Sunday, November 25, 2012

A different kind of attribution

When I teach our Performance Fundamentals and Attribution classes, I often say how we frequently borrow concepts from other places: attribution is just one example. We didn't come up with the idea of attributing an event to a cause, or determining how various causes contributed to an outcome. 

Today's post deals with an attribution that has nothing to do with performance. It is also a bit of a delicate subject, so I hope it's okay.

The subject: prostate cancer.

I just turned 62. As I understand it, by my age roughly 60% of men have had prostate cancer. I had a physical recently, and I was told that the condition of my prostate is somewhat "unique." That is, it's in very good shape.

Unlike those men you see in some commercials, I don't find myself having to rush to the bathroom multiple times a day or throughout the night. I recall playing a round of golf with three much younger men. We all had plenty of fluids to drink during the first part of our round. When we got to a hole with a bathroom, the three young guys rushed to the bathroom while I stayed in the cart.

And so, what to attribute to my apparently quite healthy prostate? I've identified three possible causes.

#1 My morning smoothie drink. For more than 10 years (probably close to 15) I've prepared a smoothie when I'm at home, that consists of the following ingredients:
  • One serving of soy powder. I read something many years ago that suggested that the use of soy might help reduce the risk of prostate cancer. And so, I've been a devotee. I use Solgar Iso-Soy Soy Protein/Isoflavone Concentrated Powder Natural Vanilla Bean Flavor which you can get from Amazon
  • 1/2 tsp cinnamon. I had read that cinnamon is good for you, so I include a bit in my drink.
  • 1 tbsp EVOO (extra virgin olive oil). I understand that we are to consume at least some olive oil daily, and so by including it in my morning drink, I'm guaranteed having it.
  • 1 cup blueberries. I use Wyman's frozen wild blueberries. They're high in antioxidants. You can get them at BJs and Costco.
  • 3-4 frozen strawberries. Also high in antioxidants. Also taste good!
  • 1/2 cup orange juice
  • 1/2 cup grapefruit juice
  • 1 cup skim milk (a way to get calcium)
  • 1 banana (for potassium).
When I'm home, I start each day with this drink. It makes about 32 ounces, which I consume at one time. You could split it between two days, of course. It is, I think, fairly high in calories, so you might want to consider this. I happen to think they're very healthy calories.

#2 High consumption of fluids. Empirical evidence shows that I consume a much higher amount of fluids than most people. During the day I drink a lot of coffee (decaf; in the AM), water, and diet soda. Could this have anything to do with my healthy prostate? I have no idea, but looking for things that are obviously different suggests that it's a candidate.

#3 Heredity. It's possible that I have "good genes," though I don't have any easy way of finding out. My father died at 69 from pneumonia (he was a "recovered" alcoholic and heavy smoker; I don't know if he had prostate issues). His father was older when he died, but I have no evidence to suggest that he had a good or bad prostate. Details of my maternal grandfather's demise are unknown to me; I never met him, and his is an interesting story that I'll save for some other time.

There is, of course, a fourth possibility: unknown cause. I have faith in my daily drink, and believe that what I include is all healthy stuff, some of which reportedly combats cancer. While I've never heard anything about fluid consumption being good or bad for cancer prevention, knowing that my intake is higher than most suggests that it's at least a possibility.

When men turn 40 they begin to get tested for prostate cancer, and this continues for the rest of their lives. I now get annual physicals. Fortunately, my prostate is healthy. My only reason for sharing this today is because I am fully aware of the potential effects of a bad prostate. I have friends my age who often have to stop to rush to the bathroom. I don't. I sent my formula to one prostate cancer research facility, who didn't seem to be impressed, which is fine. And perhaps you won't be, either. But prevention is a good thing. And while I cannot guarantee that this drink is a good thing, it's a daily routine for me whenever I am home. My mother died of cancer when I was very young. I've had other relatives and friends who've died of cancer. And so, prevention and awareness is very important to me. Thus, this post. I hope it's well received.

A disclaimer: I am, of course, not a medical authority or practitioner. I am simply sharing something that I do. I cannot offer any guarantees whatsoever, or offer any further guidance. I have faith in it, thus my daily devotion and interest in sharing it with my readers.


  1. Dave; By 60% I think you may mean have prostate issues; according to the American Cancer Society, 1 in 6 men will be diagnosed with prostate cancer during their lifetime. There has also been quite a bit of research published recently which suggests that prostrate cancer is often over-treated, referring to the point that it is usually slow-growing and not fatal. At one point I had to ask the VA to stop giving my father unnecessary shots in the abdomen at age 85. This is not to say that it is not often a deadly disease that no one wants.

    In any case, a fascinating analogy to financial attribution. How do we validate all these factors that feel right but can't be measured?

  2. David, you may be correct; I had heard cancer, but perhaps just issues. Thanks for your contribution. As for how to validate, testing would be needed, would it not? A group of willing participants. Sadly, I don't have the bandwidth to devote to this.

  3. Some thoughts:

    - "Attribution" of cancer is tricky. If one doesn't get it, we never know why, really. Likewise if one does get it, we usually can't pinpoint why, either. And in many cases, there are conflicting studies on prevention techniques. For example, it has long been suggested that keeping the prostate "active" has preventive value, but some recent surveys show this may not be the case. But people should do whatever they can to prevent cancer, to the best of their knowledge and ability.

    - The 1 in 6 stat on men being diagnosed with prostate cancer is correct. And there is some debate about over-treatment, which is an important topic to debate. I'm not sure how quickly we can curb the 1 in 6 statistic. But the statistic we *can* make a dent in is that 1 in 20 men will die of prostate cancer. Prostate cancer is generally slow growing (but not always). A major reason so many men die of the disease is lack of awareness and failure to be tested. If men get tested and catch the disease early, they have excellent choices available to them and they will almost always survive. It would be one thing if the majority of men that we hear about dying of prostate cancer did so because they had been armed with the knowledge of their condition early on and then made the conscious choice to not be treated. Unfortunately, death today almost always means the individual failed to be tested. Men's health is an important issue; one that many are uncomfortable talking about or fail to find the time to do so. But if men were as aware and conscious about prostate cancer as women are about breast cancer, the 1 in 20 death rate would be be reduced to a fraction of that figure.

    - I don't know what the 60% statistic for an age group could be, but generally there are three reasons one could have a high prostate specific antigen (PSA) test result: cancer, infection or blockage. Symptoms occur with the latter two (e.g., need to use the bathroom frequently), whereas prostate cancer has no real symptoms until it exits the prostate (which often means it has been there for years and has migrated to blood, lymph and/or bone, which is very bad). The fact that prostate cancer is symptom-less is another reason why testing is very important.

    - This is a very timely topic, given that it is "Movember" - the month where many men grow moustaches in the attempt to raise awareness of the cancers that affect men (primarly prostate and testicular cancer), and men's health in general. Hopefully Dave's blog post will encourage more men to take care of their health!


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