TREATMENT PREFERENCES OF UROLOGISTS IN GREAT-BRITAIN AND IRELAND IN THE MANAGEMENT OF PROSTATE-CANCER

A questionnaire was sent to all full-time British and Irish urologists (n = 278) on the management of prostate cancer and was answered by 22 9 (82%). The questions included 3 specific clinical situations, namely the management of incidental disease, the timing of treatment for met astatic disease and the mode of hormonal manipulation used for advance d disease. It was found that 79% of urologists preferred a deferred tr eatment policy for incidental disease in the over-75 age group. Radica l prostatectomy was advocated by 10% of those questioned for patients in the under-60 age group. Radiotherapy was the mainstay of treatment for incidental disease in the poorer prognosis groups of incidental di sease, namely younger patients with more aggressive tumours. Most urol ogists treated patients with asymptomatic metastatic disease at the ti me of diagnosis, with 18% entering patients into the Medical Research Council trial comparing immediate with deferred therapy. Orchiectomy w as advocated by 57% of urologists as their first-line treatment for pa tients where hormonal manipulation was indicated. Consequently orchiec tomy should remain the ''gold standard'' in comparative phase III tria ls in advanced prostate cancer.