Men with prostate cancer have many treatment options and a study led by UNC Lineberger Comprehensive Cancer Center could help them make the best decision.
Researchers have identified patterns of side effects in prostate cancer patients that can help them decide the best treatments, according to a news release from the university.
UNC Linerberger researchers led the study published in the Journal of the American Medical Association that examines quality-of-life outcomes for different treatments most prostate cancer patients will face, including active surveillance (regular testing), radical prostatectomy (a surgery to remove the prostate gland and some tissue around it) and several different radiation treatments.
“Patients diagnosed with early-stage prostate cancer – and that’s the vast majority of patients with this disease – face many treatment options that are thought to be similarly efficacious,” said Dr. Ronald C. Chen, UNC Lineberger member and associate professor in the UNC School of Medicine Department of Radiation Oncology. “Therefore, the quality-of- life differences among these options become an important consideration when patients are trying to make their decisions.”
The study is necessary as prostate cancer treatment technologies have advanced. Active surveillance has emerged as an option for low-risk prostate cancer patients because it can spare them unnecessary side effects and can help them avoid treatment for several years or altogether.
“There has not been a large-scale comparison of the quality-of- life impact for these modern options, until now,” Chen said. “Existing quality of life studies have studied older types of surgery and radiation that are no longer used, and patients need updated information regarding the impact of modern treatment options so they can make informed decisions about the choices they face today.”
UNC Lineberger researchers surveyed 1,141 men diagnosed with early-stage prostate cancer between January 2011 and June 2013 for the study. They compared the men’s self-reported quality of life related to bowel, urination and sexual function across four treatments.
“At the two-year time point, patients who chose radiotherapy or brachytherapy actually had quality-of- life results similar to patient who chose active surveillance, and that may be surprising to some patients,” Chen said. “With advances in treatment technologies for both surgery and radiation, patients and physicians today must base their decisions on the quality-of-life results of modern treatments, not on results for outdated treatment modalities that caused much more side effects historically.”
Overall, Chen said the data generated from the study can help patients weigh treatment options based on their own baseline health and priorities.
“With all of the modern treatment options, patients should have accurate and realistic expectations about the frequency of side effects from treatment,” Chen said. “We found that the different treatment options have trade-offs in side effects. Each patient can look at these data to see what they care about most.”
The study was funded in part by the Patient-Centered Outcomes Research Institute, the Agency for Healthcare Research and Quality; the Integrated Cancer Information and Surveillance System; UNC Lineberger; and the University Cancer Research Fund.
In addition to Chen, other authors include: Ramsankar Basak, PhD; Anne-Marie Meyer, PhD; Tzy-Mey Kuo, PhD; William R. Carpenter, PhD; Robert P. Agans, PhD; James R. Broughman, BS; Bryce B. Reeve, PhD; Matthew E. Nielsen, MD, MS; Deborah S. Usinger, BA; Kiayni C. Spearman, BS; Sarah Walden, BA; Dianne Kaleel, BA; Mary Anderson, MPH; Til Stürmer, MD, PhD; Paul A. Godley, MD, PhD.
To read the study, go to jamanetwork.com/journals/jama/article-abstract/2612617.
Abbie Bennett: 919-836-5768; @AbbieRBennett