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Prostate Hormone Therapy May Up Heart Risks


4 Star

Prostate Hormone Therapy May Up Heart Risks

Our Review Summary

Overall, this was a well-done story about a study categorizing the harms associated with the use of androgen deprivation therapy in the treatment of earlier stage prostate cancer.  

We are especially pleased to see a story that points out some of the potential limitations of an observational study.  We wish we’d see this more often in such stories.


Why This Matters

Hormone therapy in the treatment of prostate cancer is being used more commonly.  The story highlighted the issue of the unexamined harms associated with the use of this treatment over longer periods of time.  The reason this is important is because men with early-stage prostate cancer who want to avoid the complications of surgery or radiation but also don’t like the idea of not taking action – are increasingly turning to androgen deprivation.  There are no data that prove that this primary treatment improves survival; this story was reporting on a study that adds to the growing body of literature on the harms of this treatment.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

 This story did not discuss costs, yet it could have raised questions about the lucrative reimbursement for hormone therapy as one factor driving its use in situations where it has no proven benefit.

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

Not Satisfactory

 While describing that androgen deprivation therapy was initially developed as a means of treating symptoms of advanced prostate cancer, and that there are situations in which it has demonstrated clear benefit, the story did not include quantitive information about benefit.  It could have at least mentioned that when used to treat men with metastatic prostate cancer, meaning it has spread to the bone – this treatment provides symptom relief and slightly longer survival.

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


 The story included quantitative information about the harms associated with androgen deprivation therapy. However, it mixed uses of relative risks and absolute risks within the same sentence, which we think can only confuse readers. Excerpt: 

"The greatest risk was found for drugs that target gonadotropin-releasing hormone: 159.4 cases of diabetes per 1,000 person-years, compared with 87.5 for men who did not have androgen deprivation therapy, as well as a 35 percent increased risk for sudden cardiac death, a comparable increase in heart attack risk and a 22 percent increased risk for stroke."

We urge journalists to use absolute risk throughout every story.  See our primer on this topic. 

Nonetheless, we’ll give the story the benefit of the doubt on this one.

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


Big A grade on this one.  The story mentioned that the study reported on was an observational study and explained that this meant that it could not demonstrate cause and effect. Oh, how we wish we’d see this more often!

Does the story commit disease-mongering?


There was no overt disease mongering about prostate cancer.

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


 Comments from two clinicians who were not directly associated with the study reported on were included in this story.

Does the story compare the new approach with existing alternatives?


 The story was about the harms associated with the use of androgen deprivation therapy earlier in the course of prostate cancer treatment.  It mentioned several approaches (surgical removal of the testes,  multiple hormone blocking drugs, and drugs that target gonadotropin-releasing hormone) and provided several data points for each, though the information provided did not always allow comparison of the approaches to each other.   Better organization of this information would have improved the readability of this story.

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


 The story accurately indicates that androgen deprivation therapy is commonly used in men with prostate cancer.

Does the story establish the true novelty of the approach?


 The story included the history about how the use of hormone therapy has expanded over time from the treatment of symptoms from metastatic prostate cancer to a treatment used before men have symptoms of prostate cancer.  

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


 Does not appear to rely on a news release.

Total Score: 8 of 10 Satisfactory


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