planetary species;scientists have proved it. so we all know that fishing, hunting,polluting the environment are the causes of global warming and the decrease of animalson the planet. and many of the advicesto stop often have gone unheeded. and it's a pity. we should protect the speciesbecause when we protect them, we protect the ecology;
and the ecology links with our health, the health of the planetand the people. according tothe world health organization, the 2009 swine flu pandemic isthe fastest ever spreading pandemic in history, with millions todaylikely to be infected. canadian agencies have seena 99% correlation between the number ofpig factory farms and the total number of humanswine flu cases per province. when we cram tens ofthousands of animals
in these cramped, filthyfootball-field-size sheds to lie snout to snouton top of their own waste, it's just a breeding groundfor disease. pig and other animal factory farms also create antibiotic resistantbacteria. in the us, where 70% of all antibiotics are fedto farm animals, bacterial infections claim18,000 human lives each year, which is more than all the aidsfatalities in the country.
ocean dead zones are increasing. satellite data from a recent studypublished in the journal,geophysical research letters, showed that barren zonesin the world’s oceans increased in one decade byaround 5 million square kilometers – an area equivalent to abouthalf the size of the united states. these so-called “ocean deserts”appear very dark as they lack green chlorophyllfrom plankton. as with their land counterparts,
the deserts are also hotterthan the surrounding areas. animal agriculture is largelyresponsible for these regions that support no life, as fertilizers and manuremake their way to the oceans,ultimately robbing it of oxygen and killing marine animals and plantsin increasingly larger areas. since people found outabout this talk that i was going to give here today, i’ve received a number of emailsfrom people that i respect saying
that the 18% figure isan underestimate; it’s a low estimate,and, in actual fact, it’s much higher. i had some information just recentlythat the new figures now indicate that at least halfof the greenhouse gases that are up there now –not that 15 or 20%, at least half, and maybeconsiderably more, are due to livestock production. greenhouse gases are emittedduring virtually every step ofthe meat producing process.
of the three major greenhouse gases – carbon dioxide, methane,and nitrous oxide – methane is up to 72 timesmore potent than co2, while nitrous oxide isup to 300 times more potent. sure, we have to dealwith co2 in the long run, but if you want to makean impact on climate in the next 20 years, the place to do it is withthe shorter-lived greenhouse gases, most important of which is methane.
we have a criticalenvironmental crisis now happening with effects thatwe’re seeing around the world, and if we want to addressthe warming we’re seeing now, the best bang for our buck comes inaddressing the other gases, mostly methane, and its #1 source –animal agriculture. the migrating birds have tofly farther and farther to find a place to nest, and the polar bears swimlonger and longer now – because there is no more ice –
until sometimes they drownof exhaustion, or why the neighboring country hasso many floods in recent years, so many disasters, etc. tell them how climate changeis affecting real lives, real animals, real people,and their own lives as well. but it’s also importantto show the young people that there is still hope; we can still save the planet. it’s a chance to be true heroesby being vegan,
and spread the news of this solution. together we can save lives. as we have seen from this video, a shift to a vegan diet isthe solution that makes the most senseto halt global warming. by promptly switching toa plant-based lifestyle, we will greatly reducegreenhouse gas emissions, especially methane, and restore the much needed balanceto the earth.
we are so blessed that there is still time left tosave our planet, and the solution, as presented bysupreme master ching hai and many respected scientists,is so clear and logical. now, we would like to introduceour first guest speaker, the honorable mayorjuan manuel diaz francos of the city of orizaba, who has prepared in advancea video speech for us that highlights the importancegiven to the ecology
in this progressive city. i am juan manuel dã­az francos,mayor of orizaba, veracruz, republic of mexico. our city is the birthplaceof soccer in the nation. it was the first to have a golf courseand is where the first hydroelectric power plantswere installed in the country. it is a city full of history, yet cognizant that progress needsto be sustainable. that’s why i send you this message.
maybe you are watching thisand thinking: “it is nature.” maybe when you hear ofglobal warming, you think of science fiction movies, environmentalists, radical groups,or even worse, that the reality of it ismany years away. you might continue to be wrong. this is our planet! many scientists warn ofgreat natural disasters caused by rising temperatureson our planet:
floods, famine, droughts,frost, epidemics. these will be frequentin many countries. how serious is it? very serious. but the worst thing of all isthat we ourselves are contributing tothe warming of our habitat: by using fossil fuelsand allowing industrial contamination and the destruction of forestsand wetlands. it is thought thatif temperatures continue to rise,
global warming will take placedisproportionately. it will be less in coastal areas,where the sea cools the land, and worse inland wherethe sun will burn with full force. sometimes reality isworse than fiction. our destiny will catch up with us. contaminated water will be of no useto human beings. let’s avoid future wars being foughtover water and food. we need to reversethe negative impacts on our ecosystems caused bythe lack of awareness
and of environmental educationand culture. we are using up our planet,this wonderful world which has given us so much. there is still time, but we need to changeour way of thinking and start taking action right now. in orizaba, we have much moregarbage now than in the past. it is a constant struggleto maintain a clean city. and there are many more problemsjust like this one.
future generations needto know the importance of protecting green zones,the water, and all the ecosystems. welcome, and smile.you’re in orizaba. our many thanks, honorable mayorjuan manuel dã­az francos, for your insightful message, for your example as well asfor hosting this event in orizaba. dr. rajendra pachauri, the chairman of the intergovernmentalpanel on climate change
is our next speaker. his meticulous work with hundreds ofscientists from around the world in preparing scientific reportson climate change earned him and his panel colleaguesthe nobel peace prize. dr. pachauri has long advocatedto reduce meat consumption to halt climate change. dr. pachauri has sent us his messageand supporting wishes. let’s take a look. let me start by first saluting youand greeting you on this occasion.
i am delighted that this major conference is being heldin mexico. mexico is a remarkable country: you not only have rich traditionand culture but you also have human valuesthat really can show the way for the rest of humanity. i would like to highlight the serious problem ofclimate change because this is not merely an increasein temperatures
as the erroneous use of the term“global warming” seems to suggest. what climate change represents is a complete disruption ofthe climate system, as a result of which we are seeingmuch higher frequency, intensity, and duration of floods,droughts, heat waves,and extreme precipitation events. and what is terribly tragic isthe fact that the worst impactsof climate change will be felt by some ofthe poorest communities on earth.
and we also have to be concernedabout intergenerational equity. some of us who have leda rich and full life are obviously leaving a planetthat is going to make it very difficultfor future generations and those that are yet to come,even beyond the next generation, to meet their own needs. i would like to remind you that the definition ofsustainable development, as brought out bythe brundtland commission report,
is very simple but it goes tothe heart of the values that we should be exercising tomeet the threat of climate change. sustainable development,as the commission said, is that form of development whichhelps us to meet our own needs without compromising on the abilityof future generations now, if we are going tocreate conditions by which the climate of this planetis going to get much worse, much more unpredictable,much more erratic, then obviously we are goingto make it very difficult
for future generationsto lead sustainable lives and to be able to promotesustainable livelihoods. so, i think there is urgencyin bringing about change. we have to reduce drasticallyand urgently the emissions of greenhouse gases. now, one means by whichwe can do that substantially is through changesin lifestyles. and the question you could ask is: what changes in lifestyles?
well, we certainly have to use energymuch more efficiently in everything that we do but we must also look atour eating habits. we have become much too addictedto excessive consumption of meat and animal proteins, and we have to move away from that. now, i know i’m talking to youin a location which produces a lot of livestock. livestock and the meansby which it is used for
satisfying the demand ofhuman society is clearly one major sourceof emissions. there are varying estimates. the fao brought outa report where it said that about 18% ofthe total emissions of greenhouse gases comefrom the livestock cycle. but if you look at whatthey have done clearly, there are some elements thathave been left out of that estimate. other estimates indicatea much higher percentage of emissions
from this source. however, what i’d liketo submit is what i have been saying in various partsof the world: if you eat less meat, you would be healthierand so would the planet. according to several sources,it is also one means by which human health is impairedand affected seriously. so, please keep this in mind. we owe it to ourselves.
we owe it to the future ofevery living species and, unless we bring abouta radical change, which i can assure you, as someone who turnedto vegetarianism several years ago, you will feel much better, and future generations will feelvery good about you. thank you very much. thank you so much, dr. pachauri, for being a true leaderthrough your shining example
and your wise advice. your suggestions are much valued. we now have a messagefrom ms. eva quistorp, a dedicated political activistand prominent figure of the europeanenvironmental movement for almost four decades. over the years, she has initiatedmany local and global campaigns, and has beenthe co-founder/co-organizer of civic and political organizationssuch as the german green party,
women for peace, european nuclear disarmament, the global commission to fund the un, the ecological marshall planand the climate action network. ms. quistorp is a successful author and co-author of more than15 publications. let’s watch her message now. good day! i will give my greetings
to all the participantsof the conference in veracruz. i hope you’ll be a big forceand a loud, non-violent, creative voicefor copenhagen to say, besides our changesin energy politics, to go out of nuclear energyto reduce oil consumption, to make energy savings tochange the world in the direction of solar energy. we can change our lifeby relating to regional products, ecological farming,
and by relating toour regional products – which are not brought inby airplanes or big ships – and enjoy ecological food. vegetarian ecological food isa gift of god and it tastes wonderful. it’s delicious. and if you do it in good communities, so if you share,it’s not just not eating meat, it’s creating and re-establishinga culture,
which is a spiritual culture, that we are thankful to good water, that we are thankful to good fruits, that we are thankful togood vegetables, and that we share it togetherwith prayers, with music and getting quiet within ourselves,and then the good fruits and the good vegetablescan heal our souls and give us strength for life. we have to think abouthow we enter the global media,
that there is not bad advertisement, especially for little children, so that they do not get addictedto meat; that we have to teach the schools,the teachers and the parents and maybe make counselingfor schools; that children and teachers learnhow to cook good vegetarian food so that they can see to give up meat or to consume less meat can beenjoyable and a good life. and then we should not leave the taskonly to governments.
we as consumers,we as voters, we as citizens, we as spiritual and human beingscan do a lot. worldwatch institute said nowpart of the greenhouse gases is the eating of meatand the production of meat, which is using too much water, too. and we have water problems; we have desertification problems; we have food and hunger problemsin the world besides climate change. so, to reduce the use of meatand even not to eat meat
but to be clear vegetarians and to lead a spiritual lifewith meditation and with a spirit of non-violencecan be very important in the fight against climate changeand for a more peaceful world, which i hope my dear miss ching haiwill include women’s rights, too, and will give back dignity,especially to older women who try to save the earth. our many thanks, ms. eva quistorp, for your kind greetingsand valuable remarks.
