In Reply The goal of our study was not to determine or imply the optimal treatment for patients with high-risk prostate cancer, but rather to document changes in practice patterns, which appear to be driven increasingly by cancer risk. This is good news for patients who for years have faced well-documented overtreatment and undertreatment.
We agree the overall rate of prostatectomy has remained relatively constant, but stress that surgery is now being offered more often to men more likely to benefit. Our data do not allow inferences regarding the specific reasons driving decisions between surgery and radiation therapy.
Cooperberg MR, Carroll PR. Treatment Trends for Prostate Cancer—Reply. JAMA. 2015;314(18):1977-1978. doi:10.1001/jama.2015.12607