Prostate cancer is treated differently

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Scientists at Moores Cancer Center at the University of California, San Diego and his colleagues have observed that prostate cancer therapys varied significantly between county hospitals and private providers. Patients treated in county hospitals are more likely to undergo surgery while patients treated in private facilities tend to receive radiation or hormone treatment. These findings were published online by the journal Cancer on January 25.

"The study examined the factors that drive therapy choices for prostate cancer patients" said J. Kellogg Parsons, MD, MHS, principal investigator and urologic oncologist at Moores UCSD Cancer Center. "We observed that decisions are significantly influenced by the type of health care facility where they receive care".

Surgery, radiation and hormone treatment are the most common therapys for localized prostate cancer. Each is linked to different risks and benefits with no consensus as to the most effective form of therapy, though life expectancy, other illnesses, cancer severity and patient preferences may account in part for therapy choices. Parsons and his colleagues at UCLA compared the types of therapys patients with prostate cancer received from public and private hospitals as part of a California public assistance program. The scientists analyzed the care provided to 559 men enrolled in a state-funded program for low-income patients known as Improving Access, Counseling and Treatment for Californians with Prostate Cancer (IMPACT).

Between 2001 and 2006, 56 percent of the study participants received therapy from county hospitals and 44 percent received care from private facilities. While tumor characteristics were similar in each group, patients treated in private facilities were more likely than those treated in county hospitals to be white and less likely to undergo surgery. Specifically, patients treated in private facilities were nearly two-and-a-half times more likely than those treated in county hospitals to receive radiation and more than four-and-a-half times more likely to initially receive hormone treatment instead of surgery.

While the reasons for these differences in therapy decisions are not known, the type of doctor that patients see may play a role, as per Parsons. At county hospitals, patients were initially under the care of urologists, while the initial providers at private facilities represented urologists, radiation oncologists, and medical oncologists.

"The fact that patients with prostate cancer are treated differently based on the type of hospital has implications for health policy, quality of care and equality of careespecially because public hospitals are funded by city and state governments to provide health care for underserved, poor populations," said Parsons.

After skin malignancies, prostate cancer is the most usually diagnosed cancer, and the second leading cause of cancer death among U.S. men.


Posted by: Mark    Source