Prostate Cancer Options Debated

Tuesday, June 27th 2000, 12:00 am
By: News On 6

CHICAGO (AP) — Urologists overwhelmingly recommend surgery for men with prostate cancer, while most radiation specialists favor radiation, suggesting patients are not getting a clear picture of their options, a survey indicates.

The survey of 504 urologists and 559 radiation oncologists was published in Wednesday's Journal of the American Medical Association.

Cancer of the prostate — the second most common type of cancer in American men — kills about 32,000 a year, and 180,000 men are diagnosed annually.

Treatments include surgical removal of the prostate, external radiation and injections of radioactive material into the prostate. Some doctors recommend no treatment, or ``watchful waiting,'' since most cases are slow-growing tumors in men in their 60s and 70s for whom treatment would probably not extend their lives.

In the survey, surgery was favored by 91 percent of urologists for a hypothetical 65-year-old patient whose cancer hadn't spread, although that approach is slightly more likely to cause impotence and incontinence.

Ninety-one percent of radiation specialists said they would instead recommend external radiation.

The survey authors, led by Floyd Fowler Jr. of the University of Massachusetts' Center for Survey Research, said patients should get opinions from different specialists to produce a balanced picture.

While it may not be surprising that specialists would favor the treatment they perform and know best, their recommendations ``may not be in the best interest of the patient,'' Dr. Timothy Wilt of the Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research wrote in an accompanying editorial.

At the same time, he noted that there is no clear-cut evidence that any one approach is superior.