Managing Too Much Information—The PCRI’s Approach

BY MARK SCHOLZ, MD

Knowledge is power. And what you don’t know can indeed hurt you.  However, in this modern information age, the deluge of unfiltered data can be completely overwhelming. How can patients without professional training sort it all out and distil for themselves a sensible plan of action?

No one can offer a quick fix.  Prostate cancer is too complex and there are too many behind-the-scene conflicts-of-interest simply to trust the first smiling doctor you encounter.  Although you can’t escape from the responsibility of doing your homework, you had better make sure you’re in the right classroom.

Because prostate cancer is so varied in how it affects men, PCRI has divided the disease into five major categories, which we have called Shades of Blue.  This division emphasizes the extreme diversity of this infirmity we call prostate cancer, a condition that ranges from totally innocuous to fatal.

In the process of learning about prostate cancer, failing to stick to the domain of a single Shade is like wandering randomly between five classrooms that are teaching five different subjects. Is it any wonder there is so much confusion? Patients don’t need more information. They need unbiased information that is tailored to their specific needs, i.e. their Shade of prostate cancer.

When you think about it, it’s obvious why we need a new approach to information management. In the old days, new discoveries came slowly. The doctors who were thought leaders had plenty of time to attend medical conferences to discuss disease management in a leisurely fashion to achieve broad consensus. Those days are gone forever. In this era of rapidly changing technology, consensus about a treatment probably means the treatment is out of date. These days, new treatments are vetted by experts on primetime news. Unfortunately, breaking news, due to its fundamental need to be controversial and attract an audience, tends to emphasize fringe thinking.

Relying on traditional university centers to define a sensible, middle-of-the-road plan of action is also no longer possible.  Prostate cancer is big business and most large treatment centers specialize in one form of therapy such as radiation or surgery to the exclusion of all the others. Studies show that large specialty centers do indeed yield better quality than centers treating fewer numbers of patients. However, the large centers are understandably biased toward recommending their specific form of therapy. Their advice about which treatment to select is all too often tainted by their financial conflict of interest.

The PCRI’s mission is to fill the cavernous need for unbiased information that has been created by the accelerated rate of technological discovery. Rapidly exploding technology and new treatments are a great blessing as long as these powerful tools are applied selectively and appropriately to individuals who can benefit, while withholding potentially toxic treatments from those who won’t benefit or may actually be done some harm.

With the annual PCRI conference rapidly approaching, PCRI will continue striving to fulfill its mission to provide up-to-date and scientifically-based information that helps patients and their families sort through the ever expanding number of treatment options.