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Treatment or Active Surveillance? Doctors opt for the familiar option

By: Medix team

Patients trust their doctors to choose the correct treatment for them. Unfortunately, their considerations are not always objective or based on a broad perspective on the issue. Take prostate cancer for example

There are some medical conditions that have a clear cut solution; one cure for one diagnosis. The problem arises when there are many different paths to take to health, each one with its own unique considerations. Lacking specialized medical knowledge, patients trust their doctors to choose the right treatment options for them, based on an unbiased, educated, and broad perspective on the issue.

Unfortunately, physicians aren’t always able to provide this service; their considerations can be influenced by a number of factors, such as the hospital’s protocol, personal convictions, financial considerations, availability of certain technologies and also their personal specialization in medicine. Prostate cancer is one condition in which this issue is exemplified.

Challenged with the news of prostate cancer, men are faced with two approaches; either watch the cancer closely to see how it develops, a method called Active Surveillance, or undergo invasive treatments such as a prostatectomy (removal of the prostate), or radiation therapy. As with all difficult medical choices, there are pros and cons to both courses of action that can affect the patient’s quality of life, or lead to deterioration of the disease. This is a confusing decision for anyone to make, especially if they have no medical knowledge, so most patients trust their doctors to make the decision for them.

So what are doctors recommending today? A recent study published in the July 2014 issue of Medical Care provides some insight into this question. The researchers asked 717 Urologists and Radiology Oncologists about their opinion of the Active Surveillance approach. The results showed that 72% agreed that Active Surveillance was a viable approach to men with low-risk prostate cancer..

So they were given a hypothetical patient; A 60 year old man with low risk prostate cancer. In stark contrast with the large support for Active Surveillance, only 22% said that they would recommend this path for their patient. Further, 45% said that they would recommend surgery, and 35% said that they would recommend radiation therapy. More interestingly, the study shows that most doctors recommended the treatment provided by their specialty; the Urologists were more likely to recommend surgery, while the Radiology Oncologists were more likely to recommend radiation therapy.

So where does this leave the patient? Unfortunately, patients aren’t always told about other options, and as this study shows, doctors are more likely to recommend what they know best, not necessarily what’s best for the patient. Ultimately the goal is to make the patient aware of all of the viable options for treatment (or lack thereof).


A fresh, outside perspective can be helpful in determining the right course of action to take, while also keeping in mind the wishes of the patient, whenever possible. A medical coordinator doctor is medically trained, and therefore knowledgeable about the different options, while also being objective, and having the tools to explore all of the current viable options. This can potentially avoid unnecessary risks, discomfort, and money spent on treatments. Every patient is unique and deserves to have their case be reviewed by an unbiased professional who informs him of all of the options out there.

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