Dr. Hoffman on the Urologist's Influence on Treatment Choice

Karen E. Hoffman, MD, MHSc, MPH, Assistant Professor, Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, describes the diagnosing urologist's influence on the initial treatment selected for elderly men with favorable prostate cancer.

A SEER database analysis examined 17,468 men diagnosed by 2,613 urologists who were age 66 or older with favorable prostate cancer (cT1c or cT2; Gleason 6). Overall, most of the patients examined were candidates for active surveillance (AS). However, only 15% of patients had AS while 85% received an active treatment.

In large, the diagnosing urologist was the most influential single factor behind the treatment decision, Hoffman states. This influence could be associated with the initial conversation that follows a prostate cancer diagnosis or through referrals made by these physicians.

Interestingly, Hoffman adds, urologists treating patients in a hospital environment were more likely to use AS and even among men 80 and older an active treatment was used 67% of the time.