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(Reuters Health) – An internet tool can allow a man with prostate cancer to see how thousands of other men in his situation have chosen to be treated, which can be a problem. help to better understand one's own options, suggests an American study.
Prostate cancer at an early stage may not need immediate treatment, or ever, because these tumors often do not grow fast enough to cause symptoms. Since the treatment can have side effects such as impotence and incontinence, doctors sometimes advise men to delay surgery or radiation therapy and to undergo regular screenings to re-evaluate whether the cancer warrants an intervention.
"There is often no single treatment option, because the choice of treatment for prostate cancer depends on personal preferences regarding the benefits and risks of treatment," said Dr. Karandeep Singh, lead author , from the University of Michigan to Ann Arbor.
"There are already a number of excellent resources available to the prostate cancer patient community to support this shared decision-making process," Singh said via email. "However, there are no tools that help patients discover the treatments chosen by similar men faced with a similar decision."
Singh and his colleagues set out to develop a tool worthy of the situation. They used data on treatment choices made by 5,016 men who had been diagnosed with prostate cancer to develop an online tool that predicts the most likely treatment choice based on what others men in similar circumstances have chosen.
Then they asked another 2,527 men with prostate cancer to try the tool and see how often the program predicted the treatment choice that these men would choose themselves. It turned out that the tool was very accurate.
"This tool is not meant to replace the shared decision-making process, but to increase this process by helping patients focus on the likely treatment options before meeting their urologist," Singh said.
Patients and doctors can use the tool here: bit.ly/2Kjprcw
It is only for men with early-stage tumors that do not spread to other parts of the body. It does not provide treatment decisions for men with more complex cases.
For men with early-stage tumors, the tool focuses on aspects of prostate cancer diagnosis, age and weight of patients, as well as any history of heart attack or diagnosis of diabetes. .
When men aged only 45 have low-risk tumors, they will likely see similar patients who are quite divided between opting for radical prostatectomy and opting for active surveillance, that is, giving up treatment. in favor of periodic reassessments to determine if cancer warrants it. intervention.
At age 55, men with low-risk tumors may see that more than half of similar patients choose active surveillance and less than 40% opt for radical prostatectomy. And at age 65, men with low-risk tumors could see that about two-thirds of similar patients choose active surveillance.
One of the limitations of the study is that it was not designed to prove that the web tool could help men make treatment decisions or see how happy patients are choices they have made, stress the authors of the study.
Even when men seem to present similarities in demographics and peculiarities of their tumor, the Internet tool predicts that what is best for them could vary from one man to the other said Dr. Kari Tikkinen of the University of Helsinki. and University Hospital of Helsinki in Finland.
"Of course, this data can reassure those who share their values and preferences with the automatic learning option, which seems to be the most common choice," said Tikkinen, who was not involved in the study, by e-mail.
"However, even in this kind of great situation, it might not help patients," Tikkinen said.
A man very opposed to surgery because of the risk of incontinence or impotence, for example, may not want to opt for surgery simply because that's what the tool says most men like would do, said Tikkinen.
But tools such as the one tested in the study can still help men to have more focused and nuanced conversations with their doctor about the treatment that might be ideal for them, said Tikkinen.
SOURCE: bit.ly/2Bm8MlN European Urology, online 11 October 2018.
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