21 Feb Active Surveillance May Be Appropriate for Ill Patients With Prostate Cancer

MedicalResearch.com Interview with:
Karim Chamie MD
Department of Urology
Ronald Reagan UCLA Medical Center
UCLA Medical Center, Santa Monica

Medical Research: What is the background for this study? What are the main findings?

Response:  Active surveillance has been shown to be safe and effective. There are multiple longitudinal studies that have demonstrated the safety of active surveillance for men with indolent prostate cancer. In this context, we sought out to determine national practice patterns for localized prostate cancer. Moreover, we wanted to identify patient, tumor, and physician factors that influence treatment decision. What we found was that the vast majority of patients undergo radiation therapy, regardless of patient age and health or severity of tumor. Instead, by far the most significant predictor of whether a patient undergoes radiation therapy is whether they have been referred to a radiation oncologist. On the other hand, surgeons significantly incorporate patient age and health and tumor severity when considering radical prostatectomy (surgery).

Medical Research: What should clinicians and patients take away from your report?

Response: If a patient with indolent prostate cancer is too ill to undergo surgery (because of the risk of mortality or complications), then they are unlikely to benefit from radiation therapy. Instead, these patients often times suffer serious side effects from the radiation (e.g. incontinence, bowel dysfunction, and erectile dysfunction) in their limited life expectancy. In other words, if a patient is too ill to undergo surgery for their low-risk prostate cancer, then they and their physician should strongly consider active surveillance and watchful waiting as a viable alternative. 

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Our next objective is to identify the incidence of complications due to radiation therapy among those with indolent disease and a limited life expectancy. Ideally, we would measure their quality of life and determine if there are any treatment regrets.

Citation:

MedicalResearch.com Interview with: Karim Chamie MD (2015). Who Receives Surgery or Radiation for Prostate Cancer? 

MedicalResearch.com Interview with:, & Karim Chamie MD (2015). Active Surveillance May Be Appropriate for Ill Patients With Prostate Cancer MedicalResearch.com

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Last Updated on February 21, 2015 by Marie Benz MD FAAD