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Elderly may fare worse on prostate cancer drugs

Rating

5 Star

Elderly may fare worse on prostate cancer drugs

Our Review Summary

The headline of this story "Elderly may fare worse on prostate cancer drugs" is a little misleading.  The story is about a study examining whether elderly men with localized prostate cancer gain increased life expectancy or reduced risk of dying of prostate cancer from hormone therapy and the results of the study demonstrate that they do not.  They elderly men were not compared to some other group as the title suggests.

That said, this was an informative story explaining the results of recent study which found that at least for elderly men with localized prostate cancer, hormone therapy did not provide benefit in terms of decreasing the chance they would die of prostate cancer or increase the length of time that they would live.  This information contrasts with the knee-jerk reaction to a diagnosis of cancer, where it is commonly perceived that a ‘war must be raged’ and that time is of the essence.  The results of the study reported indicate that at least in this age group with this particular type of cancer, doing something (especially when that something has risks associated with it) is not necessarily better than doing nothing. 

Good reporting with good explanations and context.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There was no information about the cost of this treatment, an important issue because the drugs are quite expensive.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

In the very opening, the story laid out that the study it was reporting on found that the treatment did not improve the survival chances of elderly men with localized prostate cancer and, in fact, slightly increased their chance of dying of prostate cancer.  In other words, this treatment did not confer survival benefit.  Including the data on the proportion of men surviving in each treatment group was helpful because it made it clear that most men in both groups died of other causes. 

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story listed some harms associated with the treatment (increasing risks for diabetes, heart disease, impotence and bone loss) but did not include estimates about the magnitude of the increase in risk.  However – as the story was about demonstration of lack of benefit, it would seem that details about harms are less relevant when there are no benefits for them to be weighed against.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story did a good job of explaining about the type of study from which the results were derived and how this type of study stacks up against others.  The story mentioned where the study was to be published.  It also included some information about the limitations of the study (i.e. ‘it is not known whether these results apply to younger men’.)

Does the story commit disease-mongering?

Satisfactory

The story did not engage in overt disease mongering.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story included quotes from two clinicians in addition to the lead author of the study.  One of the additional clinicians was  identified as not being associated with the study reported on.  The other was identified as a chief medical officer of the American Cancer Society.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story made several efforts to point out that doing ‘something’ is not necessarily better than doing nothing in this case. And while the spokesperson from the American Cancer Society mentioned that only a minority of doctors feel comfortable doing no treatment for elderly men with localized prostate cancer, readers can deduce for themselves how they feel about it (as opposed to how the doctor feels).

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story explained that the treatment, hormone-blocking drugs, was given in a doctor’s office though it did not provide information about the type of medical practice(s) that provide this sort of treatment.

Does the story establish the true novelty of the approach?

Satisfactory

The story mentioned that the use of hormone therapy was not uncommon in elderly men with localized prostate cancer.  However – the comment that "a surprising 41% got only drug treatment" is somewhat misleading because it implies that the denominator is all men with localized prostate cancer.  In fact, the study selected only men who did not receive surgery or radiation.  The actual proportion of men with localized prostate cancer who receive hormone therapy is much less than 41%.

 

Does the story appear to rely solely or largely on a news release?

Satisfactory

Does not appear to rely on a press release.

Total Score: 9 of 10 Satisfactory

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