we have our second guest speaker, the honorablemr. alonso domã­nguez ferrã¡ez, general coordinator of the environmentof the state of veracruz. he will join us here inthe lovely city of orizaba at this momentous event, to discuss the ecological problems that society and the whole world facetoday. he has worked tirelesslyto generate new green projects centering around better managementof waste materials
and improved care ofthe vast natural areas, the air and the water sources that provide life and abundanceto the various regions of this state. please welcomemr. domã­nguez ferrã¡ez with a warm round of applause. good afternoon and welcometo all of you. i’d like to respectfully greetmaster ching hai, and send her our sincere recognition and thank her for sharingher important message with us
through this important technologythat allows us to bring two distant regions of the planetclose together, and to tell master ching haithat, in this auditorium, we have important citizens whohave come as representatives from a range of publicand private organizations, as well as academicand research institutions, the media,non-governmental organizations and civic associationsand not-for-profits. but most of all,here in the auditorium,
we have parents, housewives,students, youths and children who wish and care fora healthier environment, clean and eco-friendly surroundings; an environmentally healthy city,region, nation and planet. we have all heard aboutclimate change and not only that,we have begun to experience its devastation: such as floodingin the state coastal regions in the last years; or extreme storms that causedthe balastrera river to overflow;
the melting of our belovedpico de orizaba glaciers, and in the future, who knows how many moresuch phenomena and tragedies. this is one of the greatest challengesthat human beings have ever faced. the fact that we have emitted 350 parts per million ofcarbon dioxide in the atmosphere, along with the immense amount ofmethane and other greenhouse gases, is seen as a threat forhumanity’s current lifestyle. it is a great challenge
because it means a changeof mentality in which there is an appreciationof satisfying needs that do not go beyond basic necessities;perhaps, the best thing could be to pursue that religious maxim of seeking happinessby means that go beyond the material. but, returning to our earthly problem, this change of mentality awayfrom consumerism that has become so popularwould bring, along with a lessening in materialsand energy consumption,
an increase not onlyin environmental quality but also in the chances of survivalfor the human race. unfortunately, the simplistic visionof some economists who imposethe developed world’s rules has linked the reduction of materialsand energy consumption with a decrease inthe gross domestic product and consequently a decline in progressand well-being for human beings. nonetheless, an ecologicalor environmental view of the economy allows us todiscard this pseudo-theory
of traditional economy that reducingmaterial and energy consumption means a decrease in well-being. in the first place,humankind’s well-being is not necessarily connectedto an economic measure such as gross domestic product. secondly, to speak of reducingmaterial and energy consumption implies, in physicaland ecological terms, an increasein the system’s efficiency. however, the challenge is not only
to reduce materialand energy consumption, but also to changethe source of energy on whicheconomic production depends, switching from fossil fuelsto renewable energies or those based on solar energy. this challenge entailsa technological change that is comparable tothe discovery of fire in the history of humankind. many people have found objectionsto these technological changes
from technical as well aseconomic points of view; these same people and all of us muststand up as environmental leaders, responsible today for the well-beingof future inhabitants. those are the challenges thatimpel us to fight climate change. as we can see, some of themare strategic and can only be promotedfrom relevant positions. however, there are others that have to be undertaken withpersonal and local actions, such as changing the mentality of consumerism
and wasting energy, food and material. i invite all of you to begin to act: let’s change our consumption habits, our way of eating, buyingand way of life for a lifestyle that helps us winour battle against climate change. finally, i would like tohighlight that this city, orizaba, is a blessed landbecause of features that make her unique such asher two kinds of forests, the cloud forestand the high mountain forest;
surrounded by beautiful green hills, with an abundance of waterand an enviable climate; but most of all for her people,such as those who have come today, people who are committedto her well-being, who try to send the message of respectfor our environment at every possible chance, people who are awareand know that today, more than ever, we have to take the initiativeand act. listen to our children
and protect their forests,their basins, their rivers, their lakes, their jungles,their mountains, their oceans, and each ofthe different ecosystems that makes up this marvelous planet on which the miracle of lifeis possible, so that tomorrow, if we do it well, nature and mother earth will reward uswith more life, more biodiversity. and if we do not, our children and their childrenwill reproach us.
maintain your car,separate your trash, take care of the water, save energy, don’t waste,plant trees! our sincere thanks, the honorablemr. alonso domã­nguez ferrã¡ez. we appreciate your deep concernwith the urgent issue of the global warming situation. our next video message is fromthe honorable andrew bartlett, one of the most sincere politiciansin australia.
a former senator, mr. bartlettrecently announced his return to the australian political sceneas the green candidate for the federal seat of brisbane, a move applauded by many citizens. mr. bartlett is a veganand an animal rights activist. let’s watch his message now. hallo, my name is andrew bartlett. i’d like to welcome you to the climate changeinternational conference,
the theme of “sos – quick actionsto stop global warming,” those who gathered in mexico toexamine issues of climate change, and to explore what wayswe can all make a difference. there’s a wide range of changesthat need to happen. all of us will need to changeour lifestyles, particularly those of usfrom wealthier countries. one of the quickest things we can do, removing meat and dairy productsfrom our diet or even eating less of those products,
makes an immediate benefitto the environment and particularly in regards togreenhouse emissions. but changing our dietsdoesn’t cost anything, doesn’t need any new technology and will not cause any problemsin regards to overall loss of jobs. it’s a quick, easyand very effective way to reduce the dangers ofclimate change as quickly as possible, because methane from livestock isa highly potent greenhouse gas; but it’s also one that dissipatesmuch more quickly
than carbon dioxide. the less meat, the less dairy productsyou consume and others consume, those things do make a difference, and each time an extra personadds that message to the wider global community, then the more people will realizehow important it is and the more people will realize that they too can makea very immediate difference, reducing the dangersof climate change,
reducing unnecessaryanimal suffering, reducing the impacts onthe environment. during my time in parliamentand in politics, more broadly, one of the crucial lessonsi learned is that every individual personcan make a difference. encourage others to speak out,whether it’s letters to the editor, comments on websites,ringing in to radio shows, raising the issue in your community,
down at your clubs,everywhere where people gather. it’s an issue that concerns everybody. it’s an issue that is urgent and we all can have a role to play. we all can make a differenceand we need to be doing it now. i’d like to wish you wellfor your gathering. be veg, go green2 save our planet. our many thanks,mr. andrew bartlett, for your words of hopeand encouragement.
and we especially appreciate thatyou remind us that we can all make a changethrough our daily actions. our second speaker ismr. edgar espinoza cisneros, an environmental geographer. he also specializes in bioethics,particularly in the moral aspects of the relationship between humanityand the animals. please welcomemr. espinoza cisneros! good afternoon. thank you for being here.
good afternoon. it’s truly an honorto be here this afternoon, and i appreciatethe wonderful opportunity to talk at this conference. ever since i began to reflect on the great injusticeand cruelty with which humans treat animals, some of the first questionsi asked myself were: “what would be necessary to changethe current human attitudes
and perceptions towardsnon-human animals for a better world for both? what would be one ofthe most important actions that we can take to achieve this? and also, how can we go aboutchanging such unethical attitudes from the root?” since then, i’ve been ona philosophical journey trying to come up with an answerof how we can change in a positive direction.
to introduce my statement, i must first talk briefly aboutthe vision of an illustrious person and on whom this ideal is based. it is one of the manywho have fought for animal rights and whom i deeply admire. george angell was the founder ofthe massachusetts society for the prevention of crueltyto animals and was a prominent figurein animal rights and the anti-cruelty movementin north america
back in the 19th century. rebelling against the paradigmsof that time, that little considered animal welfare, he fought against cruelty and in favor of animal rightsof protection, kindness, and care. as part of his vision, angell advocated the needfor humane education – teaching peoplethe principles of kindness, compassion and respect for all life.
he created a nationwide networkof humane education clubs, especially destined for the young;however, angell incorporated and presided over the american humaneeducation society, an organization designed tooffer instruction to all age groups. for this and other reasons,angell was a visionary, and sharing his belief, i envision a world ofhumane education where compassion is instructedsince birth
and is placed at the coreof our character. it is important to start at the basisof our educational system, at the root, inculcating compassionformally at all educational levels, but particularly in students,in primary and secondary education - an age in which it is easier to reachthe minds and hearts of people and where compassion can permeatemore easily. this may include active socializationwith animals since early childhood, including vegetarian dietsin school cafeterias and adoptingan educational approach that
values animals forwhat they truly are: loving, sentient beings that deserve our respectand consideration. this is important for various reasons. first of all, given that there area range of different family scenarios in which children develop, this will guarantee that children will be instructedin compassion and humane values through formaleducational institutions,
notwithstanding family conditions. secondly, from my personal experience, i’ve seen that targetingyounger audiences is much easier because they’re shapingtheir personal perceptions of society and the world itselfand thus can be more sensitive. it is no secret thatthe cultivation of compassion in current and future generationsinexorably leads to a more integrated, caringand peaceful society and citizens. consequently, in my personal opinion,
this subject should receiveas much priority as other subjects such asscience, math, or social studies. also, as a result ofinstructing compassion, we would also promote better health in our children by feeding thema vegetarian diet. we must not forget that compassionis at the root of vegetarianism. personally, it was compassionfor animals and for our planet which made me and my familyadopt the vegetarian diet. aside from all the more short-termbut very important measures
that we can implement to help change the currentunjust attitude towards animals, working from the basis of educationis truly paramount. so, as mentioned before, this entails making a changeat the root, by injecting compassionand humane values into the moral dimensions ofnew generations that will lead the worldin the near future, caring not only for their kind,
but also for other creaturesand the environment in general. in sum, it is necessary to advocatefor including compassion and humane educationinto academic systems since the early stages of life, supported by national governmentsand communities alike and for the medium-to long-term benefit. however, the marvelous resultsare well worth the effort. lastly, we should remember thathuman beings will not live in peace until they treat all beings
that accompany us on this worldwith compassion and respect, regardless of differences. if humans are to evolve, and if evolving impliesa positive connotation, then surely the path to followin order to evolve is respect and reverencefor all forms of life. only then will we truly feelpeace and satisfaction. so, let’s start instructingour children the entire scope of love which includes not only our kind,
but also animals, plantsand the environment in general, and start collaborating withnational governments and ministries to include compassionateand humane education in our schools. thank you. thank you, mr. espinoza cisneros, for your very relevant observations. our next video message is from a famed peruvian musician,animal activist and artist, mr. pedro allemant.
mr. allemant has found the ideal wayto combine his love for the animals, music and art through his project“futuro vega*pop” to help raise awareness aboutthe plight of animals in factory farms and other abusive situations. imprisoned, i can see on the road a path of illusions disappearing i can see the end
and i don’t understand it i am scared to think of what’s going to happen i want to live, to escape from my prison and run for my life! i saw you leave, going away from me towards hell…
confined to a corner behind the breeze the light touches my being like a caress i would like to cry on seeing my sadness there’s a pain in me death is approaching… i want to live
hallo, my name is pedro allemant. i am from futuro vega*pop. it is an art project that promotes respect for all animalsthrough music. animals in this society areconsidered slaves. we use them as our food, we wear their fur,we use them for entertainment, we experiment with them, and we are not aware that they arealso individuals capable of feeling.
