Will you have proton therapy for prostate cancer or radiation therapy for prostate cancer? Will you be subjected to prostate cancer surgery? The answer to those question may depend on exactly which type of doctor you see.
A new study published in the Archives of Internal Medicine (Vol. 170, No. 5), by an investigator at The Cancer Institute of New Jersey (CINJ) and colleagues at Memorial Sloan-Kettering Cancer Center in New York, shows that the type of specialist that menwith localized prostate cancer see can influence the form of therapy they ultimately receive.
The study found that patients aged 65 and older who consult a urologist are more likely to undergo surgery to remove the prostate, while those who consult a radiation oncologist and a urologist, regardless of age, usually receive radiation
therapy.
This latest study examined 85,088 men who were diagnosed with localized prostate cancer between 1994 and 2002 using information from the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database to determine the type of specialist they saw and the therapy they received. The treatments included radical prostatectomy (surgery to remove the prostate), radiation therapy, primary androgen deprivation (hormone) therapy, and expectant management (an approach also known as received. Here's what they discovered:
Among the younger men, aged 65 to 69...* 70 percent who saw only a urologist had a radical prostatectomy. However, if men in this group saw a radiation oncologist and a urologist, 78 percent had radiation therapy. * Among those who saw a medical oncologist and a urologist, 53 percent had a prostatectomy and nearly equivalent numbers had either radiation therapy (17 percent), expectantmanagement (16 percent), or primary androgen deprivation therapy (14 percent).Rates of hormone treatment and expectant management increased with age for men evaluated by urologists alone and for those evaluated by both urologists and medical oncologists. Finally, visits to primary care physicians (PCPs) were infrequent between diagnosis and receipt of therapy, with 22 percent of patients visiting any PCP and 17 percent visiting a PCP with whom there was an established relationship at least 12 months prior to diagnosis. Irrespective of age, unrelated medical conditions, or specialists consulted, men who saw a PCP following diagnosis were more likely to receive expectant management than those patients who did not see a PCP."These practice patterns are no surprise but are notable because specialists who treat prostate cancer tend to favor the treatment they themselves deliver, despite the fact that no one has shown one treatment for early stage prostate cancer to be better than another," said Thomas L. Jang, MD, MPH, urologic oncologist at CINJ, assistant professor of surgery at UMDNJ-Robert Wood Johnson Medical, and the lead author of the study. "It is very important for patients to receive an unbiased,balanced perspective on the full range of treatment options, as the treatments for localized prostate cancer have different side effects and different recovery profiles, and involve a different time commitment."The team cautions that because men in the study were older than 65, the findings may not apply to younger patients.Don't miss these related articles...5 Common Men's Health IssuesNo Cures for Heart Disease, Clinton's Case Shows
