The Prostate Lab www.prostatelab.com
A Letter to the Editor, the Times of London
SUBJECT: Prostate tests
FROM: Mr. Joseph C. Smith (former President, British Association of
Urological Surgeons, 1992-94)
Sir, Dr Stuttaford ("Why early prostate tests are essential", January 29,1998)
cites evidence that, without early diagnosis and radical therapy, seven men
out of ten who "develop" prostate cancer die of it. I would remind your
readers that only a tiny fraction of those who contract the disease die of it - one in one
hundred, according to one estimate.
Dr Stuttaford also quotes US research showing a 94 per cent ten-year
survival after operation, rather than well-known Swedish research which
shows a similar ten-year survival without any treatment. The only long-term
case-controlled study, which was conducted in the US, showed no
statistically significant benefit from surgery at 23 years.
It may be true, as Dr Stuttaford states, that German patients (screened)
have a survival rate 50 per cent better at five years than their British
counterparts. However, screening will pick up the disease at least five
years before clinical presentation, so these figures suggest that treatment
does nothing to prolong survival.
I support properly controlled prospective trials of the treatment of early
prostate cancer; but until an effective treatment is found I shall continue
to enjoy my red wine, in blissful ignorance of my own level of PSA
(prostatic specific antigen).
Yours etc,
J. C. SMITH
(President, British Association of Urological Surgeons, 1992-94), 23
Banbury Road, Oxford OX2 6NX.
January 31, 1998