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Doctor's Specialty Often Steers Prostate Cancer Care

Therapy choice is influenced by physicians' preferences, research suggests

TUESDAY, March 9 (HealthDay News) -- The kind of treatment received by a prostate cancer patient often depends on the type of specialist providing the patient's care, new research shows.

U.S. researchers analyzed data on more than 85,000 Medicare beneficiaries aged 65 and older who were diagnosed with prostate cancer between 1994 and 2002. Of those patients, 50 percent were seen only by urologists, 44 percent by urologists and radiation oncologists, 3 percent by urologists and medical oncologists, and 3 percent by all three specialists.

Within nine months after diagnosis, 21 percent of patients had surgery to remove the prostate and surrounding tissue (radical prostatectomy), 42 percent had received radiation therapy, 17 percent underwent a hormone therapy called primary androgen deprivation and 20 percent chose no treatment ("watchful waiting"), according to the report published in the March 8 issue of the journal Archives of Internal Medicine.

The researchers found a strong association between the type of treatment and the type of specialist consulted, according to a news release from the journal's publisher.

Radical prostatectomy was the most common type of treatment in patients aged 65 to 74 seen only by a urologist (34 percent of these men). Radiation therapy was the most common treatment for patients of all ages seen by both urologists and radiation oncologists. Primary androgen deprivation or watchful waiting were most common among patients seen by urologists (with or without medical oncologists) than among patients seen by urologists and radiation oncologists.

"Our findings provide new insight into the relationship between physician visit patterns and receipt of therapy for localized prostate cancer," wrote Dr. Thomas L. Jang and colleagues. "The pattern of specialist visits and treatment that we observed suggests that [physician] preferences may be affecting treatment decisions of Medicare patients."

The study authors concluded: "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."

More information

The U.S. National Cancer Institute has more about prostate cancer treatment.

-- Robert Preidt

SOURCE: JAMA/Archives journals, news release, March 8, 2010

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