Health News Review

Here’s another problem with the practice of TV networks using physician “contributors” to comment on health care news. They may have a clear conflict of interest that is not addressed.

When the American Cancer Society released its updated guidelines on prostate cancer screening today, Fox News reported:

“Dr. David Samadi, a Fox News contributor and chief of Robotics and Minimally Invasive Surgery at Mount Sinai School of Medicine in New York City, said he thinks the new guidelines could cause unnecessary deaths.

“In my practice, we find men in their 30s and 40s that are at high-risk and develop prostate cancer,” Samadi said.

“Knowing your PSA is power, it is educational; you follow it all the time. You can find a silent prostate cancer that will not affect you, and there is a possibility to over-diagnose, but that’s a risk the patient needs to take. You could also find cancer that could lead to death.”

The number of prostate cancer deaths continues to decline because of regular screening, Samadi added.

“I really recommend (the age) of 40 as a baseline age,” Samadi said.”

Doesn’t Fox see that he has a blatant conflict of interest on this topic as one who runs a robotic surgery center? There are countless ways to counter these short quotes from Dr. Samadi, but I’m not going to run through them here. Read the Cancer Society report and you’ll find all of them there – in dispassionate, non-conflicted, evidence-based depth.

Look at how Katie Hobson of US News & World Report included an expert urologist’s input, and one with a much more open-minded and balanced perspective.

“… the gist of all this is a firm end to the notion, still held by some clinicians, that screening for prostate cancer is “the same as colorectal cancer screening or cholesterol screening,” says Durado Brooks, director of prostate and colorectal cancers for the ACS and coauthor of the report.

“There has to be a conversation,” says John Davis, assistant professor in the department of urology at the M. D. Anderson Cancer Center in Houston. “And these guidelines give some very nice bulleted points and Web links you could build into an information sheet and give to patients.”

Comments

Evan Falchuk posted on March 3, 2010 at 3:34 pm

That is kind of wild, Gary.
Still, you have to admit that there are so many mixed messages out there about prostate cancer screening that it is hard to know what to think as a lay person.
I’m not sure who to blame for that. But the idea of just delegating these discussions to time-strapped primary care doctors seems very unrealistic to me.
Some more thoughts on that here: http://bit.ly/cd5SI1
Cheers,
Evan Falchuk

r grom posted on March 3, 2010 at 8:12 pm

I respect the work you do.
I was treated for prostate cancer 7 years ago. I’m familiar with the subject.
For a professional to be quoted as having a ‘conflict of interest’, in my opinion, does not make him/her right or wrong, inappropriately influenced/ not influenced, good or bad. What’s important is how a professional reacts to those ‘conflicts of interest’.

David Samadi posted on March 3, 2010 at 10:11 pm

Prostate cancer is a topic and disease that is very important to me
you ask why? I deal with young and old men who come in with prostate cancer and are worried about their sex life, continence and cure rate.
Average age of my patients, series of over 2500 surgeries is 54 years old, that means that there are a lot of men in the 40′s that are diagnosed with prostate cancer.
I also here that people say” men will die with prostate cancer and not because of it’. Well it depends on what kind of prostate cancer. It is important for men and their spouses to know that not every prostate cancer is the same. You have low risk, medium risk and high risk
you have low PSA and high PSA, you have smooth prostates and prostates with Nodules. So every individuals are different and that is why the EXPERTISE of the doctors is the key in this whole picture. Race plays a role with African Americans having 3to1 ratio of risk compare to white patients, Family History plays a big role. So while guidelines are important you need to talk to your doctor and discuss this in detail.
Please leave the politics out of this, whether you like Fox News or not that is your right but do not confuse someone’s future and their destiny with politics.
Fortunately we are able to catch them early and give not only life back to our patients but also preserve an excellent quality of life with sexual function and urinary control.
If you would like to discuss this further, feel free to email me at robotmd@aol.com or call 888-robot10
Knowing your PSA is very important, but what you do with it has to do with your history of PSA or your doctors that are following these tests
The last thing we need is to save few bucks on behalf of many lives out there, just like the argument of mammogram, the government need to leave PSA alone and let patients make that decision.

Gary Schwitzer posted on March 4, 2010 at 7:34 am

Dr. Samadi,
Your final sentence confuses two important points.
1. The American Cancer Society, which issued this report, is NOT A GOVERNMENT AGENCY.
2. The new focus of the ACS report was precisely on “letting patients make this decision.” The new emphasis was on informing men of the benefits AND the harms of screening in a shared decision-making encounter.
So you seem to be raising two straw man arguments. The facts are:
This was not a move by government to deny screening.
This was a strong statement in support of informed, shared decision-making.