Navigation Links
Surgeon's Preferences Dictate Choice of Kidney Cancer Surgery
Date:3/10/2008

Candidates for less radical procedures may not be getting them, study says

MONDAY, March 10 (HealthDay News) -- A surgeon's skills and preferences may dictate treatment choices for kidney cancer more than clinical factors such as tumor size or the patient's general health, a new study finds.

This means many patients who are candidates for less radical surgical procedures, such as a partial nephrectomy where only part of the kidney is removed, may not be getting them, the California researchers said.

"The world of medicine is slow to incorporate new technology," acknowledged Dr. Patrick Lowry, an assistant professor of surgery at Texas A&M Health Science Center College of Medicine. "It's kind of like a family tree. When more people are trained in it, they go out and spread it to others."

"Partial nephrectomy is more difficult and has more potential complications, and people may shy away from it," added Lowry, who's also section head of laparoscopy and endourology at Scott & White Memorial Hospital in Temple.

Radical nephrectomy, or removing the entire kidney, remains the gold standard for treating early-stage kidney cancer. While the procedure has a greater than 90 percent cure rate, it increases the risk of developing chronic kidney disease, the study authors said.

Over the past two decades, partial nephrectomy and laparoscopy (minimally invasive surgery) have started to make inroads in the field. These newer alternatives are easier on the patient and equally effective at controlling the cancer, yet not used anywhere nearly as often as radical nephrectomy, the researchers noted.

"On a national level, less than half of patients are getting one or the other [partial nephrectomy or laparoscopy] for small tumors," said study author Dr. David Miller, a clinical instructor in urology at the University of California, Los Angeles. "The question is whether there's some reason at a patient level, or that physicians are not doing these procedures for one of any number of a variety of reasons. We tried to quantify that."

For the study, the researchers looked at 5,483 Medicare beneficiaries who had undergone surgery for localized kidney cancer between 1997 and 2002. The study was part of the Urologic Diseases in America Program, funded by the National Institute of Diabetes and Digestive and Kidney Diseases.

Slightly more than 11 percent of the patients had a partial nephrectomy (43 performed laparoscopically) while the vast majority -- 88.9 percent -- had the entire kidney removed (515 laparoscopically).

The findings will be published in the April 15 issue of Cancer.

"For partial nephrectomy, the only thing that explained more of the variation in use than the surgeon you saw was the size of the tumor," Miller said. "For laparoscopy, the surgeon was more important than any other characteristic."

"If we believe as a specialty and as a society that newer procedures are beneficial, we have to think about how to tackle it," he added.

Patients also have a role to play in guiding their care, Miller said.

"Patient education and understanding and self-advocacy are important in discussing, with the primary doctor or urologist or surgeon," the treatment options, he said.

For instance, patients can ask questions like: "'What are the different treatment options available for this tumor? I've heard about partial nephrectomy. Is that a possibility in my case and, if it's not, why isn't it? If you think the whole kidney needs to be removed, what about the possibility of having it done with less invasive surgery?'" Miller said.

More information

The U.S. National Cancer Institute has more on kidney cancer.



SOURCES: David Miller, M.D., clinical instructor, urology, University of California, Los Angeles, David Geffen School of Medicine; Patrick Lowry, M.D., assistant professor, surgery, Texas A&M Health Science Center College of Medicine, and section head, laparoscopy and endourology, Scott & White Memorial Hospital, Temple; April 15, 2008, Cancer


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. MedHelp to Add Top Stanford Surgeons and Specialized Forums to Online Health Community
2. Surgeons Remove Gallbladder Through Vagina
3. CRH Medical to exhibit at American College of Surgeons Annual Clinical Congress
4. Cosmetic Surgeons Gather in Dubai for World Congress, Hospital Opening
5. Starion Instruments Launches Next-Generation Tissue Ligating Shears at the American College of Surgeons Clinical Congress
6. Patients should ask surgeons about using honey to heal wounds
7. Expert Neurosurgeons and Neuro-oncologists to Speak at 6th Annual Brain Tumor Awareness Day Convention
8. Survey shows gender differences are factor when surgeons in training choose a subspecialty
9. American College of Surgeons Comments on JAMA Article on Surgeon Shortage
10. Holiday Hand Safety 101: Hand Surgeons Offer Tips for a Safe Carving Season
11. Over 600 Surgeons Certified to use TruFUSE(R) to Treat Back Pain Sufferers
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Surgeon's Preferences Dictate Choice of Kidney Cancer Surgery
(Date:2/8/2016)... ... February 08, 2016 , ... TopConsumerReviews.com recently awarded their highest five-star rating to ... are derived from a cluster of melanin when exposed to sunlight. Although most moles ... a lifetime of embarrassment. Historically, mole removal has involved a painful, often ...
(Date:2/8/2016)... ... 2016 , ... Guruji Mahendra Kumar Trivedi is offering 3 days of accelerated ... his birthday on February 10th. During this time, people can achieve better health, ... 250,000 people from over 40 different countries as an “ordinary man with an extraordinary ...
(Date:2/8/2016)... ... 08, 2016 , ... According to research by the National ... technicians to be certified or obtain continuing education. To increase patient awareness of ... Your Mouth?” campaign to inform dentists and patients about the possible lack of ...
(Date:2/7/2016)... , ... February 07, 2016 , ... Women's Excellence staff, ... Wear Red Day. National Wear Red Day is the first Friday each February ... disease and stroke cause 1 in 3 deaths among women each year – more ...
(Date:2/7/2016)... Scottsdale, AZ (PRWEB) , ... February 07, 2016 ... ... & Neck and Facial Plastics, has added Kybella® to his medical and surgical ... is a newly approved FDA injectable medication used as a non-surgical alternative for ...
Breaking Medicine News(10 mins):
(Date:2/8/2016)... 2016 Alzheimer Diagnostic Tests - Medical ... Medical Devices sector report , "Alzheimer Diagnostic Tests ... overview of Alzheimer Diagnostic Tests currently in pipeline ... the pipeline products with comparative analysis of the ... reviews major players involved in the pipeline product ...
(Date:2/8/2016)... LONDON , Feb.8, 2016 Aesthetic Devices ... GlobalData,s Medical Devices sector report, "Aesthetic Devices - Medical ... Devices currently in pipeline stage. This ... secondary and primary research by GlobalData,s team of industry ... be removed or altered based on the availability and ...
(Date:2/8/2016)... TOKYO and FAIRFIELD, N.J. ... (Otsuka) and Medimetriks Pharmaceuticals, Inc. (Medimetriks) today announced that ... exclusive development and commercialization rights for OPA-15406 in the ... agreement also provides manufacturing rights.  OPA-15406 is a topical, ... for atopic dermatitis. --> ...
Breaking Medicine Technology: