This is a powerful piece of writing that you have shared, halbert. It seems like it become easier for you to talk about
this topic as time has gone by...it was the same for me.
The passages that you have quoted are very noteworthy. I think that this one also hits people sharply on the side of their head:
halbert's article said...
In some instances, unnecessary treatment of prostate cancer is curing some men who do not need to be cured, with significant detriment to their quality of life. The large number of "cured" makes aggressive treatment look good when one does not realize that many of the cured did not need to be cured.
I also like/agree with your call for the progressive thought-leaders in medicine to more vocally "call-out" their brethren who are (still) perpetuating the overtreatment epidemic. I'll add two other powerful examples of "call-outs" from the leaders of different facets of prostate cancer care.
The first quote is from Anthony Zeitman, MD, who was just awarded the ASTRO Gold Medal in July 2016, the highest award given by the radiation oncology group. Zeitman is director of Harvard's radiation program, and was past-president of ASTRO. This quote comes from an ASTRO editorial he wrote while president, admonishing his peers:
Dr. Zeitman said...
A perfect storm of clinical evidence and economic reality has arisen in which urologists and radiation oncologists need to examine the evidence, examine their souls, and start to carefully look at every new patient asking, before anything else—is treatment really needed at all? If it is not, and that will frequently be the answer, then they must be prepared to lead the patient along the less financially rewarding and decidedly unglamorous path of active surveillance. The training of resident doctors has to date been so focused on cure, and the culture of early detection/early treatment so deeply in-grained, that it is little wonder that this shift in thinking is yet to reflect itself in everyday practice.
The second quote is from Mark Scholz, MD, a medical oncologist who treats many men here at HW/PC out of his world-renowned practice Prostate Oncology Specialists. Scholz is co-founder and past president of the Prostate Cancer Research Institute (PCRI, where several HW/PC members recently attended the conference) and is co-author of the book "Invasion of the Prostate Snatchers." This passage admonishing his peers is from the book:
Dr. Scholz said...
Ten years ago the experts believed that immediate curative treatment was needed for every man with prostate cancer. Today, after 20 years of vigorously detecting and treating every case of prostate cancer, it has become clear that almost half of the 230,000 men diagnosed every year are undergoing radical treatment for a cancer that is incapable of metastasizing. Now it’s time for the medical community to come to grips with the fact that over a million men in the United States are living with impotence and incontinence for no justifiable reason. This is a disaster of gargantuan proportions.
Shockingly, even though we can now readily identify these harmless cancers, the problem of rampant overtreatment continues. In 2015 another 50,000 men will undergo unnecessary radical treatment. The medical industrial complex that has been gaining momentum for 25 years refuses to confess its tragic errors. The huge investments in enormously expensive medical equipment need to be paid off. No one is willing to accept responsibility, make apologies or confess wrongdoing for all the overtreatment. The existing system is entrenched and the doctors are too comfortable with the status quo.
These, along with the doctor's message you posted, halbert, are powerful, powerful messages.
My crystal ball says that they are finally setting in...more and more are "getting it"...finally.
Post Edited (JackH) : 10/5/2016 9:07:05 AM (GMT-6)