Megan Bailey, Oncology Roundtable
A new study published in the Journal of Clinical Oncology found that prostate cancer patients seen by multidisciplinary teams are more likely to choose active surveillance than those seen by specialists in one-on-one settings.
The Massachusetts General Hospital study showed that the rate of men choosing active surveillance over aggressive treatment was nearly double for those seen in multidisciplinary clinics (43% and 22%, respectively). Correspondingly, the number of men treated with radical prostatectomy or radiation therapy decreased by 30%.
Researchers followed 701 men with low-risk prostate cancer who received either multidisciplinary consultations with medical oncologists, radiation oncologists, and surgical oncologists, or who met with each of the specialists individually.
Upon receiving their diagnosis, the men were given the option to pursue a radical prostatectomy, radiation therapy, or active surveillance.
Multidisciplinary clinics offer balance of opinion
Researchers attribute the difference in treatment decisions to the balance of opinions provided in a multidisciplinary clinic. Past studies have found that physicians tend to be biased in favor of their own treatment modality and may unintentionally pass this bias along to their patients.
In a study where specialists were asked how they would prefer to be treated if diagnosed with prostate cancer, 79% of urologists chose radical prostatectomy and 92% of radiation oncologists chose radiation therapy.
Active surveillance a viable alternative to aggressive treatment
Active surveillance has been proven to be a cost-effective alternative to aggressive treatment in men with low risk prostate cancer, which is slow growing and often does not present serious symptoms. Men who choose active surveillance also have the added benefit of avoiding side effects of aggressive treatment, such as incontinence and impotence.
Of the 240,000 men diagnosed with prostate cancer annually in the U.S., approximately half of them are candidates for active surveillance. However, more than nine in 10 men choose treatment instead.
"Instead of pulling the trigger so quickly…men need to understand that for the most part, prostate cancer is simply not an urgent situation," said Dr. H. Ballentine Carter, a urologist from Johns Hopkins Medicine in Baltimore.
For more information about multidisciplinary treatment planning for prostate cancer, please see the Oncology Roundtable publication, Next Generation Tumor Site Strategy, Volume II.
The Roundtable's study, Elevating the Patient Experience, provides further information on operationalizing multidisciplinary clinics.
A summary of the Massachusetts General Hospital study is also available through Reuters.