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Fighting prostate cancer by doing nothing

Rating

4 Star

Fighting prostate cancer by doing nothing

Our Review Summary

The article provides an overview of treatment for early prostate cancer. Major strengths of the article are that the true natural history of prostate cancer is accurately described, namely that prostate cancer is slow-growing, many men will die of something else, and that men may not need to be treated at all. The article also does a good job of comparing and contrasting what men might stand to gain or lose by undergoing treatment or by waiting. Information on costs could improve the article as well as stating more explicitly that the benefit of aggressive treatment of early prostate cancer is unknown and/or uncertain.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The article doesn’t mention costs of “active surveillance” or any other treatment strategy. There is a cost associated with any of these choices.

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

Not Satisfactory

Because of the uncertainty over treatment benefit, quantification of benefits, such as how much longer can one expect to live or how many lives are saved can’t be known. However, the article could have been more explicit about the issue of uncertain benefits with aggressive treatment for early prostate cancer.

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

Satisfactory

The article does a good job of discussing harms of treatment, including risk of losing an opportunity to cure one’s disease by waiting, risk of sexual problems and leaking urine with treatment, and risk of having treatment and subsequent side effects and still having prostate cancer threaten your life.

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

Satisfactory

The story is an informational piece about prostate cancer treament in general, making this a difficult criterion to evalaute. However, one overarching message is that there is a great deal of uncertainty around treating early prostate cancer. With that in mind, the article does describe that there are no direct head to head trials comparing surgery and radiation treatments, which accounts for much of the uncertainty. It remains controversial whether any aggressive treatment of early prostate cancer is effective.

Does the story commit disease-mongering?

Satisfactory

The article does a terrific job of discussing early prostate cancer, includuing the fact that many prostate cancers are slow-growing, that many men will die of something else, and that many men may never need treatment. It also does a good job of comparing and contrasting what a man might have to gain and lose with and without treatment. Calling surgeons “medical artists” is a bit dramatic, but this term is attributed to patient support groups.

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

Satisfactory

The story used several independent sources of information and for that we give it a satisfactory score. However, one concern is reporting that “researchers–and a few doctors–are beginning to agree” about waiting for treatment. Many of the researchers are themselves doctors, so this is clumsily confusing.

Does the story compare the new approach with existing alternatives?

Satisfactory

The article does a nice job of comparing and contrasting treatment options, including active surveillance, surgery, and radiation. It also talks about hormone therapy, but appropriately cautions readers about what is and isn’t known about the timing of this option as well.

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

Satisfactory

The article describes several available treatment choices currently being used for prostate cancer.

Does the story establish the true novelty of the approach?

Not Satisfactory

This story refers to “active surveillance” as the “newest thinking in the disease.” However, this really isn’t a new treatment option and is widely used in other countries. It’s probably more accurate to describe this as a treatment that is chosen less commonly rather than a new treatment.

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

Satisfactory

There is no evidence that this story relied solely or largely on a news release.

Total Score: 7 of 10 Satisfactory

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