they have the capacity to feelthe same as you and me and, therefore, they deserve respectand justice. we can stop this by being vegan,living a 100% vegetarian lifestyle. i would like to thankthe sos climate change conference for the invitation, and because there is alsoa big problem on this planet which is the threat happeningright now due to climate change. the meat industry is what makesthis problem become more serious. therefore, it is in our handsto stop this.
if you really care aboutother animals, be vegan. thank you! thank you very much, mr. allemant,for that beautiful message. our next guest speakeris a marine biologist, ms. annette bodier,who has a big heart for all animals. she is founder of the humane society “perros en puerto”in puerto escondido, oaxaca, the first organizationof its kind in the state. let’s please welcome ms. bodier.
good evening. i’m very honored to be here tonightwith you, and to be able to sharesome of my experiences i had since i started helpingthe stray dogs, the stray dogs in mexico. a friend of mine asked me once,“annette, why? why dogs? why mexico?” and the more i thoughtabout his question, the more i realized it wasn’t actuallya conscious decision of mine;
it was more likea matter of circumstances that led me to undertake this projectto help dogs. i actually was on the wayto south america and i came to mexicoin late 2005 after i left india where i had been workingas a teacher trying to implementnew teaching strategies on environmental educationfor secondary schools. i really enjoyed that work, however after my dogjaia was poisoned,
i left india very heartbroken because i just thoughtit was time to move on and i just needed to starta new project somewhere else. within months of arriving in mexico,i was adopted by a stray dog and she was a little puppyi found on the street, and although i wasn’t ready tohave that dog at the time – because i knew i had to travel a long wayto get to ecuador still – i couldn’t give her away and after i’d looked after herfor two months already.
so, i decided to keep her and i traveled with her downto puertos escondido. while living there i found a place that reallysuited me well and where i could doa lot of good work. and i founded the association“perros en puerto” with the idea in mind to helpthe stray dogs, and to better the community and make the lives for the animalsmore pleasant there.
since the formation ofthe humane society in august last year, we have rescued and helpedmany animals - not just dogs, but also cats. and our main purposes are reallythe aspect of rescuing animals and looking after them, trying to control the overpopulationof animals, especially dogs through sterilization campaigns,and trying to educate the community with regard to animal care.
i’m sure you all know the sayingthat “a dog is man’s best friend.” to me personally, however, this relationshiphas become a lot more meaningful. it has become a relationship ofunconditional love, loyalty and caringbetween two species that are able to understand each otherand respect each other. tonight i would like toshare a story with you, a story about a young puppywhich really touched my life in a very special way,and her name was pancha.
i met her while i was driving homeone sunday in october last year and i saw this tiny, little,skinny puppy dragging her sad bodyalong the street and i immediately stoppedand got out and picked her up. and as i picked her up, i realized she had two injured legsand she couldn’t walk anymore. so i took her to the vet the next day, and he diagnosed herwith a fractured spine
and trapped nerves and basically said she was able toregain her ability to walk again, but it would be a long wayto recovery. however, six months later she managed to actuallystart walking again, and after intense medication, a long, long time of confinementand therapy - that was most importantly loveand affection. pancha was what i would calla very determined and happy spirit,
even throughout the difficult monthsof her recovery. she had trained me well to respondto all her kinds of barking – like when she wanted to have food,when she wanted to be carried back from the garden into the housewhile she still couldn’t walk. once she was able to walk she would come out with usevery morning on our daily beach walk. and she was alwaysthe first one out the door squealing like a little pigbeing so happy, and just being happy thatshe could walk again.
she became my right-hand helpafter i opened a shelter for orphaned and abandonedstreet puppies. she was eager to adopt them all. she developed a maternal instinctthat was incredible. and yes, she was justthe best “puppy sitter” i’ve ever had really. sadly, pancha died. she drowned in a tragic accidentin august this year and we still all miss her,her loving and happy spirit.
especially the puppies miss her,because they all lost their mama. although pancha is no longer with usin body, in the short time we were privilegedto have her in our lives, she taught us much about loveand compassion, attributes that not onlywe humans share, but also animals can shareamong each other. they have the same feelingsas we have: they can hurt, if you hurt them, they feel pain, they feel happiness,
they suffer neglect and abuse. so, what i would like to say is thatalthough we care for the animals on the street, we also want to help the humansand animals to live together peacefully and respectfully. we need to give to the animals -not only our companion animals - a chance to livea full and dignified life. maybe if we can become more sensitive towards animal needs,we will be able to make a change,
and which leaves me with onlyone question for you to ponder on tonight, which is: what can you do as an individualto make a difference in an animal’s quality of life?thank you. thank you so much, ms. bodier. we know that the animals make so much difference in our lifeand they love us unconditionally, and thank you for reminding us thatwe have to love them, too. distinguished guests,ladies and gentlemen,
we are very grateful and privileged to welcome our special guest of honor,supreme master ching hai. a world renowned spiritual teacher, bestselling author, highly lauded artistand dedicated humanitarian, supreme master ching hai has beenfully devoting her time, energy and resources to protecting our worldfrom global warming. she is one of the most caringand leading voices globally in the raceto save our planet.
supreme master ching hai has beenrequested by many concerned media to shareher knowledge and insight. she has lent her supportin humanity’s efforts to curb global warming by gracingvarious climate change conferences around the world. please join us now to watcha special documentary entitled “for our beloved planet,” a brief biography aboutsupreme master ching hai. let us watch it now.
supreme master ching hai is a world-renowned spiritual teacher,artist, and humanitarian whose loving assistanceextends across cultures. born in central ã‚u lạc (vietnam), supreme master ching hai studiedin europe and worked there for the red cross. she soon realized that sufferingexists in all corners of the globe, and her yearning to find a remedybecame the foremost goal in her life. she then embarked on a journeyin search of spiritual enlightenment.
eventually,in the himalayas in india, she received from a true master the divine transmission ofthe inner light and sound, which she later calledthe quan yin method. after a period of diligent practice, she attainedthe great enlightenment. soon after her returnfrom the himalayas, at the earnest request of thosearound her, supreme master ching hai sharedthe quan yin method with others,
encouraging them to look within tofind their own divine greatness. before long, invitationsarrived from the americas, europe, asia, australia, and africafor supreme master ching hai to give lectures. supreme master ching hai’scompassionate heart has also been reflectedin her meticulous care for the less fortunatein different circumstances. the funding generatedfrom her artistic creations has enabled the support of her missionof comforting god’s children
in times of need. more recently, supreme master ching haihas authored books that have become #1international bestsellers, namely, the birds in my life,the dogs in my life, and the noble wilds. these volumes, now translatedinto several languages, reveal many insights intothe deep emotions and thoughts of our treasuredanimal co-inhabitants,
highlighting their gracious spiritand unconditional love. wishing to acknowledge othersfor their actions and influence toward developmentsof goodness in the world, supreme master ching hai foundedthe shining world leadership award in march 2006. since then, she has also establishedother awards, such as the shining worldcompassion award, shining world hero and heroineawards, shining world honesty award,
shining world protection award, shining world intelligence award, and shining world inventor award. this honor is presented toindividuals, nations, and organizations such as the 2nd president ofthe republic of slovenia, dr. janez drnovå¡ek, renowned british primatologistdr. jane goodall and us-based nonprofitsave the children
whose exemplary workshave significantly contributed to the harmony, beauty,and sustainability of our earth. supreme master ching haihas given much to our world, both spiritually and materially. although she does notseek acknowledgment, in recognition ofher selfless contribution, government representativesand private organizations worldwide have presentedsupreme master ching hai with prestigious awardson numerous occasions.
among these werethe gusi peace prize (2006), first-place silver forthe 27th annual telly awards (2006), los angeles music weekcertificate of commendation (2002), the world spiritual leadership award(1994), and the world citizenhumanitarian award (1994). in addition, february 22and october 25 have been proclaimed by government officialsin the united states as the supreme master ching hai day. her dedicated aid to the worldcontinues till this day,
with millions of grateful hearts among leaders and their co-citizensalike. supreme master ching hai isamong notable pioneers in our society today who wiselyand courageously express concern about climate change. in fact, for more than 20 years, she has strongly advocatedpreserving the environment. she initiated the alternative living and sos global warming campaignsto promote a benevolent lifestyle
without animal products. “be veg, go green,2 save the planet” is now a well-known motto that originated fromsupreme master ching hai. in our era, supreme master ching hai is truly a selflesslydedicated individual, tirelessly helping world citizenscreate a bright future for our beloved planet. just recently on october 29, 2009,
supreme master ching haiwas the honored guest speaker at the association ofmexican magistrates pro environmental justicein mexico city. her video message clearly discussedthe causes of global warming, how it is impacting mexicoin particular, and the one effective solution:the organic vegan diet. today is the fourth timethe mexican government has invited supreme master ching hai to address the urgent issue ofglobal warming via videoconference.
esteemed guests,ladies and gentlemen, let’s give a warm round of applause for the most generoussupreme master ching hai. hallo, supreme master ching hai! hallo! welcome to mexico. thank you so much for inviting me.thank you. you look great in purple. this, how you call it?
vegan fur, vegan fur. it’s really beautiful. i want to match your suit. that’s why. (yes.) it’s vegan. it’s not animal fur. and it still looks beautiful, right? you like it? yes.
it’s completely beautiful. everybody likes it, yes? thank you, thank you. it’s perfect for the weather here. is it cold there? it gets a little bit chillyin the evening, yes. yes, yes, yes. also, it’s winter, everywhere is cold. it’s better thanheating the planet. no?
but, i hope you are warm. the audience is warm? yes, we are, master. good. thank you once againfor your kind acceptance to share your extremelyprecious time with us. i am glad to be able to.i’m glad. i’m very glad. i love the mexicans.i love your country. and we love you.
supreme master ching hai,earlier in the program our distinguished speakershave presented their expertise and their perspectives onthe current global crisis. and our experts, they have talked about many sectorsof their expertise, such as those of society, political, educational,environmental, and social, and their knowledge has beenvery instructive and very important to us.
so master, we would be so gratefulif you could now share with us your thoughts and viewsabout the global warming situation. yes, i would be very honored to contribute some ofmy humble knowledge about our very precious planet. i have been listening as well. i have been listening toyou two mcs, and all the vips,and all the experts, videotapes and their concern about the planet
and their knowledgeand their advice to us what to do. i’m also very grateful like you are,for their very generous advice and sharing their time with us. i will also do my part, and i hope together we can findcommon ground again to save our precious home. i am trying some spanish, i hope you can understand, like:hallo and good afternoon to all of you.
