This research project is in progress. PCORI will post its findings here within 90 days after our final review is complete. In the meantime, results have been published in peer-reviewed journals, as listed below.
Background: Prostate cancer is the most common cancer in men, with more than 240,000 men diagnosed and 30,000 dying from it each year. Many treatment options exist for patients with early prostate cancer, but few studies have directly compared the different treatments in terms of their effectiveness in curing the cancer and their impact on patient quality of life. In addition, recent advances in technology have introduced more costly treatments such as minimally invasive radical prostatectomy (MIRP), intensity-modulated radiation therapy (IMRT), and proton therapy (PT). The rapid adoption of these new technologies resulted in an estimated $350 million increase in US healthcare expenditures in 2005 alone. Yet, the clinical benefit from these newer treatments is unproven. Few studies have directly compared patient outcomes from older versus newer techniques for radiation therapy (IMRT versus PT) and surgery (open prostatectomy versus MIRP). In fact, two recently published studies suggest that newer surgical and radiation treatments may cause worse outcomes than older treatments.
Objective: To examine comparative outcomes after four to five years among different prostate cancer treatment options.
Method: NC ProCESS is a cohort of 1,700 patients from diverse backgrounds diagnosed with early prostate cancer and who were enrolled from January 2011 to June 2013. This observational study collects information on quality of life, cancer control, and health care received, inclusive of treatment and management of subsequent effects including complications and recurrence. We will use several statistical techniques to minimize the chance that differences between patients receiving different treatments will lead to misleading results about the effect of the treatments on quality of life, disease-free survival, and use of healthcare resources.
Patient and Stakeholder Engagement: We have collaborated with patients and other stakeholders from initial study design through data collection. Stakeholders will continue to be closely involved in interpretation of study findings and dissemination of findings to patients who can directly benefit from them.
Anticipated Impact: Study results can help patients and physicians make treatment decisions and inform policy makers and other stakeholders about the comparative effectiveness of different modern treatment options. These results will provide new, timely and urgently needed information to help patients and clinicians in the decision-making process.
Evidence for Decisions
Prostate Cancer: Evidence for Decisions
Early-stage prostate cancer can be treated in different ways. Two recent PCORI-funded research studies provide new information on the effects of treatments and can help patients navigate their treatment decisions.