Navigation Links
Prostate Cancer Treatments Often Compound Existing Health Problems
Date:11/26/2007

Many patients getting therapies that are not the best for them, study says

MONDAY, Nov. 26 (HealthDay News) -- More than a third of prostate cancer patients may receive treatments that are inappropriate because of problems they are already having with urinary, bowel or sexual function, a new study suggests.

These mismatches might occur, because patients don't give enough information to their doctor or because their doctor favors a particular type of treatment, according to the report in the Nov. 26 online edition of Cancer.

"We found an awful lot of patients whose treatment seemed to be contraindicated by urinary, bowel or sexual problems they had before they got treated," said lead researcher Dr. James Talcott, from the Center for Outcomes Research at Massachusetts General Hospital Cancer Center in Boston. "That's pretty good evidence that information wasn't transmitted or didn't factor in with the treatment decision."

Unlike other cancers, there are several treatment options for prostate cancer. The treatment that is best for an individual patient is based on several factors, including stage at which the cancer is diagnosed, age of the patient, and existing problems with urinary, bowel or sexual function that the patient has.

Treatments include external radiation therapy; brachytherapy, in which tiny radioactive particles are implanted into the prostate gland, and the surgical removal of the prostate gland.

Although these treatments are effective, each has a different set of side effects. External radiation can lead to bowel dysfunction, brachytherapy can cause urinary problems, and surgery can damage nerves involved in sexual function.

Treating patients who already have problems in these areas with a procedure that could exacerbate their problem is usually not recommended.

For example, treatment designed to preserve normal functions, such as nerve-sparing, prostate-removal surgery, is not appropriate for patients who have already lost sexual function, Talcott said.

To find the extent of treatment mismatches, Talcott's team collected data on 438 prostate cancer patients. Patients were asked to complete questionnaires that included questions about urinary incontinence and other urinary problems, and bowel and sexual dysfunction.

The researchers found that 89 percent of the patients had some level of urinary, bowel or sexual problem before starting treatment. Among these patients, 34 percent of those with one serious symptom had a mismatched treatment, as did 37 percent who had a less serious symptom. Moreover, 40 percent of those who had several symptoms also received contraindicated therapy.

In addition, among patients with significant dysfunction in all three areas for whom no treatment would be recommended, only 5 percent chose watchful waiting. In this strategy, patients are not treated but are followed closely.

These mismatches appear to occur because doctors and patients don't communicate well. Patients are often reluctant to talk about urinary, bowel and sexual problems, Talcott said. "And, sometimes patients override their doctor's recommendation," he added.

Talcott also thinks that physicians can be wedded to a particular treatment at the exclusion of others. "Surgeons believe in surgery, and radiation oncologists believe in radiation," he said. "That may be part of the problem."

To counterbalance physician bias, patients should get another opinion, Talcott said. "Patients should always get a second consult," he said. "It's a good idea to talk with a surgeon, a radiation oncologist and possible a medical oncologist."

One expert thinks that patients need to make an informed decision about which treatment is best.

"The kind of doctor that you see often predetermines the treatment you receive," said Dr. Durado Brooks, director of prostate and colorectal cancer at the American Cancer Society. "Urologists are much more likely to have a surgical solution, and those who see a radiation oncologist are more likely to have radiation."

Patients need to be well-informed about their condition and the possible treatments and their side effects, Brooks said. "Patients need to arm themselves with as much information as possible about what their treatment options are, and what some of the contraindications of particular treatments are," he said.

Men also need to know what all the treatment options are, Brooks said. "Men need to be aware that, in some cases, depending on their overall medical condition and the stage of their cancer, that it is, at times, appropriate not to have any active treatment," he said. "Watchful waiting is a legitimate option in a significant proportion of men."

"In addition, doctors need to work with their patient to choose the best treatment option, Brooks said.

