Central Perk

joi, 19 decembrie 2013

The Shape of Things to Come: Google in 2014

Posted: 18 Dec 2013 03:15 PM PST

We can't imagine the future without first understanding the past.

In this post, I will present what I consider the most relevant events we experienced this year in search, and will try to paint a picture of things to come by answering this question: How will Google evolve now that it has acquired Wavii, Behav.io, PostRank, and Grapple, along with machine learning and neural computing technology?

The future of Google will be based on entity search, semantic search, and Ã¼ber-personalization, and all the technologies it acquired will interact with one another in order to shape the Google we will experience in 2014. I'll show you how to deal with it.

The past

Last year, in my "preview" post The Cassandra Memorandum, besides presenting my predictions on what would have been the search marketing landscape during this 2013, I presented a funny prophecy from a friend of mine: the "Balrog Update," an algorithm that, wrapped in fire, would have crawled the web, penalizing and incinerating sites which do not include the anchor text "click here" at least seven times and do not include a picture of a kitten asleep in a basket.

Thinking back, though, that hilarious preview wasn't incorrect at all.

In the past three years, we've had all sorts of updates from Google: Panda, Penguin, Venice, Top-Heavy, EMD, (Not Provided) and Hummingbird (and that's just its organic search facet).

Bing, Facebook, Twitter, and other inbound marketing outlets also had their share of meaningful updates.

For many SEOs (and not just for them), organic search especially has become a sort of Land of Mordor...

For this reason, and because I see so often in the Q&A, in tweets sent to me, or in requests for help popping up in my inbox, how many SEOs feel discouraged in their daily work by all these frenzied changes, before presenting my vision of what we need to expect in Search in 2014, I thought it was better to have our own war speech.

Somehow we need it:

(Clip from the "The Lord of the Rings: The Return of the King" by Peter Jackson, distributed by Warner Bros)

A day may come when the courage of SEOs fails. But it is not this day.

A methodology

"I give you the light of EaÌˆrendil ... May it be a light for you in dark places,
when all other lights go out."

Even if I'm interested in large-scale correlation tests like the Moz Search Engine Ranking Factors, in reality I am convinced that the science in which we best excel is that of hindsight.

For example, when Caffeine was introduced, almost no one imagined that that magnification of the SERPs would have meant its deterioration too.

Probably not even Google had calculated the side effects of that epochal infrastructural change, and only the obvious decline in the quality of the SERPs (who remembers this post by Rand) led to Panda, Penguin, and EMD.

But we understood just after they rolled out that Panda and Co. were needed consequences of Caffeine (and of spammers' greed).

And despite my thinking that every technical marketer (as SEOs and social media marketers are) should devote part of their time to conducting experiments that test their theories, actually the best science we tend to apply is the science of inference.

AuthorRank is a good example of that. Give us a Patent, give us some new mark-up and new social-based user profiling, and we will create a new theory from scratch that may include some fundamentals but is not proven by the facts.

Hindsight and deduction, however, are not to blame. On the contrary; if done wisely, reading into the news (albeit avoiding paranoid theories) can help us perceive with some degree of accuracy what the future of our industry may be, and can prepare us for the changes that will come.

While we were distracted...

While we were distractedâ€"first by the increasingly spammy nature of Google and, secondly, by the updates Google rolled out to fight those same spammy SERPsâ€"Big G was silently working on its evolution.

Our (justified) obsession with the Google zoo made us underestimate what were actually the most relevant Google "updates:" the Knowledge Graph, Google Now, and MyAnswers.

The firstâ€"which has become a sort of new obsession for us SEOsâ€"was telling us that Google didn't need an explicit query for showing us relevant information, and even more importantly, that people could stay inside Google to find that information.

The second was a clear declaration of which field Google is focusing its complete interest on: mobile.

The third, MyAnswers, tells us that Personalizationâ€"or, better, Ã¼ber-personalizationâ€"is the present and future of Google.

MyAnswers, recently rolled out in the regional Googles, is a good example of just how much we were distracted. Tell me: How many of you still talk about SPYW? And how many of you know that its page now redirects to the MyAnswers one? Try it: www.google.com/insidesearch/features/plus/â€Ž.

What about Hummingbird?

Yes, Hummingbird, the update no SEO noticed was rolled out.

Hummingbird, as I described in my latest post here on Moz, is an infrastructural update that essentially governs how Google understands a query, applying to all the existing "ranking factors" (sigh) that draw the SERPs.

From the very few things we know, it is based over the synonym dictionaries Google was already using, but applies a concept based analysis over them where entities (both named and search) and "word coupling" play a very important role.

But, still, Google is attending primary school and must learn a lot, for instance not confusing Spain with France when analyzing the word "tapas" (or Italy with the USA for "pizza"):

But we also know that Google has bought DNNresearch Inc. and its deep neural networks, which had gained great experience in machine learning with Panda, and that people like Andrew Ng moved from the Google X team to the Knowledge Team (the same of Amit Singhal and Matt Cutts), so it is quite probable that Google will be a very disciplined student and will learn very fast.

The missing pieces of the "future" puzzle

As with any other infrastructural change, Hummingbird will lead to visible changes. Some might already be here (the turmoil in the Local Search as described by David Mihm), but the most interesting ones are still to come.

