Pharyngula

This is a rather chilling story of academic freedom getting trampled. A whole pile of documentation is available at that link, I’ll try to simplify it down a lot.

UC Davis was sponsoring a public seminar on prostate cancer; specifically, they were actively promoting the prostate specific antigen (PSA) test. One professor, Michael Wilkes, objected — the PSA test is now discouraged as worse than useless. Wilkes is a specialist in prostate cancer; he knew this. Heck, I knew this, and my local MD knows this. He explained to the department that was sponsoring the seminar that it was wrong, and he also published an op-ed in the San Francisco Chronicle that does a very good job of explaining why tests with lots of false positives and false negatives are no good.

UC Davis just announced a seminar for the public on “men’s health.” That title notwithstanding, the program appears to be entirely about prostate cancer and in particular about the prostate specific antigen screening test. Prostate cancer can be devastating, and the PSA is intended to find cancer early – in time to do something about it.

If only it were that simple. Research has shown that there are steps people can take to improve the quality and length of their lives, even before they’re having any symptoms. (That’s what “screening” for disease is.)

Unfortunately, though, the devil’s in the details, and many possible screening programs turn out not to do any good – and in fact some tests like PSA cause harm. That’s why virtually all expert public health panels do not recommend the PSA test.

A blood test that isn’t accurate can fail to find disease that’s present, leading to false reassurance. It can also report disease when it’s not really there, leading to unnecessary use of other tests (like biopsy) that are not so benign. Perhaps most concerning, the PSA test frequently identifies something that qualifies as cancer under a microscope but acts nothing like cancer in real life. That is to say, the large majority of PSA-discovered “cancers” would never cause any problem whatsoever if they went undetected.

But because doctors can’t tell whether one of these “cancers” is benign (as it usually is), or might occasionally be one of the bad actors, finding something through screening invariably leads to treating it.

Most of the men so treated would have been just fine if they never knew about the cancer. But when they’re treated (whether with surgery, radiation or chemotherapy), the majority suffer really life- affecting effects, such as impotence and/or incontinence. That’s why both of the two very large trials of PSA screening published in 2009 found no (or at most a tiny) benefit, but a great deal of harm.

Wilkes was doing exactly what a responsible scientist ought to do, correcting public misinformation about his field of expertise.

Unfortunately, a dean, an associate dean, and the Health System counsel at UC Davis were very upset that a professor was criticizing a public health program that they were putting on. Never mind that they were dispensing unsound health information; he was dissing their turf. Among other things, they responded by threatening Wilkes academic appointment and and taking away his lab space.

The good news in the end, though, is that the UC Davis Committee on Academic Freedom and Responsibility has come through; reviewing the case, they’ve determined that Wilkins’ academic freedom was violated and slapped down the various administrators who’d punished him for being a responsible public scholar.

I’m wondering, though, how often these kinds of cases come up and the scholarly responsibilities are squelched. For a lot of people, these are tough decisions: their livelihood can be threatened and their ability to do the work they love compromised. I’m incredibly fortunate in my case to have tenure at a university that so far has demonstrated a commendable commitment to academic freedom — I can publicly declare that my university’s Center for Spirituality and Healing is a colossal boondoggle and complete betrayal of reason and responsibility, and my job is still safe.

But then, I know of other cases. I have a colleague at another university who learned that they were offering seminars that were far worse than what UC Davis was doing — we’re talking New Age bullshit by a con artist who is promising to teach magic powers — and so wrote a polite letter to the individuals in charge of the program. The response was a complete blow-off, an endorsement of the charlatan, and a gentle suggestion that my colleague’s nose ought to stay out of this affair, or risk being an unemployed appendage. I am itching to scream bloody outrage at this nonsense, but I can’t…it’s not my job that would be on the line.

So tell me…who else is experiencing quackery and bullshit peddled through their place of employment, and can’t speak out because your administration is staffed by pandering ignoramuses? Dish, please. Anonymity will be respected.

Comments

  1. #1 Michael Dean
    Oklahoma
    June 8, 2012

    Please do not limit this to College levels…
    Oklahoma Secondary School teachers are slowly being squeezed into the Conservative Rethuglican For-profit education mold.
    First, we do not have tenure (protection is “career status” and is very limited)
    Second, the legislature removed independent review of dismissals. Now the last recourse is the school board, which has already approved of the action to begin with!
    Third, dismissals can now be conducted based on “need” and next year, on “performance reviews” rather than on seniority.

    I have personal knowledge of three science teachers who are forbidden by building principals to teach evolution. I know of two science teachers who teach creationism (with principal approval) rather than science. There are districts that REQUIRE posting “In God We Trust” in every classroom.
    I feel very blessed to have progressive administrators in my district that actively work with me and allow me the freedom to teach.

