Front-line Prostate Cancer Treatment Variation
Front-line strategies for treating prostate cancer vary significantly from physician to physician, according to a retrospective study in JAMA. Using the Surveillance, Epidemiology, and End Results cancer registries, researchers gathered information pertaining to men 66 and older who were diagnosed with low-risk prostate cancer between 2006 and 2009. Physicians involved in each case were identified using Medicare claims, and physician characteristics were elucidated from the American Medical Association Physician Masterfile. Based on this information, researchers created mixed-effects models showing variation in management and observation-related factors.
Case-adjusted rates of observation varied from 4.5 percent to 64.2 percent among urologists, and researchers found that urologists who treat advanced stages of prostate cancer were less likely to manage low-risk disease with observation. Notably, the diagnosing urologist influenced front-line treatment variation more than patient or tumor characteristics — 16.1 percent versus 7.9 percent, respectively. When front-line treatment was recommended, prostatectomy, cryotherapy and brachytherapy were most commonly performed.
Study Challenges Benefit of Prostate Supplements
In a retrospective analysis of 2,207 men ages 36 and older who were treated with intensity-modulated radiation therapy for localized prostate cancer between 2001 and 2012, supplements purporting to enhance prostate health were found to provide no benefits related to prognosis or radiation toxicity reduction. The men were treated at National Cancer Institute-designated comprehensive cancer centers. Researchers presented their findings at a meeting of the American Society for Radiation Oncology.
Approximately half the study’s cohort took some form of supplement, but only about 10 percent took prostate-specific or general men’s health supplements, according to Nicholas Zaorsky, MD, resident physician in radiation oncology at Fox Chase Cancer Center and lead author of the study. More than 90 percent of the supplements contained saw palmetto, a fruit-bearing plant known for its use in medicines used to decrease symptoms associated with an enlarged prostate. There is no consensus regarding its efficacy in this regard.
A Case for Sex-specific Heart Medication?
In what is believed to be the first long-term follow-up study using MRI imaging to show how the heart’s anatomy changes over time, researchers from Johns Hopkins University School of Medicine have discovered significant differences in aging male and female hearts. The finding suggests the need for development of sex-specific heart failure medications, researchers say. The results appeared in the journal Radiology.
The differences were illuminated after researchers examined MRIs of nearly 3,000 patients between 54 and 94 years of age who did not have pre-existing heart diseases. The study’s key finding may be the anatomical differences in the left ventricle. The chamber shrank in both sexes, but in men, the muscle encapsulating the left ventricle became bigger and thicker with age. In women, it remained the same or shrank slightly.
Commonly prescribed heart failure medications reduce the thickness of the heart muscle and enhance its performance. Women may not reap the same benefits as men from such medications.