Patterns of Care: A CME Series Activity


It is important for physicians treating prostate cancer to be aware of similarities and differences between his or her practice patterns and those of their peers. It is also important for these physicians to recognize that heterogeneity exists both within and between the urology and radiation oncology communities, especially in clinical situations for which there is suboptimal research evidence.

This program focuses on the self-described practice patterns of randomly selected urologists and radiation oncologists on a variety of key clinical issues in prostate cancer. Also included is clinical investigator commentary and references addressing these issues. This CME program will provide physicians treating prostate cancer with information on national cancer patterns of care to assist with the development of clinical management strategies.


  • Compare and contrast management strategies of urologists and radiation oncologists for the treatment of prostate cancer.
  • Discuss prostate cancer management issues for which relative agreement and heterogeneity exist in patterns of care.
  • Counsel cancer patients about multiple acceptable treatment options when they exist.


The purpose of this issue of Patterns of Care is to support these objectives by comparing the perspectives of 100 randomly selected community urologists with those of 50 radiation oncologists, all interviewed in depth in September of 2005, and to offer in-depth commentary from faculty regarding their practice patterns in the management of prostate cancer.


Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Research To Practice designates this educational activity for a maximum of 2.0 category 1 credits toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.


This monograph is one issue of a CME series activity. To receive credit for this activity, the participant should read the monograph and complete the evaluation located in the back of this book or on our website, PowerPoint files of the graphics contained in this document can be downloaded at


This program is supported by an education grant from AstraZeneca Pharmaceuticals LP.


This educational activity includes discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantor.


Research To Practice is committed to providing its participants with high-quality, unbiased and stateof- the-art education. We assess potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent conflicts of interest are identified and resolved by a peer review content validation process. The content of each activity is reviewed by both a member of the scientific staff and an external independent reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

In addition, the following faculty (and their spouses/ partners) have reported real or apparent conflicts of interest that have been resolved through a peer review process:

E David Crawford, MD: Professor of Surgery and Radiation Oncology; Head, Urologic Oncology, University of Colorado Health Sciences Center, Aurora, Colorado. Grants/Research Support: Abbott Laboratories, Dendreon, TAP Pharmaceuticals Inc. Anthony V D’Amico, MD, PhD: Professor and Chief of Genitourinary Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts. No financial interests or affiliations to disclose. Adam P Dicker, MD, PhD: Associate Professor and Director, Division of Experimental Radiation Oncology, Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania. Grants/ Research Support: AstraZeneca Pharmaceuticals LP, Novartis Pharmaceuticals Sanofi-Aventis. Robert Dreicer, MD: Professor of Medicine, Cleveland Clinic Lerner College of Medicine; Director, Genitourinary Medical Oncology; Associate Director, Experimental Therapeutics, Departments of Hematology/Oncology and the Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Grants/Research Support: AstraZeneca Pharmaceuticals LP, Berlex Inc, Celgene Corporation, Eli Lilly and Company, Sanofi- Aventis; Speakers Bureau: Celgene Corporation, Sanofi-Aventis. Mario A Eisenberger, MD: R Dale Hughes Professor of Oncology and Urology, The Johns Hopkins University, Baltimore, Maryland. Grants/Research Support: Centocor Inc, Cytogen Corporation, Sanofi-Aventis; Consulting Fees and Speakers Bureau: Sanofi-Aventis. Leonard G Gomella, MD: The Bernard W Godwin Professor of Prostate Cancer; Chairman, Department of Urology, Jefferson Medical College; Director of Urologic Oncology, Kimmel Cancer Center, Philadelphia, Pennsylvania. Consulting Fees: AstraZeneca Pharmaceuticals LP, GlaxoSmithKline, TAP Pharmaceuticals Inc. Laurence Klotz, MD: Professor of Surgery, University of Toronto; Chief, Division of Urology, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario. Consulting Fees: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Merck and Company Inc, Sanofi-Aventis; Speakers Bureau: AstraZeneca Pharmaceuticals LP. Gregory S Merrick, MD: Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, West Virginia. No financial interests or affiliations to disclose. Professor Sir Richard Peto: Clinical Trial Service Unit (CTSU), University of Oxford, UK, Oxford, United Kingdom. No financial interests or affiliations to disclose. Daniel P Petrylak, MD: Associate Professor of Medicine; Director, Genitourinary Oncology Program, Columbia Presbyterian Medical Center, New York, New York. Grants/Research Support and Speakers Bureau: Celgene Corporation, Eli Lilly and Company, Sanofi-Aventis; Consulting Fees: Cell Genesys Inc, GPC Biotech Inc. Mack Roach III, MD: Professor of Radiation Oncology and Urology; Vice Chair, Radiation Oncology; Director of Clinical Research, Department of Radiation Oncology, UCSF Comprehensive Cancer Center, San Francisco, California. Grants/Research Support: Amgen Inc; Consulting Fees and Honoraria: Amgen Inc, AstraZeneca Pharmaceuticals LP, Calypso, Cytogen Corporation, MedImmune Inc, Praecis Pharmaceuticals Incorporated; Speakers Bureau: AstraZeneca Pharmaceuticals LP; Other Support: Siemens AG. Howard I Scher, MD: D Wayne Calloway Chair in Urologic Oncology; Chief, Genitourinary Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York. Grants/Research Support: Millennium Pharmaceuticals Inc, Sanofi-Aventis; Consulting Fees: Abbott Laboratories. Mark S Soloway, MD: Professor and Chair, Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida. Consulting Fees: Fujirebio Diagnostics Inc, Merck and Company Inc, Roche Laboratories Inc. Contracted Research: Antigenics Inc. Ian M Thompson, MD: Professor and Chair, Henry B and Edna Smith Dielmann Memorial Fund Chair in Urologic Science, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas. Honoraria: AstraZeneca Pharmaceuticals LP, Merck and Company Inc, Mission Pharmaceuticals Ltd. Anthony L Zietman, MD: Professor of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. No financial interests or affiliations to disclose.

The scientific staff and consultants for Research To Practice are involved in the development and review of content for educational activities and report the following real or apparent conflicts of interest for themselves (or their spouses/partners) that have been resolved through a peer review process: Terry Ann Glauser, MD, MPH, Richard Kaderman, PhD, Neil Love, MD, Douglas Paley, Michelle Paley, MD, Margaret Peng, Lilliam Sklaver Poltorack, PharmD and Kathryn Ault Ziel, PhD — no real or apparent conflicts of interest to report; Sally Bogert, RNC, WHCNP — shareholder of Amgen Inc. Research To Practice receives education grants from Abraxis Oncology, Amgen Inc, AstraZeneca Pharmaceuticals LP, Biogen Idec, Genentech BioOncology, Genomic Health Inc, Roche Laboratories Inc and Sanofi-Aventis, who have no influence on the content development of our educational activities.

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