Featured Research

from universities, journals, and other organizations

Prostate cancer treatment choices vary based on type of specialist consulted

Date:
March 8, 2010
Source:
JAMA and Archives Journals
Summary:
Men who visit a radiation oncologist appear more likely to receive radiation therapy for prostate cancer, whereas men who consult with a urologist with or without a medical oncologist are treated more frequently with hormone therapy, watchful waiting or a radical prostatectomy, according to a new study.

Men who visit a radiation oncologist appear more likely to receive radiation therapy for prostate cancer, whereas men who consult with a urologist with or without a medical oncologist are treated more frequently with hormone therapy, watchful waiting or a radical prostatectomy, according to a report in the March 8 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Related Articles


For most of the nearly 200,000 American men diagnosed with prostate cancer each year, the disease is localized (i.e., has not yet spread), according to background information in the article. Treatment options for these men include surgery to remove the prostate and surrounding tissue (radical prostatectomy), radiation treatment, hormone therapy (including primary androgen deprivation therapy) or watchful waiting (expectant management). "Selecting the appropriate treatment can be challenging, since no therapy has emerged as clearly superior," the authors write. "Patients rely on the clinical judgment, treatment philosophy and recommendations of counseling physicians to help them make informed decisions."

Clinicians' perceptions regarding optimal prostate cancer therapy appear to vary by specialty and geographic region. To assess whether these preferences were associated with treatment decisions, Thomas L. Jang, M.D., M.P.H., then of Memorial-Sloan Kettering Cancer Center, New York, and now of The Cancer Institute of New Jersey, New Brunswick, and colleagues identified 85,088 Medicare beneficiaries age 65 or older who were diagnosed with prostate cancer between 1994 and 2002.

Overall, 42,309 men (50 percent) were seen only by urologists, 37,540 (44 percent) by urologists and radiation oncologists, 2,329 (3 percent) by urologists and medical oncologists and 2,910 (3 percent) by all three specialists. Within nine months of diagnosis, 21 percent (18,201) had a radical prostatectomy, 42 percent (35,925) received radiation therapy, 17 percent (14,021) underwent primary androgen deprivation therapy and 20 percent (16,941) chose watchful waiting.

The type of treatment was strongly associated with the type of specialist consulted. Thirty-four percent of men who were seen exclusively by a urologist had a radical prostatectomy; it was the most frequent form of therapy in men 65 to 74 years who were seen only by urologists. In contrast, radiation therapy was the most common treatment for men of all ages who saw both radiation oncologists and urologists. Those seen by urologists, with or without medical oncologists, were more likely than those evaluated by urologists and radiation oncologists to receive primary androgen deprivation therapy or watchful waiting.

Visits to primary care physicians were infrequent between the time a man was diagnosed and when he started treatment; 22 percent of patients visited any primary care clinician during this timeframe, and 17 percent visited a primary care clinician with whom he had an established relationship. Regardless of age, co-occurring illnesses or specialist visits, men who saw primary care clinicians were more likely to be treated with watchful waiting.

"Our findings provide new insight into the relationship between physician visit patterns and receipt of therapy for localized prostate cancer," the authors write. "Prior physician surveys suggest that urologists and radiation oncologists might recommend their own treatment modality based on their stated preferences in response to hypothetical survey questions. The pattern of specialist visits and treatment that we observed suggests that these preferences may be affecting treatment decisions of Medicare patients."

"This finding and the known preferences of prostate cancer specialists for the treatment they themselves deliver underscores the need to ensure that all men are well informed and have access to balanced information prior to making this important treatment decision," they conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Thomas L. Jang; Justin E. Bekelman; Yihai Liu; Peter B. Bach; Ethan M. Basch; Elena B. Elkin; Michael J. Zelefsky; Peter T. Scardino; Colin B. Begg; Deborah Schrag. Physician Visits Prior to Treatment for Clinically Localized Prostate Cancer. Arch Intern Med, 2010; 170 (5): 440-450 [link]

Cite This Page:

JAMA and Archives Journals. "Prostate cancer treatment choices vary based on type of specialist consulted." ScienceDaily. ScienceDaily, 8 March 2010. <www.sciencedaily.com/releases/2010/03/100308171001.htm>.
JAMA and Archives Journals. (2010, March 8). Prostate cancer treatment choices vary based on type of specialist consulted. ScienceDaily. Retrieved April 2, 2015 from www.sciencedaily.com/releases/2010/03/100308171001.htm
JAMA and Archives Journals. "Prostate cancer treatment choices vary based on type of specialist consulted." ScienceDaily. www.sciencedaily.com/releases/2010/03/100308171001.htm (accessed April 2, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, April 2, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Wound-Healing Laser Soon to Be a Reality Israeli Scientist

Wound-Healing Laser Soon to Be a Reality Israeli Scientist

Reuters - Innovations Video Online (Apr. 1, 2015) Israeli scientists says laser bonding of tissue allows much faster healing and less scarring. Amy Pollock has more. Video provided by Reuters
Powered by NewsLook.com
Liberia Sees Resurgence of Drug Trafficking as Ebola Wanes

Liberia Sees Resurgence of Drug Trafficking as Ebola Wanes

AFP (Apr. 1, 2015) The governments of Liberia and Sierra Leone have been busy fighting the menace created by the deadly Ebola virus, but illicit drug lords have taken advantage of the situation to advance the drug trade. Duration: 01:12 Video provided by AFP
Powered by NewsLook.com
Stigma Stalks India's Leprosy Sufferers as Disease Returns

Stigma Stalks India's Leprosy Sufferers as Disease Returns

AFP (Apr. 1, 2015) The Indian government declared victory over leprosy in 2005, but the disease is making a comeback in some parts of the country, with more than a hundred thousand lepers still living in colonies, shunned from society. Duration: 02:41 Video provided by AFP
Powered by NewsLook.com
7-Year-Old Girl Gets 3-D Printed 'robohand'

7-Year-Old Girl Gets 3-D Printed 'robohand'

AP (Mar. 31, 2015) Although she never had much interest in prosthetic limbs before, Faith Lennox couldn&apos;t wait to slip on her new robohand. The 7-year-old, who lost part of her left arm when she was a baby, grabbed it as soon as it came off a 3-D printer. (March 31) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins