Controversy in managing patients with prostate cancer

BMJ 1998;316:1919-1920 ( 27 June )

Editorials

Controversy in managing patients with prostate cancer

Banish dogma, get more data

The first 150 words of the full text of this article appear below.

Life is uncertain, and never more so than when a serious illness like prostate cancer strikes and a decision must be madeabout how to proceed. Ideally, the clinician would find (or remember)the relevant research, interpret the findings as they apply tothe patient at hand, estimate prognosis, and discuss treatmentoptions objectively and with compassion and support. Even then,life remains uncertain; for any particular patient, no matterhow good the evidence and precise the probability estimates, therecan be no guarantee.

This irreducible uncertainty is confronted routinely by doctors and patients and is rarely a source of clinical controversy.Trouble begins when experts reach different conclusions from thesame piece of evidence. The poorer the evidence, the more discretionarythe interpretation, and the more controversial the conclusion.When available evidence is totally inadequate to inform decisionsthat must be made, then clinical controversy may border on chaos.. . . [Full text of this article]

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Patients with prostate cancer should be enrolled in a national, controlled trial: R G Willis
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Benger, J., Thompson, C K., Cheseldine, D. L., Learmonth, G. M, Learmonth, G. M, Armstrong, R., Armstrong, R. (1999). CTI Medicine Update. Health Informatics Journal 5: 156-171
Willis, R G (1999). Patients with prostate cancer should be enrolled in a national, controlled trial. BMJ 318: 126-126 [Full text]