New ‘Patient Pathway’ study indicates majority of patients guided towards surgery, without full exploration of other available treatments

DATE: Data from a new survey of prostate cancer patients highlights significant gaps in the advice patients receive, and ask for, on the treatment options available to them.

The live survey, conducted by BXTAccelyon via Facebook, which has been running since May 2017, has to date seen over 180 men diagnosed with prostate cancer answer a range of questions – from the point of initial medical assistance and treatment guidance and advice, to treatment and post-treatment experience.

Overwhelmingly, patients were found to have been given either one or two treatment options of the five listed in the survey, with surgery – otherwise known as radical prostatectomy – being the most widely recommended at 61%. Only 11% of patients surveyed received advice on three or more of the available options.

Moreover, 59% of patients did not ask about alternative treatment options, and 43% did not seek any additional information. With 51% of patients discussing their treatment options within a week of diagnosis, the survey indicates that many men might be making choices very quickly without considering all the options.

Saheed Rashid, Managing Director, BXTAccelyon, comments: “The data confirms that too many patients are currently being offered radical prostatectomy, a serious operation to completely remove the prostate gland and surrounding tissue, without also being advised on less intrusive alternatives with equally high success rates.

“If we were to make a comparison with breast cancer, it’s the equivalent of women being steered towards radical mastectomy. With today’s advances in cancer treatment for prostate cancer, this is an anathema!”

A number of recent global academic studies make compelling reading for alternative treatment options. A study published in the New England Journal of Medicine revealed radical prostatectomy has the greatest impairment of sexual function and urinary continence when compared with active monitoring and radical radiotherapy with hormones. Whilst the ASCENDE-RT study from Canada analysed the outcomes of patients with intermediate- and high-risk prostate cancer (typically the domain of radical prostatectomy) over a ten-year period, and found that low dose rate Brachytherapy (LDR-B) in conjunction with hormones and whole pelvis radiotherapy offered highly favourable outcomes. Finally, advances in treatment options such as LDR-B, where a new 4D implant technique further improves the patient experience by replacing an operating theatre procedure under general anaesthetic with a straightforward outpatient appointment, enabling faster recovery times and saving hospital costs, also warrant consideration by patients and healthcare professionals alike.

The open feedback from patients post-treatment backs up the findings on the treatment options, with the majority of those surveyed indicating that their words of advice to patients newly diagnosed would be to “check all the options”; “consider all information, and post procedure side effects, and how this may affect your quality of life”; and “seek as much information as you can from as many sources. Try if possible not to make a knee-jerk decision”.

Mr. Rashid concludes: “Prostate cancer is highly intimate, so it’s perfectly understandable that some patients might feel embarrassed when it comes to discussing their symptoms or treatment options. However, patient choice is key – and that demands accurate, informed discussion about the pros and cons of every treatment, from outcomes to process. All of the treatments approved by NICE clearly have a role to play in successfully treating prostate cancer. But before a patient is pushed straight to radical prostatectomy, the full breadth of options should be discussed in detail with every patient.”