Jane Brody on prostate cancer in the NYT


Jane Brody is an experienced journalist who writes regularly about issues related to health care in The New York Times. Your sitemaster regularly reads her columns because she does her homework with care and provides sound information for her readers.

In the past couple of weeks, Ms. Brody has written two articles on prostate cancer in The New York Times:

Both of these articles provide good introductions to important perspectives on testing for and management of prostate cancer and particularly low-risk forms of the condition.

4 Responses

  1. A PSA TEST IS CRUCIAL FOR MEN OVER 50. ONCE YOU HAVE A READING BETWEEN 2-4.0, YOU CAN ADOPT “WATCHFUL WAITING”. A CONSISTENT READING ABOVE 4.0 SIGNALS A BIOPSY MAY BE REQUIRED. IF YOUR GLEASON SCORE IS 7 OR ABOVE, YOU MAY NEED TO HAVE A) A RADICAL PROSTATECTOMY, B) A LAPROSCOPIC PROSTATECTOMY, 3) RADIATION TREATMENT, 4) HORMONE TREATMENT, AND A FOLLOW-UP PSA TEST EVERY 6 MONTHS TO A YEAR, FOR 5 YEARS.

  2. Unfortunately there are so many errors in this comment from Dr. Hill that all it does is prove that having a PhD in something doesn’t make you an expert in something else. We strongly advise readers to do their own very careful analysis of the available information as opposed to following this erroneous guidance.

    At the most basic level, (a) a man can have an aggressive form of prostate cancer than needs immediate treatment even though his PSA level is < 4.0 ng/ml, and (b) there are many men with Gleason 3 + 4 = 7 forms of prostate cancer who can remain on active surveillance, with no treatment whatsoever, for years (and sometimes for decades).

  3. While many of us appreciate the publicity for PSA and the active surveillance protocol, not to mention the profile on our good friend Howard Wolinsky, the level of accuracy and research in Jane Brody’s article are not as thorough as usual. Here are just a couple of issues:

    (1) The level of progression for men on AS is quite a bit higher than 5-10%; probably around 30-33% per the UCSF and Sunnybrook cohorts.
    (2) Gleason 3 + 4 should not be considered low risk disease; anytime there is a 4 in the Gleason score, there is risk. Even 3 with a little 4 is still intermediate risk … albeit AS may still be appropriate.

    I have blogged several more issues — you’ll find the post here

  4. Dear Rick:

    Respectfully, I think you need to go back and look more carefully at Jane Brody’s articles.

    First, she never says that the level of progression for men on AS is 5 to 10%. She quotes Scott Eggener as stating that the level of progression is “5 percent annually for the first five to 10 years.” That’s much more that 5 or 10% over a 10-year period.

    Second, she never states that Gleason 3 + 4 = 7 is “low risk”. She states clearly that “a composite score of less than 7 is generally deemed low-risk disease” and later that “A pattern 3 has no ability to metastasize, but a 4 is aggressive, Dr. Klotz explained. Thus, a Gleason score of 3 plus 4 is considered less aggressive than 4 plus 3.”

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