Although this story tries to put things in perspective, the headline and lead sentences push readers onto shaky ground that is not supported by the evidence presented. It jumps back and forth between evidence and speculation.
This story improperly presents hormone therapy as a single type of treatment and the choice for patients being to either get “it” or not. In fact, there are several varieties of hormonal approaches used in prostate cancer treatment and this study found that different therapies were associated with different levels of heart disease risk, thus raising the possibility that refining treatment choices could minimize the concerns.
The study was an observational review of heart disease among men being given hormonal therapies for prostate cancer. The story should have made clear that this type of study cannot establish cause-and-effect. What’s more, the study design appears to have serious limitations that are not addressed in the story. This last point highlights one hazard of reporting on presentations at medical meetings; unlike articles published in leading journals, meeting presentations do not undergo formal peer review. As a result, weaknesses in the design, gaps in the data and alternative explanations may be undeclared… and then unreported by journalists.
Costs are not mentioned in the story.
Other than one general quote at the very end of the story, there is no explanation of why some men with prostate cancer are given hormonal therapies or how the expected benefits of the therapies compared with potential side effects.
This story focuses on one potential harm of hormonal therapies given to men with prostate cancer. And while some specifics are included in the body of the story, the headline and lead of the story paint a much harsher picture of the potential risk than do the actual statistics reported by the researchers.
Although this study used data on a very large number of patients with prostate cancer, its results don’t justify the headline claim that “prostate cancer treatment may spark heart problems.”
By its very nature, this sort of observational study can only point out associations, not causation. While this analysis meshes with hints from earlier reports that raised questions about whether eliminating or blocking testosterone might have some effect on the hearts of patients, it leaves huge questions unanswered.
For example, the reporter failed to address an important concern about the design of the study: that it compared prostate cancer patients who received hormonal therapies to people in the general population.
By not comparing prostate cancer patients who received hormonal therapies to other prostate cancer patients who did not receive hormonal therapies, the researchers left open the possibility that men with prostate cancer have a higher risk of developing heart disease in general… and that at least some of the hormonal therapies may not actually be associated with additional heart disease risk.
In addition, while this story reported that “[p]revious studies have found hormone therapy given to prostate cancer patients with a history of heart disease increases their chances of dying,” it failed to tell readers that this latest study found that men with a previous history of heart disease had a less pronounced increase in risk of an event.
Plenty of caveats. There was no overt disease-mongering of prostate cancer nor of heart disease.
The story included quotes from two independent experts but not much balance therein. One seems to inappropriately exaggerate the potential benefit of hormone therapy and the other seems to minimize the potential for harm from its use. The story should have also noted the sources of funding for the study. According to a news release, the study was funded by the Swedish Research Council, the Stockholm Cancer Society and Cancer Research UK. Nonetheless, the story barely meets the expectation for this criterion.
The story does not tell readers what other options men with prostate cancer have.
The story points out that hormone therapy is commonly given to men with prostate cancer.
However, the lead sentences mislead readers by describing hormone therapy as a single treatment, rather than a collection of different treatments. The distinction is particularly important because this study and others indicate that different hormonal therapy techniques may be associated with different risks of heart disease.
The story does not explain how this study is different than previous studies on this topic. Indeed, the story ignored the key finding that different hormonal therapies were associated with different heart disease risks, thus raising the possibility that treatment choices could be refined.
The story does not appear to rely largely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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