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Low Consultation Rates with A Radiation Oncologist Prior To Prostatectomy in Australia – Implications for Multidisciplinary Care

Objectives: To determine what proportion of Australian patients are reviewed by a radiation oncologist prior to radical prostatectomy for presumed localised prostate cancer. Patients and Methods: Medicare Benefits Schedule item number data was used to identify all patients who underwent radical prostatectomy in Australia from January 1, 2014 to January 1, 2016. Demographic information and further MBS data was abstracted from an additional six months preceding the study period to determine whether patients had a previous prostate biopsy or transurethral resection of the prostate (TURP), and consultation with either a urologist, radiation oncologist or both pre-prostatectomy. Results: 11,527 patients had a radical prostatectomy in Australia during the study period, of whom 88% (n=10,144) had a prostate biopsy or TURP performed during the preceding six months. Only 9.38% (n=1,081) of all patients were seen by a radiation oncologist prior to radical prostatectomy. Men aged 70-79 were reviewed at a slightly higher rate (13.7%). By comparison, patients were seen by a Urologist on average 4 times (± 2.07) prior to prostatectomy, with surgery following 37.21 (± 36.48) days after the most recent consultation. Conclusion: Fewer than ten percent of men have a consultation with a radiation oncologist prior to undergoing a prostatectomy for presumed clinically localised prostate cancer. To enable patients to make an informed choice regarding potentially oncologically equivalent treatment modalities, methods to increase involvement of the radiation oncologist in the management pathway should be further evaluated.