Cancer News, Treatment and Research

A state-wide study conducted by the California HealthCare Foundation shows that where someone lives can largely determine what type of cancer treatment they receive. Experts say the results of the study most likely repeat themselves from state to state.

An article in the Contra Costa Times profiles the new study, which concentrated on individuals who were being treated (or had been treated) for prostate or breast cancer. It looked at treatments in small towns with few oncology practices versus those in cities or in towns with large university hospitals or other top-rated facilities and lots of oncologists with differing opinions.

For example, prostate cancer patients in the town of Tracy in California’s Central Valley were almost always treated with brachytherapy, a form of “internal” radiation where tiny radioactive seeds are planted in the diseased area to kill cancer cells. On the other hand, patients who lived not far from Stanford University were treated with a more sophisticated form of external beam radiation that closely targets the affected area and spares healthy cells as much as possible.

Even though Tracy is just a 90-minute drive from the Stanford area, the problem could be that one or more oncologists or practices in that area promote brachytherapy and, hence, don’t offer other suggestions for cancer treatment, notes the study.

This can have a sizeable impact on the care residents receive, said Maribeth Shannon, director of the market and policy monitor program for the California HealthCare Foundation, a nonprofit group in Oakland that strives to improve health care for residents of the Golden State. “You’ve got to wonder if all the (Tracy) men realize what their options are,” she added.

Shannon confirmed that the study also shows that patients must play a bigger role in the decision-making process regarding their treatment options. If that happened, she said, there would be fewer differences from one community to the next.

“Physicians, for whatever reason, get comfortable with a particular treatment,” she said. “There’s not as much true, shared decision-making as there should be.”

Shannon also believes that doctors make recommendations based on what was popular during the time they were in medical school. A better option, she noted, is that doctors provide their patients with the tools they need (information, statistics, etc.) to help them “weigh the medical evidence and the trade-offs in each choice.” Once that happens, patients need to do their part in the decision-making process.

“Engage – tell the doctor what you think,” Shannon stresses.

Read more: Study Shows Geography Effects What Cancer Treatment a Patient Receives