Do you want to know what they are? Then watch and listen to what Oren Etzioni of Wavii (bought by Google last April 2013) says in this video:

As well described by Bill Slawski here:

The [open information] extraction approach identifies nouns and how they might be related to each other by the verbs that create a relationship between them, and rates the quality of those relationships. A â€œclassifierâ€ determines how trustworthy each relationship might be, and retains only the trustworthy relationships.

These terms within these relationships (each considered a â€œtupleâ€) are stored in an inverted index that can be used to respond to queries.

So, it can improve the usage of the immense Knowledge Base of Google, along with the predictive answers to queries based on context. Doesn't all this remind you what we already see in the SERPs?

Moreover, do you see the connection with Hummingbird and how it can link together the Knowledge Graph, Google Now, and MyAnswers; and ultimately also determine how classic organic results (and ads) will be shown to the users over a pure entity-based and semantic analysis, where links will still play a role, but not be so overly determinant?

So, if I have to preview the news that will shake our industry in 2014, I would look to the path Wavii has shown us, but also especially to the solutions that Google finds for answering the questions Etzioni himself was presenting in the video above as the challenges Wavii still needed to solve.

But another acquisition may hide the key to those questions: the team from Behav.io.

I say team, because Google did not buy Behav.io as a society, but the entire team, which became part of the Google Now area.

What was the objective of Behav.io? It was looking at how peoplesâ€™ locations, networks of phone contacts, physical proximity, and movement throughout the day could help in predicting a range of behaviors.

More over, Behav.io was based over the smart analysis of the all the data the sensors in our smartphones could tell about us. Not only GPS data (have you ever looked at your Location History?), but also the speakers/microphones, the proximity detection between two or more sensors, which apps we use and which we download and discard, the lighting sensors, browser history (no matter which search engines we use), the accelerometer, SMS...

You can imagine how Google could use all this information: Again, for enhancing the predictive solution of any query that could matter to us. The repercussions of this technology will be obvious for Google Now, but also for MyAnswers, which substantially is very similar to Google Now in its purposes.

The ability to understand app usage could allow Google to create an interest graph for each one of us, which could enhance the "simple" personalization offered by our web history. For instance, I usually read the news directly from the official apps of the newspapers and magazines I like, not from Google News or a browser. I also read 70% of the posts I'm interested in from my Feedly app. All that information would normally not be accessible by Google, but now that it owns the Behav.io technology, it could access it.

But the Behav.io technology could also be very important for helping Google understand what the real social graph of every single person is. The social graph is not just the connection between profiles in Facebook or Twitter or Google Plus or any other social network, nor is it the sum of all the connections of every social network. The "real life social graph" (this definition is mine) is also composed of the relations between people that we don't have in our circles/followers/fans, people we contact only by phone, short text messages or WhatsApp.

Finally, we should remember that back in 2011 Google acquired two other interesting startups: PostRank and Social Grapple. It is quite sure that Google has already used their technology, especially for Google Plus Analytics, but I have the feeling that it (or its evolution) will be used to analyze the quality of the connections we have in our own "real life social graph," hence helping Google distinguish who our real influencers are, and therefore to personalize our searches in any facet (predictive or not predictive).

Image credit: Niemanlab.org

Another aspect that we probably will see introduced once and for all will be sentiment analysis as a pre-rendering phase of the SERPs (something that Google could easily do with the science behind its Prediction API). Sentiment Analysis is needed, not just because it could help distinguishing between documents that are appreciated by its users and those that are not. If we agree that semantic search is key in Hummingbird; if we agree that Semantic is not just about the triptych subject, verb, and object; and if we agree that natural language understanding is becoming essential for Google due to Voice Search, then sentiment analysis is needed in order to understand rhetoric figures (i.e. the use of metaphors and allegories) and emotional inflections of the voice (the ironic and sarcastic tones, for instance).

Maybe it is also for these reasons that Google is so interested in buying companies like Boston Dynamics? No, I am not thinking of Skynet; I am thinking of HAL 9000, which could be the ideal objective of Google in the years to come, even more so than the often-cited "Star Trek Computer."

What about us?

Sincerely, I don't think that our daily lives as SEOs and inbound marketers will radically change in 2014 from what they are now.

Websites will still need to be crawled, parsed, and indexed; hence technical SEO will still maintain a huge role in the future.

Maybe from a technical point of view, those ones who still have not embraced structured data will need to do so, even though structured data by itself is not enough to say that we are doing semantic SEO.

Updates like Panda and Penguin will still be rolled out, with Penguin possibly introduced as a layer in the Link Graph in order to automate it, as it happens now with Panda.

And Matt Cutts will still announce to us that some link network has been "retired."

What I can predict with some sort of clarityâ€"and for the simple reason that people and not search engines definitely are our targetsâ€"is that real audience analysis and cohort analysis, not just keywords and competitor research, will become even more important as SEO tasks.

But if we already were putting people at the center of our jobsâ€"if we already were considering SEO as Search Experience Optimizationâ€"then we won't change the they we work that much.

We will still create digital assets that will help our sites be considered useful by the users, and we will organize our jobs in synergy with social, content, and email marketing in order to earn the status of thought leaders in our niche, and in doing so will enter into the "real life social graph" of our audience members, hence being visible in their private SERPs.

