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Reuters rehashes news release in story on deep-sea laser treatment for prostate cancer

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1 Star

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Laser therapy with deep-sea drug kills prostate cancer in trial

Our Review Summary

prostateThis story is a rehash of a misleading University College London news release that reported results of a phase 3 trial of a cancer treatment called vascular-targeted photodynamic therapy (VTP), which involves injecting a light-sensitive drug into the bloodstream and then activating it with a laser to attack tumor tissue.

We also reviewed the news release. The story reported some quantified benefits and harms that were mentioned in the news release. But this coverage does not explain the full extent of quantified benefits and harms, offers no discussion of study limitations or the potential cost of this treatment, and falsely conveys that low-risk prostate cancer requires prompt treatment. There are no independent sources and no mention that the trial was funded by the biotech company that developed the treatment.

 

Why This Matters

News outlets that run PR pieces and call them news stories undermine the credibility of health journalism and erode the ability of real health reporting to advance public dialogue. This is a case in point.

Of the millions of men diagnosed with low-risk prostate cancer, those who read this story could be misled into believing they need treatment for something that will never harm them. The exaggerated claims in this story could spawn needless anxiety for many men and prompt inquiries to their physicians about a treatment option that at this point has no obvious benefits. Few men with low-risk prostate cancer will die from it, and this story never makes that point. Unfortunately, it isn’t rare for misleading news releases to influence coverage. A recent study described in a HealthNewsReview.org blog post showed that exaggerations about medical findings in news releases increase the odds that news coverage will also exaggerate those findings.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not discuss the potential costs of this therapy.

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

Not Satisfactory

The story states:

Results of a trial in 413 patients showed that the drug, which is activated with a laser to destroy tumor tissue in the prostate, was so effective that half the patients went into remission, compared with 13.5 percent in a control group.

In the trial only 6% of patients treated with VTP needed radical therapy compared with 30% of patients in the control arm who were under active surveillance.

While it’s good to see some numbers, we have concerns about the “radical therapy” statistic and what it means, which we’ll address below in the “Evidence Quality” criterion.

We also call foul on a quote by the researcher who says the treatment represents “a huge leap forward,” which is an exaggeration. It’s too soon to say if this is a real advance or merely a costly and ineffective treatment that exposes patients to potential harm for no reason.

Here’s one reason why readers would do well to temper their enthusiasm: The study follow-up was too short to show a survival benefit–which is the ultimate goal of treating prostate cancer. We wish the story had called attention to that limitation.

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

Not Satisfactory

This story regurgitates nearly word-for-word what’s in the news release:

While radical therapy causes lifelong erectile problems and incontinence, VTP only caused short-term urinary and erectile problems which resolved within three months, the researchers said. No significant side-effects remained after two years.

As we mentioned in our review of the news release, it’s a disservice to patients to downplay harms with the word “only.”

The story does not give the proportion of patients on VTP who experienced adverse events, which was 80 percent. Nor does it mention that 30 percent of VTP patients versus 10 percent of those in the active surveillance group had serious adverse events.

Finally, both the story and the news release gloss over the fact that over 1/3 of patients needed repeat treatment within 2 years, and that men undergoing VTP appear likely to need to be on the same monitoring protocol as those on active surveillance (meaning they will need biopsies, which carry risks). VTP and prostate biopsies can cause harms.

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

Not Satisfactory

The story doesn’t mention several important study limitations, including the fact that more research is needed to determine the long-term efficacy of tissue-preserving therapies such as VTP in controlling prostate cancer, according to the study itself.

Moreover, one of the outcomes reported in the release — the need for radical prostate surgery, which the researchers say is lower with VTP — is problematic because neither the release nor the story say how it was determined that additional treatment was needed.

One reason that men switch from active surveillance to surgery is that they are uncomfortable not treating their cancer. In this study, the men in the intervention group may have been more comfortable not aggressively treating their cancer because they were getting the VTP. The cancer progression reported in this study is actually much higher than has been reported in other studies.

In his accompanying editorial, Stephen Freedland, M.D., of Cedars-Sinai Medical Center, argues it’s “not readily apparent” who might benefit from VTP, which he says amounts to over-treatment for patients with low-risk disease and under-treatment for patients with aggressive cancers. He says that VTP proved only “marginally effective” for prostate cancer after two years, at a cost of higher frequency of serious adverse events including urinary and sexual problems. Further, her writes:

Although better than active surveillance, any treatment that leaves residual cancer in more than half the men (as in this study) is not ideal. Moreover, more than a quarter of men “progressed” within two years, again suggesting a non-ideal treatment.

