Ask doctors, not billboards

A surgeon at Brigham and Women’s Hospital compared the traditional way of treating prostate cancer with newer, less-invasive methods, including a robotic surgery technique that is often advertised on billboards and widely touted as having fewer side effects. All approaches worked equally well in controlling cancer, but a higher percentage of men who chose the less-invasive techniques suffered from incontinence and impotence. While the percentage of men suffering those effects was small in both cases, the result still came as a surprise.

Of course, the Brigham study shouldn’t be the last word on the subject. It covered the period from 2003 to 2007, when robotically assisted surgery was just coming into its own. Many surgeons were still getting the hang of it. As with many procedures, patients should look around for a doctor with as much experience as possible. Especially as time goes on, the robotic procedure may turn out to be the best choice for many patients.

Fortunately, prostate cancer usually develops slowly, so patients have the time to weigh the alternatives in treatment, which include radiation as well as removal of the gland.

Indeed, this typically slow-growing cancer presents patients with an even more basic choice: whether to treat it at all or just rely on “watchful waiting.’’ The emergence of the prostate-specific antigen test for early detection has resulted in the discovery of many cancers that, left on their own, would never threaten the health of the patient. If there is any disease that calls for unhurried give-and-take between patient and doctor, it’s prostate cancer.

Such decision-making should not be swayed by advertising for the latest treatment on the market. Such ads might help hospitals drum up enough business to pay for the surgical equipment, but the Brigham study shows that minimally invasive does not always translate into minimal side effects.