What factors are important to consider when deciding on a prostate cancer treatment approach? Dr. Himisha Beltran reviews key considerations and highlights the important role patients play in their care.
Dr. Himisha Beltran is Director of Translational Research in the Department of Medical Oncology at Dana-Farber Cancer Institute. Learn more about Dr. Beltran, here.
What are the considerations when choosing treatment for prostate cancer?
Yeah, so there are many considerations when thinking about a therapy choice for a patient with prostate cancer. Oftentimes, we use clinical features, radiology, blood tests, and now molecular features incorporating into that to really guide care based on how indolent or aggressive the cancer is. There are some cancers that don’t need to be treated that we follow on active surveillance. There are different states where we may do intermittent treatment, weighing the risks and benefits of the therapy.
And then, in the more advanced setting where you need continuous treatment – and there is now many choices of different drugs that are approved for prostate cancer – we often make these choices with our patients based on not just the trajectory of the cancer but also weighing the side effects and quality of life and other issues for those different treatment modalities. And I see precision medicine as providing one extra layer of information to help guide those conversations.
What’s the patient’s role in making treatment decisions?
The patient is the center. It’s really our role to help inform and partner with them because now we have a lot of choice. And one choice might not be the same for each individual. And so, we use clinical features and features of the cancer, but the other features factor, such as quality of life. It factors cost considerations – the logistics of it all. These can vary across the different treatments. And so, it really requires really going through everything with the patient. And the patient really does have a voice and really should be the center of that treatment decision.
Prostate cancer treatment is complex, and sometimes there are questions there are questions that a patient might have that their physician did not answer adequately. And they really should speak up because it’s important to know what all the options are. There are even things like the DNA sequencing. It can be difficult to interpret. And you may not know what available treatments are there unless you ask the questions.