Prostate Cancer -

March 17, 2010 15:55 ET

Prostate Cancer Treatment Expert Dr. David B. Samadi, MD Responds to Cancer Institute of New Jersey Study

Who's in Charge: the Doctor or the Patient?

NEW YORK, NY--(Marketwire - March 17, 2010) -  According to a new study, who you see for prostate cancer heavily determines the treatment you will receive. The study, released by The Cancer Institute of New Jersey in New Brunswick and published in the Archives of Internal Medicine, claims that while most prostate cancer treatment options differ in many aspects, the majority of options are similar across the board. It suggested that the treatment administered depends on the specialty of the doctor providing the treatment.

The study utilized Medicare data between 1994 and 2002 and surveyed more than 85,000 men 65 and older diagnosed with localized prostate cancer, or cancer confined to the prostate gland. It was determined that it should be the patient's preference, and not his doctor's, to decide the treatment to pursue for prostate cancer, something that Dr. David B. Samadi, Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center, sharply disagrees with.

"This study only looks at a small subsection of patients, just like with the study in October's Journal of the American Medical Association, conducted by Dr. Jim Hu. Hu's study found that minimally invasive robotic surgery, or robotic prostatectomy, carried a higher risk of impotence and incontinence than traditional open prostate surgery," challenged Dr. Samadi. This study suggests a pattern of specialist visits and prostate cancer treatment that may be affecting treatment decisions of Medicare patients. "By only surveying Medicare patients aged 65 and older we cannot definitively determine that the patient should choose their treatment, because there are so many variables at stake in making that decision."

According to the study, half of the patients saw an urologist only, 44 percent saw a radiation oncologist and an urologist, and 3 percent saw an urologist and medical oncologist. The remaining 3 percent saw all of the aforementioned specialists. In the first nine months, 21 percent of patients had a radical prostatectomy, 42 percent received radiation therapy, 17 percent had hormone therapy and 20 percent opted for active surveillance.

A direct connection was found between the types of treatment administered with the type of specialist consulted. Thirty-four percent of patients who consulted only an urologist opted for the radical prostatectomy. In fact, it was the most common treatment for men ages 65 to 74 that only consulted urologists. Radiation therapy was the most popular decision for men of all ages who consulted both radiation oncologists and urologists. Hormone therapy, or watchful waiting, was the treatment of choice for patients seen by urologists (with or without medical oncologists) than those who saw urologists and radiation oncologists.

"Men who are diagnosed with prostate cancer are understandably scared and confused," explained Dr. Samadi, "but to leave the treatment decision solely in their hands is not always wise considering their state of mind." The study noted that with a wide variety of treatment options available, "the physician who is providing the counseling for these patients should go to great lengths to provide a balanced perspective, an unbiased perspective, on these treatment options," or get a second opinion. Dr. Samadi couldn't agree more.

"Of course, the final say belongs to the patient, but as a surgeon and an oncologist, I always give my patients a balanced idea of their options, based on their highly individualized tests results," said Dr. Samadi. "Not all patients are good candidates for surgery, or radiation therapy, or active surveillance," Samadi continued, "but with my varied background, they are never alone in their decision because I partner with them on their best course of treatment."

Dr. Samadi recommends that when faced with a prostate cancer diagnosis, do your research, not just on the disease and treatment options, but also on the doctor that you will see for a consultation. Samadi counsels patients to know their options, know the side effects and really decide if you want to live with the disease or actively fight it. "No matter which study comes out, my message will be the same," concluded Samadi, "Get informed and see the best; you would want nothing less for your own loved ones." 

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