Long-Term Outcomes of Localized Prostate Cancer Survivors
Abstract
Today, men diagnosed with early (localized, non-metastatic) prostate cancer face a confusing and challenging decision: selecting the treatment that is best for them. There are several different options, ranging from active surveillance (monitoring only without immediate treatment) to surgery to various types of radiation. Treatment options have improved significantly over time, and patients must have long-term outcomes data from these modern treatment options in order to make an informed decision. Unfortunately, there are almost no research data on this topic. Patients and physicians today have long-term data from outdated treatments (older types of surgery and radiation that are no longer commonly used today) or short-term outcomes from modern treatments that are insufficient to inform decision-making. This proposed study will provide this urgently needed information to patients. Not surprisingly, prostate cancer outcomes from modern treatment options is one of the highest-priority research areas, as indicated by the National Academy of Medicine (formerly called Institute of Medicine). In 2010, the study team collaborated with a large group of national stakeholders, including patient groups and cancer experts, to design a study that addresses this important need. This collaboration ensured that the designed study answers questions and studies outcomes that are most important to patients and other stakeholders. The result was the North Carolina Prostate cancer Comparative Effectiveness & Survivorship Study (NC ProCESS). From 2011-2013, the study team worked with the North Carolina State Cancer Registry to enroll 1,519 men newly diagnosed with prostate cancer. Realizing that minority patients are often underrepresented in prostate cancer studies, our population-based study design successfully enrolled a diverse group of patients (25% African American, much higher than other studies; diverse socioeconomic situations; includes Veterans). This is an observational cohort and includes many patients who chose active surveillance, robotic surgery, and different modern types of radiation treatment. This is an Institutional Review Board-approved study, and we have followed the patients prospectively/annually with quality of life surveys and medical records. So far, this study has published short-term quality of life results; these results have made a large impact—becoming part of a new decision-aid for patients and clinicians—and were incorporated into the 2018 ASCO Prostate Cancer Guidelines. In this proposal, we seek to study long-term outcomes of these survivors. We propose to create a unique and comprehensive data set that includes quality of life, insurance claims data, and cancer registry data in order to study outcomes at 8 to 10 years of follow-up. This includes long-term urinary, bowel, and sexual quality of life after active surveillance, surgery, or radiation; medical procedures or hospitalizations due to treatment-related complications; cancer control/recurrence; and overall survival. Long-term data are important because some treatments (e.g., radiation) may cause late complications that occur many years after treatment, and long-term data are needed to compare the recurrence and survival outcomes across different treatment groups. Because this information does not currently exist and is urgently needed, the results of this study will be timely and highly informative to patients and physicians. Study results will have an immediate impact by helping newly diagnosed prostate cancer patients make better informed treatment decisions that best fit their preferences and goals. For example, if a patient places a high priority in choosing a treatment that best preserves his long-term sexual function, this study will provide the data necessary for the patient to make a suitable choice. This study focuses on prostate cancer survivors, which is much needed because there is an overall lack of research focused
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910512
Entities
People
- Ronald Chen
Organizations
- United States Army
- University of North Carolina at Chapel Hill