Doctors steer prostate cancer treatment choices

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the ONA take:

In cases of low-risk prostate cancer, the decision of whether to enter active surveillance is more often determined by the diagnosing physician than by the disease symptoms.

Researchers at the Anderson Cancer Center in Houston reviewed 12,000 prostate cancer cases for treatment decisions and related factors, and they discovered that the diagnosing physician was twice as likely to impact the surveillance choice as were the disease characteristics. The study included data from 12,068 men and 2,145 urologists. Approximately 80.1% of patients received upfront therapy, whereas 19.9% of patients opted for observation. if the diagnosing urologist treated the non-low risk prostate cancer, the percentage of patients opting for observation alone was 29% lower.

Current National Comprehensive Cancer Network (NCCN) clinical guidelines recognize observation as a reasonable option in cases of low-risk prostate cancer. Research has not demonstrated that observation has any worse survival or greater morbidity when compared with fast, definitive treatment. Belief of urologists and radiation oncologists in their own treatment modality is thought to steer their advice, and patients may have to initiate discussion of watchful waiting as opposed to more active treatment.

The findings of this study were published online in JAMA Internal Medicine.

Doctors steer prostate cancer treatment choices
Doctors steer prostate cancer treatment choices

Physicians who diagnosed low-risk prostate cancer had more influence over the decision to enter active surveillance than did the disease characteristics, a review of 12,000 cases showed.

Overall, about 20% of the men chose active surveillance as the initial approach to management. Rates of active surveillance among the diagnosing urologists varied from 4.5% to 64% of patients, according toKaren E. Hoffman, MD, MPH, of MD Anderson Cancer Center in Houston, and colleagues.

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