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Most prostate cancer specialists don't recommend active surveillance for low-risk patients
Date:6/16/2014

veillance is an effective alternative for men with low-risk prostate cancer. In addition, 80 percent agreed that active surveillance was underused in the United States.

But Don't Recommend It for Their Own Patients

"However, 71 percent of the physicians responded that their patients were not interested in active surveillance," the researchers write. The rate was over 80 percent for radiation oncologists, compared to 60 percent for urologists.

When asked what treatment they would recommend for a hypothetical 60-year-old man with low-risk prostate cancer, just 22 percent of the physicians said would endorse active surveillance. Instead, 45 percent would recommend surgery (radical prostatectomy) while 35 percent would recommend some form of radiation therapy.

In general, the recommendations split along specialty linesmost respondents recommended the treatment provided by their specialty. After adjustment for other factors, urologists were four times more likely to recommend surgery, compared to radiation oncologists. Urologists were also much less likely to recommend any form of radiation therapy.

Urologists were more than twice as likely to recommend active surveillance, compared to radiation oncologists. Doctors who worked in academic medical centers were also more likely to recommend active surveillance.

The survey adds to recent evidence that physicians view active surveillance as a "reasonable approach" to initial treatment in appropriate patients with low-risk prostate cancer. Both groups of specialists acknowledge the growing concern about overtreatment of prostate cancer.

However, "that hasn't consistently translated into their self-reported patterns of treatment recommendations," Dr Kim and colleagues write. "Our study suggests that there remain some key attitudinal barriers to active surveillance among prostate cancer specialists, especially considering radiation oncologists and urologis
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Contact: Connie Hughes
Connie.Hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

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