The future I painted is telling us that is the route to follow. The only thing it is urging us to do better is integrate our internet marketing strategy with our "offline" marketing strategy, because that distinction makes no sense anymore for the users, nor does it make sense to our clients. Because marketing, not just analytics, is universal.

Sign up for The Moz Top 10, a semimonthly mailer updating you on the top ten hottest pieces of SEO news, tips, and rad links uncovered by the Moz team. Think of it as your exclusive digest of stuff you don't have time to hunt down but want to read!

Seth's Blog : Which charity?

Which charity?

Organized non-profits provide reach, leverage and consistency that can't be matched by the millenia-old model of individuals helping those they encounter in the community. It's one of the extraordinary success stories of the industrial age that they've been able to have such a worldwide impact with relatively few resources. As our choices continue to increase (yes, there's now a long tail of philanthropy), it gets ever more important that we make conscious choices about what to support and how.

Here are a few questions with no right answers, questions that might help you think about where you want to allocate your charitable support...

Are you more drawn to emergencies that need your help right now, or to organizations that work toward long-term solutions to avoid the emergencies of the future?

Would you prefer to support a proven, scaled, substantial organization, or does the smaller, less well-known organization appeal to you?

How much personal impact and leverage do you seek?

Are you a browser, jumping from issue to issue, or are you more excited about a long arc of a relationship?

Is this donation anonymous? If it's not, who will you choose to tell? Does their reaction matter?

How much of your donation activity is the result of opportunities and outreach from the organization, and how much from unprompted giving? (Hint: organizations do a lot of outreach because it works on their donors, not because it's fun. You will get more of what you respond to.)

What story do you tell yourself about you and your giving?

Are you focused on published numbers of organizational efficiency (how much goes into fundraising and admin)? Or does it make more sense to focus on the organization's impact as it goes about its mission? How will you decide to measure that impact, or does it not matter to you?

[Worth a second to note that every question I just asked could be asked about just about any marketed product you buy on a regular basis, whether it's coffee, cars or a consulting firm.]

There are no perfect charities, just as there are no perfect cars. But the imperfection of cars doesn't keep us from buying one--we pick the model (and the story that goes with it) that best serves our needs.

What an extraordinary opportunity to support something that matters to you.

• Email to a friend •

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miercuri, 18 decembrie 2013

Mish's Global Economic Trend Analysis

European Banks Dump Massive Amounts of Subordinated Debt on Investors
Italy's President Warns of "Widespread Social Tension and Unrest" but Offers No Solutions; "Pitchfork Protest" Comments From Italy
Fed Tapers $10 Billion with Cornucopia of Dovish Platitudes; You Talk Too Much!
Cancer Free: I Beat Prostate Cancer; Mish the Guinea Pig

European Banks Dump Massive Amounts of Subordinated Debt on Investors

Posted: 18 Dec 2013 04:19 PM PST

The Financial Times notes a Big rise in subordinated debt issuance by EU banks

Banks have taken advantage of yield-chasing investors to issue $90.7bn of subordinated debt for the year to date, a 41 per cent increase compared to the same period in 2012. It is the highest such volume since the $122.4bn seen in 2008 according to Dealogic, the data provider.

The figures follow a deal agreed by European regulators earlier this month that will bring in so-called bail-in rules for senior bondholders from 2016, two years earlier than envisaged by finance ministers in their common position agreed in June.

Banks are also expected to issue record amounts of loss-absorbing contingent convertible – or "coco" – bonds next year, which can either convert to equity or wipe out investors entirely if a bank's capital ratio falls below a pre-agreed level.

Junior Bonds

An apt description for "subordinated debt" is "junior bonds". From Wikipedia ...

Subordinated debt (also known as subordinated loan, subordinated bond, subordinated debenture or junior debt) is debt which ranks after other debts should a company fall into liquidation or bankruptcy.
Subordinated debt has a lower priority than other bonds of the issuer in case of liquidation during bankruptcy, and ranks below the liquidator, government tax authorities and senior debt holders in the hierarchy of creditors.
Subordinated debt is issued periodically by most large banking corporations in the U.S. Subordinated debt can be expected to be especially risk-sensitive because subordinated debt holders have claims on bank assets only after senior debt holders. Subordinated debt holders also lack the upside gain enjoyed by shareholders.
Consider asset-backed securities. These are often issued in tranches. The senior tranches get paid back first; the subordinated tranches later. Mezzanine debt is another example of subordinated debt.
Subordinated bonds are regularly issued as part of the securitization of debt, such as in the issue of asset-backed securities, collateralized mortgage obligations or collateralized debt obligations.
Corporate issuers tend to prefer not to issue subordinated bonds because of the higher interest rate required to compensate for the higher risk, but may be forced to do so if indentures on earlier issues mandate their status as senior bonds.

Now that we know what subordinated debt is, it's easy to understand the increase in issuance. It relates to bail-in procedures in the alleged European "banking union".

Laughable Eurozone Banking "Non-Union"

Consider my post on December 17, 2013: Laughable Eurozone Banking "Non-Union"; Expect Disorderly Breakup

Gunnar Hökmark, the lead negotiator for the parliamentary side, said: "We now have a strong bail-in system which sends a clear message that bank shareholders and creditors will be the ones to bear the losses on rainy days, not taxpayers."

Details show the alleged rainy-day fund is a pathetic €12.5bn of joint funds not available until 2020, even though 128 banks covered in the agreement have an aggregate balance sheet somewhere between €26 trillion and €27 trillion.

