Case Review: Rationale and Methods in mCRPC - Episode 6
Evan Y. Yu, MD: Another thing that I didn’t previously discuss is goals of therapy with this patient. For every patient who I see with cancer, and especially those who have a life-threatening cancer—those with an incurable cancer like this patient—I certainly discuss goals of care.
I’m very forthright in counseling the patients on what the goals of our treatment are. If they’re somebody who can potentially be cured of the cancer, that’s always the goal if we can accomplish it safely and with good quality of life. However, if that’s just not possible, I let the patient know that. I talk to the patient about that. I always ask the patient if they want to know about prognosis. I don’t want to surprise anybody with numbers. Most patients do want to know their prognosis, but if they don’t, I respect that as well.
I generally do lay out what our goals are in advance, whether this is a curative therapy or whether this is a palliative therapy. But in prostate cancer, in particular, I emphasize that even palliative therapy can be used for many years.
I think it’s very important to give patients a prognosis, or some sort of a time frame they can think about and work with if they’re interested in that. The reason is so they can do good life planning, family planning as well. They can also feel reassured. We have many good treatments available. Generally, the course of the disease and the natural history of some other cancers are that they are more aggressive.
Our patients with prostate cancer can live for many years. It’s helpful for them to know that, and it’s helpful for them to know that there are many other treatment options that can be used down the road to help them accomplish their goals.
Transcript edited for clarity.
Case: A 66-Year-Old Man with Metastatic Castration-Resistant Prostate Cancer
Treatment and Follow-Up