Are certain men more likely to get surgery for advanced prostate cancer?

When prostate cancer spreads, it's standard for men to undergo castration to reduce the supply of testosterone feeding their disease. That can happen one of two ways: either with a drug delivered every few months — at $12,000 per injection — or with a cheaper surgery to remove the testes. In oncologist Dr. Hala Borno’s clinic at UCSF, all of the indicated prostate cancer patients she treats get the injected drug, which is recommended. But Borno wanted to know: Are certain men more likely to get the surgery?

In a new analysis of more than 10,600 advanced prostate cancer patients, Borno found that was the case for men who were Latino, rural, poor, or covered by Medicaid. Borno said the findings make her wonder if there are other factors driving differences in initial treatment plans — and whether that might contribute to their outcomes.