Social factors affect prostate cancer therapy

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Being married increases the likelihood that a man will choose prostate surgery or radiation therapy rather than “watchful waiting” in the event of a Prostate cancer diagnosis, new research suggests.

Whites and Latinos are more likely to choose surgery over radiation treatment compared with blacks, but race does not appear to influence the likelihood that a patient will choose watchful waiting.

To assess factors that influence Prostate cancer treatment decisions, Dr. Thomas D. Denberg and colleagues at the University of Colorado Health Sciences Center in Denver analyzed data from the Surveillance, Epidemiology and End Results (SEER) cancer registry and Medicare inpatient records from 1995 to 1999.

They report their findings in the medical journal Cancer.

Black men were less likely than white men to undergo prostate surgery (30 percent versus 38 percent,) whereas Latinos were more likely to undergo surgery (45 percent).

Overall, however, race or ethnic group had little effect on the decision to undergo surgery or radiation therapy, with rates varying between 65 percent and 68 percent for the three groups.

Age affected treatment decisions, with curative-intent therapy (surgery or radiation) chosen 84 percent of the time by men younger than 70 years old versus 56 percent for those 70 or older.

For those younger than 70, married men were more likely to undergo curative therapy than were unmarried men (86 percent versus 75 percent), as well as prostate surgery specifically (65 percent versus 47 percent). Corresponding figures for those 70 years old or older were 61 percent versus 44 percent for curative treatment and 24 percent versus 14 percent for prostate surgery.

Denberg’s group suggests that “it is possible that married men (or their wives) advocate therapy that they perceive as likeliest to yield a cure, whereas unmarried men are more likely to lack social supports that would encourage aggressive interventions.”

The authors believe that physicians “should recognize the importance of cultural and social forces was well as biomedical factors in decisions regarding the treatment of patients with early-stage prostate carcinoma.”

SOURCE: Cancer, May 1,2005.

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