Treatment Options And Percentages

Does anyone know on a percentage basis the order in which the following primary treatments are chosen after a diagnosis of prostate cancer and are these percentages radically different in foreign countries..

Active Surveillance
Surgery
External beam radiation
Hormone therapy (ADT)
Brachytherapy
High dose brachytherapy
Cryotherapy
HIFU

I suspect the first four choices account for 85% of the PC treatment performed but I could be wrong...Does anyone know the actual numbers?

That's an interesting chart, Casey. Thanks for posting it......

Arnie in DE

I think that it's important to remember that there is not a one-size-fits-all answer to the question of "which treatment is best for me?" (I know that you aren't suggesting otherwise, but I'm feeling inspired to make additional comments.    )   The biology of each case can be so different, each patient's personal situation can be so different (age, health, personality, etc)...there simply will never be a single solution for treating PC.

Some (not all) cases have a real choice in primary treatments, and in those cases it's both a blessing and a curse—a blessing to actually have options with similar outcomes to choose from, but a curse to have to choose one.

Looking a little further down the road than this chart projects (2012), my crystal ball has a continued increase in use of targetted focal therapies (TFT) and Cyberknife...again, these are not options for all cases, but as these solutions continue to mature from both a process and equipment perspective, I think these will increasing be seen as excellent alternatives. Over time, we will continue to be less freaked-out by the "big-C" word with prostate cancer and for the guys who continue to be increasingly accurately defined as low risk, we will treat PC more as a chronic disease.

If you'd like me to read your palm, I can do that too... 

 

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Added later:  It was interesting that one comment accompanying this chart was that the increase in IMRT/IGRT was projected to be largely driven by economic factors.  More doctors are installing the (very expensive) equipment right in their offices, so that they can steer you conveniently right into the treatment room...one-stop shopping can be popular.

Post Edited (Casey59) : 2/4/2011 9:51:14 AM (GMT-7)

Maybe Active Surveillance is one of the things they think of as "treatment".

here is what is going on in Denver. Until now, surgery and treatment on the new Linac's (linear accelerators) had to be performed in the big hospitals because that's where the equipment was..most of the hospitals in Denver are now owned by the big health-care corporations..The cancer doctors, the specialists fought very hard to maintain their "private contractor" status, there bill was separate from the hospital..

In the hospital where I am being treated, management laid down the ultimatum to the specialists, including the radiation oncologists, come work for us as employees or lose access to the equipment you need to practice your profession....

Result. Many of the specialists are abandoning the hospitals and building their own "Treatment Centers" outside the hospital system. Most of these centers try to be "one stop shops" equipped to handle all but the most complex procedures..They make deals with the insurance companies and can undercut the hospitals while maintaining the income levels they have become accustomed to..That's their plan anyway...

The underlying question is this..The average Radiation Oncologist makes $500,000 a year...Many medical specialists feel this is an appropriate income range and they are fighting to maintain it..The people who are paying the bills are moving in the opposite direction, trying to reduce costs and make the practice of medicine more affordable..A major collision is underway..In Denver, this has resulted in twice as many Linac's as can be supported..Treatment centers advertise on the radio, put up bill-boards..Treating cancer is big, big, business..Hospitals are struggling as their highest profit services are being siphoned away from them..

Fairwind said... here is what is going on in Denver...   Inter-metropolitan variation in PC treatment modes (between, for example, Denver and similarly sized Seattle) is less significant than (i) the intra-regional, but geographically disadvantaged differences (rural hospitals versus Comprehensive Cancer Centers, at the two extremes), and (ii) socio-economic backgrounds (most specifically, whether you have private health insurance or not).   Perhaps more significantly, these two factors were significant in mortality rate differences.   Our current system of care is...er, uh, uneven.  

Casey,
Is there any supporting information on this chart. Such as is this US only? What might be included in "other".

Tony

Casey then I have ask the $64,000.00 question...Where did you get this chart?

Tony

No My challenging questions came from Terry Herbert on my UsTOO Facebook page...

www.facebook.com/pages/UsTOO-Las-Vegas-Chapter/206932628271

And anyone is welcome to join us.

Tony

Casey,

What is a Renaissance scientist/statistician?

Tim

It's not the issue of anonymity...it's more one of "overhead", "bandwidth", "BTUs"...

Not really knowingly doing anything different, but try this:
http://www.urotoday.com/images/conferences/aua_ny_2010/8.30%20gejerman.pdf



Tim, the scientists from the past always used taste (well, maybe not always) to help complete their fullest understanding of whatever they were studying. Marie Curie (first woman Nobel Prize winner) basically poisoned herself to death in the lab...

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added later as an edit:  Sorry, I also get an error when using the link as posted here.  Not sure what I'm doing wrong, because I'm copying it directly from the file I have open in another window.  I'll keep fiddling with it, but the presentation was by Dr Glen Gejerman from The John Theuer Cancer Center at Hackensack (NJ) University Medical Center.

Try this:  LINK

Or try this:  LINK2     <<<-------   this one seems to work

Post Edited (Casey59) : 2/4/2011 3:17:03 PM (GMT-7)

and now the $64K...?