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September 16, 2002


Interpreting the prostate studies

Last week, I wrote about the Swedish prostate cancer trial. Both Medpundit and RangelMD weighed in with similar takes. Today's Boston Globe has a well written and thought out editorial - Prostate prospects.

It speaks volumes about the nature of prostate cancer that a major study could show that surgical treatment reduces the risk of dying from the disease but does not reduce a patient's risk of dying within the study period.

Those two conclusions came from a Swedish study conducted from 1989 to 1999 and reported in last week's New England Journal of Medicine. The findings are not contradictory because prostate cancer has traditionally been diagnosed in men old enough so other diseases often kill them before their cancerous prostate does, especially since so many prostate tumors grow very slowly.

This puts patients and their doctors in a quandary: Should they aggressively treat the malignancy, running a high risk of impotence and incontinence, or should they engage in watchful waiting to see whether the cancer will show itself over time to be one of the fast-growing ones that will lethally metastasize if left untreated?

Contrast this well reasoned approach with the headlines in the popular press. I worry about the sensationalizing of medical findings. How does medical 'news' affect doctors and patients? I suspect that these stories can cause anxiety in many. They also can impede decision making, as good decision making requires a balanced review of the data. The 'popular press' is not interested in a balanced review, they are interested in attracting attention and viewers or readers. Kudos to the Boston Globe for understanding this major issue.

Posted by on September 16, 2002 06:26 AM | TrackBack




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It would be nice if everybody could find a doctor with half the common sense of this one. - Junkyardblog

An academic general internist comments on medical issues and the current state of medicine.

I reserve the right to be blatantly opinionated; you should take the right to criticize me!!



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