  2. #2 anon
    June 8, 2012

    PZ—
    I tried to be anonymous in the prior post, but it filled in my info anyway…can you fix?

  3. #3 Duane
    June 8, 2012

    After my yearly checkup, I was referred to a urologist because I had a PSA value “slightly above” (the specialist’s words) average for my age. Despite a lack of prostate cancer history in my family going back at least six generations, he convinced me to have a prostate biopsy performed. I’ll spare you the details on that.

    The biopsy came back negative, but there was something called ASAP tissue found, and a second biopsy was scheduled. I endured that one, too.

    The next year, after my yearly exam, my PSA level came back even higher, and my specialist recommended a saturation biopsy, in which the entire prostate is sampled. He scheduled me for one more blood test, just to be sure, then turned to me and asked, “You are avoiding all sexual activity for 3-4 days prior to the test, right?”

    Oh, man.

    Fast forward 3-4 days. I abstain, then take the test. The results? Normal. Completely normal.

  4. #4 Duane
    June 8, 2012

    Apologies for the above not being strictly on topic.

  5. #5 Doodieman
    The load stone.
    June 8, 2012

    I Doodieman, have mastered the art of biology to the point where I am the shit. The ninjas I fight, can’t even cut the shit out. If you try to defeat me, you obviously have shit for brains.

  6. #6 Texas Aggie
    Boston
    June 8, 2012

    My father had prostate cancer. All his brothers (4) had prostate cancer. My exfather in law died of prostate cancer. My brother had cancer in all six samples of his biopsy. My biopsies weren’t that bad at first, but after it was totally removed, they found that cancer had infiltrated every lobe of the prostate, but fortunately had not gone beyond the capsule. The biggest benefit however, is that for the first time in years, I can now urinate without having to strain, and the sudden urges to go to the bathroom have completely disappeared.

    Ignoring prostate cancer is not the way to go either. By the time you have symptoms beyond prostate hypertrophy, it is often too late. And the article should have mentioned that there have been improvements on the screening that determine how much of the PSA is free and how much is conjugated. This has cut the false positives quite a bit.

  7. #7 BO_Behold
    June 8, 2012

    I work for an organization that employs some people who believe that windmills are a viable energy source. It is pretty bad.

  8. #8 BO_Behold
    June 9, 2012

    Classic.

  9. #9 Nick Lally
    June 9, 2012

    Dear PZ Myers,
    If not PZ Myers, please see that this email reaches Professor PZ Myers.

    PZ, I just wanted to thank you for giving me the inspiration as a results of your posting:
    (See: Posted on: January 4, 2009 9:50 PM, by PZ Myers, an article about Nick Lally)
    It gave me enough inspiration to counter with Truth and determination by starting the first ever Creation Science Hall of Fame (see: http://www.creationsciencehalloffame.org) just 10 months after your posting on Pharyngula.

    I truly hope that some day before you die that you may discover Truth.

    Sincerely,
    Nick Lally

  10. #10 'Tis Himself
    June 9, 2012

    I truly hope that some day before you die that you may discover Truth.

    Creationism and truth are 180° out.

    I hope when you grow up you discard some 2500 year old religious myths and replace them with reality.

  11. #11 David Hewitt, M.D.
    California
    June 10, 2012

    There is no defense of the academic freedom assault. However, there is, perhaps, a slight defense of the seminar itself–this happened almost two years ago (September 2010), and the full weight of recommendations were not against PSA at that time.

    The PSA has, for too long, been a substitute for real clinical knowledge, at least for some physicians.

  12. #12 GregH
    June 10, 2012

    Dear Mr. Lally: It looks like you’re trying to implicate PZ Meyers in the creation of your nonsensical website. Are you not big enough to stand up for your own delusional beliefs? Here, try this on for size: “I, Nick L., thought up this silly creationist shooting gallery all by myself, mostly because, well, sports guys have a hall of fame, and they’re famous, so I want to be famous too!”

  13. #13 impartial observer
    Ireland
    June 10, 2012

    You think that’s bad, just try questioning climate science orthodoxy if you really want to call down a perfect shot storm (pardon my spelling) on your head.
    Even ol’ PZ shoots first and doesn’t bother to ask questions later in that field, ‘cos the science is settled.
    I am a great admirer of PZ and read his blog with great pleasure both for the no-nonsense style as well as for the clear logic employed.

  14. #14 Andy
    Michigan
    June 10, 2012

    During my HR review at a job, I didn’t have any negative criticism about me at all, but had to listen to some swill about crystal energy or some crap, and what it meant for my career. It was awful, but speaking up would have put me on the wrong end of HR.

  15. #15 Quran Tutor Online
    http://www.thequrantutorsonline.com
    June 13, 2012

    This is such a nice site, has very useful information. I will definitely come back to this website and will increase my knowledge.
    Quran Tutor Online

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