Men Have Regret Years after Prostate Cancer Treatment

Excerpt:

“After years of introspection, about 15% of men with localized prostate cancer regretted the decisions they made regarding treatment, a survey of almost 1,000 patients showed.

“About twice as many men expressed regret after radical prostatectomy or radiation therapy as compared with active surveillance. The single biggest contributor to regret was treatment-associated sexual dysfunction, as reported in the Journal of Clinical Oncology.”

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Active Surveillance of Prostate Cancer Associated with Favorable Outcomes in Younger Men

Excerpt:

“Younger age was associated with lower risks for disease progression and biopsy-based Gleason score upgrades during active surveillance of low- or intermediate-risk prostate cancer, according to a study published in Journal of Clinical Oncology.

” ‘The results of this study indicate that younger patients with low-risk prostate cancer experienced favorable outcomes when managed with active surveillance at nearly 5-year median follow-up,’ Michael Leapman, MD, assistant professor in the department of urology at Yale University School of Medicine, told HemOnc Today. ‘Younger patients have conventionally been counseled to receive definitive treatment, even in the setting of low-risk disease. This study is impactful as it may expand the use of surveillance, potentially limiting the harms of overtreatment for patients with screening-detected low-grade tumors.’ ”

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Active Surveillance Preserves Quality of Life for Prostate Cancer Patients

Excerpt:

“Faced with the negative quality-of-life effects from surgery and radiation treatments for prostate cancer, low risk patients may instead want to consider active surveillance with their physician, according to a study released Tuesday by the Journal of the American Medical Association (JAMA).

“The Vanderbilt University Medical Center study led by Daniel Barocas, M.D., MPH, associate professor of Urologic Surgery, compared the side effects and outcomes of contemporary treatments for localized with in order to guide men with prostate cancer in choosing the best treatment for them.

“Surgery is considered by some to be the most definitive treatment, and there is evidence from other studies that it has better long-term cancer outcomes than radiation for higher-risk cancers, but it has more sexual and urinary side effects than radiation.”

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Four New Studies of Oncotype DX® Genomic Prostate Score™ (GPS) Reconfirm Value of Test in Guiding Early-stage Prostate Cancer Risk Assessment and Treatment Selection

Excerpt:

“Genomic Health, Inc. (GHDX) announced today the presentation of results from four studies evaluating the clinical value and utility of its Oncotype DX® Genomic Prostate Score (GPS) in the management of early-stage prostate cancer. Collectively, these new data highlight the test’s ability to predict disease aggressiveness and refine risk stratification across National Comprehensive Cancer Network (NCCN) clinical risk groups.

” ‘We now have 22 clinical studies, involving more than 4,200 prostate cancer patients, that distinguish Oncotype DX as the only test developed specifically for men who are deciding between active surveillance or definitive treatment. The test is validated to provide individualized information about both the current state and future risk of patients’ prostate cancer,’ said Phil Febbo, M.D., chief medical officer, Genomic Health. ‘Together with the recently published economic analysis demonstrating substantial cost savings of more than $2,200 per patient tested, the data presented will support increased adoption and reimbursement of Oncotype DX as physicians aim to bring precision medicine to their prostate cancer patients.’ “

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Study: For Men with Prostate Cancer, Emotional Distress May Lead to More Aggressive Treatment

Excerpt:

“The anxiety many men experience after being diagnosed with prostate cancer may lead them to choose potentially unnecessary treatment options, researchers from the University at Buffalo and Roswell Park Cancer Institute report in a new study.

” ‘Emotional distress may motivate men with low-risk prostate cancer to choose more aggressive treatment, such as choosing surgery over active surveillance,’ said UB’s Heather Orom, the lead author on the study, published in the February issue of the Journal of Urology.”

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Photodynamic Therapy Can Preserve Tissue in Low-Risk Prostate Cancer

Excerpt:

“Vascular-targeted photodynamic therapy with padeliporfin was significantly better than active surveillance over a 2-year period in men with low-risk localized prostate cancer, according to a new study. The treatment could allow men to avoid more radical therapy.

” ‘Focal therapy and active surveillance are both tissue-preserving strategies,’ wrote study authors led by Mark Emberton, MD, of University College London in the United Kingdom. ‘However, focal therapy differs from active surveillance in that it treats disease—by the process of selective tissue ablation—above a certain risk threshold and monitors disease below that threshold, because the latter is deemed to be clinically significant.’ ”

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Similar 10-Year Survival With Active Monitoring, Surgery, or Radiotherapy for PSA-Detected Clinically Localized Prostate Cancer

Excerpt:

“In the UK ProtecT trial reported in The New England Journal of Medicine, Freddie C. Hamdy, FRCS, FMedSci, of the University of Oxford, and colleagues found no significant differences in prostate cancer–specific or overall mortality among men with clinically localized prostate cancer detected by prostate-specific antigen (PSA) testing who underwent active monitoring, surgery, or radiotherapy. Metastases and disease progression were more common with active monitoring. Median follow-up in the study was 10 years.”

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Treat or Monitor Early Prostate Cancer? 10-Yr Survival Same

Excerpt:

“Men with early prostate cancer who choose to closely monitor their disease are just as likely to survive at least 10 years as those who have surgery or radiation, finds a major study that directly tested and compared these options.

“Survival from prostate cancer was so high—99 percent, regardless of which approach had—that the results call into question not only what treatment is best but also whether any treatment at all is needed for early-stage cases. And that in turn adds to concern about screening with PSA blood tests, because screening is worthwhile only if finding cancer earlier saves lives.”

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Patients with Low Risk Prostate Cancer on Active Surveillance Experience Good Quality of Life

Excerpt:

“Active surveillance (AS) has become an increasingly important alternative to surgery, chemotherapy, or radiation treatment for men diagnosed with low risk prostate cancer. However, what is the impact of AS on health related quality of life (HRQoL) in patients selected or opting for this conservative form of disease management? New research published in The Journal of Urology found that patients on AS who were tracked for three years experienced similar HRQoL as men without prostate cancer, both clinically and psychologically.

“The majority of men diagnosed with prostate cancer have low risk disease and face a difficult decision between having the disease managed conservatively through AS or undergoing definitive therapy. These results can help guide physicians and patients through this decision-making process.”

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