Fox News uses Dr. David Samadi, a New York urologist and “Chief of Robotics” at his NY hospital, as a “medical contributor.” We’ve seen and heard him promote his pet approaches in the past. He did it again this past Sunday, touting his own favorite approach over another approach known as the Cyberknife, along with sidekick physician medical news contributor Dr. Marc Siegel.
I asked one of our medical editors, Dr. Richard Hoffman, to comment on the segment. His areas of research interest are prostate and colorectal cancer screening and prostate cancer treatment outcomes, with expertise in clinical epidemiology, health services research, and meta-analysis. He wrote me:
The Fox segment seemed designed to confuse audiences. The host begins by describing a new robotic radiosurgery (Cyberknife) that the expert commentator then explains is neither a robotic procedure nor a surgery while at the same time showing clips from one of his robotic surgical procedures. The banner graphic across the bottom of the screen reads radiosurgery vs. robotic prostatectomy, but Dr. Samadi launches into an infomercial-like presentation touting only the advantages of surgery, including citing the new techniques that reduce surgical complications. However, his innovative SMART surgery techniques appear to be a robotic adaptation of the nerve-sparing prostatectomy pioneered decades ago by Dr. Patrick Walsh. Furthermore, numerous studies actually suggest that treatment complications (primarily sexual dysfunction and urinary incontinence) are comparable between robotic and open prostatectomyand usually occur less often following radiotherapy than surgery.
The points about PSA levels dropping to zero after surgery, the more accurate staging with surgery, and the challenges in performing prostatectomy after radiation are true, but are used to disingenuously suggest that surgery leads to better cancer control and survivaleven though there are no data from head-to-head comparisons supporting this contention. Dr. Siegel earnestly proclaims that he does not want to compare the procedures (and why not?) but rather rely on the art of medicine–which compels him to recommend the skills of his esteemed colleague, the urologist Dr. Samadi. Whether a professional acquaintanceship with a radiation oncologist would change Dr. Seigels artistic temperament is unclear.
The segment never addresses an important issue underlying any treatment decision for prostate cancer–the substantial risks of overdiagnosis and overtreatment. An estimated 23% to 42% of prostate cancers detected by screening would never cause problems during a mans lifetime. Providing any treatment, however artfully delivered, for men with these low-risk cancers is thus potentially unnecessary and harmful.
Mind you, questions can and should be raised about the Cyberknife approach (and have been previously on this blog).
But this Fox “News” segment was over-run with conflicts of interest and confusing, one-sided testimonial.
Clearly, Samadi’s PR machine is in high gear, because today he sent out a news release touting his robotic approach over both the Cyberknife and high intensity focused ultrasound (HIFU) – the latter in the news today based on a British study.
Presumably he had to pay to send out the news release. Presumably he didn’t have to pay for his Fox News free publicity. Each approach delivered the surgeon’s pro-surgery advocacy. But one was supposed to be a news segment. At least that’s the way it was labeled.
Samadi and Siegel also got a big Forbes column placed two weeks ago, touting, “The New World of Prostate Cancer,” with the same message that “surgery is better than radiation or watchful waiting.”