The motive for this story appeared to be to pave the way for the introduction of two very expensive proton therapy centers in Central Ohio. But there was no discussion of some of the very lively debate underway in the industry about the costs and effectiveness of this approach.
Instead, the story told about one man leaving Ohio to go to Florida for this treatment. Period. No data. No evidence. No independent expert perspectives. No comparisons with other treatments. No discussion about the uncertainties that exist about whether many prostate cancers should even be treated.
In this time of escalating health care costs – when the stimulus plan has more than a billion dollars in it for comparative effectiveness research – this hometown cheerleading story left readers empty.
An estimate for the cost of treatment was provided, and the story stated that the man’s Medicare plan covered the treatments.
This story provided insufficient information for a reader to judge the benefit of the treatment.
While it did include a comment from the patient to the effect that this treatment was ‘just as good at getting rid of cancer as other treatment’ there was no support for that statement provided from the medical literature or medical experts, nor was there a context in which to understand it. To evaluate how valuable it is to get ‘rid of cancer’ one has to be able to compare the benefit of ‘getting rid of cancer’ with how often it actually causes problems.
Again – the patient interviewed in this story informs the reader that in his view, the side effects associated with proton therapy were less. This is one man’s opinion. And in fact, as the article failed to specify what side effects may be encountered, readers are left without much understanding of the stakes involved.
All we were given was the experience of one person.
So although the story stated "Zuber said the treatment methods he researched, including proton therapy, had similar results in getting rid of cancer.", this cannot be considered ‘evidence’. How was this ‘research’ done? Is his interpretation colored by the treatment choice he made (we all like to think that the choice we’ve made is the best)?
In fact, there is no high-quality evidence assessing how the long-term outcomes of proton therapy compares with the other means of treatment. The story never hinted at this.
Prostate cancer is a widely but often over-diagnosed cancer. The patient’s experience of having multiple elevated PSA levels before finally being diagnosed raises the possibility that he had an indolent, microscopic cancer. It would have been helpful to know the patient’s age–evidence suggests that treatment benefit decreases after age 65. The proton-beam facilities see the high number of prostate cancers as a boon to their business model (the article notes 75% of patients are being treated for prostate cancer) even though for many men treatment of any kind is unnecessary and potentially harmful. None of this was mentioned in the story.
Although it was a story about prostate cancer, there was no information provided about the incidence of this disease and how the number diagnosed and the number with lethal or potentially lethal disease differs.
No individuals with expertise in prostate cancer, prostate cancer treatment, or prostate cancer patients appear to have been interviewed as part of this story.
Interview comments from a single patient without reference to the evidence or perspectives of experts in the field is not first-rate journalism.
The story did mention radiation and surgery in passing. This is insufficient for readers to evaluate the relative merit of these treatments in comparison to proton therapy. In addition, there was no mention that another option for men with prostate cancer is to actively monitor their situation and possibly avoid treatment altogether.
The article noted that the specialized equipment for delivering this treatment is currently available at a limited number of locations (5) in the US.
The story discusses two different plans to build proton therapy centers in central Ohio, but it fails to ask an important question: are two such facilities needed in central Ohio, with costs per facility noted as $125-180 million?
There was no background information about the history or track record of this treatment.
While there was no obvious press release on which this story was based, it is also unclear why this patient’s comments are news at this time.
It appears that the primary purpose of the article was to create support for the local developer’s plans to build a radiation facility. That way, Dublin residents won’t have to leave home for "state-of-the-art" treatment–whether needed or not.
A better story would have explored some of the questions that experts have raised about the costs and effectiveness of this approach.