Also consider "stress tests".

Stress Tests

European Central Bank President, Mario Draghi Says ECB Won't Hesitate to Fail Banks in Stress Tests.

For details, please consider ECB President Mario Draghi Announces New Stress Tests; Translating "Draghize"

Perhaps the possibility of genuine stress tests, however slight, has sent banks running for cover.

Another possibility is banks are so poorly capitalized that some will fail even with watered down stress tests.

This lead to the key question: If banks are issuing subordinated debt because they need to, why should anyone want it?

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com

Italy's President Warns of "Widespread Social Tension and Unrest" but Offers No Solutions; "Pitchfork Protest" Comments From Italy

Posted: 18 Dec 2013 01:12 PM PST

President Giorgio Napolitano, Italy's figurehead president (power is in the hands of the prime minister) fears "indiscriminate and violent protest."

Napolitano is a bit late in his assessment given the massive number of "pitchfork protests" already underway. Moreover, Napolitano offers no solution to the mess.

Ambrose Evans-Pritchard reports Italy's president fears violent insurrection in 2014 but offers no remedy.

Events in Italy are turning serious. President Giorgio Napolitano has warned of "widespread social tension and unrest" in 2014 as the Long Slump drags on.

Those living on the margins are being drawn into "indiscriminate and violent protest, a sterile lurch towards total opposition".

His latest speech is a veritable Jeremiad. Thousands of companies are on the "brink of collapse". Great masses of the working people are on the dole or at risk of losing their jobs. Very high rates of youth unemployment (41pc) are leading to dangerous alienation.

"The recession is still biting hard, and there is a pervasive sense that it will be difficult to escape, to find a way back to full growth," he said.

Mr Napolitano is alarmed, and so he should be. The "forconi" pitchfork revolt has taken a disturbing turn for Italy's elites. Police took off their helmets in sympathy at the latest mass demo in Turin.

This is becoming an anti-EU movement. One of the Forconi leaders has just been arrested for climbing up the EU offices in Rome and ripping down Europe's blue and gold flag.

Where this is going is anybody's guess. Citigroup says Italy will remain stuck in depression with growth of 0.1pc in 2014, zero again in 2015, and 0.2pc in 2016. If so, Italy's output will be 10pc below the former peak a full eight years after the crisis, a far worse performance than during the Great Depression.

Even if the eurozone recovers over the next three years or so, the best that Italy can hope for is stabilisation at levels of mass unemployment – 20pc if you include Italy's extremely high level of discouraged workers (three times the EU average) who have dropped off the rolls. The question is how long society will tolerate this. None of us know the answer.

Pitchfork Comments From Italy

In regards to the pitchfork protests I asked reader "AC" who is from Italy but now lives in France for some comments. "AC" replied ...

Hello Mish

The "pitchfork protest" consists of heterogeneous groups with heterogeneous goals: some are asking for lower taxes and less bureaucracy, some others are asking for more government spending and intervention. And for still others, it is not clear at all what they are asking for.

There is no common goal, no common target, no common platform, not even a common method of protest. There is no clear leadership in the movement. The only common glue seems to be the protest against privileges of the political class.

In comparison, Beppe Grillo's star movement was very well organized from the beginning, with a clear leadership. This has been key factor in its further development.

From that standpoint, I think the "pitchfork movement" will not last long, at least in the present form.

That said, it's significant the protest is spreading out rapidly in such a anarchist way. People are ready to follow anybody who shows a little bit of anger and has some capacity to organize people.

Where this leads is unpredictable.

Best regards,
AC

Solutions

What Italy needs to do is easy enough to describe in six simple bullet points.

Dump the euro
Lower taxes
Political reforms
Economic reforms
Pension reforms
Work rule reforms

However, describing what needs to be done, and actually doing it are two different things.

In the above list, only number three is being discussed in a serious way, and then only because the Constitutional Court recently ruled that seat appropriation in parliament (giving a majority in the lower house to the largest vote-receiving party) is unconstitutional.

See Italy looks to replace unconstitutional election law.

Curiously, a return to equal representation could mean more gridlock on economic reforms because the numerous party system in Italy practically guarantees no one will ever get a majority.

In the meantime, as "AC" notes, the protest is spreading in unpredictable ways.

Perhaps it fizzles, perhaps it gets organized, perhaps it merges with Beppe Grillo's 5-Star Movement, or perhaps it culminates in mass "I'm mad as hell and can't take it anymore" riots.

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com

Fed Tapers $10 Billion with Cornucopia of Dovish Platitudes; You Talk Too Much!

Posted: 18 Dec 2013 11:42 AM PST

Coupled with a cornucopia of dovish statements the Fed finally decided to taper, a measly $10 billion per month, half out of mortgage purchases, half out of treasury purchases.

Here are some snips from the FOMC release. Emphasis mine.

The Committee recognizes that inflation persistently below its 2 percent objective could pose risks to economic performance, and it is monitoring inflation developments carefully for evidence that inflation will move back toward its objective over the medium term.

In light of the cumulative progress toward maximum employment and the improvement in the outlook for labor market conditions, the Committee decided to modestly reduce the pace of its asset purchases. Beginning in January, the Committee will add to its holdings of agency mortgage-backed securities at a pace of $35 billion per month rather than $40 billion per month, and will add to its holdings of longer-term Treasury securities at a pace of $40 billion per month rather than $45 billion per month.

