Three professional societies — the American Urological Association, the American Society for Radiation Oncology and the Society of Urologic Oncology — have issued a series of evidence-based clinical guidelines on how to manage localized prostate cancer.
The recommendations urge physicians to take cancer severity into account when considering treatment option, but also stress the importance of shared treatment decision-making, in which physician explain and guide their patients through the many options available.
“Selecting optimal care for each prostate cancer patient is a complex process that requires physicians to help patients choose options consistent with the patient’s own values and in accordance with the best available scientific evidence,” Dr. Martin G. Sanda, MD, chair of the guideline development panel and the urology department at Atlanta’s Emory School of Medicine, said in a press release.
“The new clinical guideline offers a framework to facilitate such shared decision-making, while also specifying which cancers are better managed by active surveillance, as well as providing guidance as to which treatments are appropriate for cancers warranting intervention,” said Sanda. “It also provides specifics for implementing care options, managing side effects and administering post-treatment follow-up.”
Before it was finalized, many peer reviewers with various backgrounds approved the document, which offers suggestions on how to best manage localized prostate cancer of varying risk groups.
Localized prostate cancer — the type that hasn’t spread outside the prostate — that is deemed to have a low risk of spreading or becoming aggressive, is best managed with active surveillance, suggest the guidelines, which recommend radical prostatectomy or radiotherapy in combination with androgen-deprivation therapy for men with intermediate or high-risk tumors.
Since risk stratification is at the core of the guidelines, there’s an entire section defining low, intermediate and high-risk tumors. The document, which contains 68 statements, also offers advice on managing side effects and what to expect from various treatment outcomes, including health-related quality of life.
U.S. doctors will likely diagnose more than 161,000 cases of prostate cancer in 2017. An estimated one in seven men will develop this disease during their lives. However, their odds increase to one in five if they are African-American, and one in three if prostate cancer runs in their families.
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