Targeted Ablative Therapies for Prostate Cancer

Area of Science:

• Oncology
• Urology
• Medical Decision Making

Background:

• Men diagnosed with low- to intermediate-risk, clinically localized prostate cancer (PCa) face complex treatment decisions.
• Elevated PSA levels may indicate indolent disease, potentially not requiring intervention.
• Radical treatments offer cancer control but risk urinary and sexual morbidity.

Purpose of the Study:

• To explore the treatment decision-making process for men with localized prostate cancer.
• To compare the benefits and drawbacks of active surveillance (AS) versus radical therapy.
• To highlight the impact of disease indolence on treatment choices.

Main Methods:

• Review of current treatment guidelines and clinical evidence.
• Analysis of patient-reported outcomes and quality of life considerations.
• Discussion of the psychological impact of living with a PCa diagnosis under AS.

Main Results:

• Active surveillance (AS) preserves genitourinary function and quality of life.
• Radical treatments provide greater certainty for cancer control.
• The decision is influenced by the risk of indolent disease and potential morbidities.

Conclusions:

• The choice between AS and radical therapy for localized PCa involves balancing cancer control with quality of life.
• Understanding disease indolence is crucial for informed decision-making.
• Shared decision-making is essential to address patient preferences and concerns regarding prostate cancer treatment.