The Committee is maintaining its existing policy of reinvesting principal payments from its holdings of agency debt and agency mortgage-backed securities in agency mortgage-backed securities and of rolling over maturing Treasury securities at auction. The Committee's sizable and still-increasing holdings of longer-term securities should maintain downward pressure on longer-term interest rates, support mortgage markets, and help to make broader financial conditions more accommodative, which in turn should promote a stronger economic recovery and help to ensure that inflation, over time, is at the rate most consistent with the Committee's dual mandate.

If incoming information broadly supports the Committee's expectation of ongoing improvement in labor market conditions and inflation moving back toward its longer-run objective, the Committee will likely reduce the pace of asset purchases in further measured steps at future meetings. However, asset purchases are not on a preset course, and the Committee's decisions about their pace will remain contingent on the Committee's outlook for the labor market and inflation as well as its assessment of the likely efficacy and costs of such purchases.

The Committee also reaffirmed its expectation that the current exceptionally low target range for the federal funds rate of 0 to 1/4 percent will be appropriate at least as long as the unemployment rate remains above 6-1/2 percent, inflation between one and two years ahead is projected to be no more than a half percentage point above the Committee's 2 percent longer-run goal, and longer-term inflation expectations continue to be well anchored.

The Committee now anticipates, based on its assessment of these factors, that it likely will be appropriate to maintain the current target range for the federal funds rate well past the time that the unemployment rate declines below 6-1/2 percent, especially if projected inflation continues to run below the Committee's 2 percent longer-run goal.

You Talk too Much

Clearly the Fed is trying not to upset the markets and wants the stock and bond market bubbles to build. But all the Fed can really do is talk.

Will it work? The answer is "not forever". Of course bubble expansion is never in the best general interests of anyone but the banks and already wealthy.

I offer this musical tribute.

Link if video does not play: Frankie Ford - You Talk Too Much

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com

Cancer Free: I Beat Prostate Cancer; Mish the Guinea Pig

Posted: 18 Dec 2013 12:46 AM PST

In October 2012 I was diagnosed with prostate cancer. I am now cancer free. Here is my story, a detailed one, with test results.

I have been taking PSA tests every couple years since 2007. It's a routine blood test recommended for men as they get older.

PSA stands for Prostate Specific Antigen. Elevated readings may indicate evidence of prostate cancer. Any reading under 3.0 is normal but some doctors may say 4.0 and others 2.5. It's not an exact science to be sure.

My test in August of 2012 was elevated (6.65). Another test in October was also elevated (7.13)

My regular doctor strongly recommended a biopsy.

The biopsy showed I had cancer. My "Gleason Score" was 6. The surgeon that performed the biopsy (Dr. G) strongly recommended surgery. He gave me a cost of $20,000.

What follows is my general understanding of methods of dealing with prostate cancers and problems that may result from treatment.

Do your own due diligence and consult a doctor if you are in a similar situation.

Problems With Surgery

Prostate surgery can cause all sorts of complications including loss of sexual functions and urinary incontinence. I had not yet started dating following the death of my wife Joanne in May of that year.

Imagine telling a date "Hi, I'm Mish. I have prostate cancer", or worse yet "I'm impotent and have urinary incontinence thanks to prostate surgery".

Even if there are no complications, the very best one can hope for with prostate surgery is loss of ability to ejaculate (a 100% given), then perhaps with drugs like Viagra, Cialis, or Levitra an erection or orgasm can be achieved.

My doctor recommended radiation therapy. Unfortunately, the complications are similar, and costs higher, especially for proton beam therapy.

For a discussion of proton beam therapy, please see the Cancer.Org discussion Is proton beam therapy for prostate cancer worth the cost?

This is my general understanding after talking with doctors and reading countless articles: With surgery, complications arise immediately, with radiation therapy, additional complications may arise years down the road.

Three Options

My own research showed three potential options.

Surgery
Radiation Therapy
Wait and See

I wanted other opinions, so I talked to an oncologist. Oncology is a branch of medicine that deals with cancer.

The oncologist informed me that we caught the cancer "very early". He also stated "based on your conditions, there is no statistical evidence that strongly favors any one course of action. Equal results are obtained by surgery, by radiation therapy, and by waiting".

Hmmm. No statistical difference between the three options?

Actually, there is a difference, but for those who have an aggressive form of cancer then just let it go. Otherwise, until you find out whether it's aggressive or not, it's point blank wrong to rush to surgery. So I didn't.

Yet, I also decided "wait and see" was not doing enough. So I spent at least 60 hours researching things one could try. I discovered some interesting studies and elected to try a cocktail of the most promising things, but I also wanted to keep up with regular PSA tests to monitor for aggressive forms of cancer.

My own doctor was against the cocktail idea (but was willing to go along with it provided I kept up the PSA monitoring). The oncologist said "the cocktail would not do me any good but would not hurt either".

I informed the oncologist that I was going to have a PSA test every month. He commented something along the lines of "Why do you want to do that? Every six months is sufficient. The tests are not that reliable." That is not an exact quote, but is best as I can remember.

My thought - which I did not express - was "What kind of mathematical silliness is that? The more unreliable a test is, the more tests one should take to weed out erroneous outlier results."

