Treatment preferences of urologists in Great Britain and Ireland in the management of prostate cancer.
A questionnaire was sent to all full-time British and Irish urologists (n = 278) on the management of prostate cancer and was answered by 229 (82%). The questions included 3 specific clinical situations, namely the management of incidental disease, the timing of treatment for metastatic disease and the mode of hormonal manipulation used for advanced disease. It was found that 79% of urologists preferred a deferred treatment policy for incidental disease in the over-75 age group. Radical prostatectomy was advocated by 10% of those questioned for patients in the under-60 age group. Radiotherapy was the mainstay of treatment for incidental disease in the poorer prognosis groups of incidental disease, namely younger patients with more aggressive tumours. Most urologists treated patients with asymptomatic metastatic disease at the time of diagnosis, with 18% entering patients into the Medical Research Council trial comparing immediate with deferred therapy. Orchiectomy was advocated by 57% of urologists as their first-line treatment for patients where hormonal manipulation was indicated. Consequently orchiectomy should remain the "gold standard" in comparative phase III trials in advanced prostate cancer.
Waymont
B
B
Department of Urology, Queen Elizabeth Hospital, Birmingham.
Lynch
T H
TH
Dunn
J
J
Bathers
S
S
Wallace
D M
DM
D001291:Attitude of Health Personnel; D003657:Decision Making; D006801:Humans; D007494:Ireland; D008297:Male; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014572:Urology