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Swedish Study Finds Surgery For Prostate Cancer Better Than Waiting

Rating

4 Star

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Swedish Study Finds Surgery For Prostate Cancer Better Than Waiting

Our Review Summary

Great ending quote from an independent expert about how “there will always be questions, and an ongoing need to individualize therapy.” The story could have mentioned shared decision making as a solution here when men and their doctors are looking to “individualize” the care.

We especially appreciate how the story was “framed” right out of the box when it stated: “Don’t leap to any conclusions. Like every new study of prostate cancer, the results need to be carefully parsed”.

 

Why This Matters

Individuals with early stage prostate cancer struggle to understand how to best make use of study outcomes to make a decision about whether to pursue active intervention to treat prostate cancer and this story helped provide some context for being able to do so.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There was no discussion of costs. Costs would include treating the double digit rates of incontinence and erectile dysfunction in these younger men who do have surgery. The surgery may help them live longer, but many, especially since younger at time of surgery, live decades with these potential harms and folllowup costs of the surgical choice.  This should get at least a line in such stories.

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

Not Satisfactory

The story reported only the relative difference in the number of men in each treatment group who died during the follow-up period.  For readers to understand what the real difference in risk is, information about the absolute difference in risk needs to be reported. See the AP story for comparison.

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

Not Satisfactory

The story provided quantitative information comparing the rate of all cause mortality in the two groups; it also indicated that more men in the group that didn’t have surgery had hormone therapy.  To be balanced, the story should have indicated that there are commonly occurring side effects from surgery to remove the prostate such as incontinence and sexual problems.

The competing HealthDay and AP stories, by comparison, did a better job of this.

The story would have been better if it had indicated that for men with prostate cancer, taking hormone therapy means that the cancer has progressed; further providing readers with insight about the absolute rates at which men in the two groups needed hormone therapy would have provided a more complete picture.

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

Satisfactory

The story did a fine job of explaining how the prostate cancers had been diagnosed as well as noting that the cancers were all early stage; it informed readers that the men in the study were randomly assigned to either have their cancer surgically removed immediately or not; and that the study being reported on was really just an additional report on the progress of men as they are farther out from the start of the study.

Does the story commit disease-mongering?

Satisfactory

There was no overt disease mongering.

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

Satisfactory

The story included quotes from the author of an editorial about the study reported on.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentioned the use of newer surgical techniques than those used to treat the men in the study who underwent prostatectomy. It also mentioned newer radiation therapies.   In addition, the story concluded:

  • “Unfortunately, there haven’t been any large studies in which prostatectomy and radiation therapy have been compared in patients with early-stage prostate cancer who have been randomly assigned to one or the other. Two such studies are underway. Results are some years off.”

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

Satisfactory

The story discussed the treatments in the study, radical prostatectomy and watchful waiting, and explained how watchful waiting differed from the active surveillance approach used in this country.

Does the story establish the true novelty of the approach?

Satisfactory

It was clear from this story that the approaches to managing prostate cancer detailed in the study reported on are neither new nor novel.

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

Satisfactory

This story did not rely solely on a press release.

Total Score: 7 of 10 Satisfactory

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