Saturday, June 14, 2008

Prostate Drug Reduces Cancer - Perplexes Urologists

The NY Times is reporting today that two new studies now demonstrate the startling effectiveness of the drug finasteride in reducing the incidence of prostate cancer tumors in men.

This is certainly very good news for men, most of whom will have to deal with prostate problems at some point in their lives. Many with the decisions around what to do with a prostate cancer diagnosis. And you can take it from me, that is not an easy process to navigate.

It has been seven years since The Author was diagnosed and treated for this common male cancer. So after my own Urologist tried to rush me into an unnecessary surgery ("Why don't we go ahead and just schedule the procedure for early next week?"), I did the research and opted for brachytherapy - close proximity radiation delivered through surgically implanted seeds (pictured above).

The surgery is just too invasive, fraught with too many profound complications and side-effects, and simply unnecessary in many cases. It is, however, the most profitable procedure that is performed by Urologists who closely guard the franchise - often to the detriment of their patients. That's right. When you leave medicine to the free market, medical specialties start competing with each other for your dollar and the foundation of trust is shattered. For example, brachytherapy is delivered by an oncological radiologist or an interventional radiologist. This crew competes with Urologists for your health-care dollar. This is profit-driven, physician-centric care. It is not patient-driven in any way. The Times article hints at the real problem:

"...most leading specialists say, a major problem is that men are getting screened, discovering they have cancers that may or may not be dangerous, and opting for treatments that can leave them impotent or incontinent...While it might seem convoluted to offer a drug to prevent the consequences of overtreatment, that is the situation in the country today, others say. Preventing the cancer can prevent treatments that can be debilitating, even if the cancers were never lethal to start with...What the drug’s proponents are advocating is taking a drug to somehow compensate for what many believe is the nation’s overzealous diagnosis and treatment of the disease."

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