is that okay? that’s very good, master. yes, it’s very good. good afternoon, master. good. yes. i can see our verydistinguished guests and the government officialsof mexico. i’m very, very honored to be ableto be with you, very precious people. every time i was in mexicoi never forgot the emotion
of the people there. they treated me likethey’d known me for hundreds of years, like i have been their family members. i have never forgottenand i almost could not leave mexico. i almost wanted to stay there forever. what a beautiful people! what a beautiful race of people! and i really wish that we can continue to keepthis race of people
and their very gracious traditionexactly on where they are, and that we can push awaythe dark cloud of climate change that is threatening all of us. respected statespersons,gracious speakers, and audience members,i am truly glad to see you, and i want to conveymy thankfulness for all the hospitality that you have reserved for me personallywhenever i was in mexico. it is a great honor for meto be invited once again
to participate in this important event in the blessed stateof veracruz, mexico. and i am truly touchedto be in the presence of the genuine, hospitable,intelligent, dedicated, but humble mexican people. so humble but so great. through our previous meetingstogether, i have come to know that the mexican government and peopleare most sincere and concerned
about our planet, and only want the bestfor their country and the presentand future generations. but, of course, whateveraffects mexico will affect also the world. yes. so, i am glad that the governmentof mexico is taking serious steps and making projects to tryto halt global warming. that will help the whole planet. and i also feel a deep,deep appreciation
for the beauty of mexico,her spiritual legacy, and deep-rooted traditions thatshine through the history so much to treasure and preserve. however, it also pains meto think that everything wonderfulabout your country and about our world isin grave danger of disappearing due to global warming. mexico is enduring prolonged drought, and making things worse,the pandemic.
and countless countries share theseand other challenges, while less predictable perilspush humankind even more to the edge. but luckily, there is still time asall the experts have told us before me that you have heard,that we still can save it all. you can save your country,your people, your children, your animals, and your planet. we can still keep our hopebecause we have the solution: it’s in our home, it’s in our hands, it’s in our heart.
the solution is right herebegins with us. i offer hereby my humble respectand heartfelt wishes that you find this conferencemeaningful and helpful to you. thank you so much. good luck to everyone. thank you so much,supreme master ching hai, for your respect and lovefor all people and particularlyfor the mexican people, and thank you for sharingyour compassionate understanding.
surely you can lead us intoa new era of sustainability and love between all things, between all people, between all planets and animals. supreme master ching hai, some of our speakers and guestshave prepared some questions and would very much like totake this opportunity to receive your wiseand loving insight. i will share with you what i canand what i know.
please go ahead. thank you, master. first, the honorablemr. alonso dominguez ferraez, general coordinator of the environmentfor the state of veracruz has two questionshe would like to ask you. hallo, master ching hai. it’s a pleasure for me to meet againby this technology. question one. you propose vegetarianismas a solution to stop
livestock breedingand the generation of methane gas. in that sense, how can we, as parents, influence our childrento change their dietary habits? the second question. mexico is a country that is dependenton the oil industry. how can we switch fromthe use of hydrocarbons as an energy source to other typesthat will lead to a change in our consuming habits? we think it's difficult
because our economydepends on oil. thank you for your answer. yes. hallo, senor ferraez. thanks for inviting me again and for coordinatingthis beautiful event. how are you, sir? fine, and you? me too, me too, yes. you look good.
thank you for your caring question. the first question is how do weas parents influence our children, yes? senor ferraez, by example,senor, by example. influencing our children, especially toward something thatwill help the world, is much easier than influencing many adults. we adults are more difficult tochange into something new or to accept some new concept;
but the children,they are still young, flexible, and very open to new ideas, and they’re purer at heart, yes. so, we hear about children whoremember being in heaven before they came to this life, or even ones who remembertheir previous life. it is on the newspapersand in the media, they report about these things. they are thus not attached tothe things of this world as much as
we, the adult people, do. in fact, children normally do noteven care for the taste of meat. they just learn to eat itfrom their parents first, just like we learnt to eat itfrom our parents. even in school, studies have found thatwhen given a choice, the young students preferredfresh fruits and vegetables by themselves. nobody even influenced them.
so, from a young age, children naturally gravitate towardcompassion and health. all you need to do, senor ferraez i’m sure you ask thisnot for yourself, or not just for yourself, but for all the parentsin the world and so, all we have to do isbe a good example, yes. remember, parents arethe first ever teachers of their children.
so, we become vegan and show themand explain to the children. then we can show them the way. we will explain to themwhy we are vegan, and when they are very young,they will try to eat whatever you serve them in any way. and when they are older, we can explain thatthis way of life, first of all, is helping the planet, saving lives,and it is also helping themselves.
so, vegans are healthier,happier, more intelligent, and live longer. another thing we can do for our children,and any of their friends who want to join in, is to go visit,like, a farm sanctuary. this is a place where the animalslive safely and well taken care of without fear of being killed. there, the children cancome close to the animals and even touch them,communicate with them.
we have heard children say once they make friends with the cowor the sensitive pig, that they cannot eat them anymore. as parents, we should doeverything possible to help our children makethe connection between these loving, beautiful,noble living beings and the piece of dead,rotting flesh that people eat. we should also explainabout the suffering of the animals, which is so immense thatwe cannot even imagine.
it’s too much, too much for usto watch if we know about it. we can share another partof the animals’ truth, which is that the tender young babiesare taken away from their mothers and killed in a horrible way, and let the children knowthat the mothers then have to endure the pain of beinghooked up forcibly every day to machines for milking; milk that should have gone totheir babies and then they are killed.
all of this is a sad, but true, story. there, of course,are many more gruesome, utterly cruel and inhumane actsinvolved in animal industry. we, as parents, can also helpyoung children’s veg lifestyle by going to schooland explaining to the teacher and the food service staffthat your child is a vegan. you can even offer to help withcooking classes so that they more fully understand. there are many studies now thatshow the benefits
of a healthy school lunchand snacks program. children are even knownto concentrate better when they are eating more fresh fruitsand vegetables. the americans’ first lady nowalways introduces fresh fruits and vegetables tothe children of america. and if we help the school tounderstand these benefits, they may also adopt themmore widely themselves. i know it feels like hard work,but we just have to do, somehow, if we wantto save our home.
but nowadays, many schoolsand parents even plant vegetables in the school or in the home gardenswith the children, and the children lovethese activities as well, as they’re eating more vegetableswhich they grew themselves! so, finally, we can alsotell our children that by being vegan, they are directly helpingto heal and save our planet, and helping the parents, helping themselvesand all that lives in this world.
children are very loving at heart. so, if they know thatby being vegan, they can save many lives, they would be very,very willing to do it. we want to be able toleave a world for the children, a world of green and lush beauty, a world of humans and animalspeacefully coexisting together. they will love to helpto make this happen. thank you, senor ferraez.
thank you for being so good. you ask such intelligentand really practical questions. i understand your concern aboutmaking the switch toward other forms of energyand away from oil, senor ferraez. it may relieve you to hear that we don’t have todo this right away, because the oil industry is notthe biggest of our planetary problems. scientists have pointed outmost recently that global warming does not ariseprimarily from oil-based technologies.
not cars, not planes,not trains, not ships, not even coal power plants. but the livestock that you mentionedin the first part of your question, that is the number one source ofglobal warming worldwide; and methane is the primarygreenhouse gas generated by livestock. one study in mexico found thatlivestock was responsible for 97% of the country’sagricultural methane! so, i repeat: the number one source
of global warming isfrom our consumption ─ killing of all the cows, pigs,chickens, sheep, eggs, dairy. this, along with the killing ofbillions of beautiful fish for food, is what causes the mostclimate-related trouble for our planet. researchers in the uscame up with a simple comparison. according to calculationsthey performed, they concluded thateating a vegan diet for a year is more effective atcooling the planet than
driving a hybrid vehiclefor the same period of time. so we can see thatputting down the meat is more important than forgoinga gas-powered car. another good news about thissimple dietary solution is that methane, as a greenhouse gas, also dissipates quicklyfrom the atmosphere. in fact, methane is nowestimated to be 100 times more heat-trappingthan carbon dioxide; but this gas also disappearsout of the atmosphere
in around 12 years, or less, while co2 can remainfor thousands of years. so, eliminating livestock productionas this major source of methane is thus one of the fastest waysto cool our planet. this doesn’t mean we forget aboutthe problem of the oil industry. it’s just a slight shift of focusto address the most urgent situation first. once we have done that, then we can continue to developgreen alternatives to things like oil.
but first, to get a senseof the lethal impact that livestock raising has on our world, let’s take a look ata few of the details. some of the global warming effectsthat we hear about are a continued rise inthe earth’s atmospheric temperature, warming of the ocean, along with acidification, more frequent and stronger storms, prolonged droughtsand intensified heat waves,
soil desertification,plant and animal extinctions, and even melting of permafrost,which could trigger massive releases of more methane gas! that would be catastrophicbeyond an unthinkable scale. mexico and your neighboring nationshave already suffered from some of these effects. besides the drought that has stricken parts of mexicofor over a decade now, other countries like guatemalahave been facing extreme shortages,
with over 550 fatalities and more than 400,000 familieswho have been in need of food and water assistance. in ecuador, officials have startedrotating electricity outages due to low water levelsin the nation’s hydroelectric dams. venezuela is also beginning toration out water as she suffers from the worst droughtsince 1947, with june and october 2009being the driest months in over 100 years.