"If one takes the time to have a discussion, educate the patient and not rush them into a decision, then you may be able to allow them to get past their emotional response and make a more educated, logic-based response," Brooks said.

Brooks noted that because there are so many treatment options in prostate cancer, patients may insist on a particular treatment even though it's not the best choice for them.

"Where treatments are contraindicated in other places in medicine, doctors don't provide a treatment for a patient just because that's what they say they want," Brooks said. "You explain that that treatment is simply the wrong treatment for you, and therefore, we are not going to take that approach."

More information

For more on prostate cancer, visit the American Cancer Society.



SOURCES: James Talcott, M.D., Center for Outcomes Research at Massachusetts General Hospital Cancer Center, Boston; Durado Brooks, M.D., director, prostate and colorectal cancer, American Cancer Society, Atlanta; Nov. 21, 2007, Cancer online


'/>"/>
Copyright©2007 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Conventional prognostic factors fail to explain better prostate cancer survival in most Asian men
2. First biomarker discovered that predicts prostate cancer outcome
3. Frequent Prostate Screens Fail to Improve Aggressive Cancer Diagnoses
4. New male sling procedure helps prostate cancer survivors who suffer from urinary incontinence
5. Us TOO Launches National SEA Blue Campaign for Prostate Cancer Awareness Month
6. Red wine compound shown to prevent prostate cancer
7. Barbershop Talks Cut Black Mens Prostate Cancer Risk
8. Generic prostate drug helps find high-risk cancers early
9. Finasteride unlikely to induce high grade prostate cancers
10. Shrinkage of prostate led to overestimation of cancer risk in trial
11. Prostate Cancer Awareness Week to Screen Thousands
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/29/2016)... ... April 29, 2016 , ... For those who skip meals occasionally ... miss. That was among the many new lifestyle diet tips offered by nutritionists Pam ... Hour® Power of Water® radio show. Bonny and Lawrence noted that because proper nutrition, ...
(Date:4/29/2016)... ... ... Regenerative Medicine Solutions (RMS) scored 94.8124 out of 100 on Tampa ... for Tampa’s Best Places to Work. They were ranked in the Big Category, which ... our team,” says RMS Human Resources Manager Irene Miller. “We work hard to build ...
(Date:4/29/2016)... ... 2016 , ... Nike Softball Camp at the College of Brockport in New ... girls aged 10-18. All facets of the game will be covered; hitting, fielding, base-running, ... one of the finest softball facilities in the region. The outstanding professional college staff ...
(Date:4/29/2016)... ... April 29, 2016 , ... HEALTHCAREfirst , ... coding services, and Deyta Analytics, recently announced the recipients of the fourth annual ... quality as measured from the caregiver’s point of view. The official list of ...
(Date:4/29/2016)... ... 2016 , ... Intellitec Solutions will be a sponsor at ... the Broward County Convention Center. The event is a chance for finance professionals ... public facility management. Intellitec Solutions will highlight their customized accounting solutions designed for ...
Breaking Medicine News(10 mins):
(Date:4/27/2016)... 2016  Hologic, Inc. (Nasdaq: HOLX ... the fiscal second quarter ended March 26, 2016.  ... increased 41.2%, and non-GAAP diluted EPS of $0.47 ... on a reported basis, and 6.3% on a ... another good quarter, highlighted by 14.6% growth in ...
(Date:4/27/2016)... Transparency Market Research has published ... Global Industry Analysis, Size, Share, Growth, Trends, and Forecast ... skincare devices market was valued at US$ 7,255.8 Mn ... CAGR of 10.1% from 2015 to 2023 to reach ... full Skincare Devices Market (Treatment Device - LED Therapy Devices, ...
(Date:4/27/2016)... April 27, 2016 ... the  "Global Anesthesia Disposables Market 2016-2020"  report ... ) ,The global anesthesia disposables market ... of 4.03% during the period 2016-2020.  ... threat to patients, safety. Organizations like the ...
Breaking Medicine Technology: