MedicalResearch.com Interview with:
Jennifer Cullen Meyer, PhD, MPH
Director of Epidemiologic Research, Center for Prostate Disease Research
Assistant Professor, Norman M. Rich Dept. of Surgery, Uniformed Services University
Rockville, MD 20852
MedicalResearch.com: What is the background for this study?
Response: Men diagnosed with prostate cancer who are at low risk for cancer progression may choose to defer immediate treatment with curative intent and, instead, monitor their cancer. This strategy is referred to as “active surveillance.” The primary benefit of active surveillance is that it allows men to temporarily defer definitive cancer treatments that are known to cause decrements in health-related quality of life (HRQoL). Studies have shown that HRQoL is better in men choosing active surveillance as compared to other treatment modalities. However, prior to our study, it was not known whether men on active surveillance experience worse HRQoL than men without prostate cancer.
MedicalResearch.com: What are the main findings?
Response: Our study compared men diagnosed with low-risk prostate cancer who selected active surveillance as their cancer management strategy to patients who underwent a prostate biopsy but were not found to have prostate cancer. These groups were similar in that both were under “suspicion” for prostate cancer, prompting the biopsy. We found that these two groups reported very similar HRQoL over a three year period. Both groups experienced slight declines in HRQoL over time, and differences in HRQoL between the groups were not clinically significant. Most interestingly, we did not observe major differences in the mental health scores between cancer patients managed on active surveillance and men without prostate cancer.
MedicalResearch.com: What should readers take away from your report?
Response: Our study suggests that selecting active surveillance does not negatively impact a man’s health-related quality of life for the first few years following a cancer diagnosis. Additional research is needed in in diverse study populations. If this finding is confirmed, it may prove useful to prostate cancer patients struggling to decide whether to begin an active surveillance protocol.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should extend follow up for these groups of men beyond three years, to see if our observation persists over time. Other measures of health-related quality of life should be included, such as scales capturing depression and anxiety. Studies should also examine the HRQoL of patients who transition from active surveillance to curative treatment.
MedicalResearch.com: Is there anything else you would like to add?
Response: Our longitudinal patient cohort is racially diverse and drawn from equal access health care settings. Patients are all counseled for treatment options in the context of a multi-disciplinary clinic that includes an urologist, a radiation oncologist, a medical oncologist, and a nurse educator. As a result, many factors that influence treatment decision-making and access to care are more comparable for patients enrolled in this cohort.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
J Urol. 2016 Aug;196(2):392-8. doi: 10.1016/j.juro.2016.02.2972. Epub 2016 Mar 11.
Prospective Quality of Life in Men Choosing Active Surveillance Compared to Those Biopsied but not Diagnosed with Prostate Cancer.
Pham KN1, Cullen J2, Hurwitz LM3, Wolff EM1, Levie KE3, Odem-Davis K4, Banerji JS1, Rosner IL5, Brand TC6, L’Esperance JO7, Sterbis JR8, Porter CR9.
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