Dr. Mason on Treatment Decisions Following 10-Year PROTECT Data in Prostate Cancer

Malcolm Mason, MD, Cancer Research Wales Professor of Clinical Oncology at Cardiff University, discusses how to determine a treatment strategy for patients with prostate cancer following the 10-year PROTECT study data.

If a clinician has a patient who has been diagnosed with early localized prostate cancer based on a prostate-specific antigen (PSA) and the patient is otherwise well, that patient would likely have a very good outcome and their likelihood of dying from prostate cancer is very low, explains Mason.

However, there is the question of giving that patient immediate treatment or active surveillance. For patients with low-risk disease, the data from this study adds weight to the argument that those patients should be offered active surveillance in preference to immediate treatment. The patient should be adequately informed about the data and the consequences. There is a trade-off between the side effects of immediate surgery or radiotherapy versus the increased likelihood of disease progression if they defer treatment. There is no right or wrong answer, explains Mason.

The effectiveness of anticancer treatments as curative treatments appears to be equivalent. Additionally, neither one is free of side effects, but the side effect profile is different. Mason does not believe that we can offer a simple, best option in terms of surgery versus radiotherapy based on toxicity. They both cause side effects and this is where a discussion is needed between the physician and the patient to decide what is best for the individual.