By Tami Dennis
Too many urologists are failing their patients with late-stage prostate cancer. So says Cy Stein, M.D., Ph.D., deputy director for clinical research at City of Hope’s comprehensive cancer center.
Stein, who is the Arthur and Rosalie Kaplan Chair and Professor of the Department of Medical Oncology and Therapeutics Research, says treatments for prostate cancer — even advanced prostate cancer — have changed. But some private practice urologists haven’t kept up.
Surgeons prepare for a robotic-assisted prostatectomy. (Photo by Alicia Di Rado)
Instead of referring patients to medical oncologists for specialized care or telling them about the many clinical trials
now available, such doctors simply continue treating patients by using older, often less-effective medications — much as they would have done years ago.
“Patients don’t even know they have other treatments available to them,” says Stein. Patients are trusting urologists to do the best by them — and some are not.
He points to the many drug treatments that have become available in recent years — drugs with which non-oncologists may not be familiar. “Our drugs have been shown to prolong life,” he says, but too few people are receiving them.
The new drugs may prolong life only by a few months, Stein acknowledges, but such drugs are how most cancers will be fought — not with a miracle, penicillin-type of cure.
“If you get another and another [life-extending drug], and you start to piece them together, you’re going to add years to people’s lives — good years,” he says.
Working with physicians and specialists who have kept abreast of the latest developments and knowledge is crucial. So, too, is being aware of just how “very complicated” the PSA tests can be at diagnosing prostate cancer.
PSA, for prostate-specific antigen, is the best we’ve got, along with a digital rectal exam, for detecting prostate cancer, Stein
says. But, “PSA is not by any way infallible. PSA can fool you — there are a lot of false positives.”
And then comes the decision about what to do about a diagnosis: That decision is not as straightforward as it might seem.
With prostate cancer, as with any cancer, you need to call in the specialists