Multidisciplinary care critically important for prostate cancer patients

Only half of the men who receive a prostate cancer diagnosis in North Carolina consult with more than one type of physician before deciding on a course of treatment, according to research presented by University of North Carolina researchers at the 2013 American Society for Radiation Oncology (ASTRO) annual meeting on Sept. 24.

Working with local hospitals across North Carolina, UNC researchers led by Ronald Chen, MD, MPH, assistant professor of Radiation Oncology in the UNC School of Medicine, and Paul Godley, MD, PhD, Professor in the Division of Hematology/Oncology - both members of the UNC Lineberger Comprehensive Cancer Center - surveyed patients about their decision-making process after a prostate cancer diagnosis.

"Prostate cancer is a unique disease where there are multiple treatment options, ranging from active surveillance to surgical treatments to radiation treatments. Each option has advantages and drawbacks, and patients often can have difficulty making a decision among the numerous available options. Multidisciplinary care, which is the model we have at UNC, where patients get to speak to a urologist and a radiation oncologist, often can allow the patient to make the most informed decision,'" said Dr. Chen.

The results are the first findings from the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS), a multi-year study funded by the Agency for Healthcare Research and Quality, which is following approximately 1,500 prostate cancer patients from across North Carolina.

The study found that only about 50 percent of patients with newly diagnosed prostate cancer consulted with multiple types of physicians prior to treatment, and most indicated that the physician is the most influential informational source in decision-making.

"We also wanted to assess what the barriers are to receiving radiation treatment, from the patient's perspective. Many patients told us that they are worried about the potential effect of radiation treatment on their ability to perform daily activities, the length of recovery after treatment, and risk for side effects related to urinary, bowel and sexual function. Many patients also reported that they didn't think radiation treatment could cure their cancers. Many of these appear to be misconceptions which contradict the available research evidence regarding the effectiveness and quality of life outcomes from radiation treatment for prostate cancer," said Dr. Chen.

Research has shown that physicians treating prostate cancer tend to recommend approaches from within their discipline - urologists are more likely to recommend surgery while radiation oncologists more likely to recommend radiation therapy. The UNC team also has found that patients who received advice from a single physician did not possess the same level of knowledge about the treatment options as their counterparts who received multidisciplinary care.

"Our research shows that multidisciplinary care is critically important for prostate cancer patients, but this is an area of unmet need across North Carolina," said Dr. Chen.