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Hormone therapy for prostate cancer puts heart at risk

Published: April 03, 2009


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December 12, 2015

It depends on what mruease you’re using to define better , but the answer is probably No, by most mrueases. A much higher percentage of men in the U.S. than in the U.K. undergo screening, biopsy, and treatment. That can good OR bad, depending on how you look at it: A much higher percentage of men in the U.S. undergo *unnecessary* screening, biopsy, and treatment than in the U.K., but a small percentage more American men have their lives prolonged because of it. (Most do not. Prostate cancer generally has such late onset, and is so slow-growing, that for every men who survives other diseases long enough to die _of_ it, six men will die _with_ it, but of unrelated causes.)The average man diagnosed with prostate cancer in the U.S. has more years of life ahead of him than the average man diagnosed with prostate cancer in the U.K. But the comparison is not very worthwhile, because American men are, on the average screened earlier and diagnosed more liberally. Many men initially diagnosed with prostate cancer in the U.S. wouldn’t even be considered ill in the U.K. (Since these tend to be the men who will die of something else long before they die of prostate cancer, the diagnosis is technically accurate, but can be very misleading.) Prostate cancer is MUCH more expensive in the U.S. than in the U.K., by at least a factor of two and probably more like five or six. From the standpoint of society at large, that means treatment in the U.K. is much more cost-effective. On the other hand, it means that almost no men in the U.K. have their final days prolonged by drugs costing $5,000 a month, but some Americans do.Prostate cancer treatment is MUCH fairer in the U.K. than in the U.S. Any citizen of the U.K., no matter how poor, receives quite good medical care. In the U.S., a very few citizens receive much better medical care; most receive about the same; but a very substantial minority (40 to 80 million Americans) receive far worse care.

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