My next PSA reading one month later was a disaster (17.65). At that point I was pretty sure I had an aggressive form of prostate cancer but I still wanted to try my "do something" program for one more month.

Mentally I prepared myself for surgery.

In December, my PSA crashed, as did three subsequent scores. Here are the dates and results.

Date	PSA Reading
11/29/2007	1.77
3/20/2010	1.66
8/1/2012	6.65
10/16/2012	7.13
11/15/2012	17.65
12/13/2012	2.99
1/24/2013	2.39
3/6/2013	2.35
7/11/2013	1.94

Given that my December and January results were normal, I was quite happy with my alternative program.

The surgeon, "Dr. G" was not. In January, he wanted another biopsy immediately and sent me a later stating "If you intend to continue to be evaluated by our office, you need to schedule the requested biopsy without delay. If you wish to see another urologist we would be happy to forward your records, but otherwise please contact our office to schedule an appointment."

That is an exact quote. It marked the end of my relationship with "Dr. G".

I had two more PSA readings, in March and July, each normal, and each lower than the one before.

In a recent followup conversation with the oncologist, he informed me the series of PSA tests was not conclusive.

I had my own doubts as well. I was wondering if something I was taking may be artificially lowering my PSA readings.

I decided to have another biopsy, but with a different surgeon.

Before I get to the result, I need to mention other possible explanations for the 7.13 PSA reading: Drugs like Viagra, Cialis, or Levitra can elevate the numbers. So can sex.

In case I needed surgery, I wanted to know in advance how my body would react to such medications. I was on Levitra at the time of the elevated reading.

I Beat Prostate Cancer

As you can surmise by the title of this post, my latest biopsy, about a week ago, came back benign.

Below, I list what supplements I took and why. First let's wrap up some loose ends.

Is Surgery Recommended for Gleason 6?

Those in my situation may wish to read What is a Gleason 6 Prostate Cancer and also WatchWait.Com.

From the above link: "Does prostate cancer need to be treated? For most men, the answer may be NO!"

American Society of Clinical Oncology Chimes In

The American Society of Clinical Oncology chimes in with Gleason Score 6 Adenocarcinoma: Should It Be Labeled As Cancer? Read the first paragraph below carefully.

Overtreatment of low-grade prostate cancer (Gleason score ≤ 6) is a recognized problem today, with systematic prostate gland sampling triggered by prostate-specific antigen (PSA) measurements. The extent to which overtreatment is caused by fear of death resulting from cancer, fear of litigation from undertreatment, and misaligned incentives that reimburse more for treating rather than monitoring when appropriate is not known. Nevertheless, fear of death resulting from cancer likely plays some role, and removing the label "cancer" could reduce unnecessary treatment of low-grade disease. On the other hand, undertreatment of prostate cancer and a missed opportunity for cure in those who could benefit is a real risk of relabeling a cancer as noncancer. We have decided on an alternative modification of the Gleason scoring system and herein present the arguments for and against removing the label of cancer from Gleason 6 tumors. ....

Data demonstrate that using a time horizon of 10 to 15 years, less than 3% of men diagnosed with Gleason score ≤ 6 and classified as low risk (based on a PSA < 10 ng/mL and stage ≤ T2a) will die as a result of prostate cancer whether treated or not. The evidence calls into question the need for treating men with Gleason score 6 tumors (graded in the modified system) who have a life expectancy of fewer than 10 to 15 years, especially if considered low risk.13 But the reality is that today, men older than age 65 years with Gleason score 6 tumors on needle biopsy are treated as though they harbor a tumor with the same biologic potential as those with a Gleason score ≥ 714,15—a one-size-fits-all approach that is inconsistent with medical evidence suggesting that physicians and patients view a Gleason score 6 cancer today as a lethal phenotype in most cases.

Interested parties may wish to read the rest of the article.

Why the Rush and Pressure for Surgery?

The answer is easy: $20,000 each.

Let's put it this way: "Dr G" is very skilled at them.

By the way, in my first conversation with the oncologist I stated the biopsy showed I was 10% cancerous. He said "say that again". So I repeated "Dr. G said I was 10% cancerous".

The oncologist replied "That's not correct. Of the 12 samples, only one had cancer and one was questionable. The cancerous sample was 10% cancerous."

Now that is a hell of a lot different than being 10% overall cancerous wouldn't you say? I had a witness for the conversation with Dr. G.

First Biopsy Results - October 2012

On December 17, 2013, I finally saw the actual results of the first biopsy!

Dr. G would only release them to another doctor, not to me, unless I went in to sign a release. The oncologist had already seen them, but shouldn't Dr. G have shown them to me immediately?

First Biopsy Results

Twelve samples were taken. Ten were benign. Here are the two non-benign samples exactly as written on the report.

G: Prostate, Needle Biopsy, Right Base; Prostatic Adenocarcinoma, Gleason Score 3+3=6, Involving 10% of One Core (See Comment)
A: Prostate, needle biopsy, left lateral base; High Grade Prostatic Intraepithelial Neoplasia (PIN)
Comment G: Combined immunostain (PIN 4) for racemase, and bsasal cell markers, p63 and HMWCK (performed at Centegra Hospital McHenry, Illinois) supports the diagnosis of adenocarcinoma; the glands strain strongly for racemase and basal cell strains are negative. No perineural invasion invasion is identified in this case. This case was included in the pathology Integrated Quality Assurance Program.

