Prostate cancer survival gains when patients own tools

Prostate cancer treatment with surgical or prosthetic devices can improve survival among men with advanced prostate cancer, according to research published in the American Journal of Scientific Computing.

The study, lead by researchers at The University of Manchester, East Anglia and Ghent University, assessed how the number of participants who were offered clinical prostate cancer surgery—a new combination approach—changed the course of their disease. Survival time was determined by calculating the movement time to reach the goal of a marked reduction in physiological or structural limitations (SWL) achieved in patients and compared to that reported in patients who achieved the surgical procedure or used the prosthetic devices.

The study, which was funded by the National Institute for Health Research England (NIHR) West Lothian Trust, Empe UK, Kestar TCPL, Home Health, and Sally Davies PLC, funded the SMART Research Gains Team (SRGET) project.

The results showed that the number of participants agreeing to undergo an NICE Trial Prostate Cancer Trial decreased from six in 2010/11 to two in 2016/17.

For men and women who achieved surgical resection (e.g. prostate cancer surgery and urology) the numbers were three to four per 1,000 and to two per 1,000 respectively for men and one per 1,000 and to one per 1,000 for those who used a prosthetic device.

For men from Northern Ireland, South Wales and Scotland (who did not go on to undergo neoadjuvant reconstruction) the numbers were two per 1,000 for either surgical resection or prosthesis operation, at between one and two per 1,000 for surgery and one per 1,000 for prosthesis. This means that the estimated number of patients following an accelerated surgical course may have been shaved down to three or less in a much more conservative and safe way.

For men with moderately-graded disease from adult euthypertetal status, survival at 24 months of follow-up in 2016/17 was about four men per 1,000 and was close to three per 1,000 in the period 2009/10 to 2016/17. After surgery using a prosthetic device, about 225 men per 1,000 were in the studies cohort, compared to between one and two per 1,000 in the surgical resection cohort.

“If further studies confirm results from our study in men, a simple clinical guideline that surgical resection leads to minimal neurocognitive impairment, similar to cognitive dysfunction in non-surgical men, could take on greater importance in guiding treatment,” said the study’s main author, Dr. Jian Chen of The University of Manchester.

Co-author Dr. John Durrington of Ghent University, the Netherlands, said: “The guidelines in alternative prostate surgery programs are based on data from pain experiences and on the amount of neuroblastoma removed and the type of therapy used. Patients are reassured that this is acceptable information and we support accurate information when choosing the appropriate patient combination.

“In our project, we compared the outcomes of patients undergoing the surgical resection and surgical rodectomy versus those who achieved surgery via a combination of instruments. We hope that this study helps to change clinical trial workforce in these difficult to treat subgroup groups.”

The study’s findings are published in the American Journal of Scientific Computing.