Invasion of the Prostate Snatchers
Only about 1 in 7 men with newly diagnosed prostate cancer are at risk for a serious form of the disease. “Out of 50,000 radical prostatectomies performed every year in the United States alone,” Dr. Scholz writes, “more than 40,000 are unnecessary. In other words, the vast majority of men with prostate cancer would have lived just as long without any operation at all. Most did not need to have their sexuality cut out.”
Full New York Times book review of Invasion of the Prostate Snatchers here.
The reviewer, Dana Jennings, points out that his prostate cancer was one of the aggressive the 1-in-47 cases where he would have died without surgery. The other men, statistically 46 of 47, were probably maimed unnecessarily. Dana’s cancer was initially identified as slow-growing. His surgeon discovered it was a more deadly form. I suspect many men probably opt for the surgery just to avoid the small chance that they have the aggressive form.
This is an old story. Richard Albin, the inventor of the PSA test calls it “hardly more effective than a coin toss”.
http://www.nytimes.com/2010/03/10/opinion/10Ablin.html?emc=eta1
You need the test to find out if you have aggressive cancer. If you don’t, you are probably better off keeping you prostate in tact.
Prostate snatchers? Way too many old movies too late at night.
This is yet another scare tactic designed to delegitimize decisions by individuals in favor of the rigid practice guidelines which have done so much to reduce the prostate cancer survival rates in nations that already have ObamaCare.
Eurocare-3 put 5 year prostate cancer survival rates at about 70% in 1999. Survival was highest in Tyrol (Austria), where “intensive prostate-specific antigen (PSA) screening has been in place since 1992…the wide European range in survival is largely attributable to differences in the intensity of diagnostic and screening activity…” During the same period, the SEER US 5 year survival rate was roughly 95%, probably because the privately controlled, decentralized, US medical system innovated much, much faster.
Deciding how to treat prostate cancer is complex. There are a lot of treatments and all have different side effects. A small early trial (Bill-Axelson et al., 2008) randomly assigned Swedes with localized prostate cancer to surgery or so-called “watchful waiting.” The “watchful waiting” group had a higher rate of death from prostate cancer after 12 years of follow-up–12.5% versus 17.9%. The men in the surgical group also had fewer “distant metastases”–19.3% versus 26%. The Swedish sample was small, 695 men. Larger trials are underway, but based on its results the decision to do surgery is by no means “prostate snatching.”
Linda makes an important point. If 98% of prostate cancers are better left intact, how come Britain has a prostate cancer mortality rate far worse than the United States and most European countries? Isn’t the British NHS largely doing what the authors of the book believe is the better treatment option?
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