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Richard W. Switzer, MD
Southwestern Urology Ltd Tucson, Ariz

JAMA. 1993;270(14):1692.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—This letter is written in regard to the two ghastly articles on the treatment of prostate cancer you published in the May 26, 1993, issue of JAMA.

The first article on radical prostatectomy¹ purports to show that the recent increase in this procedure has not changed the death rate from this disease and then quotes death rates for the 15 years prior to the increase to substantiate this. The important period will be 15 to 20 years after surgery, not before. The authors do not seem to understand that a sea change has occurred in the diagnosis of prostate cancer because of the advent of the PSA test and the availability of ultrasound-guided biopsy.

The article by Fleming et al² on clinically localized prostate cancer creates a model for treatment based on assumptions, estimates, and assignments, many of which are spurious and all of which . . . [Full Text PDF of this Article]

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