The U.S. Preventive Services Task Force, which got into so much trouble almost two years ago over its recommendations to cut back on breast-cancer screening, is now advising doctors to abandon prostate cancer screening for healthy men.
I was critical of the breast-cancer coverage in Nov., 2009, because too many reporters seemed to think their own opinions were more important than the studied conclusions of the task force. Here I focus on The New York Times, which has three stories on the subject, and which either broke the story, or was alone in picking up a tip from The Cancer Letter, a respected industry-insider newsletter.?(The recommendations are not scheduled to be released until next week, so I cannot link to the task force?s findings or announcement.) [Update: The Washington Post, which originally ran an AP story online, now has its own story, by Rob Stein. The Los Angeles Times?has a story as well, posted late last night.]
Gardiner Harris tells it like it is in The New York Times.?The task force, according to Harris, is recommending that the prostate-specific antigen test be thrown out altogether for healthy men. It?s a dramatic conclusion. And Harris has the stats and the quote that remove any uncertainty about much of the expert thinking on the subject:
From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence or both. As a result of these complications, the man who developed the test, Dr. Richard J. Ablin, has called its widespread use a ?public health disaster.?
Wow. The originator of the test, who has as large a stake in it as anybody, not only says it?s being misused?he calls its use a disaster. Nicely reported, and nicely written. The Times also weighs in with a separate Q-and-A for patients by Tara Parker-Pope on her Well blog. It?s a smart way to handle the story?the news on page 1, and the sidebar for patients in the online health section.
So far, so good. Now, here?s the surprise: The Cancer Letter, which did?a brief but valuable recap of the breast-cancer controversy, contains the revelation that this Sunday?s New York Times Magazine will carry a story on the controversy by the freelance investigative science reporters Shannon Brownlee and Jeanne Lenzer.
If the coverage of the prostate-cancer story has not so far generated the kind of controversy sparked by the breast-cancer recommendations, the article by Brownlee and Lenzer is certain to ignite it. The story begins with the point of view of critics of the recommendation, including a personal attack on the American Cancer Society?s chief scientific officer, Otis Webb Brawley:
? it can be more than a little jarring to hear, for example,?James Mohler, chairman of the urology department and associate director of the Roswell Park Cancer Institute in Buffalo, say of his friend: ?I have known Otis for over 20 years. He doesn?t come off as being ignorant or stupid, but when it comes to prostate-cancer screening, he must not be as intelligent as he seems.? Or Skip Lockwood, the head of Zero, a prostate-cancer patient advocacy group, charge that Brawley is more concerned about saving men?s sex lives than about saving the men themselves.
This attack is a response to Brawley?s skepticism about the prostate cancer test. And the article online includes this jarring graphic:
When it?s put that way, who wouldn?t want to know? A different and more reassuring graphic might have used the choices that doctors face in interpreting the test: You have cancer. You don?t have cancer. Or, We don?t know. And for almost all patients, according to the task force, the check mark would go in the third box: We don?t know.
Brownlee and Lenzer do a very nice job of recounting the history of the P.S.A., and the story is nicely balanced, despite the frightening lede. (We might raise the question of whether the lede was pushed upon the writers by the editors. Frightening stories often attract more readers than balanced stories. You can look for this one to be one of the most emailed stories at the Times when it comes out. Harris?s story is already No. 2 this morning, and it?s not the frightening one.)
Also, Harris makes an important point (sadly, unattributed) that I couldn?t find in the magazine story?that ?the task force can also expect resistance from some drug makers and doctors. Treating men with high P.S.A. levels has become a lucrative business.?
Kudos to the Times for its extensive coverage. My only complaint would seem to be that the editors did not look at both stories and think about how they worked together, with the result that the Times is delivering two somewhat different messages to its readers.
- Paul Raeburn
?
kim delaney dead sea scrolls new jersey nets all my children online all my children online sly and the family stone sly stone
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.