Fewer surgeries indicate enlightened care

Congratulations to The Bee’s Barbara Anderson for writing “a lower number of prostate cancer surgeries could speak to good support for well-trained urologists. …”

The 27th International Prostate Cancer Update will document a 5 percent drop in radical prostate surgery in the southern San Joaquin Valley in response to the 2012 U.S. Preventive Task Force pronouncement that PSA screening does more harm than good. Medicare private sector insurance carriers need not pay for the PSA test to screen for cancer. In other regions, radical prostatectomy rates dropped as much as 40 percent.

The low number of radical cystectomies performed here is also an indication of good medical practice, not bad. My 2003 presentation to the American Urological Association Western Section, based on data from the Fresno Veterans Administration documented dramatic shortening of bladder cancer patient’s lives after radical surgery. Patients having the surgery had a mean time to death of five years compared to 10 years for patients who did not have the surgery.

My data, featured in Urology News and in my book, “How to Avoid the Over-Diagnosis and Over-Treatment of Prostate Cancer,” may have helped put the brakes on the radical surgery rate.

This story was originally published January 27, 2017 at 3:36 PM with the headline "Fewer surgeries indicate enlightened care."