I’m on vacation this week but I enjoyed sitting back and watching a urology kerfuffle over claims about a robotic surgery study and associated news release.
Here’s what the American Urological Association (AUA) tweeted earlier today.
The Twitter responses are from a Pittsburgh urologist whose Twitter handle is @daviesbj.
There’s a lot going on here, so let me break it down.
The AUA’s link – in its Tweet – goes to a news release from David B. Samadi, M.D, Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital. He cites a study published online in the July issue of European Journal, “Oncologic Outcomes at 10 Years Following Robotic Radical Prostatectomy.” Samadi wasn’t involved in that study. But he has a sterling track record of self-promotion, as we’ve written in the past. The Samadi news release states:
According to a new study from Detroit, Michigan, robotic prostatectomy yields highly successful long-term prostate cancer results. In fact, nearly all — 98.8% — of the patients remained prostate cancer survivors at ten years post-surgery; results comparable to the more invasive surgical method used in the past.
That’s what even urologist Davies reacted to.
My gut reacted immediately. But I’m not supposed to be working – and besides, I have no funding now anyway – so I leaned on one of our past content experts, Dr. Richard Hoffman, to comment on the study. Hoffman isn’t a urologist. He has been Interim Director for Cancer Prevention at the University of New Mexico Cancer Center. And 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 has helped develop shared decision making tools for prostate cancer screening and treatment of localized prostate cancer.
He wrote me:
“The AUA does misrepresent the data. The 98.8% refers to the proportion of subjects who had not died from prostate cancer. Only 73.1% were biochemically free of cancer, meaning that the rest had a rising PSA suggesting cancer progression/recurrence.
The observational design means that investigators cannot make any meaningful comparisons of robotic surgery results with those obtained by open prostatectomy, Thus, Samadi’s comment that robotic prostatectomy is “a preferred treatment” is not based on convincing evidence, just on the “preferences” of surgeons and patients who see the surgeons’ ads.
The investigators did not address treatment complications, which occur frequently (particularly erectile dysfunction, urinary incontinence) and adversely affect quality of life. The issue of treatment harm is particularly important for this study because–based on Gleason score, PSA levels, and clinical stage–a substantial proportion of these men had low-risk prostate cancers. The optimal treatment for such men is actually active surveillance, meaning that they would be monitored closely and offered active treatment only if there was evidence of disease progression. While the study shows good surgical outcomes, many of the men likely would have done well without any treatment.”
Gee, that’s quite a different story than what the AUA tweeted, and what Dr. Samadi’s news release stated.
Let’s see how the urologists duke it out.
——————-
Follow us on Twitter:
https://twitter.com/garyschwitzer
https://twitter.com/healthnewsrevu
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Comments are closed.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like