Localized Prostate Cancer: Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy

MedicalResearch.com Interview with:

Professor Jenny Donovan  PhD   OBE FMedSci NIHR-SI AcSS FFPHM Director, NIHR CLAHRC West (National Institute for Health Research Collaboration for  Leadership in Applied Health Research and Care West) at University Hospitals Bristol NHS Trust Bristol, UK

Prof. Jenny Donovan

Professor Jenny Donovan  PhD
Director, NIHR CLAHRC West
(National Institute for Health Research Collaboration for
Leadership in Applied Health Research and Care West)
at University Hospitals Bristol NHS Trust
Bristol, UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: PSA testing identifies many men with prostate cancer, but they do not all benefit from treatment. Surgery, radiation therapy and various programs of active monitoring/surveillance can be given as treatments for fit men with clinically localized prostate cancer. Previous studies have not compared the most commonly used treatments in terms of mortality, disease progression and patient-reported outcomes. In the ProtecT study, we used a comprehensive set of validated measures, completed by the men at baseline (before diagnosis), at six and 12 months and then annually for six years.

The main finding is that each treatment has a particular pattern of side-effects and recovery which needs to be balanced against the findings from the paper reporting the clinical outcomes (Hamdy et al).

MedicalResearch.com: What should readers take away from your report?

Response: This research has shown that there are advantages and disadvantages to each treatment – active monitoring, radiation therapy and surgery. A key message is that men do not need to rush to make a decision about treatment, but should consider the differences between the treatments in terms of disease progression and side-effects, and make a choice that suits their views about their quality of life and current or likely future health concerns.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: We need to follow the ProtecT study men for another 5-10 years to discover how survival, progression and impacts on quality of life will develop in the longer term. Further research is also needed to differentiate between prostate cancers that will progress from those that will not. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The paper reporting the clinical findings from the ProtecT trial (Hamdy et al) showed very few deaths among these men with localised prostate cancer diagnosed following a PSA test – they had a 99% survival over a median of 10 years, regardless of whether the treatment was active monitoring, radiation therapy or surgery.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer

Jenny L. Donovan, Ph.D., F.Med.Sci., Freddie C. Hamdy, F.R.C.S.(Urol.), F.Med.Sci., J. Athene Lane, Ph.D., Malcolm Mason, M.D., Chris Metcalfe, Ph.D., Eleanor Walsh, M.Sc., Jane M. Blazeby, Ph.D., F.R.C.S., Tim J. Peters, Ph.D., F.Med.Sci., Peter Holding, R.G.N., Susan Bonnington, R.G.N., Teresa Lennon, R.G.N., Lynne Bradshaw, R.G.N., Deborah Cooper, R.G.N., Phillipa Herbert, R.G.N., Joanne Howson, R.G.N., Amanda Jones, R.G.N., Norma Lyons, R.G.N., Elizabeth Salter, R.G.N., Pauline Thompson, R.G.N., Sarah Tidball, R.G.N., Jan Blaikie, R.G.N., Catherine Gray, R.G.N., Prasad Bollina, M.B., B.S., F.R.C.S.(Urol.), James Catto, Ph.D., F.R.C.S.(Urol.), Andrew Doble, M.S., F.R.C.S.(Urol.), Alan Doherty, F.R.C.S.(Urol.), David Gillatt, M.S., F.R.C.S.(Urol.), Roger Kockelbergh, D.M., F.R.C.S.(Urol.), Howard Kynaston, M.D., F.R.C.S.(Urol.), Alan Paul, M.D., F.R.C.S.(Urol.), Philip Powell, M.D., F.R.C.S.(Urol.), Stephen Prescott, M.D., F.R.C.S.(Urol.), Derek J. Rosario, M.D., F.R.C.S.(Urol.), Edward Rowe, M.D., F.R.C.S.(Urol.), Michael Davis, M.Sc., Emma L. Turner, Ph.D., Richard M. Martin, Ph.D., and David E. Neal, F.R.C.S., F.Med.Sci., for the ProtecT Study Group*

September 14, 2016
DOI: 10.1056/NEJMoa1606221

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Last Updated on September 15, 2016 by Marie Benz MD FAAD