Prostate cancer patients and their doctors can now get enhanced guidance on treatment options and consequences, thanks to a new checklist developed by researchers at Scotland’s University of Aberdeen.
As described in their study, “A core outcome set for localised prostate cancer effectiveness trials,” which appeared in BJU International, the checklist covers the 19 most important core outcomes when evaluating possible treatments. It is likely to be useful to medical professionals seeking to “decode” the results of current prostate cancer medical trials, which might translate into better assistance when deciding which treatments would benefit their patients.
The three-year systematic review that led to creation of the checklist received funding from Cancer Research Aberdeen and North East Scotland (CRANES). It included reviews of hundreds of prostate cancer trials worldwide. Surprisingly, the study found dozens of distinct ways to define and measure the same outcomes, making it difficult to compare and contrast various findings.
“At the moment, we are effectively comparing apples and oranges when it comes to prostate cancer studies,” Thomas Lam, chief investigator and an honorary senior clinical lecturer at the University of Aberdeen, said in a press release. “Some studies only look at incontinence, some look only at erectile dysfunction, others will look at different outcomes, and they often have different scales of success and failure. As a result it is incredibly difficult for patients and surgeons to make informed decisions about which treatments will yield the best results for them personally.”
After reviewing the existing trial results, the research team held comprehensive interviews with patients, urologists, oncologists and nurses. Researchers narrowed their findings down to a list of 19 core outcomes that every localized prostate cancer trial should register. This includes measures like death from prostate cancer, death from any cause, local and distant disease recurrence, disease progression, quality of life, urinary function and sexual function.
This set of outcomes applies across all treatments, including surgical removal of the prostate, active surveillance and external radiation.
“This is the first step in standardizing the outcomes we use to demonstrate how effective treatments are in prostate cancer research — ultimately helping men with prostate cancer and the doctors who treat them make a more informed choice about treatment options,” said Steve MacLennan, research fellow at the University of Aberdeen. “Research trials comparing treatments for prostate cancer are being done all the time, but the outcomes they are recording are not all uniform and so it is difficult to compare like for like. If all trials record the same outcomes in the same way, it will be far easier for patients and surgeons to interpret the data and understand clearly what their options are with regards to treatment and what the likely side effects could be.”
Added Lam: “This is a solution made for patients by patients, in equal partnership with surgeons, cancer specialists, nurses and numerous other specialists. Everyone has different priorities, and we want patients to be able to decide what the most important outcomes are for them and choose treatment that will meet their needs. This core outcome list is the first step towards us achieving that.”