Lies, Damn Lies, Statistics, and Research Studies.

As Mark Twain famously said,  “There are three kinds of lies: lies, damned lies, and statistics.”  For those of us following developments in medicine and health, we could amend his statement to “there are lies, damned lies, statistics, and medical research studies.”
Mark TwainNo news cycle is complete without including the results of some new “scientific study.”  One’s head begins to spin at the seemingly contradictory results.  For example, coffee:  Bad for you; may cause a heart attack.  No, good for you, because it helps prevent heart disease. Well, sort of good for you.  Oh, wait, risky for you in certain circumstances.

More recently, the Wall Street Journal published an article* interviewing a researcher who asserted that the 30-year campaign by the American Heart Association that encouraged everyone to avoid natural saturated fats like butter and meat has contributed to the obesity epidemic. Nor has the rush to eliminate fat from our diets done very much to decrease heart disease at all.  “Low fat” and “no fat” apparently have far greater marketing benefits than health benefits.

Some “research” is not research at all, but merely silly, such as the assertion that bras cause breast cancer.

But when it comes to serious medical research, we cancer patients are more than mildly interested. For men with prostate cancer, especially those still considering what kind of treatment to elect, two great battles continue:

  • Robotic-assisted radical prostatectomy (‘RARP,’ aka “robotic surgery”) vs. traditional open radical prostatectomy (ORP) surgery, and
  • Electron beam radiotherapy (EBRT) vs. proton beam radio therapy (PBRT).

A February 2014 press release from the UCLA Jonsson Comprehensive Cancer Center asserts that ” cancer patients who undergo robotic-assisted prostate surgery have fewer instances of cancer cells at the edge of their surgical specimen and less need for additional cancer treatments like hormone or radiation therapy than patients who have traditional ‘open’ [laparoscopic] surgery.”

A summary of another study** published in the Journal of Clinical Oncology in April 2014 states,  “results show that RARP lowers rates of blood transfusion and prolonged hospital stay. However, overall complication rates, readmission rates, and need for additional cancer therapies were similar in RARP and ORP.”  The study’s conclusion, “although RARP is associated with a few benefits, it does not decrease overall complication rate and is not associated with any economic benefits according to this analysis.”

Admittedly, these two studies are not about exactly the same aspects of RARP. The one clear thing is that the differences between the two methods of prostate surgery are minor at best–except that RARP is more expensive than ORP because somebody has to pay for those robots.   But none of these “scientific” results simplifies the patient’s decision process.

We could cite the similar battling studies for traditional EBRT versus PBRT.  Each technology had its cadre of dedicated partisans preaching their respective gospel. About the only thing both sides agree on is that PBRT is more expensive.  But again, there’s no clear alternative to help a man decide because there are no meaningful differences between crucial measures like disease-free life extension or overall quality of life–the things that matter most to patients.

As a marketer, I know that none of these studies “accidentally” makes it on TV news or into print without a concerted public relations effort behind it.  There is invariably an agenda, and too often the study is being sponsored directly or indirectly by a company or organization (including non-profits) with a vested interest in the study’s results.

As usual, patients are left at the bottom of the informational food chain.  We have been trained by the media to believe that “scientific research” studies make us better informed consumers.  But in reality we are mostly left more confused.  Marketing may be an effective method for informing consumers as to alternative choices when it comes to consumer goods.  But, as I’ve observed before, cancer and marketing are not a particularly healthy mix.

There may be valid science behind battling and often contradictory studies.  But that does not make them very useful to laypeople attempting to make life-altering decisions about treating their cancer.  Unfortunately, a hundred years later, Mark Twain’s aphorism is more valid than ever.

*Wall Street Journal May 3, 2014  May not be available to non-subscribers.
** May require login.

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