Robots and protons and prostates (and more) - evaluate the evidence

Any journalist thinking of writing about the wonders of robotic surgery should be aware of the flurry of evidence-based analyses raising questions about what we know and what we don't know about this expensive technology. I've blogged about several recent items:

A Journal of Clinical Oncology paper concludes that "Risks of problems with continence and sexual function are high after both (robotic and open prostatectomy). Medicare-age men should not expect fewer adverse effects following robotic prostatectomy." This clashes with manufacturer's claims.

An editorial accompanying that journal article - and a separate op-ed on the New York Times' website - each say that the questions applied to robotic prostatectomy should also be applied to expensive new radiation treatment technologies such as intensity modulated radiation therapy and proton beam therapy. One editorial described this "medical arms race" as "crazy medicine and unsustainable public policy."

An ear-nose-throat specialist who blogs wrote about a story he saw fawning over "surgeons on the cutting edge in the fight against sleep apnea" using robotic surgery. He wrote that this is "overkill...akin to using a rifle to kill an ant on the wall."

We write about these issues quite often. You can search on our blog and find other examples of robot excitement that need to be tempered with more questions about evidence.

By the way, if you haven't read Invasion of the Prostate Snatchers (pictured here), it's worth a look.