The prostate is this year’s breast.
It’s an organ with deep psychological significance to its owners, which men are having cut out, sometimes unnecessarily, at the first hint of the dread word “cancer.”
One of my best friends had this done some years ago. He said it would effect a 100% cure. Often it will (it has in his case), just as a quick mastectomy will often keep a woman’s breast cancer from taking her life.
But is it necessary?
A new study in the Annals of Internal Medicine, under oncologist Mark Stein of the Cancer Institute of New Jersey, finds that 75% of men with low-risk prostate cancer, indicated by a PSA test, are nevertheless getting highly aggressive treatments like prostatectomies, the full or partial removal of the organ.
It’s an expensive operation, and is sometimes followed by chemotherapy or radiation, as well as a lifetime of pill-popping. That’s a lot of suffering, and a lot of money, spent on cancers that may not be deadly.
Dr. Stein wants other tests, beyond the PSA, used in making these decisions. Other researchers admit that prostate cancer is often over-treated.
A year ago the health reform debate was turned upside down by government-funded studies showing that, in the case of breasts, overly-aggressive diagnosis and over-treatment was mutilating women to no good purpose.
Now we are learning the same thing about men and their prostates.
Fact is, some cancers just go away. Population studies, taken retrospectively, can discover over-treatment and over-diagnosis that is costing people organs and self-esteem, as well as costing society untold billions.
Health IT makes these studies easier to perform, and more statistically valid.
If Electronic Health Records (EHRs) can share common formats, if they become searchable and subject to mass calculation, if we let comparative effectiveness do its job and not rely on small cohorts like the Framingham Heart Study, we can dramatically improve diagnosis and treatment of cancer and other diseases.
And we can save hundreds of billions of dollars in the process.
Or we can continue mutilating our sex organs as punishment for having them, throwing billions of dollars away in the process, and probably not increasing our average life expectancy by one day.
Now that the arguments over “rationing” and “death panels” are starting to fade, can we let technology do its work on our behalf?
UPDATE: Microsoft has just announced a system that links its Amalga hospital automation solution to contract research done by PPD. A great example of what I’m talking about.
