Turkish Journal of Urology
UROONCOLOGY - Original Article

What Is Your Choice for Androgen Deprivation Therapy in Metastatic Prostate Carcinoma: Surgical or Medical?

1.

Department of Medical Oncology, Dokuz Eylül University, Institute of Oncology, İzmir, Turkey

2.

Department of Urology, Tepecik Education and Research Hospital, İzmir, Turkey

3.

Division of Medical Oncology, Department of Internal Medicine, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey

4.

Department of Medical Oncology, Haydarpaşa Education and Research Hospital, İstanbul, Turkey

5.

Department of Preventive Oncology, Dokuz Eylül University, Institute of Health Sciences, İzmir, Turkey

6.

Department of Urology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey

Turk J Urol 2022; 48: 287-293
DOI: 10.5152/TJU.2022.22076
Read: 328 Downloads: 104 Published: 01 July 2022

Objective: At the time of diagnosis, approximately 16.5% of prostate cancer patients are metastatic. The main framework of metastatic prostate cancer treatment is androgen deprivation therapy, which is performed surgically or medically. The aim of this study is to evaluate the attitudes of medical oncologists and urologists about orchiectomy as androgen deprivation therapy.

Material and Methods: A total of 387 physicians working in the Departments of Urology (n=217) and Medical Oncology (n=170) were included in this descriptive study. Data were collected through an electronic survey.

Results: Only 7.5% of participants indicated that they offered surgical castration to their patients. Urologists preferred surgical castration more than oncologists for the treatment of metastatic castration-sensitive prostate carcinoma (P=.003). The reasons why medical oncologists preferred surgical castration less are that it is an invasive procedure, has risk of morbidity and mortality, high cost of hospitalization, and may cause deterioration of the patient's body image (P < .05).

Conclusion: This study showed that physicians were less likely to perform orchiectomy as an androgen deprivation therapy. Although the most important reason for this is the patient preference, the biased presentation of treatment options to patients, the lack of knowledge of physicians about orchiectomy, and the effect of the pharmaceutical industry should also be kept in mind.

Cite this article as: Semiz HS, Kisa E, Caliskan Yildirim E, et al. What is your choice for androgen deprivation therapy in metastatic prostate carcinoma: Surgical or medical? Turk J Urol. 2022;48(4):287-293.

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