Doctors Treat Patients as ATMs

I now understand there was absolutely nothing in that report that remotely suggests a need for immediate surgery.

I have posted on this before already. Please see Unnecessary Surgeries? You Bet! Doctors Treat Patients as ATMs; US Healthcare System Explained in Six Succinct Points

My Prostate Research

Here are two key articles I found in my research.

Resveratrol -Powerful Protection Against Prostate Cancer

Good news for men concerned about prostate cancer: resveratrol is a supplement that blocks it at every stage, from beginning to end. A polyphenol found in grapes and other plants, resveratrol was first identified as a multistage protector in 1997, and now is considered a leading agent against prostate cancer by researchers at Houston's MD Anderson Cancer Center and other institutions. Resveratrol works through more than a dozen different anticancer mechanisms and selectively targets cancer cells. This single supplement modulates hormones, has several mechanisms that stop cancer cells from multiplying, and even has the ability to destroy cancer cells.

Resveratrol originally gained notice when researchers suggested that it is the agent in wine that protects against heart disease. Because of its antioxidant and anti-inflammatory actions, resveratrol also was investigated as a possible anticancer supplement. Since research began in earnest in the 1990s, resveratrol has been the subject of hundreds of scientific papers, making it one of the most intensely studied supplements on the market today.

In one review of resveratrol, University of Wisconsin researchers set out six criteria for a good anticancer agent: it should a) have no toxic effects in healthy cells; b) work against different types of cancers; c) be administered orally; d) have known mechanisms of action; e) be inexpensive; and f) be acceptable to humans.4 Resveratrol met all six criteria.

One remarkable aspect of resveratrol is that it can be very toxic to cancer cells but does not harm healthy cells; in fact, a person taking resveratrol for protection against prostate cancer may receive cardiovascular benefits as a side effect.

Another important aspect of resveratrol is that it may be combined with other phytofactors to potentially enhance its effects. Resveratrol naturally occurs with other polyphenols such as quercetin in plants such as grapes. Quercetin may enhance resveratrol's bioavailability and cancer-killing effects. Another plant extract, indole-3-carbinol, or I3C, may work synergistically with resveratrol to kill more cancer cells because I3C stops cell growth at one point in the cell cycle while resveratrol stops it at another point. Physicians employ this same concept when prescribing combinations of chemotherapeutic drugs for their patients—each drug halts cancer cell growth at a different stage of the growth cycle

Resveratrol, on the other hand, has multiple, anti-prostate cancer effects. Resveratrol halts the growth of hormone-positive and -negative cancers; works through multiple mechanisms to stop cancer cells from multiplying; is effective from the earliest to the latest stages of cancer; protects DNA from damage; and may inhibit cancer metastasis. Combined with quercetin and the powerful anti-hormonal agent I3C, resveratrol may be the best cancer-preventive approach available today.

Can Resveratrol Prevent Prostate Cancer

Next consider Can Resveratrol Prevent Prostate Cancer?

Resveratrol is repeatedly in the headlines as a potent anti-aging nutrient and I have written about this extensively in my article, Is Resveratrol the Fountain of Youth? A new cell study shows that resveratrol1 can block the transition of cancer cells into the form that becomes aggressive prostate cancer that is more likely to kill.

This study builds on earlier prostate cancer cell research that showed prostate cancer cell suppression and the induction of death signals in various types of prostate cancer cells. The new research shows that resveratrol communicates to the core gene signal, NF-kappaB , turning it down so as to turn down the key molecular mechanism involved in the progression of prostate cancer (the overexpression of NF-kappaB ).

As I have previously pointed out, the common doses of resveratrol that show benefit and safety in animal studies range from 2.5 mg – to 10 mg per kilogram. This translates to an approximate dose range of 150 mg – 700 mg per day for a 150 pound adult, a sensible and safe dose range until more data is in.

It is generally assumed that most nutrients have inherent wisdom, meaning that they can help knock out possible that very high doses of resveratrol may be able to induce cell death in healthy cells instead of cancer cells while keeping healthy cells alive – which is certainly true for resveratrol. However, it is the generally assumed anti-aging benefit. Until more human data is in, I would keep the dose to no more than 1000 mg per day.

Mish the Guinea Pig

Preventing cancer was not an option for me. I already had it. My goal was to kill it.

What follows is the cocktail that it took. It is based on the above research as well as numerous other articles. The first four items in my cocktail mix list were mentioned above.

I also took a few other things for other reasons. Explanations follow my list.

This is not a recommendation. Consult your doctor.

Mish Cocktail

Resveratrol: 250 mg twice daily
Indole-3-Carbinol: 200mg twice daily
Bromelain: 500mg twice daily
Querceten: 300mg twice daily
Turmeric Extract: 300 mg twice daily
Vitamin D3: 5,000 IU twice daily
Vitamin K2: 100mcg twice daily
Vitamin B12: 100mcg twice daily
Selenium: 50mcg twice daily
Sodium bicarbonate orally: One half teaspoon twice daily - 1 hour in the morning right after I get up, and again in the evening right before bed – empty stomach

#1-9 were taken with meals.
#10 was on an empty stomach so as not to buffer stomach acid digestion.

