Researchers used Medicare data to track the specialty and primary care visits of some 85,000 men with localized prostate cancer. Half the patients were seen exclusively by urologists, and 44% by urologists and radiologists. Visits to primary care physicians in the interval between diagnosis and treatment were infrequent (22%).
The researchers found that men consulting only urologists were much more likely to undergo radical prostatectomy, while those consulting both a urologist and a radiation oncologist were more likely to receive radiation therapy.
A commentator, looking at what he calls the "prostate cancer treatment bazaar," finds "an embarrassing lack of comparative clinical trials" among the therapies. In order to offer more "than just a marketing pitch" to patients trying to choose, he recommends that primary care physicians participate in shared decision making.
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