Measuring Patient-Based Outcomes: Setting Realistic Expectations When Balancing Functional Outcomes with Cancer Control

Abstract

There is an emerging shift in the management of localized prostate cancer (PCa) from whole-gland treatment to “partial gland ablation” strategies or “focal therapy.” The dynamics in the treatment landscape of PCa is attributed to the epidemiological changes in the disease, improved understanding of the cancer biology, technological advances in prostate imaging, and novel approaches such as targeted biopsies. As focal therapy is being gradually integrated into routine clinical use, it is highly essential to incorporate the application of patient-reported outcome measures (PROMs) into focal therapy practice. Routine use of PROMs can improve patient-physician communications, aid in better decision-making, and serve as a tool for outcome measurement, performance assessment, and benchmarking. Though most of the published literature on focal therapy for prostate cancer has used validated questionnaires to measure the functional outcomes, the reporting is heterogeneous and not standardized specifically for focal therapy. Well-organized multidisciplinary working group and qualitative research interviews will help in building treatment-specific PROM tools for validation and subsequent clinical application. Researchers should be encouraged to develop PROM instruments specific for focal therapy, and incorporation of such tools into clinical practice will allow robust comparative studies essential to physicians and patients.