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Type of Specialist Seen Affects Prostate Cancer Treatment

Data suggest primary care physicians more likely to treat the disease expectantly

WEDNESDAY, March 10 (HealthDay News) -- Treatment choice for prostate cancer appears to be strongly influenced by the type of specialist a patient sees, and patients seen by a primary care physician are more likely to choose expectant care, according to research published in the March 8 issue of the Archives of Internal Medicine.

Thomas L. Jang, M.D., from the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues analyzed data on 85,088 men aged 65 years and above who were diagnosed with localized prostate cancer between 1994 and 2002, of whom 18,201 (21 percent) underwent radical prostatectomy, 35,925 (42 percent) had radiotherapy, 14,021 (17 percent) had androgen deprivation, and 16,941 (20 percent) had expectant management.

Half of the men were seen by urologists alone, while 44 percent saw urologists and radiation oncologists, 3 percent saw urologists and medical oncologists, and 3 percent saw all three types of physician, the researchers found. There was a strong association between the type of specialist seen and the primary therapy received. Expectant management was more commonly used for men treated by their primary care physician, and, the authors note, primary care physician visits after diagnosis were not associated with a greater likelihood of a visit to a specialist.

"In light of these findings, prior evidence that specialists prefer the modality they themselves deliver and the lack of conclusive comparative studies demonstrating superiority of one modality over another, it is essential to ensure that men have access to balanced information before choosing a particular therapy for prostate cancer," the authors write.

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