“how is livestock productionconnected to these damaging effects?” you will ask. there are so many ways that i’m surei don’t have enough time to tell all of them,but we can list the activities that are associated withmeat production that are causing some ofthe biggest problems for us. these include deforestation;soil erosion and desertification; excessive use of precious resources;land and water waste and pollution; and animal, plant and human diseaseor disappearance.
now, to highlight,let's zoom in on two of these problems and how they are affectingyour country and the countries in the region. now, one: deforestation. in brazil, 90% of the land deforestedsince 1970 has gone toward livestock pasture or feed. and in the southern part of mexico,tropical forests that once covered almost half of the state of tabascohave been reduced to less than 10% their original size.
at the same time, senor ferraez, pastureland for livestockhas increased to 60% of the state's total area. i repeat: pastureland for livestockhas increased to 60% of the totalof your state's area, with scientists reportingsimilar conditions in other parts of the nation. in countries like brazil, argentina and now paraguay,more and more forests
are felled for both livestockand soy crops. argentina has lost 70%of her original forests. imagine: 70% of argentina’s forestshave disappeared due to livestock. now, in paraguay,the widespread planting of genetically modified soyfor livestock feed has caused so much devastationto both the people and the environment thatseveral international groups are making a documentary to try toraise the awareness for change.
some of the benefitsof a vegetarian diet: lowers blood pressure lowers cholesterol levels reduces type 2 diabetes prevents stroke conditions reverses atherosclerosis reduces heart disease risk 50% reduces heart surgery risk 80% prevents many forms of cancer
stronger immune system increases life expectancyup to 15 years higher iq saves 70% of a total costof us$40 trillion for reducing global warming uses 4.5 times less land to grow food conserves up to 70% clean water saves 80% of the clearedamazonian rainforest from animal grazing
a solution for world hunger: free up 3.4 billion hectares of land free up 760 million tons of grainevery year (half the world’s grain supply) consumes 1/3 fossil fuelsof those used for meat production reduces pollutionfrom untreated animal waste maintains cleaner air saves 4.5 tons of emissionsper us household per year stops 80% of global warming
plus more… now, number two:soil erosion and desertification. the clearing of land for livestockhas created instability and serioussoil degradation across the country of mexico. in the northern regions of mexico nearly two-thirds of the land isclassified as being in a total or accelerated state of erosion. in these regions, which are highlyvulnerable to desertification,
researchers have found that the soil condition is made worseby livestock grazing. so, when the livestock eatsall the vegetation and tramples the land, what is left behind iscement-like ground, unable to grow anything. this worsens global warmingbecause more carbon is released from the dying plants and bare soil. the soil then becomes hotterand overloads the atmosphere with
even more heat-trapping carbon. and this is on top ofthe methane generated by the livestock itself. so, actually, the livestock industrygenerates more methane than what we can even calculatebecause of the related effects. such extensive damage makes itdifficult to revive, and continued livestock raisingin this case obviously leaves little hope for recovery. in a magazine interviewover a decade ago,
the president of the nationalcattlemen’s confederation of mexico spoke of your nation’sprolonged drought and its adverse effecton the cattle industry. already then there were suchdistinct signs of global warming effects. but what he did not realize thenis that the cattle industry is causing the drought. so, it’s easy to see that if we stopped this raisingof animals for meat,
the weather patterns would bequickly restored, along with the land. in the interview, the president ofthe cattlemen’s confederation also mentioned the need for more government subsidiesfor cattle raising. but what we actually need aresubsidies for life-giving practices, not the ones that take the lifeaway from the animals, take away life from us and take away life fromour future generations
and take the life fromour one and only planet. the government could easilysubsidize organic farming instead, which would provideabundant benefits for all the people of mexico and even would remove40% of the atmospheric carbon if all tillable land on earth wereorganically farmed. so, the solution is very simple, sir. we just have to turn awayfrom the animal products. we stop eating meat, dairy,eggs, fish.
if everyone does this, we will have a transformed worldin no time. it really is that easy ─just one bite at a time. removing methane from theatmosphere will remove the majority of the global warming effect. and then we can have time to findgreener power for our world rather than oil,after we save the planet. also, the vegan diet will bringmore clarity and creativity for everyone.
so, we will be able to developall the necessary resources in time. it’s just that we need tomake the switch to the animal-free lifestyle now. then everything will improve, life will be easier,and we can rest knowing that our children will have a futureto look forward to. thank you for yourvery heartfelt concern, mr. ferraez. for yourself and your children,please ask everyone: be veg, go greenand save the planet.
god bless you. many, many thanks, supreme master ching hai,for your most loving answer. thank you, honorablemr. alonso dominguez ferraez for these important questions. we appreciate you being here. some of the diseases related to meatconsumption/production: rabies
anthrax sleeping sickness q fever norovirus swine flu ebola-reston virus cured meats and fish increaseleukemia risk in children antibiotic-resistant"superbug" infections from a strain of staphylococcus aureus
blue tongue disease e coli salmonella bird flu mad cow disease (creutzfeldt-jakob disease,90% of the population at risk) pig's disease (pmws) listeriosis shellfish poisoning
pre-eclampsia campylobacter clostridium difficile diseases hidden inhealthy-appearing livestock some of the costsof meat eating: infertility eating just one servingof meat per day increases the risk of women’s infertilityby 32 percent, with additional meat consumptionincreasing the risk.
heart disease over 17 million liveslost globally each year cost of cardiovascular disease isat least us$1 trillion a year cancer increased childhood cancersand adult reproductive cancers from hormones in meat colorectal cancer over 1 million new colon cancerpatients diagnosed each year more than 600,000 colon cancer-relatedmortalities annually
in the united states alone, colon cancer treatment costsabout us$6.5 billion. millions of people are newly diagnosed with other meat-related cancersevery year. diabetes 246 million people are affectedworldwide an estimated us$174 billion spent each year on treatmentin just the united states in just the united states
obesity worldwide 1.6 billion adults areoverweight with 400 million more who are obese costs us$93 billion each yearfor medical expenses in the united states alone at least 2.6 million peopledie annually from problems relatedto being overweight or obese environmental uses up to 70% of clean water
pollutes most of the water bodies deforests the lungs of the earth uses up 43% of the world's cereal uses up to 85% of the world's soy causes world hunger & wars 80% cause of global warming plus more... some of the costs ofmilk consumption cowpox from milking cows
bacterial microbes, pesticides,and enzymes found in cheese, derived from the inner stomach liningsof other animals up to 80 percent of the caloriesin cheese are from pure fat breast, prostate and testicular cancerfrom hormones present in milk listeria and crohn’s disease hormones and saturated fat leadsto osteoporosis, obesity, diabetes and heart disease linked to higher incidencesof multiple sclerosis classified as a major allergen
lactose intolerance for more urgent information,please visit for help quitting, please visit our next question is fromms. griselda espinoza, a vegan and the cultural coordinatorat the institute of higher studies. what specific programsor quick actions can governments undertaketo help their countries switch to an organic vegan lifestyle? what can we do to help peoplemake a smooth and fast transition?
hallo, ms. espinoza. hallo, master. your question hasa sense of eagerness. i understand and i also wish thatchange will happen more quickly, like yesterday already. i’m sure you want the same ─everybody wants the same. but the governments have the powerto make this urgent transition to the organic vegan diet. first, they should banall animal products,
informing people about the facts ofanimal products, explaining that because it’s poisoning their co-citizensand piling up far more costs than any gains, economicallyand environmentally, and because it’s eating up our planet. and if the planet goes, we all go, the power ofthe government also goes. so, whatever economic value is seenin the livestock industry will mean nothing.
and it has been an illusion anywaybecause it costs our planet too much,too much. it costs us too much. we have to save the planet firstand immediately. ban all the animal productsand exploitations. next, the governments can helpthe agriculture sector transition to beingan organic vegan sector to sustain the human population with products they can consumedirectly instead of
giving them to the animals. organic vegan farming isa good solution to the food crisis. the cost of subsidizingorganic vegetable farming is very small compared tothe subsidies needed to keep the animal farms afloat ─ meaning just to keep themfrom losing money and going bankrupt. the mexican governmentalso imports meat a lot: in 2008, us$2.1 billion worthof beef, pork, and lamb from the united states were boughtby your government.
instead of draining so much money into unsustainable, unhealthy products,the government could invest in producinggood wholesome crops for the people of mexicoand the world. so we should support the farmersfinancially, technically, and train them to becomeorganic vegan farmers, wherever it is possibleto cultivate the land. it’s quite easy according toour research and results. organic vegan farming issustainable, healthy,
profitable, and in-demand right nowbecause people are more aware ofthe healthy diet, of organic farming. first, it will help the world be veg easily, thus eliminating more than half ofthe greenhouse gas emissions which are heating up our planetand endangering our lives; and second, the high-qualityorganic soil will absorb much of the rest ofthe greenhouse gas emissions and it will also help tosave our planet. organic vegan farming can savegovernments a lot, a lot of money,
80% of it. imagine all the tax moneycoming back to us or going toward buildingsomething better. for example, the cost of tryingto mitigate a significant portion of the greenhouse gases, it preserves natural forests, biodiversity,and soil quality as well. a study on small farmersin latin america who switched to organicvegetable farming found
that they earned higher revenuesthan before. according to respecteddutch scientists, tens of trillions of us dollarscan be saved by world governments if all the world becomes vegan. in addition, the governmentsof the world have the power to make the veg trendan exciting movement for everyone towarda healthier lifestyle. if we compare the trend to tobacco,which is another killer substance like meat, only after 1950,
when the first major researchcame out showing that tobaccocauses lung cancer, the government started toimplement smoking bans, gradually more and more until today ─more than 80 countries have some kind of public smoking ban. and bravo, mexico, also, for expanding to a nationwidesmoking ban in 2008. so, just to compare: studies show that the smoking bansactually helped people
to quit smoking,and the quitters were happier because of the ban, because they know thattheir habit was bad for them. some of the tragic tollsof tobacco 5.4 million smoking related deathsper year worldwide cost of smoking related illnesses: us$96 billionin the united states alone depression "light" and "mild" cigarettesjust as harmful
causes cancer and diseasesin animal companions speeds the aging process toxic residues of third-hand smoke coronary thrombosis cerebral thrombosis kidney failure mouth, liver,breast, and colorectal cancer lung cancer esophagus cancer
kidneys cancer bladder cancer chronic obstructivepulmonary disease emphysema bronchitis stroke impotence additional harmsfor second hand smoking childhood arteriosclerosis leadingto heart attacks
and strokes in adulthood sudden infant death syndrome infertility, miscarriagesand premature deliveries childhood asthma,bronchitis, ear infection cleft lip or palate hyperactivity and aggressionin asthmatic boys circulatory problems in women similarly, a ban on meat, which we all now knowfrom the studies, is
a very bad habit which kills usand our children, our loved ones, and is killing our planet. so, a ban of meat will bea strong current to carry the trend toward a vegan world. because a good leader stopswhat is bad for the people and facilitates what is good for them. they can facilitate, namely,through public campaigns, using the media, and through schoolsto inform about the benefits of the healthy, life-saving,planet-saving way of life.
and i’m praying toall heavenly beings to help as well, to further acceleratethe trend that we need, by manifesting themselves physically ─ i mean, even just for a short whilebecause they can’t stay long in our very rough atmosphere ─ but to come for a while,at least, everywhere to come and manifest themselveson our planet to awaken the leaders, the media, the influentialand ordinary citizens alike so that our planet won’t looklike mars in the near future.
so, prayer, combinedwith the efforts of citizens, and the governmentsand media’s powerful support, this formula could bring the fastestand smoothest transition to a stable planet. thank you, ms. espinoza. we shall be patient and meanwhile keep trying your bestand pray with me. thank you for beinga part of the vegan trend. thank you for loving the animals.
god bless you and your loved ones. thank you, master, for your understanding of governmentsand how they can help us. we appreciate you teaching us. you’re welcome. thank you so muchfor your compassionate answer. and thank you, ms. griselda espinoza,for your very good question. european parliamentsupports reducing meat to lower greenhouse gases.
