I’ve seen many people who avoid safe, natural treatments because of news reports, for example in taking antioxidants like vitamin E and in taking bioidentical hormones. This is a consequence of a system that promotes what conventional medicine wants you to believe about your health.

Last week the headline in the Washington Post read “Study Disputes Wait-and-See Approach to Prostate Cancer: Treatment Can Prolong Older Men’s Lives, Researchers Say.” The message in the body of the news item was that men between 65 and 85 who have been diagnosed with early stage prostate cancer have a 30% better chance of surviving the during the 10 years following diagnosis if they are treated aggressively with either radiation or surgery.

That message is based on a study reported in last week’s Journal of the American Medical Association (JAMA). The background is that the current practice for men in this 65-to-85 age group diagnosed with early stage prostate cancer is what is called watchful waiting. The common belief is that such cancers are slow growing so the man’s life is not in immediate peril and the risks and quality-of-life issues make treatment undesirable. You watch and wait and see what happens and if things get worse you take action.

The researchers examined Medicare records and compared the relative survival rates of men who had aggressive treatment to men who did watchful waiting. Because the data used in the study was after-the-fact rather than a more desirable controlled study, the researchers went through a considerable amount of statistical analysis to ensure that survival rates were not affected by factors other than the form of treatment.

This study has been made available for free on the JAMA website. A commentary that criticizes the study is not available for free. Among several important issues, two stand out. The first is that despite the researchers’ statistical efforts, the likelihood of bias remains strong. A common part of what influences a doctor’s decision about treatment is the man’s overall health. A doctor is less likely to promote aggressive treatment, with its consequent quality-of-life effects, for a man who is in poor health and not likely to live long. On the other hand, a man who is in good health with a good chance of living longer is likely to be advised to undergo treatment. In other words, the watchful waiting group of men in this study were already more likely to die.

The second issue the critics raise is the absolute risk in the study’s population of dying from prostate cancer. They note that “many more men die with prostate cancer that of it.” For the entire study population, less than 8% died from prostate cancer. That is, the vast majority (over 90%) of the men died from something other than prostate cancer.

I think we can go further in what’s wrong with this study. First of all, the set-up itself is biased. “Watchful waiting” is not the same as “do nothing.” But that is in fact what was being compared: treatment versus do nothing. What would the results look like if aggressive treatment had been compared to watchful waiting, some of which included timely and appropriate action?

Second, there’s no consideration of watchful waiting combined with restoring hormone balance using bioidentical testosterone nor the use of bioidentical testosterone as a treatment per se.

Third, there’s no consideration of alternative treatments and the difference in both survival rates and quality of life as compared to conventional medicine’s limited choice of burning or cutting.

But that wasn’t the purpose of the study and it wasn’t the purpose in promoting its results. Its purpose is to frighten you and leave you with the message that aggressive treatment will save you. That’s a big claim, one that’s not supported by the evidence.

The issues in this article are developed (with references) in issue #4 of the Progressive Health Observer in an article titled “In Your Prostate.”

Related resources are available on the Cancer page.