Photo courtesy of Huffington Post

Rapid advancements in surgical and medical treatment options often lead to overtreating early stage, low risk patients with localized prostate cancer that could benefit from watchful waiting. The Cancer Treatment Navigator (CTN) team provides second opinions about optimal treatment for the patient based on their stage and specific cancer type. CTN also informs about potential side effects that might compromise the patient’s quality of life. Caution toward overtreatment is as much of a concern for us as undertreatment. In support of our ideals, we would like to highlight a recent article in USA today that discusses Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer. This article presents an interesting facet of “patient satisfaction” survey outcomes providing confounding evidence in favor of overtreating.

According to patient questionnaires, men with early stage, low-risk prostate cancer, who could have opted for active surveillance or "watchful waiting," appear to be satisfied with the more-aggressive treatments they've chosen. Yet, privately, many men complain to their doctors of persistent side effects such as urinary incontinence and erectile dysfunction following surgery or radiation.  Dr. Claus Roehrborn, a professor and chairman of the department of urology at UT Southwestern Medical Center in Dallas says it is important for men making these choices to truly understand what to expect. He suggests, Urologists and other specialists shouldn't rely too heavily on superficial survey results from patient questionnaires, as digging a little deeper might reveal a more conflicted response. Additionally, Dr. Michael Leapman, an assistant professor of urology at Yale School of Medicine in New Haven, Connecticut, warns about marketing pushes for new technology raising patient expectations high.  He mentions, 90 percent of prostate surgery performed in the U.S. now is robotic rather than open surgery. Immediate surgical outcomes – less blood loss and shorter hospital stays – appear to be better for robotic-surgery patients. However, the data don't really show improved long-term results in cancer outcomes or sexual function.

A new study in the July issue of the Journal of Clinical Oncology tracked long-term survivors of localized prostate cancer for up to 15 years. Men who were monitored but didn't undergo radiation or surgery were less likely to report regret than those who underwent active treatment.

CTN works directly with patients and their specialists through the entire process of reviewing medical history, details of diagnosis and identification of the best treatment option. Our personalized services help patients sort through the dilemma of undertreating or overtreating and understand their choices clearly. CTN is not affiliated with any drug development or surgical device company. We leverage our scientific expertise and experience toward unbiased opinions and recommendations for the patient.

Glioblastoma’s unfavorable prognosis is largely due to the high possibility of recurrence combined with limited approved treatments. Several clinical trials with new treatment approaches for recurrent glioblastoma are running at a variety of cancer treatment hospitals, academic and government institutions. They offer hope but create a tough landscape to navigate for patients and caregivers. Some therapies are acknowledged more in popular press while shadowing others with hidden potential.

To this end, the Cancer Treatment Navigator (CTN) team would like to highlight a novel treatment currently in clinical trials for recurrent glioblastoma. It was brought to our attention via an interview with Dr. Priya Kumthekar, MD and Dr. Alexander Stegh, Ph.D. at Northwestern University Feinberg School of Medicine, published last month in OncoTherapy Network. It is called NU-0129 and is a so-called nano-particle. That means super small. NU-0129’s super small size and shape allows it to successfully reach the site of the tumor in the brain. Once there, it interferes with the cancer cell’s biology and stops its growth which essentially can kill the cancer cells. Researchers at Northwestern University are evaluating this drug for its tolerability and ability to get directly to the brain tumor for maximum effectiveness.

On a practical level, rapid advancement in clinical science for cancer treatment has left oncologists strapped for time and resources. Especially when research is required beyond standard hospital protocols for treating most patients. When a clinical trial is considered, very often the clinical trial run by a patient’s hospital ends up being recommended as the best course of action. But that doesn’t mean it is the best choice based on comprehensive research and consideration of all trials running throughout the country. Consequently, one of our main objectives at CTN is to help cancer patients gain access to promising clinical trials based on thorough research and evaluation of published data and compared to the diagnosis, treatment history and specific cancer type of each individual client. Another hurdle that we help overcome is the unnecessarily restrictive eligibility criteria for trial enrollment. Often patients are turned away because many trials only pre-select for very healthy cancer patients to participate. This is done to minimize side effects that might be blamed on the study drug. However, cancer patients are often not healthy, but they still deserve the right to make their own decision about added potential health risks from an experimental medicine. We share the belief with many experts in the field that clinical trials should be for a patient’s welfare and not only for the benefit of a hospital or an individual company’s new blockbuster drug.