Freedland also points out that the benefits of VTP in this study may have been inflated because technological advances that were not commonly used during the study period are now allowing researchers to more accurately determine which patients are candidates for aggressive treatment versus those with low-risk disease in which active surveillance is more appropriate.

Freedland’s editorial is publicly available online, but the story doesn’t mention it.

Does the story commit disease-mongering?

Not Satisfactory

The story shares the flaws of the news release it’s based upon.

It says that prostate removal causes lifelong erectile problems, but this is not always the case. Nerve-sparing procedures can preserve potency for a substantial proportion of patients.

In addition, active surveillance is described as monitoring and treating only “when” the cancer becomes more severe. The correct phrasing would be “if and when” the cancer progresses, because many of these cancers will not progress.

The phrasing “kills cancer” in the headline is also questionable, as it sends a false message that low-risk prostate cancer needs to be eradicated. In fact, most men with small, isolated prostate cancers can live for years without treatment.

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

Not Satisfactory

The story misses the mark on two counts. First, it contains no independent sources. That’s a particularly concerning omission since there’s nothing to counter hyperbolic quotes from the study’s lead researcher that the findings are “excellent news for men with early localized prostate cancer” and “truly a huge leap forward.”

Further, it says the treatment “was developed by scientists at the Weizmann Institute of Science in Israel in collaboration with the privately-owned STEBA Biotech.” But it doesn’t say that Steba, which holds the commercial license for the treatment, funded the study, a fact that was in the news release, or that all of the researchers involved in the study were compensated by Steba, which was reported in the study itself.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story addresses the current standard of care for low-risk prostate cancers, active surveillance, along with treatments for more aggressive disease. But as noted above, we don’t think the description of active surveillance is accurate, the description of radical therapy is excessively gloomy, and the story doesn’t warn that people treated with VTP will likely need to follow the same protocol involved with active surveillance. For these reasons we think the comparison is Not Satisfactory.

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

Satisfactory

The story says the treatment is “being reviewed by the European Medicines Agency (EMA) for possible license, but it is likely to be several years before it can be offered to patients more widely.”

Still, we’re left wondering what “more widely” means here. Is it already available to some patients? The story doesn’t say.

Does the story establish the true novelty of the approach?

Satisfactory

This coverage establishes the novelty of the study. It’s puffery to call this “a huge leap forward” but we’ve addressed that concern elsewhere.

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

Not Satisfactory

This coverage is based entirely on a news release (which we also reviewed), with no attribution to let readers know that there’s no actual reporting here. In some cases, entire paragraphs were lifted from the news release with only minor stylistic changes. The following paragraphs are almost word-for-word like those in the news release:

Men with low-risk prostate cancer are currently put under active surveillance, where the disease is monitored and only treated when it becomes more severe. Radical therapy, which involves surgically removing or irradiating the whole prostate, has significant long-term side effects so is only used to treat high-risk cancers.

While radical therapy causes lifelong erectile problems and incontinence, VTP only caused short-term urinary and erectile problems which resolved within three months, the researchers said. No significant side-effects remained after two years.

In the trial, only 6 percent of patients treated with VTP needed radical therapy compared with 30 percent of patients in the control arm who were under active surveillance.

The trial involved 47 treatment sites in 10 European countries, most of which were performing VTP for the first time.

The VTP treatment is now being reviewed by the European Medicines Agency (EMA) for possible license, but it likely to be several years before it can be offered to patients more widely.

Total Score: 2 of 10 Satisfactory

Comments (2)

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sharon begley

December 27, 2016 at 7:52 am

This is a nicely done and useful review, but let me raise one point: you seem to assume that Kate read only the press release and not the paper in Lancet Onc (you describe the story as ‘based entirely on a news release,’ implying that she did not read/rely on the paper at all). That assertion seems to be based on the similarity between the release and her story (as in the paragraphs you call out). You could be right, but unless you checked with Kate it seems like an unfair assumption/allegation.

Reply

    Joy Victory

    December 27, 2016 at 9:56 am

    Hi Sharon, thanks for the feedback. There were several red flags for us:

  • The narrative flow of the story is almost identical to that of the news release, especially the first three paragraphs (a lead, a little bit about the study, and then a quote from the researcher, which is the same one that appeared in the news release, just shortened). The story then discusses the deep-sea aspect for a bit before again returning to the news release structure, with a similar description of active surveillance, and then harms of radical therapy, then another quote taken directly from the news release.
  • Also, as mentioned above, the story contains passages lifted directly from the release, with no attribution.
  • As such, there is no information in the story that doesn’t also appear in the release, and nothing to suggest that an outside source was consulted.
  • So, while we can’t know for certain whether the reporter also read the study or consulted other sources, no information from the study or other sources seems to have made its way into the coverage — and that’s ultimately what matters to readers.

    Reply