Prostate Cancer Surgery Fails To Cut Death Rate In Study

[xchrom]

http://www.bloomberg.com/news/2012-07-18/prostate-cancer-surgery-fails-to-cut-death-rate-in-study.html

Surgery for prostate cancer was no better in saving lives than observation over a 10-year period, according to one of the first rigorous studies to compare the two approaches in American men with early-stage disease.

The U.S.-funded study assigned 731 men across the country with early prostate cancer to have the gland surgically removed or be observed without any attempt at curative treatment. Ten years later, 47 percent of men in the surgery group had died, mostly from other diseases, versus 49.9 percent who were just watched, results published in the New England Journal of Medicine found. The difference wasn’t statistically meaningful.

The study is certain to fuel the debate over whether doctors are aggressively treating prostate cancer in men who aren’t likely to die from it, causing side effects such as incontinence and impotence.

“There is no question in my mind that what we have been doing in the United States for the last 20 years has hurt a lot of men needlessly,” said Otis Brawley, chief medical officer for the American Cancer Society. “We need to be telling men that there is tremendous evidence that a large number of men with prostate cancer could be watched and don’t need to be treated.”

[MannyGoldstein]

1. This is something like the 5th study to show the same thing

Walletectomy, with incontinence and impotence on the side.

[still_one]

2. It all depends on the grade of the tumor. You cannot paint one brush for all. I am also suspect of

U.S. study funding since they have been saying similar things with mammography and colonoscopy, which makes me wonder if this is just their way of rationing healthcare

[skepticscott]

4. Well, if something is not available

in unlimited quantity, to be had for the taking, no matter how great the demand, then yes, rationing in some form probably has to take place. Unless doctors, nurses, hospitals and drug companies can be persuaded to provide their services for free and if there will always be enough of them with enough time and energy to provide every last smidgen of medical care that anyone could conceivably want, then yes, rationing in some form probably has to take place, as abhorrent as that concept is to people who have it fixed in their minds that unlimited health care should be available to everyone.

[hedgehog]

3. The problem with such studies is that the descriptions don't tell us

the age of the participants. My husband had prostate cancer at age 55. His uncle has it now at age 85. I think surgery was the proper option for my husband. I think taking his uncle to surgery borders on malpractice!

[still_one]

5. There are a lot of reasons, and I know people who lives were saved by it. I can only say if Congress

decides that insurance shouldn't cover it, then I want that enforced for every member of Congress

[hedgehog]

6. No one is suggesting that Congress will stop requiring insurance companies to cover this.

But let's reframe the discussion:

Suppose that everyone was still treated for numerous ailments by bleeding. Suppose that finally, double blind studies began to show that bleeding may be causing harm in some cases. Would your knee jerk reaction be to protest that someone is depriving you of this treatment, or to ask for more studies? After all, I'm sure there would be hundreds of people to step forward and describe how they were cured after being bled.

Let's try a more recent and actual situations: It seemed obvious that the way to treat breast cancer was to give full body radiation to ensure that all the cancer cells were wiped out, then to replace the bone marrow destroyed by the treatment with a transplant.

It seemed obvious until it was done and it didn't work.

What about hormone replacement therapy, an obvious treatment for all the ills of menopause. That is, until studies showed that not only didn't it protect women's hearts, but it was causing breast cancers.

[still_one]

7. The problem I am having is that similar studies have come out saying mammographies and colonoscopies

Do not necessarily save lives.

These are diagnostic tests, including digital and psa assay monitoring for velocity and family history in the psa case

With the pressure to cut medical costs I am concerned about conflicts of interest with some of these studies

There are a lot of reasons healthcare costs are too high, but I would suspect a lot of it is due to price gouging by insurance companies and hospital administrators

We were told that cyclamates cause cancer. All data available suggest those conclusions were flawed. I also believe that GD Searle which produced nutrasweet and coincidently had that product available was involved in muddling the results of the interpretation.

We are told by those in the financial industry, and repeated adnaseum by the MSM that the financial crisis was not due to deregulation

Of course this is not the same as a clinical trial, but conflicts of interest do exist, and frankly I have grown quite skeptical

[hedgehog]

8. At the same time, annual mammograms provide nice steady profits

Last edited Mon Jul 23, 2012, 04:31 PM - Edit history (1)

for radiology centers.