Type of specialist may influence prostate cancer treatment

For patients with localized prostate cancer, the type of specialist seen may affect the type of therapy they receive, according to a study from Memorial Sloan-Kettering Cancer Center. Specifically, men between the ages of 65 to 69 years who see a urologist would have a greater likelihood of undergoing prostate surgery, but those who consult both a radiation oncologist and a urologist- regardless of age-would likely receive radiation therapy.

“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, a urologist and co-lead study author. “It is very important for patients to receive an unbiased, balanced perspective on the full range of treatments.”

Researchers evaluated 85,088 records of men 65 years old and older who were diagnosed with prostate cancer between 1994 and 2002, compiling information from the SEER (Surveillance, Epidemiology, and End Results) Medicare-linked database to assess specialist type seen and treatment received.

Half of the men were seen only by a urologist, 44% by a radiation oncologist and a urologist, 3% by a medical oncologist and urologist, and 3% by all three specialists. A significant association was found between the type of specialist consulted and the treatment received. In men 65 to 69 years old, 70% of those who consulted a urologist underwent radical prostatectomy only; of those treated by a radiation oncologist and a urologist, 78% had radiation therapy. Among men who consulted a medical oncologist and urologist, 53% had prostatectomy, 17% were treated with radiation therapy (17%), expectant management (16%), or primary androgen deprivation therapy (14%).

The study was presented recently at the American Society of Clinical Oncology annual meeting in Chicago. Look for additional coverage of this meeting in an upcoming issue of Urology Times.