The patient’s perspective: What does the patient want? Book Section
| Authors: | Fainberg, J.; Greenwood, B. M.; Kasraeian, A.; Ehdaie, B. |
| Editors: | Polascik, T. J.; de la Rosette, J.; Sanchez-Salas, R. |
| Article/Chapter Title: | The patient’s perspective: What does the patient want? |
| Abstract: | Prostate cancer is the most common (non-cutaneous) cancer among American men, affecting one in eight men in their lifetime. The management of organ-confined prostate cancer is similarly complex as not all diagnosed cancers require immediate treatment, while for some, early detection and more aggressive management are necessary to optimize the possibility of cure. Deciding “what to do?” is a challenging process for a man recently diagnosed with prostate cancer. This dilemma continues to grow more challenging for both patients and their urologists/physicians as long-term studies, such as the recently published 15-year ProtecT trial (comparing active observation, radical prostatectomy, and radiotherapy), show that prostate cancer-specific mortality remained low regardless of the treatment assigned. Thus, the authors concluded that “the choice of therapy involves weighing trade-offs between benefits and harms associated with treatments for localized prostate cancer.” Simply put, the majority of men diagnosed with prostate cancer are engaged in a dual quest: they seek the most effective therapeutic approach to manage their malignancy while concurrently aiming to minimize the treatment’s impact on their overall quality of life. This dilemma frequently constitutes a complex, nuanced, and arduous decision-making process. The ideal focal therapy discussion is patient-centered and involves three meaningful outcomes: cancer control, maintenance of sexual function, and urinary function. This “trifecta” of excellent outcomes is the goal of most focal therapy providers and the outcome that the patients are seeking, regardless of tumor location, size, and energy modality utilized. Balancing cancer control and quality of life is of paramount importance; it is about arriving at a balance between the cancer’s biology, the patient’s priorities, and the tools the provider has to best achieve these outcomes. For patients and urologists alike, focal therapy is redefining the therapeutic landscape for localized prostate cancer by offering a nuanced approach that aims to bridge the gap between active surveillance and more aggressive radical treatment options. Its patient-centric focus on minimizing adverse effects while achieving targeted cancer control places it as a highly appealing option, particularly for those with targetable, localized diseases. However, its integration into standard care protocols will need further and more comprehensive long-term data in order to confirm, to a greater extent, its continued long-term safety and efficacy. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2024. |
| Book Title: | Imaging and Focal Therapy of Early Prostate Cancer. 3rd ed |
| ISBN: | 978-3-031-66753-4 |
| Publisher: | Springer Nature |
| Publication Place: | Cham, Switzerland |
| Date Published: | 2024-01-01 |
| Start Page: | 47 |
| End Page: | 52 |
| Language: | English |
| DOI: | 10.1007/978-3-031-66754-1_4 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Book Chapter: 4, located in 'Part I: Why Consider Focal Therapy?' -- Source: Scopus |
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