This story gives the appearance of objective vetting of the science, but the headline really sums up the spirit of the reporting. The take away message is "Statins may protect prostate cancer patients," even though the evidence is thin, the costs unknown and the science poorly explained.
Statins have been heralded as a miracle drug from the moment they hit the market. Aside from their well-established cholesterol lowering powers, their side benefits are often touted, too. Were this study to be a true breakthrough, this would be a truly unique class of drugs: one that protects patients against two of the top killers of adults, heart disease and cancer.
The lack of cost information is particularly troublesome in this case because there are so many statins on the market, and cost information would be easy to find.
As explained above, there are many numbers given about the potential benefits, but it is hard to say what they all mean. A big missing piece is some explanation of what they did to "control for other factors."
There is no mention of potential harms. Statins do have side effects, contrary to their glowing press. And, although the story does say that more study is needed, it makes no mention of the fact that cancer patients may be taking a host of other drugs that could interact poorly with statins.
There are many attempts to evaluate the evidence here, but none of them work. The story swings back and forth and back again between relative risk reduction (30%) and absolute risk reduction figures. Actually it never quite completes the absolute risk reduction calculation but makes the reader do the math. If the numbers that are provided in the story are correct, it appears that it’s a 9% absolute risk reduction – not quite as impressive sounding as the 30% relative figure. The story does give the caveat, "The research does not prove that taking cholesterol-lowering drugs directly slows the growth and progression of prostate cancer." But there are no outside experts raising questions about the research as there was in a competing HealthDay story. Overall, too spotty a job to earn a satisfactory grade.
The story presents the scope of the disease clearly and concisely. "About one man in six will be diagnosed with prostate cancer during his lifetime, and one in 35 will die of the disease, according to the American Cancer Society. In the U.S. alone, roughly 190,000 new cases of prostate cancer were diagnosed last year." But why aren’t we given any estimates of recurrence, since that’s what the story is about?
Durado Brooks provides some great context at the end, and it would have been nice if this were higher up.
There is a brief mention of radiation, but that is merely in passing. There really is nothing in the story about what a typical treatment regimen might be for these patients and what it might be like if statins became the go-to treatment. There also isn’t anything in the story that offers any theory about what might be causing this. It seems as if the authors don’t really know and are just excited about this potential connection that they have made. If they, or someone else in the field, were pressed to offer a theory, some of the holes in the evidence might begin to show.
Statins are widely available under several brands, many of which are mentioned in the story. At the same time, the reporter does explain that additional study would be needed before doctors would know whether to prescribe statins to prostate cancer patients and at what point in their treatment regimen.
There is this odd quote in the story from the study author. “Obviously this is just one study, and it is observational,” he says. “But if these findings are confirmed, this is pretty profound.” This could have been a great opportunity for the reporter to explain what he means by an observational study and how much, much, much more work on a much larger group of patients would be necessary before statins could be safely recommended as a cancer treatment. Instead, the quote just ends on a positive note.
It does read a lot like the news release. But it’s clear the interviews were fresh, and at least one outside source was consulted. http://www.cancer.duke.edu/modules/news/article.php?storyid=257
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
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