It is estimated that 25-50% of men may be over-treated for their prostate cancer. This means they undergo treatments that incur adverse effects (e.g. erectile dysfunction, incontinence) for a cancer that is not likely to spread during their lifetime. Active surveillance is an alternative option for patients when the prostate biopsy indicates their cancer is unlikely to spread quickly. However, in as many as 30 percent of cases, the cancer may turn out to be more aggressive than it initially appeared at the time of diagnosis. This limits the number of men and their physicians who feel comfortable choosing active surveillance. Therefore, better tests and tools are needed to discern which men can safely and confidently choose active surveillance and which need immediate active treatment.
The project is intended to improve standard of care through precision medicine for men diagnosed initially with early stage/low grade prostate cancer who may be candidates for active surveillance instead of active treatment. Scientists will first develop and validate a novel risk-prediction model to provide better information about the patient’s true risk of cancer progression. The UCSF team will next implement a decision support intervention to help men better determine whether to treat or to monitor their disease. The intervention will include a secure website and live coaching support from genetic counselors, to provide and explain to patients a personalized summary of their cancer risk and management options.
Dr. Peter R. Carroll, MPH, MD, Professor and Chair of the Dept. of Urology is the Principal Investigator, and co-Principal Investigators include Drs. June Chan, DSc (Professor, Epidemiology & Biostatistics and Urology) and Matthew R. Cooperberg, MD MPH (Associate Professor, Urology and Epidemiology & Biostatistics). Other UCSF team members include John Witte, PhD, Professor of Epidemiology & Biostatistics and Urology; Jeffrey P. Simko, MD, PhD, Associate Professor of Pathology and Urology; John Neuhaus, PhD, Professor of Epidemiology & Biostatistics; Erin Van Blarigan, ScD, Assistant Professor of Epidemiology & Biostatistics; Stacey Kenfield, ScD, Assistant Professor of Urology; Laura Dunn, MD, Associate Professor in the UCSF Psychiatry; and Jeffrey Belkora, PhD, Associate Professor of Surgery and Philip R. Lee Institute for Health Policy Studies.
The study will utilize the UCSF Urology tissue bank, and the ongoing prostate cancer registry study, CaPSURE, and leverages existing collaborations with Genomic Health Inc. and GenomeDx, two leading industry partners in the area of prostate cancer biomarkers.
For a more in-depth story on this award, please click here.