Patients with prostate cancer said to consider radiation as well as surgery

Patients with prostate cancer are at the center of a dispute between two groups of medical specialists.

These men have potentially curable cancer and the dispute is about the best way to get information on both curative treatment options.

Urologic surgeons and radiation oncologists want patients to be fully informed so that, when they make a choice, they can trust them.

Men also want it, but the only way to do it is for them. irony is that the dispute is "

Traditionally, if a man is suspected of having prostate cancer, his family doctor refers him to an urologist who then studies his case and discusses his options.

Urologists control the gateway for their patients about surgery and radiation therapy. They may or may not reference the patient on a radiation oncologist

Radiation oncologists say that urologists are not able to give optimal information about radiation because it is not their specialty.

They say that patients can be influenced what surgeons say and should instead be referred to a radiation oncologist for complete information about the treatment.

They want the double consultation to become routine.

According to the medical literature, surgery and radiation for localized prostate cancer produce equivalent cancer control with logistical differences and side effects. Informed choice, men need to know the advantages and disadvantages of both and what differences are personally preferable.

Pushing a Double Consultation

More than 18,000 Australian men will be diagnosed with prostate cancer this year. Most will have early illness and it is not known how often or when urologists inform men about radiation or the frequency with which they refer to it.

Sometimes they do not, letting men find their own way.

Although the tension between the two groups has long existed, it was largely retained in the professional field until 2015, when it erupted in public.

Last month, radiation oncologists once again opened the issue with a call to action. Men who were able to receive radiation therapy did not receive accurate and up-to-date information on the subject.

A position statement, published by Royal Australian and the New Zealand College of Radiologists (RANZCR), stated that to be fully informed, all men seeking a cure must speak to both specialties. "We also know that in the urology training program, there is no requirement for radiation oncology students," says Sandra Turner, Associate Professor, Radiation Oncologist.

As an elected councilor of the College's Radiation Oncology Faculty, she leads the Double Advisory Campaign

"For a few years we tried to work with urologists to make a statement about the optimal way of care – see the two specialists – but it never came to light."

a lack of will, so we decided that it was better to draw a line in the sand to say that's what patients believe. "

" If we state our position very clearly, we have a starting point, "

50 percent are missing

According to available data, she says that it is a" best practice " for men to have a discussion with both specialists. When she talks about the situation in Australia to international colleagues, she says that they are shocked.

She says this conflict is not about getting more patients for radiation oncologists. "Most of us work in the public system and are always out of the way."

She believes rather that many men get "a brutal deal" by not having it. no double consultation and raises it in public as a last resort. ] Will Medicare discounts for MRI change the way of care for prostate cancer? ” width=”620″/>

Although it may have short-term negative effects for patients, it hopes positive results in the long run.

As the treatment of curative prostate cancer is rarely urgent, she says that men have time

Professor David Currow, chief of cancer service and CEO of the Institute of Cancer from New South Wales (NSW), said to be aware of the options,

The Royal Australian College of General Practitioners said that men would be denied vital information if they only saw that they were being treated. an urologist and that going forward without complete information could lead to regrets later stress.

But while seeing the two specialists would be ideal, Dr. Evan Ackermann Chair of the College's Quality Care Committee said that this might not be realistic given the co Cancer Voices Australia, an independent and volunteer voice of Australians affected by the disease, hoped that the position statement would serve as a catalyst for discussions on how to improve existing processes

. The position statement was sent to stakeholders earlier this year, asking for support, the Prostate Cancer Foundation of Australia has refused to endorse it fully.

Its CEO, Jane Endacott, told the Financial Review that diagnosed with prostate cancer should know all their options in order to make an informed decision, practically or economically, it may not be possible to consult both.

"We strongly recommend that anyone consulted should ensure that all treatment options are discussed," she said.

Not surprisingly, the Urological Society of Australia and New Zealand (USANZ) did not support the statement of position.

Its members encourage patients to consult a radiation oncologist but oppose it becoming mandatory

Urologists disagree

With five times more urologists managing prostate cancer than radiation oncologists, delays would occur if double consultation was mandatory.

The company issued a statement saying that there is no evidence that double consultation is a "best practice."

She says "best practice" is to provide personal counseling, a multidisciplinary team (which includes radiation oncologists), give patients good info written statements and then advise them.

"Urologists are highly skilled and experienced in counseling in the management of prostatic diseases," says Professor Peter Heathcote

While acknowledging that there may be a minority of men who may have been misinformed, he said the majority Those who desired more information or clarification were urged to consult with other urologists, radiation therapists and / or medical oncologists, if possible

. he added that additional opinions are potentially costly, can aggravate the inconvenience for patients, especially in rural and regional areas, and may be undesirable for the patient.

While the political struggle continues at the top,

Today, many men with localized cancer avoid or delay active treatment, opting instead for "active surveillance", a program on which they turn. are carefully monitored in case their cancer becomes aggressive.

This litigation does not concern patients opting for active surveillance,

Another step in the evolution has been taken this month, when a reimbursement of health insurance is became available for men to have an MRI to rule out and monitor prostate cancer

.

Radiation oncologists recommended that, at the bottom of the MRI report, there be a statement stating that best practice is to consult both an urologist and an urologist. a radiation oncologist

As MRIs are performed by members of the same college, this recommendation has a favorable chance of being taken care of

Jill Margo is an associate professor at the University of Ottawa. NSW University