... reduce your meat consumptionor stop eating meat totally. during discussionson greenhouse gas reduction goals, the climate committeeof the european parliament officially recognized livestock’scontribution to global warming and recommended a reductionof subsidies to the livestock industry to curb methane. the european parliament has adoptedits own position on climate change as an institution. and as a vice-president,
one of the proposals i’ve madeis in line with your own; which is that we should eatfar less meat because that’s one of themajor sources of greenhouse gasses. please eat less meat,and let's make taxes on meat. that's definitely one of the issueswe are talking about. i'd like to tell people what the cost is of eating meat,for the environment worldwide. my name is jens holm. i’m a member ofthe european parliament.
please, be veg, go green,2 save the planet! what are your thoughtson this conference? very good. it looks at many topics that sometimes are unknown to us,such as changing our food from eating animal meatto being vegetarian to help contribute toreducing pollution and global warming. as part of the media,what are you doing today to raise people's consciousness
regarding actionsto stop climate change? we are the voice and spokespersonto inform people of what is happening and take all measures toprevent this from continuing and to prevent our planetfrom disappearing. what do you think of includinga section on vegetarianism and options such asvegetarian recipes, for example at least once a week,in the media where you work? it would be a good idea. to begin with, i imaginethe public would like it
or become vegetarian. people would like to know howto cook different foods and vegetables. master, first of all,thank you for the work you are doing on this planet. how good it is thata person like you has made the decision totravel all over the world so that we, who sometimes don’t knowwhat is happening, become aware. thanks for this work,master, and don’t give up.
good luck. she is wonderful, a wonder ─the master. i congratulate her wholeheartedly. it is already an experiencewe’ve all had by listening to her. the master is a divine person. everything she said is true, and we are going to adhere to it. it is not an order from her, but she shares her experienceso that we can act better.
after this videoconference, would you becomea complete vegetarian? sure! do you know why i sayi will become a vegetarian? because now the food i eatmakes me ill. i want to become a vegetarianonce and for all. people have become aware and,well, i believe that people areleaving with a task to meditate on at homewith the family, to try to change dietary habitsin a different way,
and especially within the frameof having known what climate change involves,what global warming means. what do you think aboutthe vegetarian diet after the conference? would you think ofbecoming a vegetarian? well, the fact is that i am alwayseating much less meat. we have instilled in our children, the family, that they have toprepare their food and should eat vegetables,greens, etc.,
so we obviously, yes,have come to think about it, we are thinking about itand are meditating on it, and yes, we are consumingless and less (meat). be veg, go green,2 save the planet! could you give us your commentson this videoconference? well, quite an interesting topic,much thought out, on what we usually hearabout global warming. and above all, there aredifferent options in favor of our planet.
i think it's quite interestingand very attractive too. what do you think aboutthis videoconference? interesting, because it is about our planetand that we have to take care of it. it is cool as it tells usabout sentient beings. it seems perfect to me,because we have to save our planet. would you become vegetarian,mariana? yes, because i love animals and i would not like to bein their body or soul
when they are tortured. as the head of jurisdictionand as a doctor, and in my personal life, i would recommend everyone tobe vegetarian or vegan. remember that meat containstoo many toxins, and those toxins obviously poisonour body ─ as their name implies. the best thing to do iswhat nature dictates to us, and nature is so perfect that it has created food for ushuman beings.
and this food for human beings isbased mainly on fruits and vegetables. what was said in this conferencei thought was very important, and even before i heard iti was already reflecting on this ─ that we all are living beingson this planet and deserve respect, regardless of whether we are rational or if we coexist with animals. i always tend more to have vegetablesand fruits, and most of all, i do it for what was mentionedin this conference ─ for the compassion thatwe ought to have towards
all the other living beingson this planet. what are your thoughtsabout this videoconference? it was wonderful. i was able to really feel the energyof the participants, especially the treatment ofall persons involved in the project, the good vibes, if i may say, of all participants ─either assisting, or the staff ─ of this nice project. as a university professor,
what message would youbring to raise awareness in your students to cooperate and participate in this great struggleto save the planet? i think one of the small thingswe can do is to develop didactic material, for example,with illustrations on climate change, on the treatment to animals,on the culture of veganism. take it as text and start from thereand somehow create a little awareness in the students. obviously also address these issues.
what message would you sendto supreme master ching hai? to continue doing what she(supreme master ching hai) is doing because she is doing it very well. it is awakening many hearts,raising awareness and, above all, i think thatlittle by little it is changing the directionthis planet is taking.

Kamis, 22 Desember 2016

como se presenta el cancer de colon

como se origina el cancer de colon

como se presenta el cancer de colon

psa screening. what's a guy to think? so, why have screening tests? so the purpose of a screeningtest is designed to find at-risk individuals beforethere are problems. you want to find at-risk populations. you want to identifythe disease early. you want to prevent the lateoutcomes, such as illnesses, fractures, metastasis,death even. you want it to be costeffective, you want it to be
simple, and you want to limityour false negatives or your false positive. when your test comes up, ding! you want it to be that it'sreally ding, and not maybe it's not and maybe it isn't. and so, how do you designa perfect screening test? and think about someof the ones we have. colonoscopy, well, theyhave to drink that stuff. you have to poop a lot. you have to go have a telescope. maybe a half a percent ofthe time there can be a
rupture of the colonduring the colonoscopy. you know, that's some work justto find early colon cancer. and women go for pap smears,and you go for mammographies and then they want you to get theultrasound, and then they want to do the needlebiopsy, and what percent of those are really positive?so people will go through a lot of process for the sakeof a screening test. so psa, how beautiful is that, right?it's a blood test. could it be any simpler thango get your blood drawn
and maybe this gives you someyes or no answers? so in theory, a psa is a greatscreening test, and actually, probably even less scary thansome of the other things you can do. so, before you makeany decisions about psa. that sounds pretty convincing. you have to have a foundation. you have to understand thebasics of prostate cancer, so you have to lay that foundationand take it from there. so, prostate cancer, youhave to know, is a slow, progressive disease. it kills people maybe in 10 years,
maybe in 15 years,maybe in 20 years. so, it's not a life or deathimmediate kind of a problem. really interesting, if you doautopsies on guys, something like a third of guys at age60 you might find prostate cancer in their prostate.they didn't know it. they died of something else. maybe half the men at age70 have prostate cancer. and maybe, you know therule of thumb we always talk about is 90% of men atage 90 have some
cancer in their prostate,if you checked. and actually, interestingtrauma studies have shown that something like 15%of 30-year-olds have prostate cancer. you know, people have somehorrible car wreck and they do an autopsy study and, oh mygosh, we find prostate cancer. so, it's there, right. andit's, and it's not necessarily actuallykilling people. and, it's not necessarilykilling everybody because
90% of men are not dyingof prostate cancer, if they live long enough. the current us incidence,roughly, it's like one in six. that's 16% of men in the uswill be diagnosed with prostate cancer. the death risk ofprostate cancer is about 3%. so that's not really asignificant death risk compared to the incidence. it is however, the numberone solid cancer in men. the only cancer that's morecommon in men is skin cancer.
there's a whole staging system. i don't know if you guys,anyone's ever had a friend or yourself been through any kindof malignancy, any kind of cancer. you know, how nasty is it? where is it? what's the stage? how spread, or howcontained is it? so, most us men are stillin a really early stage. t1 is basically you found duringsome kind of a screening test, like psa. and 85% is still alljust there in the
prostate. so localized atdiagnosis is still just hanging out in the prostate andhasn't spread yet, okay. in our world, we talk aboutagain, how aggressive this disease is. and some ways topredict how aggressive it might be, is somethingcalled the gleason score. you can look at the cancer underthe microscope, you say, alright and if it looks kind of likethis, you call it a six, and if it looks kind of more likethis, you call that a seven. and if it looks more like that,you call that an eight,
and there's ways torank these things. in theory the scalegoes from two to ten. no one uses two toten, so six to ten. six is the least aggressive,seven is a moderate, eight, nine, ten gets clumped togetheras the most aggressive. and we look at the psa, and howspread or contained is it when someone shows up. howhealthy is the patient? you know, the guy who's gottwo heart attacks and the oxygen tank and comesin in a wheelchair,
prostate cancer's not his risk. and how old is the patient? odds are, if you made it to 80,you've got a better chance of making it to 90 than me. because you've already made it to 80. you've already proven something. but, let's face it. people don't live forever. and so, in oldergentlemen, maybe the 10, 15, 20-year cancer is not reallyyour biggest concern. alright, what is psa? (prostatic specific antigen) actually, it's not designed to make urologists busy,and pathologists busy.
it's really designed, it'sactually liquefied semen. turns out that, it's alsofloating around your blood stream, and it's in all men. various things will makethere be psa in your blood. you can have anenlarged prostate. every guy, if youlive long enough, gets an enlarged prostate. and the symptoms are mild orhuge, depending on the guy. but everyone's going to havesome enlargement of their
prostate, which means everyguy's going to have some rise with their psa as they age.it just happens. prostatitis, or inflammation,could be infection, could be a viral thing, could be a catheterwent past, anything that makes itis, anything that makesan inflammation, will make the psa go up. of course, cancer of theprostate will, urinary tract infections, bladder infections,trauma, you had a foley catheter, you landed hard,blood down there, even sexual
intercourse will make thepsa go up a little bit. medications, finasteride,proscar, avodart, things that shrink the prostate help guyspee better, that'll make your psa go down, and then whichcompany's psa test you use will also make somedifference in the values. so if i use the hypertech, itcould be actually be 25% higher than if i used the worldhealth organization version. and so it's not just psa, onesize fits all, things will affect it. there are normal values.
we say less than four isnormal, but the median, what's the middle mark? you have 99 guys, whatis the middle number? so the middle number, not theaverage, but the middle number for men in their forties is 0.7. that's pretty low. actually i never see those,because they never come to the urologist, the primary looksat it and goes this is fine and they never even get to me. and you see the median, themiddle of the road number
kind of goes up as people age. so your prostrate gets bigger,it makes a little more psa. alright so, prostratecancer right. in the psa era, sincewe've been using psa. people die less often. so in the early 90s, 45,000 guysa year died of prostate cancer. and now, it's about 30,000 guysa year die of prostate cancer. and i have to tell you,there's a lot more older guys. right, so the numerator gotsmaller, the denominator got
bigger. there's less guys dyingof prostate cancer. that's great. roughly one insix guys in 1990s presented with stuff alreadyall over the place. and we can't stop that.we can slow it down but we're playing catch up. and now that's like one in 50. so now one in six guyspresented it with really advanced disease and nowit's one in 50 guys present with really advanced disease. and there's actually this areain austria, the tyrol region.
so the tyrol regiondid this trial. every guy in tyrol, austriagot their psa screened. as opposed to the restof austria which didn't. and, the tyrol's had a lot lessdeath and prostate cancer than the other, the rest of thecountry for about 10 years, until the rest of the countrystarted doing psa, then they caught up. so wow, ifyou do large mass readings you really decreasethe death rate. in the us, the death rate fromprostate cancer has dropped
about 4% every yearsince this started. 40,000 down to 30,000,45 down to 30, whatever. it's been a significant dropand there's more older guys. mortality's lower, morbidity, orsickness, or illness is lower. isn't this great? and everything kind of fell apart, from a scientific or from a study standpoint in 2009, when the new england journal of medicine, they had two articles that said, "don't screen for prostate cancer." and there were two trialswith a lot of people in them.
