Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Cancer screening and treatment cannot focus on mortality alone

Kevin Pho, MD
KevinMD
November 10, 2010
Share
Tweet
Share

When patients undergo medical treatment — like radiation therapy for prostate cancer, for instance — little is reported about the lifelong side effects that can arise.

That’s because outcomes have disproportionally focused on survival.  Whether a patient has incontinence, impotent, or blood in the urine stemming from prostate cancer therapy has largely been overshadowed.

In a recent New York Times’ column, Pauline Chen highlights the Patient-Centered Outcomes Research Institute.  According to health policy analysts,

the potential of such an enterprise will be fully realized only if the institute supports initiatives and strategies that place the patient experience not only front and center in research but also smack in the middle of the medical mainstream.

Obtaining patient experiences after treatment is important.  Quality of life sometimes can be just as, if not more, important than survival itself.

This segues into the recent findings from an NIH trial showing a lung cancer mortality benefit from annual screening chest CT scans.  I wrote about this last week, saying,

there remains a concern about the risk of cumulative radiation exposure [from] an annual chest CT … And finally, there is the concern about incidentilomas that screening CTs will bring. Incidental findings that result from a screening CT may necessitate further workup that may only confirm a benign condition. Furthermore, these tests tend to be more invasive — like a biopsy, for instance — which can put the patient at harm.

The Times also wrote cautiously about the findings, not only highlighting the cost — potentially reaching into the billions of dollars — but also the number needed to treat:

Some 300 people had to be screened to save a single life; the other 299 received needless radiation. There were scads of false positives — abnormalities that required further CT scans and sometimes biopsies or surgery to rule out cancer.

It’s important to highlight the patient experience after screening.  When it comes to lung cancer, that means what happens to the majority who may have to undergo potentially needless tests stemming from false positive CT scan results.

That’s why we need to proceed with caution when it comes to screening.  Mortality cannot be the only endpoint that matters.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on Facebook, Twitter, Google+, and LinkedIn.

Prev

Will the new Congress allow the physician Medicare cuts to pass?

November 10, 2010 Kevin 12
…
Next

Benefits of mammography may not outweigh the harms

November 10, 2010 Kevin 0
…

ADVERTISEMENT

Tagged as: Oncology/Hematology, Patients

Post navigation

< Previous Post
Will the new Congress allow the physician Medicare cuts to pass?
Next Post >
Benefits of mammography may not outweigh the harms

ADVERTISEMENT

More by Kevin Pho, MD

  • Surgeon General’s warning: the dark side of social media on children’s mental health

    Kevin Pho, MD
  • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

    Kevin Pho, MD
  • Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

    Kevin Pho, MD

More in KevinMD

  • The Spandex dilemma: Does size still matter?

    Janet L. Cray
  • Surgeon General’s warning: the dark side of social media on children’s mental health

    Kevin Pho, MD
  • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

    Kevin Pho, MD
  • Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

    Kevin Pho, MD
  • Remembering Heather Armstrong: the tragic loss of the “Queen of Mommy Bloggers” sparks a global conversation on mental health

    Kevin Pho, MD
  • Celebrating 2 million downloads of The Podcast by KevinMD!

    Kevin Pho, MD
  • Most Popular

  • Past Week

    • The hidden costs of the physician non-clinical career transition

      Carlos N. Hernandez-Torres, MD | Physician
    • The gastroenterologist shortage: Why supply is falling behind demand

      Brian Hudes, MD | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • Why private equity is betting on employer DPC over retail

      Dana Y. Lujan, MBA | Policy
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • End-of-life care cost substance use: When compassion meets economic reality

      Brian Hudes, MD | Physician
  • Past 6 Months

    • Physician on-call compensation: the unpaid labor driving burnout

      Corinne Sundar Rao, MD | Physician
    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
  • Recent Posts

    • End-of-life care cost substance use: When compassion meets economic reality

      Brian Hudes, MD | Physician
    • Smart design choices improve patient care outcomes [PODCAST]

      The Podcast by KevinMD | Podcast
    • Breast cancer and the daughter who gave everything

      Dr. Damane Zehra | Conditions
    • Physician wellness is not yoga: Why resilience training fails

      Tomi Mitchell, MD | Physician
    • Visual language in health care: Why words aren’t enough

      Hamid Moghimi, RPN | Conditions
    • The coffee stain metaphor: Overcoming perfectionism in medicine

      Maryna Mammoliti, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden costs of the physician non-clinical career transition

      Carlos N. Hernandez-Torres, MD | Physician
    • The gastroenterologist shortage: Why supply is falling behind demand

      Brian Hudes, MD | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • Why private equity is betting on employer DPC over retail

      Dana Y. Lujan, MBA | Policy
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • End-of-life care cost substance use: When compassion meets economic reality

      Brian Hudes, MD | Physician
  • Past 6 Months

    • Physician on-call compensation: the unpaid labor driving burnout

      Corinne Sundar Rao, MD | Physician
    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
  • Recent Posts

    • End-of-life care cost substance use: When compassion meets economic reality

      Brian Hudes, MD | Physician
    • Smart design choices improve patient care outcomes [PODCAST]

      The Podcast by KevinMD | Podcast
    • Breast cancer and the daughter who gave everything

      Dr. Damane Zehra | Conditions
    • Physician wellness is not yoga: Why resilience training fails

      Tomi Mitchell, MD | Physician
    • Visual language in health care: Why words aren’t enough

      Hamid Moghimi, RPN | Conditions
    • The coffee stain metaphor: Overcoming perfectionism in medicine

      Maryna Mammoliti, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Cancer screening and treatment cannot focus on mortality alone
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...