Diagnosis, referral, and primary treatment decisions in newly diagnosed prostate cancer patients in a multidisciplinary diagnostic assessment program

Authors

  • David Guy Sunnybrook Health Sciences Centre, Odette Cancer Centre
  • Gabriella Ghanem Sunnybrook Health Sciences Centre, Odette Cancer Centre
  • Andrew Loblaw Sunnybrook Health Sciences Centre Odette Cancer Centre
  • Roger Buckley North York General Hospital
  • Beverly Persaud North York General Hospital
  • Patrick Cheung Sunnybrook Health Sciences Centre Odette Cancer Centre
  • Hans Chung Sunnybrook Health Sciences Centre Odette Cancer Centre
  • Cyril Danjoux Sunnybrook Health Sciences Centre Odette Cancer Centre
  • Gerard Morton Sunnybrook Health Sciences Centre Odette Cancer Centre
  • Jeff Noakes Sunnybrook Health Sciences Centre Odette Cancer Centre
  • Les Spevack North York General Hospital
  • David Hajek North York General Hospital
  • Stanley Flax North York General Hospital

DOI:

https://doi.org/10.5489/cuaj.3510

Abstract

Introduction: We aimed to report on data from the multidisciplinary diagnostic assessment program (DAP) at the Gale and Graham Wright Prostate Centre (GGWPC) at North York General Hospital (NYGH). We assessed referral, diagnosis, and treatment decisions for newly diagnosed prostate cancer (PCa) patients as seen over time, risk stratification, and clinic type to establish a deeper understanding of current decision-making trends.

Methods: From June 2007 to April 2012, 1277 patients who were diagnosed with PCa at the GGWPC were included in this study. Data was collected and reviewed retrospectively using electronic patient records.

Results: 1031 of 1260 patients (81.8%) were seen in a multidisciplinary clinic (MDC). Over time, a decrease in low-risk (LR) diagnoses and an increase intermediate-risk (IR) diagnoses was observed
(p<0.0001). With respect to overall treatment decisions 474 (37.1%) of patients received primary radiotherapy, 340 (26.6%) received surgical therapy, and 426 (33.4%) had conservative management;
57% of patients who were candidates for active surveillance were managed this way. No significant treatment trends were observed over time (p=0.8440). Significantly, different management decisions
were made in those who attended the MDC compared to those who only saw a urologist (p<0.0001).

Conclusions: In our DAP, the vast majority of patients presented with screen-detected disease, but there was a gradual shift from low- to intermediate-risk disease over time. Timely multidisciplinary
consultation was achievable in over 80% of patients and was associated with different management decisions. We recommend that all patients at risk for prostate cancer be worked up in a multidisciplinary DAP.

Downloads

Download data is not yet available.

Downloads

Published

2016-04-18

How to Cite

Guy, D., Ghanem, G., Loblaw, A., Buckley, R., Persaud, B., Cheung, P., Chung, H., Danjoux, C., Morton, G., Noakes, J., Spevack, L., Hajek, D., & Flax, S. (2016). Diagnosis, referral, and primary treatment decisions in newly diagnosed prostate cancer patients in a multidisciplinary diagnostic assessment program. Canadian Urological Association Journal, 10(3-4), 120–5. https://doi.org/10.5489/cuaj.3510

Issue

Vol. 10 No. 3-4 (2016): CUAJ April

Section

Original Research

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.