so this big european trial had182,000 men, and did a psa every four years, and theyhad nine-year results. the united states trialhad almost 80,000 men, they randomized to screening with apsa every year to no screening, and they had seven-yearresults, so not nearly as long. and what did theeuropeans showed? and they showed that there wasan 8% cancer in a screened group versus almost 5% in the controlgroup, which means they were getting found otherwise, butnot through the screening test.
there's at least, atleast, a 20% reduction in death from prostate cancer. this is the way they said it. you have to screen 1400 menand treat 48 guys with prostate cancer to save one fromdying of prostate cancer. that doesn't soundso good, right? that's not so good odds. you've gotto treat almost 50 guys to keep one from dying from it? what happens to the 45,000 to30, that sounded pretty good five minutes ago, nowit's not sounding so good.
suddenly it sounds like we'reover treating a bunch of guys. they've actually since gone backand cleaned up the numbers and there's, there's probablymore like 20 to one. 20 to one is still kind ofa lot of guys, you know? if you say we're going to getrid of that group, we're going to get rid ofthat group. we're going to pickjust these guys. we try to make thedata a little cleaner. it's probably more like 20 toone, which is still a pretty big
ratio of guys to treatto save that one. unless you're theone of course, right? and that's always the catch. and then if you look at theselittle graphs, another way to look at it is to run them outof years, so at nine years we're starting to see that the red armis different from the blue arm, but if you look at some of theguys that had the mid at the 14. you know the difference betweenthe non-screened versus the screened, that graph isreally starting to spread.
and so, if you got a diseasethat doesn't kill people for 10, 15, or 20 years, you know one ofthe concerns, without being too defensive is that well maybe wejust didn't wait long enough to see what happens when those,when you get more time. what if those thingsare really diverging? wow, that is a bigdifference then. so, we have to listen to whatthey said and then you got to think at whether you reallywant to use all that data or is there, you want to lookat it more carefully.
now the us trials, statisticallythere's no difference between the screened andunscreened, no difference. at seven years there'sno difference if you got screened or didn't.well, not so good. another study, out of sweden, sothey randomized men aged 50 to 70. they had a20-year follow-up. 20 years, that's more likewhat we're looking for. they screened every sixth man,did a digital rectal exam and they found no benefit toscreening at 20 years.
alright, well there's anotherlike nail in the coffin for the screening test. so, these things reallyspeak against screening. you also want to look at bothsides, and there are some really big problems with these studies. in europe, just for starters,every four years really may not be often enough, or frequentenough to pick up the cancer. you wait two, four yearsand you miss that window. the window opens to findit, you wait four years.
oh, too late. they'vealready shut. so, four years mightnot be frequent enough. now, this is, i think thebiggest problem with any of these trials, was the us trial. there's supposed to be screeningversus no screening, except half of you guys snuck over and, andgot into the screening thing. so, at least, at least 50% ofthe don't screen control arm, got screened, by theirprimary care doctors. so it wasn't screening versusno screening, it was pretty good
screening versus almostas good screening. always, if you want to tell thedifference between groups, you have to have twodifferent groups. they didn't have twodifferent groups, and both really didn't wait long enough. so, again, if you want to havesome understanding whether this'll make a difference at 20years, you have to be able to run out the statistics, somewhatcloser to 10, 15 to 20 years, not seven years or nine.these things really raise
some significant questionsabout over-detection. maybe we're just findingtoo much of this cancer. less people dying, but remember,it's almost in everybody. so maybe, maybe unfortunately,the psa is finding those guys who are going todie with it anyway. and the estimated risk ofover-detection is maybe, half the guys at age 75, we didn'treally want to find it. you've detected cancerthat really wasn't going to risk their health.
that's a lot of, remember i saidearlier a screening test, you want to find stuff, but youdon't want to have too many positive that aren't real, andtoo many negatives that aren't real. so that's a lot of false positives. and recently, since i made thistalk, a big us preventative task force group has come along andthey basically said because of the risk of over-detection,the us preventative task force services group says don'tdo any psa screening. so they just went from basically screeneverybody to screen nobody.
so, i have to say i think ingeneral, that someone just chucked out the babywith the bath water. i appreciate, and i understandand i don't want to over-treat my male patients. but i kind of don't want togo back to the old days when someone sick showed up with bonemetastases and we're playing catch up because we never do. that's not so good either. so, can we try to nuancethis a little bit? can we use this better?
alright, so first of all,i have to say detection really should notequal treatment. i think there has been a realmove in american urology to not treat everybody, and thatreally started to grow about five, six, seven years ago. and unfortunately it doesn'tquite get recognized in that task force recommendationnot to screen anybody. because what they say is ifeveryone gets detected and everyone gets discovered to haveprostate cancer, goes on to get
treatment, you're going toover-treat a lot of guys. and they say if that'sthe assumption, then, yes, we're over-treating alot of people and we shouldn't dopsa screening. if that algorithm has changedsome, and we are finding prostate cancer but some guyswe're treating it some guys we're not, are we trying topick and choose who is going to benefit from it, thenmaybe psa's still helpful. so, detection shouldnot equal treatment.
there are definitely sometypes of prostate cancer that don't need to be treated. so another big swedish trial, 15year data, by picking out guys under age 65 to get treated,because they have the longest life expectancy and have thegreatest potential risk for dying of prostrate cancerbecause again it's kind of slow. if you pick out guys under 65. this swedish study shows thatyou would need only seven men to treat to save one life.
and quite frankly, that's verymuch in line with the colon cancer screening numbers, andthe breast cancer screening numbers and a lot of theseother screening numbers. so, seven to one, may soundlike it's still a bunch of guys getting treated, but that'sactually, in the scheme of epidemiology, andscreening type of studies. that's pretty good. alright,well maybe we're just going to have tofinesse who we find and who we look for and whowe treat. a pivot trial.
they got a whole bunch ofva patients, and they try to randomize it to surgery,or they got randomized through surveillance. we're just going to watch you,and if something bad happens we'll treat you. they found eventually 700patients, but they had to screen 14,000, because no onewanted to go into the trial. because every guy who wants to,says, "i don't want someone else to decide if i get watched ortreated, i just want to
make my own decision." it took them forever to getanyone who actually agreed to be randomized to have someone elsemake that decision for them. you know, it's america. you can't tell me what todo, so no one wanted to be in that trial. i don't know that i would haveeither, but no one wanted to be in, so it took a long time. but essentially there is nobenefit to treating guys
with low-risk disease. and remember, when wetalked before, what makes it risky or not. one of those big thingsis that gleason score. so guys with a low gleasonand not too much of it. that's low risk. and if youtreated them, you weren't going to make them livelonger than if you just watched them. alright.at least it's starting. it got really fuzzythere for a while.
we're starting to, things arestarting to come back into focus a little bit more about whowe're going to search.there's some mild benefit to moderatedisease, and there's definitely a survival benefit for treatingguys with higher risk disease. psa was higher, thegleason score was higher. your biopsy 12 slivers, tenof them have cancer in it. duh, that's a fair amountof cancer in there. so, again, it's starting tocome a little more into focus. if you look at what'schanged over the years.
if you look at attempts athaving more scientific trials. i think there's some reallystrong implications that we don't have to ceasescreening entirely. and actually those trials andthat discussion improves what you have to talk aboutwith your patient. and it improves some of thescreening techniques and maybe it's going to help us improvesome of the treatment decisions. so, how do we take it fromthe monkey up to the guy walking upright? and how do weevolve this psa test?
well a guy walks in theoffice and his psa last year was two and now it's five. and maybe ten years ago let'ssay, alright, so you went from two to five, we'regoing to do a biopsy. well, no. now the next step is "why don'tyou come back in six weeks we're going to check the psa again."and you know, sometimes it goes down, it'sback to 2 and a half again. alright, so something madesome itis, something made some inflammation insidethat prostate and the
numbers came back down again. alright, great, you didn't havea biopsy, isn't that great? we checked your number again. we can age adjust these numbers. you can cut off 2 and a halfif you're in your forties. you can watch how quickly thesenumbers rise over time, and if i went from two, tofour, to five, to six. boy, that curve isgetting a little steep. then the velocity can maybehelp predict who needs a prostate biopsy. you all knowabout good and bad cholestrol?
right, well there's, basicallythere's good and bad psa. so the free psa is the good psa. you have to have atleast 25% of that. so you can look at the free psa. if there's a lot of it: great. if there's a really lowamount of it: not so great. if it's in between, it's in thestandard, classic gray zone. hard to know what to do with it,but the extremes of the good psa can be helpful. you can look athow big the prostate is. if you've got a gigantic gland,you expect you're going to have
more of a gigantic baseline psa. a little harder to do becauseit'd require having an ultrasound through the rectumto measure the prostate, to really get a verydefinitive prostate size. so, as a screening test, notgoing to put everyone through a transrectal ultrasound justto do a screening test. baseline psa, let's say you'rein your forties, or you turned 40, we check your baseline psa. if your baseline psa is 0.86or 0.4 at age 40
you know he's in a low pool. he's got like a 5% risk ofever getting prostate cancer. come back at 50. come back at60, we'll check it again. so if you start really low,you're starting really low and your risk is goingto be really low. if your baseline numberis two at age 40. well, you know, okay, wemight actually check you a little more often than if youstarted really low. if you look at people's baselinenumbers, so a 50 year old guy,
a normal rectal exam. zero to two, he's got 10%risk of prostate cancer. that's pretty low. greater thanten, that's almost 50-50. so you can look at baselinenumbers as some risk assessment of how closely i needto really follow some guy. so maybe everyone doesn'tneed an annual psa. maybe we just need to kindof have some check-ins as to how frequently it is. the american cancer society,they still say basically offer
screening to men at age 50. offer the screening to men. not everyone should have itbut, "sir, we could screen your prostate." the us preventive services taskforce actually, they used to say, "do not screen over age75." it's now don't check at all. american urologicassociation says, offer baseline to men in their 40s. and that baseline number will tell you whether you're at some risk in the long term or not. consider regular screeningfor men over age 50.
you should have at leasta life expectancy of more than 10 years. and most of the primaries arereally pretty sharp, but every now and then i get aguy come in the office. he just looks, he's old and he'ssick and he's really worn out, and he's had areally rough life. he's got the diabetes,he's got the hypertension. he's had two heart attacks.and his psa is 4.2. what do i think about it?you should go have lunch.
