By Gary Schwitzer
The
following is a collaborative post written by committee: two of our
reviewers who track the prostate cancer literature diligently — Richard
Hoffman, MD, and Ruth Lipman, PhD (both of whose bios you can find at: http://www.healthnewsreview.org/who-we-are.php) …with a little input from me.
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Sometimes our eyes wander around the country at various media messages.
Recently they settled on a morning show segment on WPIX-TV in
New York with "Dr. Steve" – who used to be CNN’s TV doc before they
found Sanjay Gupta.
It was WPIX’s chance to promote prostate cancer awareness month.
What does it mean to open a news piece with the information that
prostate cancer is "the third most common cause of death from cancer in
men of all ages" in the United States? First, it means they are wrong,
because it’s actually second, not third. More important, it doesn’t
help viewers have any sense about how commonly it actually occurs. Nor
does it help viewers understand that the great majority of men with
prostate cancer — which is the most commonly diagnosed cancer in the US –
actually die of other causes. While increasing awareness about health-related issues is conceptually a good idea, giving airtime to unbalanced
information is disturbing.
First of all — if you are going to have a urologist speak to the
importance of prostate cancer testing (PSA tests) and treatment, you
really need to explain that the bulk of a urologist’s work involves
testing and treating men for prostate cancer, and then managing side
effects of prostate cancer treatment. You could find less conflicted
sources.
Next — what exactly does the American Cancer Society (ACS) say about PSA
testing? Not quite what the guest urologist said, which was, "The
American Cancer Society recommends that guys at average risk should
begin screening at age 50." Here’s what the ACS actually says on its
website:
"The American Cancer Society recommends that men have a
chance to make an informed decision with their health care provider
about whether to be screened for prostate cancer. The decision should be
made after getting information about the uncertainties, risks, and
potential benefits of prostate cancer screening. Men should not be
screened unless they have received this information."
The real pieces of information that men need to know about prostate
cancer are that PSA screening has only a modest benefit in reducing the
risk of dying from prostate cancer. Additionally, screening
substantially increases the risk of cancer being diagnosed. However,
while there are prostate cancers that have the potential to be lethal,
many would do no harm even if never treated — and thus don’t need to be
found. Active treatment for prostate cancer is not without risk of
significant side effects, particularly sexual, urinary, and bowel
dysfunction, that can profoundly diminish quality of life. To make an
informed decision about prostate cancer treatment, these potential
outcomes need to be factored in by the individual man facing a decision.
Lastly — although a basket of fresh fruits and vegetables can be
suggested to have all sorts of healthy implications, the data about the
role of any of the items in the basket doing anything to change one’s
risk of having — or dying from — prostate cancer is tenuous at best.
All in all, the basket of information in this hurried 2-minute, 11-second segment was pretty empty.