Urologist, not tumor characteristics, determines whether men receive androgen deprivation

Among patients with locally advanced or metastatic prostate cancer, the decision about whether to receive androgen deprivation therapy depends primarily on who their urologist is, rather than the stage or grade of tumor or patient characteristics. The finding comes from a study published recently in the Journal of the National Cancer Institute (2006; 98:839-45).

The study, performed at the University of Texas Medical Branch, Galveston, analyzed androgen therapy use within 6 months from diagnosis data from 61,717 men over 65 years of age in the Surveillance, Epidemiology, and End Results database and from their 1,802 urologists. Researchers found that 21% of variance in the use of hormone therapy was due to the urologist’s decision compared with 9.7% for tumor stage or grade and 4.3% for patient characteristics. Currently, 50% of this patient population receive ADT.

"The substantial variance in use of androgen deprivation therapy attributable to the urologist, independent of patient factors, suggests that interventions at the level of the urologist may be an effective way to modify the use of this therapy for prostate cancer," according to the authors, led by Vahakn B. Shahinian, MD.