RT Journal Article
SR Electronic
T1 Treatment options for localized prostate cancer
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP 1269
OP 1274
VO 59
IS 12
A1 Mira Keyes
A1 Juanita Crook
A1 Gerard Morton
A1 Eric Vigneault
A1 Nawaid Usmani
A1 W. James Morris
YR 2013
UL http://www.cfp.ca/content/59/12/1269.abstract
AB Objective To describe treatment options for clinically localized prostate cancer: radical prostatectomy, prostate brachytherapy, external beam radiation, and active surveillance. Quality of evidence Prostate-specific antigen (PSA) outcomes presented are from non-randomized, cohort, and other comparisons trials (level II evidence). We describe PSA outcomes from Canadian centres when they are available. One small randomized controlled trial (level I evidence) in localized prostate cancer is available to compare radical prostatectomy with brachytherapy. Main message Treatment choice in prostate cancer is based on initial PSA level, clinical stage of disease, and Gleason score, together with baseline urinary function, comorbidities, and patient age. In this article, we describe patients’ eligibility for and the common side effects of all treatment options. Prostate brachytherapy and active surveillance have evolved as new standard treatments of localized prostate cancer. We give a brief overview of the brachytherapy procedure, side effects, and PSA outcomes across Canada, as well as active surveillance guidelines. Conclusion Prostate cancer treatment requires a multidisciplinary approach, with input from both urology and radiation oncology. Input from family physicians is often as important in helping guide patients through the treatment decision process.