The Skid Row Cancer Study is a study conducted by urologist Perry Hudson to the homeless man Bowery, in Lower Manhattan. In the 1950s 1960, Hudson went to a skid line, to convince the man to volunteer for his studies. More than 1,200 men are promised clean beds, 3 free square meals a day and free medical care if they are found to have prostate cancer. Dr. Hudson by looking at a dying patient in a tuberculosis hospital that he did made him interested in prostate cancer. His discovery of a lack of information on treatment for illness and medical training for rectal examination needed to diagnose the disease prompted him to pursue research in prostate cancer.
At the start of the experiment, Hudson and colleagues selected 141 patients with symptoms and signs of urinary obstruction. However, during the trial, the patient was randomly selected. They were not told that a biopsy looking for cancer had possible side effects, namely rectal tear and impotence. According to Robert Aronowitz, before the biopsy, the patient underwent physical examinations including blood and urine tests, x-rays from the stomach, prostate massage for cytology and intravenous pyelogram. For biopsies, part of the prostate measuring 2.5 ÃÆ'â € "1.0 ÃÆ'â €" 0.5 centimeter has been removed; one half were sent to a pathology laboratory to be tested while the other half was kept for permanent preparation. If the results show cancer, perineal prostatectomy and orkiectomy are performed in men, followed by diethylstilbestrol treatment. The homeless are targeted for this biopsy because they are painful and untested, and the less vulnerable population will not be a volunteer.
Video Skid Row Cancer Study
​​â € <â €
Before securing a major research position at Columbia University, Perry Hudson received surgical training in the Navy and obtained a research position in Urology at Johns Hopkins University under William Scott. Overtime, Hudson's desire to learn more about prostate cancer led him to pursue research positions at Columbia University; where he led various research projects and was given ownership of various laboratories. In addition to his academic achievements, Hudson was appointed head of urology at Francis Delafield Hospital. Hudson's intention with Skid Row's cancer experiments is to find out whether the prostate cancer is terminal and how quickly it can be diagnosed. He continued to work in the field of urology after leaving Colombia and was also involved in "tobacco research, laboratory science... [and] other major prevention research." In addition, the efficacy of Hudson's treatment for what he considered "early" cancers using methods such as radical surgery, castration, and diethylstilbestrol therapy remained unknown at the time. However, even so, Hudson's study is still cited in many journals of urology and textbooks in the late 1950s and 60s as a new way to examine the prostate. Only in comments by the NIH in response to one of Hudson's requests for funding whether they consider malpractice, requesting the documentation of the Public Health Service policy of its compliance. Hudson has been training in South Pasadena, Florida, Columbia University, New York City, and Francis Delafield Hospital, in New York City. He is 98 years old and a certified physician in Georgia.
Maps Skid Row Cancer Study
Consequences
The ultimate goal of Dr. Hudson included finding a feasible way to use an open perineal biopsy (OPB) to diagnose prostate cancer at an early stage. He wanted to see the biological history of the disease and prove that the best way to treat it is by attacking the signs of cancer before it becomes a serious problem. However, the Bowery Series does not have an unauthorized patient control group, so it can not compare data with its experimental group. He has no evidence or evidence that the person being treated can live longer, and actually experience further health risks. Thus, the Bowery Series produces little effective data, and patients suffer side-effects by OPB. Although he can not achieve his goal, Dr. Hudson sets a precedent for future studies in impulse for the screen-and-treating movement. Prior to the Bowery Series, prostate cancer can only be detected in later stages when it is too late to save a patient's life. However, recent advances have allowed medical professionals to diagnose cancer at an early stage.
For a decade starting in 1951, Dr. Perry Hudson recruited over 1,200 subjects from the Bowery shophouses in "Skid Row" in New York. Many of the recruits were 'dashed' men with alcoholism and mental illness. To motivate enrollment into the research food, bedding, and medical care offered but the risks involved with perennial biopsy procedures are not fully explained to the patient, and many of them suffer long-term health consequences. Dr Hudson claims that the procedure, which involves the excision of 2.5x1x.5 cm nucleus of the posterior prostate does not cause harm, but independent research teams prove otherwise, reporting post-op impotence incidents, rectal lacerations, and decreased sexual function in 24 patients. The statement that the biopsy was inflicted no harm was again denied in an interview by one of the residents who claimed that impotence was a common outcome. Research results are published periodically as case series. In the early case series, the symptoms of 100 cohorts tested positive for cancer have been described. Dr. Hudson applies radical treatment to this group that is ambitiously outstripping the standard of care with little scientific support from success. In addition to the surgical castration of these 100 people, he treated them with estrogen hormone therapy, which later proved ineffective and detrimental. Hormone therapy puts the patient at risk for heart disease and stroke and causes loss of muscle tone and overall stamina. In the summarizing study, Dr. Hudson reported that of 686 patients tested, the mortality rate for men with negative biopsies was 20% and mortality rates for men with positive biopsies followed by strict treatment were 30%. Dr Hudson did not publish results for a control group or a group with a biopsy performed without hormonal treatment so the value of these results is unclear.
Ethics
The ethical integrity of the tactics Dr. Perry Hudson used to recruit volunteers for his experiments have been questioned. Some of his methods exploit the fact that most of his volunteers are homeless men. For example, Hudson will offer voluntary compensation in the form of meal tickets and temporary shelters in hospital rooms. Then, to ensure participation, the authorities will only provide a meal ticket to a volunteer once he appears for research. Because they are homeless, the volunteers see this award very interesting. In addition, their lack of education makes it more likely for Bowery men to volunteer for Hudson experiments, as they can not fully understand what they are applying for. In particular, at the time of the experiment, the open perineal biopsy method was new and largely untested, and it was not possible for a person to voluntarily undergo the procedure.
In addition, the volunteers are very uninformed. They were not given a clearly written paper about the dangers of a biopsy, like a torn rectum. Although the perineal biopsy approach seems to have benefits, the potential risk for rectal perforation is quite high.
In an interview, Dr. Perry Hudson defended his experimental ethics. He said he did not feel sorry, saying the volunteers seemed to him fully aware of the aspects involved in the research. Also, they do not accept monetary incentives from him to participate, which, if not, he says, will be "coercive". Once aware of Hudson's practice, a journal editor of Cancer wrote to him a letter asking what protection he got from the University's legal department. Hudson then stopped publishing his research results.
References
Source of the article : Wikipedia
0 Comments