you don't need to check that. that's just not what his risk is going to be. go check your sugars. really pay attention to yourother health things, because that's what's going to riskhis health, not a prostate cancer ten years down the road. so you can look atpeople's life expectancy. and we're not bad at kindof getting some assessment when you sit down look atpeople's medical records. that's what you think thechance they'll make ten years.
and there's a whole bunchof things we can check. and you go into the aua websiteand you read the recommendations and it's just like this flurryof things you should all take into consideration when you wantto decide if you want to check psa. you want to do prostatecancer screening. so the future, and this is awhole bunch of medical labels, but there's actually some really interesting new tests coming out. and every few monthsthere's some article on my trade journal saying, "there'sthe pca urine marker.
there's the dna methylation." and there's been 200 guys whohad this new test and it looks pretty good for determining whoreally has prostate cancer, and who really might havethe progressive stuff. but it's 200 guys. no one's going to change theentire practice pattern for 300 people in the united statesbased on a 200 person study. so there are really excitingfuture things coming out that are not quite readyfor prime time.
so, a couple of things,remember, detection does not equal treatment. just because we find it doesn'tmean we have to treat it. we really should bescreening with some thought. "hey if i found something,would you really even consider having it treated?" we have to screenwith a better filter. i think there is some utilityfor looking for prostate cancer. we love the fact thatdeath rates have dropped.
but it does bother us thatwe have essentially over-treated tens ofthousands of guys per year. and then we're really goingto be watching for new developments. there will be better tests. and hopefully better teststhat really can separate the wheat from the chaff. we're much more discriminatingabout who really needs to be followed and who we just letpass on the prostate issue. it's hard to talk about this inhalf an hour and it's certainly
hard for peter jennings to giveyou the 30 minute story and have you understand why the taskforce recommendation to stop completely i think is abit over shot. but the task force really did bring upsome really good points. we have to be careful thatwe don't over treat guys. questions from you guys? (man) i'm just curious, youcited the two different studies that were out there. in the context of validity orof value, what would
you say makes a good test? (dr. pietrow) so, whatmakes a good study? you know, that's like the goldstandard often times, in medical studies, is you want it to haveto be randomized, and you want that trial to be controlled. and you want to look fordifference that is real. so, the problem with the ustrial was that it wasn't controlled. youhave this absolute contamination ofthe control arm.
essentially, there's very largeportions of people who weren't supposed to be screened,got screened anyway. so, you want it to be clean,you want it to be well set-up in the first place. you're looking for differencethat's going to be measurable. so, how long people live, howpeople, how much mortality there is, how much morbiditythere is from it. so, we'll never getthe perfect psa study. you can't. it's just too hard,because it's so hard.
it's hard to follow people for20 years, and it's hard to get a... i can tell you how goodstrep throat treatment is. you can get 100 people withstrep throat, and you check them, and within a week you knowwhether they're cured or not. should we use amoxycilin, orshould we use augmentin. fine. you get some pretty quickfeedback whether that is working. so we will never havethe perfect psa screening test or prostrate cancer trials,because it takes so long to follow patients to reallyprove that you're not just
too early or you're notgetting contaminated. so they are limited. but they're not worthless,they're just not as black and white definitive aspeople want them to be. so i think there is someutility to psa testing. but i think the every guy who'sover 50 guy gets a psa test and just painting that entirewall the same color is really not appropriate. and that's what i'm trying topromote is a more nuanced and a
more rational use of "whoshould i even screen?" and patients have to bepart of that process. they have to be willing to asksome questions, and have some philosophy questions. "do i really want to bescreened? will i treat it?" if you might, then it'sworth getting the test. yes. (woman) they have a lot ofpeople that i've heard of who've had psa's up. and the first thing they want to do is a biopsy. because youdidn't talk much on that part.
is that something that'spart of the testing? because you had mentionedthat a lot of times you want to wait and see what happens. (dr. pietrow) check it again. see if it's really elevated. so if we decide we're going tocheck, and we think this test may be positive, what's next? well, we really kind of startthis whole chain rolling. sometimes you reach in andyou feel the prostate and you know that's kind of ugly.
you still want toget some tissue. you want to get a sliver sothe pathologist can tell us how aggressive is this. and that's done through aprostate biopsy, which is done through the wall of the rectum. so it's an ultrasound, kind ofabout as big around as a finger, slides into the rectum. typically we'll use some novocaine, or lidocaine, and inject that next to the prostate and numb it. and then once we're there, then
we can get our samples,which is usually 12 needle slips. slip, slip,slip goes through the wall of the rectum into the prostate. there's a little springloaded thing that goes zip, zip and, and takes a sliver. the biggest risk of a prostatebiopsy is about one or two percent risk of infection. we tend to use cipro. we give a dose of cipro beforeand then that day and then that night, and it's worked prettywell for a decade or two, except with the indiscriminate useof antibiotics, including by
urologists and other physiciansand in the feed lots. there's a growing ciproresistance, so we're now having to come up with new ways toprevent that infection rate and still keep it down to thelow one percent or so. yeah? (man) when do you recommend thepsa for one of your patients? (dr. pietrow) so, first it hasto be at least a guy who has a long enough life expectancy. so, it has to be worth looking for a disease that might hurt them in ten to 20 years. so, they have to least have tobe healthy enough to think
they can live that long. so that's step number one. i think that certainlyguys who have a family history should be screened. i think that african americanstend to have a higher rate of prostate cancer, and it tends tobe a little more aggressive as well. so african americans,people with family history, guys with a good lifeexpectancy, people who might actually consider treating it ifwe found it. those are people who it's reasonableto do a psa screening on.
(man) how do youdetermine their treatment? (dr. pietrow) essentially, i'mgoing to over simplify. but there is four ways to thinkabout the new patient sitting there in front of me that justgot diagnosed with prostate cancer. not all prostate cancerneeds to be treated. remember my comment aboutdetection doesn't equal treatment. so, let's say the guy has onesliver of gleason 6 prostate cancer. that's the least aggressive.
and it's only onesliver out of 12. and it's maybe only5% of that sliver. not the entire core,but one part of it. that's a pretty low-risk biopsyand that guy should probably just get treatedwith surveillance. which means, we're notgoing to treat him. no active treatment. that's the kind of prostatecancer that he's more likely to die with. that's that 90 year old. 90% of 90. that's that guy.
well, we just discovered, oops,i just discovered the prostate cancer that i didn'twant to discover. but if i can recognize that,i'm not going to treat the guy. so, it doesn't mean you justwalk out the door and come back if anything ever goes wrong. generally we'llfollow some psas. we might repeat a biopsyat one year or two years. maybe at four, dependingon whose protocol you want to follow.
if nothing ever really changes,essentially as the guy gets older, and if it never reallyshows up as five cores and gleason 7 and later, you willprobably never treat that guy. so, that's kind of one extreme. the other extreme is the guy whoshows up and he's already got pretty advanced disease. he shows up because hegot some rib fracture. by the time they get sent to us,we find out he's got prostate cancer, but it's already spread. and i can't cure that guy.
so that's the kind ofguy you might treat with hormone deprivation. essentially we turn offtestosterone in the body. and turns out that by deprivingprostate cancer of testosterone, you can make it shrink. and it doesn't cureit, but it stalls. and you can buy years. you can buy years of time. almost always the prostatecancer finds a way to out-sneak the hormone deprivation,the hormone suppression
and progress, and get worse. so, people with moreadvanced disease are people we just want to stall. he's 80, but he's got a lot ofprostate cancer and, i just try. i know i'm notgoing to cure him. i just want him to nothave a bad bone fracture from his prostate cancer. so, i'm going to treat him justto stall things so he can die of something else,may use stalling tactics.
hormone suppression. now, if we're talking aboutcuring, kind of in between doing nothing and stalling, there aretwo mainstays, and there's a couple of sub-flavors withinthat, but the two mainstays for treatment are either surgeryto take out the entire prostate gland, or radiation. you keep the prostate, but wetreat that tissue with radiation so that the cells die. and youcan do radiation with a beam. you go every dayfor 45 days.
because if they were to give youthat entire dose of radiation exposure, it'd be too tough. you'd have too much burnto the skin and it's just too irritable. so they take that entire doseof radiation they want to expose you to, and they give you alittle bit, little bit, little bit, little bit, little bit. by the time you're done,you've had 45 little bits that adds up to that entiredose that you want.
and that's thestandard x-ray therapy. people can implantradioactive pellets. and people say "i don't wantthat radiation, i want the seeds." it is radiation. it's just radiation seedsversus radiation that you get exposed to in a beam. but those seeds, theyget implanted surgically. you go to the o.r. and we put needles in and you drop these pellets in the tissue.
and essentially theyburn themselves out. so they release their energy,they release their energy, and then they kind of... the half-life of radiation. eventually they're notproducing any energy anymore. the seeds stay in, butthey're no longer exposing the tissue to the energy. those are the two mainstaysof radiation therapy. surgery used to be an incisionfrom belly button to above the pubic bone, then they starteddoing smaller incisions, then
they started doinglaproscopic surgery. and now, 85% of people, ifthey're going to have surgery, have, essentially therobotic laproscopic surgery. there's a machine called thedevinci robot, and it's not like the ford motor company whereit reaches and just does it. you know, somebody's telling itwhat to do at all times, but the surgeon sits at a console. cool little 3d thing you sit atand you're watching these two telescopes and you're movingyour fingers over here and over
there are these robot arms thatyou've placed inside the belly. so, when i move over here, thearms over here go like this. so it allows you to getinto the really narrow spot. it's easier to manipulate, butit's still just surgery, right? it's just a fancy tool. so the mainstays for treatmentare either surveillance, if we think the guys alow risk disease. if you think this is gleason 7,he's had a bunch of cores, and this could be a threat to hislife expectancy, you might
either do surgery or radiation. and if you think that, "boy it'sreally advanced or i just want to stall," you might dohormone therapy or suppress it. so, the next question:"surgery or radiation? what of those are better?" and there is no right answer. part of that truly ispatient preference. some guys since you have tojust sort of decide what side effects they're mostwilling to put up with. surgery has theimmediate surgical risk.
you cut out the prostate, youput the urethra and bladder back together again, and now youhave to learn how to control that muscle. andguys leak right away. now most guys get theirbladder control back, but it takes some time. radiation has what i call theinnocent bystander effects. they can aim that beam rightat the prostate but it's never just the prostate. it's the nerves that goout to the penis as well.
so erections get worse,just like with surgery. and the rectumsits right behind, and that sees some ofthe energy. and the bladder sits above andthat sees some of the energy. so part of deciding which of thetwo curative, if you were to do that, is really deciding whichof the two side effects, which of the two recoveriesam i more willing to do. historically we've done moreradiation in older patients, and we've done more surgeryin younger patients.
a 55-year-old guy, youfigure, he can recover better. he's got more strength. he'sgot more reserve. but there's really no hardand fast rule in how you treat it if you're going to doa curative approach. any other questions? alright, thank you.