Jan 8 '98 Dr. Joseph Oesterling, editor-in-chief of the journal Urology, was found guilty last July of taking money under false pretenses (a felony). Dr. Oesterling's medical license was suspended for a brief time (one week). Sentenced to community service, he was ordered to repay the University of Michigan over a hundred thousand dollars. He resigned from his job as head of Urology at the University's medical school and director of the Michigan Prostate Institute. His university web site has been shut down. Is this a tragedy or a fender-bender on the prostate cancer pike?
      Dr. Oesterling, aged 41, has a sterling reputation as a surgeon. He's known as one of the leading artists (after Patrick Walsh) in nerve-sparing radical prostatectomy. He says he's continuing his research projects and wants to put these troubles behind him. Friends and admirers in the prostate cancer community praise him as a man who spends hours of personal time answering calls from patients far and wide, trying to help them through the maze of treatment decisions.
      Dr. Oesterling failed to protect himself and the interests of cancer patients. He took what a judge viewed as kickbacks from drug companies - money and position in return for endorsing the prostate cancer drug Nilandron and a procedure called the TUNA. Hoechst Marion Roussel, which makes Nilandron, was found to have given Oesterling a check for $25,000. VidaMed, which owns TUNA, gave him a seat on their board.
      No consolation to Dr. Oesterling or his patients, but there's a touch of screwball comedy to this story.Things went haywire when a temporary secretary opened an envelope containing a $5,000 check. Along with the cheque came a letter mentioning a larger contribution to The National Prostate Research Foundation. No one had heard of such a Foundation.
      Dr.Oesterling's generosity toward patients makes it sadder that he let drug companies bribe him. While earning close to $400,000 a year, he accepted extra money from companies whose products he was testing in clinical trials. And Hoechst Marion Roussel paid for 60,000 copies of his book. Reportedly, the Beyer company has distributed the book to branches of the prostate cancer support group Man to Man. Dr. Oesterling was put once through a white-collar wringer. He was sentenced to120 hours of folding laundry and chatting to men in a homeless shelter. Perhaps he did a world of good there. Who knows, maybe he persuaded dozens of men to check their PSA's. (If they could afford the test).
"Prescription for Trouble"
How the drug companies brought about this urologist's fall has only lately reached the oncology press. Patricia Anstett of the Detroit Free Press covered the story. When Dr. Oesterling was sentenced, Anstett filed a report (datelined August 19, 1997): Prescription for trouble: U-M case reveals how much money flows from drug companies to doctors. Anstett looks at how the $55 billion a year drug business spends more than $10 billion a year on doctor-related "freebies" and advertising in medical journals.
      Pointless to pretend freebies carry no influence. Within days of receiving $25,000 from the makers of Nilandron, Dr Oesterling wrote to 2 Ann Arbor hospital pharmacies urging them to favor Nilandron over competing prostate cancer drugs.
      The system of freebies has already taken hold in the prostate cancer advocacy movement. Some drug companies are interested in "helping" prostate cancer advocacy. Not all of this help seems purely altruistic. The companies have an interest in influencing how people with cancer run their own organizations. Dr. Oesterling's story may help remind us to be aware of this.