This story by STAT covers a study of a treatment for prostate cancer that comes back after initial rounds of surgery and radiation. The treatment is hormone blocking, or androgen deprivation therapy, and its side effects are significant. In this review, we’ll occasionally compare the coverage to The New York Times’ 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.
Here, STAT does a good job of succinctly describing what is novel about this study and for which patients it may be relevant. It also was very clear on who funded the research.
Its main shortcoming is that while it does a good job of presenting the results as an incremental step forward, it presents results in relative terms rather than absolute (read here why that matters). It states that the study decreased death rates by half (50%) rather than saying that survival was improved by 5% (76% vs. 71%). This is a clear example of how presenting relative versus absolute outcomes can skew one’s interpretation of a study’s results. The Times (link) handled this better.
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 story would have been much stronger had it gotten into the absolute findings of the intervention.
No treatment costs are shown, for either radiation or hormone blocking. 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. Newer drugs that are being used now might cost more, too.
We’re told the death rate over 12 years “halved” for men who received the hormone blockers, but this doesn’t reveal the full story.
The story that ran in The New York Times does a better of explaining the results in absolute terms: 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.
STAT does not mention any negative side effects (including hot flashes and sexual problems).
The story provides some clues here, but not enough. How many men were enrolled? How long did patients receive the treatments? Was there a placebo? What were the limitations?
The story did not disease monger, and made sure to discuss that some men won’t need treatment.
An independent source was included. And this STAT story noted an important detail that the NYTimes missed: how AstraZeneca — a maker of a hormone-blocking drug for men — was a study sponsor.
Readers get a solid description of the standard of care, including typical procedures in the first occurrence, and how radiation therapy is typically used after a recurrence. Hormone blockers are not oversold as some revolutionary new advancement, but an existing treatment that needed long-term study to determine if they were beneficial.
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.
STAT is straightforward in its headline: This is an old drug, but this use is novel. An outside source helps put into context the results, calling it an “incremental” step for doctors — a more careful position than The Times’ outside source take (he calls it “a big deal;” see our review).
We didn’t find any evidence of reliance on a news release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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