NOTE TO READERS: When this project lost substantial funding at the end of 2018, I lost the ability to continue publishing criteria-driven news story reviews and PR news release reviews - once the bread-and-butter of the site going back to 2006. The 3,200 archived reviews, while still educational, are getting old and difficult for me to technically maintain on the back end of the website. So I am announcing that I plan to remove these reviews from the site by April 1, 2021. The blog and the toolkit - two of the most popular features on the site - will remain. If you wish to peruse the reviews before they disappear, please do so by the end of March 2021. After that date you may still be able to access them via the Internet Archive Wayback Machine -

The high-tech prostate treatment train has left the station…before the evidence is in

Posted By

Tags reports some staggering numbers that show how “expensive prostate cancer treatments are winning out over the old standards, driving up the cost of treatment before there’s clear evidence that they improve outcomes.” For example:

Robotic and laparoscopic procedures jumped from 1.5% to 28.7% of radical prostatectomies in the Medicare population between 2002 and 2005. MedPageToday reports:

This exponential growth appears to have run ahead of the evidence, which includes a prior analysis by a Brigham and Women’s team showing that minimally invasive prostate surgery doubles risk of genitourinary complications despite shorter hospital stays, and another study suggesting neither benefit nor harm.

Among external beam radiation treatments, intensity-modulated radiation therapy jumped from 28.7% in 2002 to 81.7% in 2005 and perhaps 100% by now.

Within brachytherapy, the addition of intensity-modulated radiation therapy jumped from 8.5% to 31.1% over the same period.

Any evidence of benefit is only coming in now after the fact. But the high-tech train has already left the station. It’s not known how much these technologies are costing Medicare.

And the prediction is that proton beam therapy will dwarf all of these technologies in cost.

You might also like


Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.


March 9, 2010 at 5:38 am

Here in the UK it is Prostate Cancer Awareness Month required because so many men still do not understand that they need to become prostate aware. We do not have a screening programme. However, amongst those who unfortunately have been diagnosed there is the same rush to get the latest treatment, often before peer review, proper trials and epidemiological study have been conducted causing huge (private) bills.
Health-care shows its ugly head as a double-edged sword in this instance: on one side progress is vital, on the other validation necessary. It is worrying to think that “the-next-best-thing” is more important than what has been shown to work.
Thank you for raising such an important issue.

From the Patient's perspective

March 9, 2010 at 10:01 am

In many cases it is the science and common sense that it leading to early adoption of new modalities. Why wait for a clinical trial to validate the obvious? The physics of a proton are intrinsically superior to a xray. When using an xray, it’s better to hit it from multiple angles than just one to diffuse the toxicity. Why would anyone knowingly want to participate in a clinical trial, and risk getting the inferior modality? If robots can help a surgeon, why not use the tool?