Re: Delayed Treatments for Prostate Cancer


"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
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"george conklin" <george@xxxxxxx> wrote in message
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The issue is to what degree surgery, by any technique, is going to do
much for a patient. You point to a 3% difference over 10 years as a
major victory, even while the big studies, much delayed, are just getting
started. One has been going 10 years with no results announced yet.

NEJM V347(11) from Sept 2002:
studied 700 men with prostate cancer. Median f/u of 6 years (not adequate
for prostate cancer studies) showed an improved disease specific
survival - a decrease from 8.9% to 4.6% which is a 48% reduction.


So, go tell government to get rid of the PIVOT studies since everything
has been decided. 700 men? And from that pitifully small number you are
going to treat millions? Horrid.



NEJM V352(19) from May 2005
Same group with longer followup, now out to 8 years (still not adequate).
Showed that "radical prostatectomy reduces disease specific mortality,
overall mortality, and the risks of metastasis and local progresssion".
Overall survival was improved by 22%. Not 3%...... but 22%. That was
statistically and is clinically significant.


3% of a sample turns into 22% 'reduction.' A committee had to decide
what the men really died of, since there were multiple causes. Just a few
differences in committee opinion would have changed the result since you are
dealing with a small sample. You know that too, but you cannot fool the
whole world with nasty posts. I still view you as once reason why research
into female cancers is so advanced compared to men. Neither is all that
good, but women have been politically active against attitudes like yours.



That is the real world data. That is LEVEL 1 evidence - these patients
who were diagnosed with cancer were RANDOMLY ASSIGNED to either watchful
waiting or to surgery. These were not "self selected" patients as you
have incorrectly argued. The numbers are not small. It was a well
designed study with a very clear endpoint showing a significant
improvement in survival in the treatment group.

Yes, that is a major victory.

No go play elsewhere cause you're in over head.

You continue to ignore how the study was done. Were you on the committee
which classified deaths from prostate cancer as compared to the other causes
which would have been possible? 700 is vastly to small for good results.
It is another example of billions for treatment and zilch for evaluation,
and the sad fact that medical journals love that situation. Now go play
with a demographer.


.

Relevant Pages

  • Re: Delayed Treatments for Prostate Cancer
    ... mortality, overall mortality, and the risks of metastasis and local ... would you tell a patient that he had a 3% ... trial of 700 patients to surgery vs. no surgery is a simple thing? ... the case of prostate cancer, we have the best studies done in the world ...
    (talk.politics.medicine)
  • Re: Medical Research-Evidence
    ... the 1% risk group was for the non-aggressive ... and let the patient make the decision. ... worry about dying from prostate cancer, whether or not there is a family ... especially as one of the treatments was not ...
    (talk.politics.medicine)
  • Re: Life or death question
    ... Is it wrong for a doctor to withhold such information from a patient? ... If they aren't going to die, ... home for the rest of their lives, ... year old grandfather had prostate cancer and it was pretty clear that time ...
    (alt.support.chronic-pain)
  • Re: Life or death question
    ... OG, to answer your question, I believe that if the patient is menatlly able to deal with the info, then yes they DEFINITELY should be told. ... If they aren't going to die, but it's information that could affect the way they'll live the rest of their lives, should they be told? ... Lets say it's going to mean a nursing home for the rest of their lives, ... My 96 year old grandfather had prostate cancer and it was pretty clear that time was going to get him before the cancer would. ...
    (alt.support.chronic-pain)