Head to head brawl: should drug companies be trusted to conduct research trials on their own drugs?

It may seem to the casual observer that the U.K.’s Great Oxford Debate (held in September at Oxford University and covered last month in the British Medical Journal) resembled a fight between the fox and the farmer over which one of them should be in charge of the henhouse. In one corner, wearing the red silk shorts, you had physician, activist and Bad Science blogger Dr. Ben Goldacre, who argues that the financial interests of a drug company lead to distorted clinical evidence when they run research trials on their own drugs.  In this corner, in the shiny blue Spandex, you had consultant Vincent Lawton, a Big Pharma veteran (most notably as a 26-year executive with drug giant Merck Pharmaceuticals), arguing that adequate safeguards already exist to keep a drug company’s research bias nicely  in check.

With the British Medical Journal refereeing the rumble, let’s tune in for Round One, led off by Vincent Lawton:  Continue reading

Medical miracle breakthrough in the news? Not so fast. . .

You know that photogenic and charming medical “expert” who is trotted out during your breakfast hour newscasts to explain the latest health buzz?  The medical miracle breakthrough that gets a full page spread in the Sunday paper? The CBS television show 60 Minutes gushing over the Kanzius cancer cure machine?  How can you tell if these news stories are on the level?

The simple answer: you can’t. In fact, as the savvy medical journalism watchdogs over at Health News Review warn:

“Every time you think you’ve seen the worst use of media coverage of health topics, something lower pops up.”

For example, here’s how HNR evaluated a “news” story on ABC’s Good Morning America about an off-label unapproved use of laser treatment for toenail fungus:

“The advantages were unsubstantiated, the harms unstated, and the effectiveness exaggerated. Promotion of an unapproved off-label use of laser treatment that has no published study results available. Disease mongering at its worst. Millions of us ‘suffering in silence’ with toenail fungus? Gag me.”

HNR makes the following assessment of the laser treatment news story:   Continue reading

The business of prostate cancer: putting profit before patients

There’s a simple blood test done routinely to screen men for a condition that is rarely serious.  But if your screening test happens to be positive, the resulting treatment and side effects are likely to be devastating to your day to day quality of life, and may include stress incontinence, overflow incontinence, urge incontinence, or continuous incontinence. And impotence, temporary or permanent.

Should you get this blood test done?

That’s the controversial question behind two large, randomized clinical trials this past year studying the relationship between PSA-based screening and prostate cancer mortality: The European Randomized Study of Screening for Prostate Cancer and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial in the U.S.  According to the European study, which involved over 162,000 men between the ages of 50 and 74 in seven countries, PSA-based screening reduced the already low rate of death from prostate cancer by 20%, but was also associated with a high risk of overdiagnosis and overtreatment.

The American PLCO trial found the rate of death from prostate cancer was very low for both the 38,343 men in the group that received annual PSA-based screening and the 38,350 men in the control group who received “usual care.” The conclusion:

“Screening was associated with no reduction in prostate cancer mortality.”

‘Non-intervention’ is what urologist Dr. Anthony Horan says he was taught when he attended medical school and also during his urology residency at the Columbia Presbyterian Hospital in New York in the mid-1970s. Explains the author of The Big Scare:  The Business of Prostate Cancer:

“We didn’t go looking for the incidental cancers that were of no clinical significance.  And if we found them, we did nothing about them.”  Continue reading