The New York Times covers a study of a treatment for prostate cancer that comes back after prostate removal surgery. The treatment is hormone blocking, or androgen deprivation therapy. In this review, we’ll occasionally compare the coverage to STAT’s story about the same study (see that story review here), since it highlights a few important ways reporters and their outlets deviate in their coverage of important research.
The Times does a nice job in capturing a complete portrait of prostate cancer, the problem with recurrence, and the difficulty in understanding why hormone blockers weren’t obviously beneficial — at least according to prior research. But what we appreciated the most was how it described the benefits of giving men hormone blockers in absolute terms; this is a more honest presentation of data, and doesn’t hype study results (unlike relative comparisons, in which a cure rate of say, 2%, is “double” a cure rate of 1%).
The weak points of the story: It didn’t discuss the costs of treating prostate cancer, especially with hormone blockers, and it missed an important potential conflict of interest.
For men who have had prostate cancer return after surgery, this study’s findings will help them make more informed decisions when choosing a treatment path. But it’s a complicated study with plenty of nuances, and this news story did a solid job distilling the core takeaways.
No treatment costs are discussed. According to a 2015 study in the journal Future Oncology, the average cost per hospital stay was $12,268, while outpatient clinic visits tallied about $4,364 per visit (surgery and radiation). However, given multiple visits, the typical prostate cancer patient can expect a lifetime cost of about $110,000.
But adding in hormone blockers, also called androgen deprivation therapy, according to a 2007 study in The Journal of Urology, can double the cost of a man’s care. Since newer drugs are being used, those costs also should have been included.
We’re given the data in absolute terms, which is very useful: 76.3% of men who got the combo radiation-hormone blocker treatment lived after 12 years, whereas 71.3% of those who received radiation alone survived 12 years after a recurrence of prostate cancer. This lets the reader clearly see how small but significant the benefit (a 5.2% difference) is. Going a step further, readers are also given the data on what actually killed men who received either treatment.
The story lays out a few harms of hormone blockers — which it notes is also called chemical castration in men — including hot flashes, breast growth and sexual problems.
Here the story goes out of its way to establish the trickiness of getting the result, including how long it took to get enough data (the study began in 1998, readers are told), and presents the evidence in absolute terms. This was a complex study and the story did a good job in presenting it to readers.
The story does a good job on this, discussing the prevalence of prostate cancer nationally and globally, and how some men may not need treatment for it, depending on their circumstances.
Two outside sources provided comment, and readers are told the study was funded by the National Cancer Institute, a government-funded organization.
However, and unlike a STAT story on the same study, the Times didn’t mention how AstraZeneca — a maker of a hormone-blocking drug for men — was a study sponsor.
The story does a nice job explaining the various treatment options, including “active surveillance,” where no treatment is given.
The story implies hormone blockers have been around as a technique for decades, but have not been widely used due to their side effects and uncertainty surrounding their actual efficacy.
The story goes the extra distance in mentioning that the dose of medicine used in this study in long longer employed. It also states that other, similar, medicines are used more commonly now. Finally, it goes on to say that studies are underway evaluating these other drugs.
The story does a good job explaining that this study is novel because it helps clarify a previous unknown: how effective hormone blocking is for controlling prostate cancer recurrence. The story quotes an outside expert who says the study “is a big deal,” and hopefully enough to change medical practice. We feel this is a fair way to frame things, because the treatment did improve overall survival–a big deal. Yet, this is an interesting difference with the STAT story, whose outside expert takes a more careful position of calling it an “incremental” step for doctors, which is also fair, since the absolute difference between the two groups was small, about 5%. Ideally, both stories would have made both points.
There is obvious original reporting in the story.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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