Tag Archive for: advanced prostate cancer treatment

Eight Factors That Impact Advanced Prostate Cancer Treatment Decisions

Several key factors come into play for advanced prostate cancer treatment decisions. In the “Which Factors Impact Advanced Prostate Cancer Treatment Decisions?” program, expert Dr. Atish Choudhury from Dana-Farber Cancer Institute shares insight about these factors that aid in working toward optimal patient care. 

1. Age

Though age is only number, age is one of the factors to look at in advanced prostate cancer treatment decisions. Several other factors play into treatment options, and when the factors are added together they comprise a balanced picture for optimal care.

2. Fitness Level

The physical fitness levels of patients can vary by age, so this is why it’s important to consider it as a treatment factor. Patients who incorporate exercise into their lives before, during, and after cancer treatment generally have shorter and easier recovery times compared to patients who live a more sedentary lifestyle. Physical fitness also boosts the immune system to help fight infections.

3. Activities

The activities in each patient’s life are also vital in helping to guide treatment decisions. If travel is important to a patient for their happiness and/or to see friends and family, this is important to weigh along with other options. Other considerations like whether a patient wants to work, volunteer, hobbies, household chores, or other things the patient wants to resume must be considered as part of their care plan.

4. Overall Life Expectancy

Different than age, each patient’s overall life expectancy is taken into consideration to weigh against treatment options. The harshest treatments may be considered too extreme for those who aren’t expected to have an extended life expectancy, but the patient’s care team can discuss these considerations with the patient and their loved ones. Make sure to ask your care provider if you have questions or concerns.

5. Medical Issues

A patient’s existing medical issues must also be considered along with other key factors. For example, if a patient has heart or lung conditions, these may be important considerations with some treatment options. Autoimmune conditions may also be a concern. Make sure that your care team is aware of all your health conditions to ensure your best care.

6. Cancer Considerations

Considerations about the cancer itself must also be weighed among key factors. Specifics like the cancer stage, grade, and whether and where the cancer has spread must be taken into account when making a decision about the treatment strategy against the cancer.

7. Patient Preferences

Of course, a patient’s preferences for their treatment and life during and after treatment must be considered. Patients have different preferences for how much value they place on quality of life and long-term survival. Care team members will take these preferences into account in treatment options.

8. Side Effects

After cancer treatment starts, side effects may be more or less severe than anticipated. Depending on the patient’s side effects, treatment adjustments like treatment type, frequency, or dosage may be adjusted for optimal patient care. Make sure to let your care provider know about all side effects that you experience. A side effect that you are tempted to dismiss may be fairly simple to make adjustments for. You as the patient are your own best advocate. If you have questions about side effects before you start treatment, make sure to ask your care provider. 


Prostate cancer treatment decisions must look at several key factors to narrow down treatment options for the best care of each patient. If you want to learn more about prostate cancer care and treatments, check out our prostate cancer information.

Tools for Choosing the Right Prostate Cancer Treatment Approach

Tools for Choosing the Right Prostate Cancer Treatment Approach from Patient Empowerment Network on Vimeo.

Dr. Rana McKay discusses the factors that impact advanced prostate cancer treatment decisions. Dr. McKay reviews potential treatment side effects and explains how patients in treatment are monitored.

Dr. Rana McKay is a medical oncologist at UC San Diego Health and an associate professor in the Department of Medicine at the UC San Diego School of Medicine. Learn more about Dr. McKay, here.

Related Resources:

What Is Personalized Prostate Cancer Medicine?

Tools for Partnering in Your Prostate Cancer Care


Katherine Banwell:

Since prostate cancer affects men differently, let’s review what factors could impact which treatment is right for their individual disease. How about we start with symptoms? 

Dr. Rana McKay:

So, yeah. I mean absolutely. I think symptoms are definitely something that plays into effect. Sometimes when patients are first diagnosed, they may not have symptoms. But, you know, boney pain, symptoms of urinary obstruction. You know, there’s specific treatments and strategies that we can deploy to help with those kinds of things. You know other factors that I think I – we take into account when we’re making decisions about which agent should any one patient receive is where are their sites of metastases? Is there disease just in the bones and lymph nodes or are there other organs involved? What’s the genomic make-up of the tumor? There are certain treatments that we would utilize if someone had a certain specific you know, genetic make-up for their tumor. You know, other things that are really important are what kind of drugs has the patient seen before or has that tumor been exposed to? Because that also helps us strategize for what to give them in the future.  

Katherine Banwell:

Do you take into consideration the patient’s comorbidities and their age and overall health? Things like that?  

Dr. Rana McKay:

Absolutely. Yeah. I think we need to absolute take that in account. I think – I think age is one thing. But I think functional status is just as – as important as the actual number itself because people are very different regarding the things that they can do at various age limits and so, that absolutely takes into account weighing the side effects of any given therapy and how that may interact with someone’s existing comorbidities and it may be something that we have to work with a team of other doctors to basically make sure that there is comprehensive, well-rounded care for any one patient.   

For example, some therapies may increase the risk of hyper-tension or increase the risk of volume overload. And so, if somebody has issues with that already we may have them see a cardiologist so we can make sure that, you know, we’re kind of addressing the totality of the patient experience. 

Katherine Banwell:

What do you mean by volume overload? 

Dr. Rana McKay:

Volume overload, I mean if they’ve got too much fluid on board. So, maybe if they have heart failure or something like that, and we have a therapy that’s going to cause them to retain fluid. And so then, we would have to work with a cardiologist to make sure that they don’t run into issues 

Katherine Banwell:

Mm-hmm. Once a man is undergoing treatment for advanced prostate cancer, how are they monitored to see if it’s actually working? 

Dr. Rana McKay:

So, a lot of ways. So, one is by just, you know, visiting with the patient. Making sure that their symptoms are in check. Making sure that they’re not developing new aches or pains that are worrisome. It’s by checking their labs in addition to their organ and bone marrow function. We would check their PSA. And PSA isn’t the whole story. But it is one factor that contributes to us determining whether treatment may or may not be working. It’s also doing intermittent scannings. So, you know, CT scans of the organs, of the lymph nodes. Bone scan and now we actually have PSMA based imaging, which can be integrated to help assess where the disease is and not yet being utilized to assess whether something is working, because we haven’t really defined the criteria there. But, it can be utilized as well.