Two new studies are raising concerns about management of early stage prostate cancer and treatment.
Patients undergoing surgery and radiation for early stage prostate cancer may not be informed of the full array of treatment options, according to one report. The other found that a widely used hormone therapy for localized prostate cancer did not increase survival. Both studies were released last week in the Journal of the American Medical Association.
The first analysis looked at variations in physician management of early stages of prostate cancer. It found that patients diagnosed by urologists were more likely to undergo a procedure within 12 months of diagnosis than to simply be observed, despite the slow-growing nature of the cancer.
Also, those patients were more likely to undergo a procedure the urologist performs.
“The findings suggest that the diagnosing urologist may influence not only the decision regarding upfront treatment but the type of treatment the patient receives,” said Dr. Karen Hoffman, lead author of the first study.
To explore care-management variations among urologists and radiation oncologists for patients with low-risk prostate cancer, Hoffman and colleagues from the University of Texas M.D. Anderson Cancer Center in Houston analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, as well as Medicare claims. Of 12,068 men diagnosed with low-risk prostate cancer by their urologist, 80% had undergone treatment within one year of diagnosis, while only 20% were simply observed, the study found.
Of 7,554 men who subsequently met with a radiation oncologist following the urologist visit, 91.5% received treatment within a year and 8.5% were observed.
Patients were more likely to undergo procedures performed by the urologists, including prostatectomy, cryotherapy, brachytherapy or external-beam radiotherapy.