Many with Prostate Cancer Do Not Benefit From Surgery

My regular readers know that prostate cancer has been a controversial topic recently. The controversy centers around our ignorance of whether treating early prostate cancer helps patients, and by extension, whether early diagnosis is helpful. In May I wrote about the US Preventive Services Task Force’s new recommendation against screening men for prostate cancer with PSA blood testing, finding that the benefits of such scree...

Without a Randomized Study Your Results May Vary

A family of osteoporosis medications called bisphosphonates (which include Fosamax, Actonel, and others) is known to cause irritation of the esophagus. These medications have been prescribed millions of times. There are a few reports of patients developing cancer of the esophagus while taking these medicines. Obviously, many more people who develop esophageal cancer have never taken bisphosphonates. So how can we tell if bisphosphonates increase the risk of esophageal cancer? A More

Aspirin for Cancer Prevention not Ready for Prime Time

Let’s imagine that we had a hunch that lighting incense at midnight contributes to weight loss, and we wanted to test that hunch. How would we do that? We would recruit lots of overweight adults and (with their permission) randomly assign them into two groups. The first group would receive a wakeup call every night at midnight and would then light some incense. The second group would still receive a wakeup call (so that the sleep deprivation itself is not a difference between the groups) and w...

Vitamin E Increases Risk of Prostate Cancer

Lots of my patients take vitamin supplements. I don’t recommend them. My patients don’t ask me about it, they just tell me. In the absence of a specific vitamin deficiency or medical condition, there is absolutely no evidence that any vitamin improves any health outcome. I’ve always assumed that vitamins are generally ineffective, but harmless. Some patients are very eager to feel like they’re doing everything they can to be healthy, and I usually decide not to say anything and instead save my...

National Panel Advises Against Prostate Cancer Screening

Every year in the US over 200,000 men are newly diagnosed with prostate cancer, and every year 30,000 men die of the disease. With a problem this common that kills so many, you would think that aggressive testing of healthy men is certain to save lives. Whether screening for prostate cancer has any benefits has always been controversial. By the way, screening means testing for a disease in a patient without any signs or symptoms of the disease. It means testing healthy members ...

Mammogram Reading Not Better With Computer Assistance

… or “Read this mammogram, HAL.” “I'm sorry, Dave. I'm afraid I can't do that.” I went to college in the late 1980s, at perhaps the peak of optimism about computer intelligence. Personal computers had just become available and there was a general expectation that computers would soon be driving our cars, accepting our commands in spoken English, and generally doing everything better than humans could. The reality has been much less consistent. There have been impressive gains in computer intel...