Re: Medical Research-Evidence


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"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in message
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"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in message
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Here is a comment from UK:

Prostate therapy benefits doubted

There are always supporters and doubters.

Many men diagnosed with low-grade prostate cancer do not benefit
from
radical treatment, research suggests.

Agreed. The study did not state nor imply every man benefited from
surgery.
In fact, it shows that operating on all men with prostate cancer
results
in
overtreatment... which we already new. The problem is, we don't
know
*which* patients will benefit. That's why you check everyone's
blood
pressure... to pick up the hypertensive patients. There's no way to
guess
which one will have high blood pressure and as of now, there's no
way
to
tell which man will get a survival benefit from surgery. All that
we
now
*know* is that some men do. The rest of your posts confirms exactly
this
and is therefore snipped.

Actually they divided the human male population into two groups:
those
cancers described as aggressive (undefined) and not aggressive (also
undefined). However, the 1% risk group was for the non-aggressive
tumors
over a 15-year period. You snipped that. It is a scandal with
billions
being spent on treatments so little has been spent on evaluation.
The
big
money is in treatments.

So George, what do you think should be done about prostate cancer? If
a
55
year old, otherwise healthy man, is diagnosed with Gleason 4+3 prostate
cancer (intermediate risk) after a screening PSA of 5.6 (elevated for
his
age) the data and medical knowledge suggest that he stands an improved
chance of survival with surgery (and proabably also with radiation
therapy).
Should he not be offered these? What do you think should be done? I
know
that if that were me at that age and health, today, I'd go under the
knife
for a radical prostatectomy. Does that mean I'm foolish? What would
you
do?

The whole point of the BBC article was that the science has not been
done yet to give good answers to these types of questions.

Fine. Based on the available data - which is all we have for the patient
walking in the door tomorrow morning - what do you think should be done in
the above scenario? The *available data* suggest he has a small but real
increased chance of long term survival with surgery (and probably for
radiation therapy). The data we don't have we can't comment on.

I'd like to hear your opinion.

My opinion is that he should be informed of all of his options, which
include surgery. He should be told many things, and among them that we
don't know if surgery will increase his longevity, but studies to date
suggest it may.

In the real world, most younger men with prostate cancer who are otherwise
pretty healthy and don't see themselves as dying in the next 1-2 decades
opt
for some sort of treatment - a decision I personally agree with especially
for intermediate and advanced cancers. Earlier cancers are more difficult
counseling and less clear about how to advise.



I think the point of the article is that it is possible such a decision
might not help at all, and might even hurt. However, I do think until basic
science of cancer undercovers the genetic-base of the disease, cutting away
at a tumor will only reduce tumor load, but stop the initial problem. The
dismal results show that.


.

Relevant Pages

  • Re: Medical Research-Evidence
    ... "Radical Prostatectomy versus Watchful Waiting in Early Prostate ... The only issue is whether a treatment works. ... differences in cancer survival rates over very long periods of time may be ... advantage for surgery vs. watchful waiting. ...
    (talk.politics.medicine)
  • Re: Delayed Treatments for Prostate Cancer
    ... "Incidence of Initial Local Therapy Among Men With Lower-Risk Prostate ... Cancer in the United States "? ... Treatment may result in morbidity. ...
    (talk.politics.medicine)
  • Re: Delayed Treatments for Prostate Cancer
    ... "Incidence of Initial Local Therapy Among Men With Lower-Risk Prostate ... Cancer in the United States "? ...
    (talk.politics.medicine)
  • Re: Medical Research-Evidence
    ... Prostate therapy benefits doubted ... what do you think should be done about prostate cancer? ... chance of survival with surgery (and proabably also with radiation ...
    (talk.politics.medicine)
  • Re: Medical Research-Evidence
    ... Prostate therapy benefits doubted ... what do you think should be done about prostate cancer? ... Maybe reducing tumor load has some effect after 10 years on prostate cancer ...
    (talk.politics.medicine)