Symptom assessment to guide treatment selection and determine progression in metastatic castration-resistant prostate cancer: Expert opinion and review of the evidence

  • Fred Saad Centre Hospitalier de l’Université de Montréal (CHUM)
  • Frédéric Pouliot Laval University
  • Brita Danielson University of Alberta
  • Charles Catton Princess Margaret Hospital
  • Anil Kapoor McMaster University

Abstract

Multiple new agents to treat metastatic castration-resistant prostate cancer (mCRPC) have become available in recent years; however, the appropriate timing and sequencing of these agents have yet to be elucidated. Until accurate biomarkers become available to allow more focused therapeutic targeting for this population, treatment selection for men with mCRPC will continue to be driven largely by close assessment of patient-related factors and symptoms. Pain, as the predominant symptom of mCRPC, is often the focus when assessing progression and the need for a change in treatment. A myriad of other symptoms, including fatigue, impact on activities of daily living, sleep, and lower urinary tract symptoms, also affect men with mCRPC, and assessment of the composite of these symptoms provides an earlier signal for the need to adjust treatment. A number of tools are available for assessing symptoms in patients with advanced prostate cancer, but they are not routinely used, given their complexity and length. A new simplified questionnaire is proposed for the assessment of symptoms, beyond pain, to inform treatment decisions for men with mCRPC.

Author Biographies

Fred Saad, Centre Hospitalier de l’Université de Montréal (CHUM)

Chef du service d’urologie

Professeur Titulaire de Chirurgie

Titulaire de la Chaire en Cancer de la Prostate 

Centre Hospitalier de l’Université de Montréal (CHUM)

Directeur, Recherche en Cancer de la Prostate 

Institut du Cancer de Montréal/CRCHUM

CHUM - Pavillon R

Frédéric Pouliot, Laval University
Assistant Professor, Department of Surgery, Urology Division, Laval University
Researcher, Experimental Uro-Oncology Laboratory and CHU de Québec Research Centre, Laval University
Brita Danielson, University of Alberta
Radiation Oncologist,
Cross Cancer Institute
Assistant Professor,
Department of Oncology,
University of Alberta
Adjunct Assistant Professor, Department of Surgery,
University of Alberta
Charles Catton, Princess Margaret Hospital
Radiation Oncologist,Cancer Clinical Research Unit (CCRU), Princess Margaret Cancer Centre, Toronto, Ontario
Anil Kapoor, McMaster University
Associate Professor of Surgery (Urology), McMaster University
Chair, Genito-Urinary Oncology Program, Juravinski Cancer Centre
Published
2018-05-14
How to Cite
Saad, F., Pouliot, F., Danielson, B., Catton, C., & Kapoor, A. (2018). Symptom assessment to guide treatment selection and determine progression in metastatic castration-resistant prostate cancer: Expert opinion and review of the evidence. Canadian Urological Association Journal, 12(9), E415-20. https://doi.org/10.5489/cuaj.5154