Blood tests showed I was deficient in B-12 and D3. My regular doctor wanted me to to take periodic shots. He claimed studies show that as people get older, pills won't be absorbed.

I said, let's try the pills and see.

The results are in: every blood test since then shows I have more than enough B12 and D3. That simple test saved me once-a-month shots.

On his recommendation, I lowered my D3 dosage to the amount shown above. Vitamin D can be toxic in doses too high.

#10 is the most controversial item on the list. If you do a bit of research on the internet you can find numerous articles on baking soda treatments for prostate cancer. "Get alkaline" is the general thesis. The way most of them describe how it works is ludicrous. Cancer is not a "fungus" as one proponent of baking soda says.

Yet, just because someone describes reasons wrong, does not mean there is no merit.

Still, my oncologist specifically warned "Do not try to change your pH. This is exceptionally dangerous and can kill you. Your body will maintain a pH strictly between 7.35 and 7.45. Urine pH will be determined by diet, exercise and other things in your body. There is no reason whatsoever for you to try to change it and attempting to do so can be dangerous to the point of killing you."

I decided to take baking soda, but not in huge amounts.
The bag of Arm & Hammer reads ...

Active Ingredient: Sodium Bicarbonate
Purpose: Antacid
Stomach Warning: To avoid serious injury, do not take until powder is completely dissolved. It is very important not to take this product when overly full from food or drink. Consult a doctor if severe stomach pain occurs after taking this product
Directions: 1/2 teaspoon to 1/2 glass (4 fl. oz.) of water every 2 hours or as directed by a physician.
Do not take more than the following amounts: seven 1/2 teaspoons (three 1/2 teaspoons if over 60 years).
Do not take the maximum dosage for more than 2 weeks

For 6 months I took 1 teaspoon of baking soda twice daily. Since then I have been taking 1/2 teaspoon twice daily.

My oncologist stated "A little bit of baking soda (sodium bicarbonate) is harmless and 1/2 to 1 tsp a day is probably having no effect on your pH. Your kidneys will simply excrete the extra bicarbonate. Baking soda injections are pure quackery and dangerous unless given by a physician for very specific health reasons - none of which you have. Taking in too much bicarbonate will overwhelm your kidneys ability to excrete it all and can kill you."

Cancer Free

The latest biopsy has 12 samples, all identically labeled "Benign, prostatic tissue. No malignancy Identified."

Technically, I am not "cancer free". A more accurate way of stating things is "the biopsy did not detect any cancer". That is good enough for me (because it doesn't get any better).

I believe the first four items on the list is what produced the results. I am not sure if baking soda did anything or not. Serious questions remain.

Serious Questions

Did I have cancer in the first place?
If so, is it really gone or did the second biopsy miss it?

My Personal Conclusions:
It's highly likely I did have cancer. Low-grade cancer in light of spiking PSA readings seems reasonable.

Similarly, I believe it's highly likely I had cancer and it is now gone. Four consecutive crashing PSAa and a benign biopsy suggest just that.

Once again: Nothing above constitutes a recommendation. I listed what I took, and what my results were. Consult your doctor before attempting anything similar.

Reflections On Medical Research

On my first visit to the oncologist, he stated "Until there is data in human beings with prostate cancer, there is no reason to believe that resveratrol has any activity whatsoever in treating or even preventing prostate cancer. Feel free to take it if you wish as it appears to be safe."

I strongly suspect he would not consider me as "human data". I do, even though I clearly do not constitute as scientific study.

So why aren't there more studies on these supplements given the articles I cited? The answer is big pharmaceutical companies are not interested in anything they cannot patent.

They would rather find a $20,000 drug that works 5% of the time (that they can patent) rather than something cheap that works 80% of the time that they can't.

In fact, the big pharmaceutical companies have attempted numerous times to regulate nutritional supplements. If it was up to them, I never would have been able to try what I did.

Individual doctors vary, and I have a great urologist now, but much of the industry is about maximizing patient costs for profits (patients be damned).

Even the insurance companies are short-sighted. They would have paid for prostate surgery but they would not pay for the repeated PSA tests. Fortunately the PSA tests and supplements are very cheap.

Final Thoughts

Had I listened to Dr. G., I would not have a prostate right now. I would be out my deductible portion of $20,000 and the insurance company would be out the rest. And on top of it all I might have run into serious complications.

I have two close friends who had prostate surgery. One came out fine, the other didn't. The friend who did not come out fine has both incontinence issues and sexual performance issues.

The friend who came out fine went to the best surgeon he could find. Is that the right approach? It seems reasonable if you need surgery, but what if you need an opinion on whether surgery is needed? How did these guys get skilled? Was it by doing too many needless surgeries?

Similar questions apply for those considering radiation therapy.

I have a great urologist now: Nejd F. Alsikafi, M.D., F.A.C.S. at UrologySpecialist.

I am on a monitoring program with PSA tests every three months and biopsies every two years (more frequently if my PSA trend changes). He agrees the treatment proposed by Dr. G was not warranted.

Finally, few, if any, doctors are likely to recommend the cocktail regimen I am on. They may go along with them, if you bring them up, but they won't recommend them. The doctors want clinical studies. Yet, Alsikafi readily admits it's not in the interests of big pharmaceutical companies to do them.

Here's the key lesson: Even if you find a great doctor, it's still very important to be your own health care advocate.

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com

joi, 19 decembrie 2013

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