Software helps men with prostate cancer choose the right treatments

August 4, 2017 by Ryan Hatoum, University of California, Los Angeles
After being diagnosed with prostate cancer, Bill Pickett used a computer program developed by Dr. Christopher Saigal, left, to help choose a treatment option. Credit: UCLA Health

Like many men diagnosed with prostate cancer, Bill Pickett faced a tough question when he came to UCLA for treatment: how to fight it?

Prostate is one of the more curable cancers—it has a 96 percent survival rate 15 years after diagnosis, according to the American Cancer Society. The options men have after a diagnosis have different side effects and trade-offs. So choosing, for example, between radiation therapy or surgery, can be complicated for a person.

"When you're diagnosed with , you realize that each can have very different side effects," said Pickett, who lives in Los Angeles and came to UCLA for treatment in summer 2016. "You really have to think about what's most important and about which treatment is best for you."

Recent research in the Journal of Clinical Oncology shows that as many as 15 percent of prostate cancer patients later regret their treatment choice.

Such difficulties led Dr. Christopher Saigal, vice chair of urology at UCLA, to develop a tool to simplify the choices for men and reduce what he calls "decisional conflict," when patients experience stress about which treatment—and consequent risks—to choose.

The tool, an online computer program called WiserCare, asks men with prostate cancer to answer questions about personal values and goals and based on those answers provides a ranking of suggested treatments.

The program works by using algorithms that incorporate medical evidence and modeling to quantify the relative strengths of what a patient says he values. For example, has he answered that having the longest life possible is less important than avoiding a side effect like decreased sexual function? The software then suggests treatment options, which the men can weigh to decide which treatment option is best for them.

"As doctors, we want to offer a patient-centered plan that gives patients the power to leverage all the clinical evidence we have and choose a treatment that fits with their personal preferences," Saigal said.

Pickett is one of the more than 300 men at UCLA who have used the tool. It's currently available to all prostate cancer patients at UCLA and is being adopted at a growing number of institutions, including Johns Hopkins and Northshore University. After completing the questionnaire online, Pickett decided that a new clinical trial would be the right choice for him.

"By the time I was done using the tool, I knew which treatment I wanted to have," Pickett said.

The trial involved taking oral drugs and subcutaneous injections in hopes of making the surgery to remove the prostate gland—known as a prostatectomy—more successful. Pickett underwent surgery at the end of January and now has no signs of the cancer in his body. He continues to be closely monitored for any cancer recurrence using the .

While the common side effects of a prostatectomy include incontinence and decreased , physicians suggest different exercises patients can use to get better control of bodily functions like urine flow. Pickett is using a variety of methods—including Kegel exercises to strengthen the pelvic floor muscles—to manage the side effects of his surgery.

"With my treatment, I just wanted the best chance at success," Pickett said. "I've been doing well post-surgery, and my side effects have been getting better each day."

Prostate cancer is one of many diagnoses that highlights the benefits of personalized medicine. While Pickett, 66, decided a clinical trial followed by a prostatectomy was best for his situation, Saigal said that other men with different preferences choose different treatments. Personalized tools like the one Saigal created aim to give patients the greatest chance at success—whatever that may mean to them.

"There is so much data out there now on this diagnosis that patients can be overwhelmed," Saigal said. "Software programs like these help patients to unlock the power of those data and apply them to their personal situation."

Saigal is measuring the impact of the software on patient decision quality and said his team has found improvements in patient satisfaction, increased knowledge about cancer and reductions in feelings of uncertainty after making a treatment decision.

"As doctors, we need to put a greater emphasis on patient preferences when guiding them through their treatment," he said. "It's important for to be as involved as they can be when it comes to decisions about their own health."

Explore further: Decisional regret doesn't differ by treatment in prostate cancer

More information: Richard M. Hoffman et al. Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study, Journal of Clinical Oncology (2017). DOI: 10.1200/JCO.2016.70.6317

Related Stories

Decisional regret doesn't differ by treatment in prostate cancer

July 11, 2017
(HealthDay)—For patients newly diagnosed with prostate cancer who attend a multidisciplinary clinic, decisional regret does not differ significantly between treatment groups, according to a study published online July 5 ...

New insights into side effects can help prostate cancer patients choose treatments

March 21, 2017
For many men newly diagnosed with early-stage prostate cancer, concerns about potential quality-of-life issues often guide treatment decisions. A new study led by UNC Lineberger Comprehensive Cancer Center researchers identifies ...

Active surveillance preserves quality of life for prostate cancer patients

March 21, 2017
Faced with the negative quality-of-life effects from surgery and radiation treatments for prostate cancer, low risk patients may instead want to consider active surveillance with their physician, according to a study released ...

Type of treatment for prostate cancer affects quality of life

April 20, 2017
Quality of life after prostate cancer treatment varies by the type of treatment patients receive, a new study reveals.

Active surveillance for prostate cancer can give men good quality of life

March 14, 2016
Choosing ongoing monitoring instead of immediate curative treatment (surgery or radiotherapy) leads to a better overall quality of life for men with low-risk prostate cancer. In fact, the Quality of life (QoL) is about the ...

ASCO and Cancer Care Ontario update guideline on radiation therapy for prostate cancer

March 28, 2017
The American Society of Clinical Oncology (ASCO) and Cancer Care Ontario today issued a joint clinical practice guideline update on brachytherapy (internal radiation) for patients with prostate cancer. The update provides ...

Recommended for you

From the ashes of a failed pain drug, a new therapeutic path emerges

November 16, 2018
In 2013, renowned Boston Children's Hospital pain researcher Clifford Woolf, MB, BCh, Ph.D., and chemist Kai Johnsson, Ph.D., his fellow co-founder at Quartet Medicine, believed they held the key to non-narcotic pain relief. ...

Repurposing FDA-approved drugs can help fight back breast cancer

November 16, 2018
Screening Food and Drug Administration (FDA)-approved compounds for their ability to stop cancer growth in the lab led to the finding that the drug flunarizine can slow down the growth of triple-negative breast cancer in ...

Traditional chemotherapy superior to new alternative for oropharyngeal cancers

November 16, 2018
A drug increasingly used in combination with radiotherapy to treat a type of cancer that forms in the tonsils or the base of the tongue is inferior to a previously favored option, according to a large, clinical trial led ...

New 'SLICE' tool can massively expand immune system's cancer-fighting repertoire

November 15, 2018
Immunotherapy can cure some cancers that until fairly recently were considered fatal. In addition to developing drugs that boost the immune system's cancer-fighting abilities, scientists are becoming expert at manipulating ...

Anti-malaria drugs have shown promise in treating cancer, and now researchers know why

November 15, 2018
Anti-malaria drugs known as chloroquines have been repurposed to treat cancer for decades, but until now no one knew exactly what the chloroquines were targeting when they attack a tumor. Now, researchers from the Abramson ...

Standard chemotherapy treatment for HPV-positive throat cancer remains the most effective, study finds

November 15, 2018
A new study funded by Cancer Research UK and led by the University of Birmingham has found that the standard chemotherapy used to treat a specific type of throat cancer remains the most effective.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.