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Read Original Story

No-Scalpel Treatment for Enlarged Prostate

Rating

2 Star

Categories

No-Scalpel Treatment for Enlarged Prostate

Our Review Summary

This story puts the cart ahead of the horse in touting the benefits and resulting outcomes before good data is available about its effectiveness or safety in the target population.  Although there were cautionary notes about the data discussed, because these seemingly conflicted with the more detailed information about the outcome of the study – they were easy to dismiss.  Rather than help readers sort out comparisons among treatments that have demonstrated benefit and outcomes, this story provided enthusiasm for an inadequately tested approach to the problem.

It is important to provide clear context about availability, extent of benefit, potential for harms,  as well as if the impact is long lasting when informing readers about treatments for common conditions.  This story did not.

 

Why This Matters

Benign prostate hyperplasia (BPH) is a condition that is increasingly common as men age and therefore information about treatment options needs to be accurate, balanced and complete.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There was no discussion of costs.

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

Not Satisfactory

The story reported on the technical success of the procedure but more importantly reported on the percentage of men who reported experiencing ‘excellent’, ‘slight’ or ‘no’ improvement.  Although the starting score of the patients was reported, it would have been valuable to translate this into information that readers could grasp.  The story should have mentioned whether the difference in symptom severity was something that the patient could detect or simply a change in a clinical score.  And to be comprehensive, the story should have provided information about the benefit that might be expected from other treatment options (e.g. TURP) for comparison.

Without a clear context about what was ‘improved’ and whether it was sufficiently better than what is was noticed by the patients themselves – it is not possible for readers to know how much value to put on what the new technique has to offer.

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

Not Satisfactory

The story did mention that one patient in the study had a serious complication that required surgery to repair the bladder.  However – since the study population was small and men were only followed for ‘an average of nine months’ after the procedure – the story could have been even more explicit and emphatic that it is too soon to know the harms associated with this procedure. It did include one independent expert’s comments to that effect.

More bothersome: the story described the complications of TURP without informing the reader about how often they occur or bothering to note that other, widely available treatments that have been around for a decade or more have reduced risks of these complications.

Any story whose first words are “a minimally invasive procedure” may paint an unjustified picture of guaranteed safety.  Special caution should be taken to counter this.

One last point on harms:  the major “harm” that the study could not address (and the story ignored) is the possible eventual need for requiring additional treatment.

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

Not Satisfactory

The story provided conflicting information about the treatment and failed to point out that there was no control group studied so it isn’t really possible to know how this treatment stacks up against those that are currently available.  The author of the study put forth a rather all or nothing view that this treatment ‘reduced symptoms of frequency and urgency of urination without causing side effects like incontinence, sexual dysfunction, retrograde ejaculation or bleeding’.   An expert in the field of BPH treatment was quoted as indicating that ‘We don’t know what the short and long-term success or complication rates are’.

One saving grace: The story did acknowledge that meeting abstracts have not undergone rigorous peer review.

Does the story commit disease-mongering?

Not Satisfactory

The story provided the reader with the fact that benign hyperplasia affects 19 million American men without any additional context about the men affected.  It would have been useful, for example to explain that this was a chronic condition that becomes more common as men age; some men find their symptoms severe enough to seek treatment; others are less bothered by the condition. BPH is not likely to cause serious complications.
There are men who choose to watch and wait, and who bypass treatment entirely. You’d never get that notion from this story.

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

Satisfactory

Two individuals who seemingly had no connections with the research reported on were interviewed for this story.  Their comments provide good insight though it was somewhat swamped by the promotional comments about this potential treatment.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story mentioned TURP and open surgery to treatment of BPH but failed to provide insight about how effective these might be in a population of men similar to those in the study reported on.  Without this information, it is not possible to size up how the new procedure compares. Additionally, the story downplayed the extensive experience with laser prostatectomy and microwave thermotherapy–effective alternatives to TURP (and thermotherapy is also an outpatient procedure).

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

Not Satisfactory

The story did not establish whether prostatic artery embolization was currently performed in the US and if so, whether it was widely available or an option only at particular centers.

Does the story establish the true novelty of the approach?

Satisfactory

The story seem to suggest that the procedure reported on was repurposed from the field of Ob/gyn where it is used for managing uterine fibroids.  If this is the case, then it might have been of interest to report on what side effects, if any, are common.

Nonetheless, we’ll give the story the benefit of the doubt on this criterion, since it didn’t establish this approach as totally new.

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

Satisfactory

The story does not appear to rely solely on a news release.

Total Score: 3 of 10 Satisfactory

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