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Martin Sanda Presents New Prostate Cancer Guidelines at AUA Annual Meeting

May 2017

Emory Urology chair Martin G. Sanda, MD, presented new evidence-based clinical guidelines for the management of localized prostate cancer during a plenary session at the annual meeting of American Urological Association held May 12-16 in Boston.

Prostate cancer is the second most common cancer in men in the United States, and is why the American Urological Association (AUA), in collaboration with the American Society for Radiation Oncology (ASTRO) and Society of Urologic Oncology (SUO), released a new evidence-based clinical guideline for the appropriate management of localized prostate cancer, which refers to cancer that has not moved outside of the prostate.

More than 161,000 new cases of prostate cancer are expected to be diagnosed in 2017. It is estimated that one in seven men will be diagnosed with this disease in their lifetime; however, their odds increase to one in five if they are African American and one in three if they have a family history.

Following a prostate cancer diagnosis, men are often faced with an array of treatment options, based on their prostate cancer severity or its potential to spread elsewhere within the body. Based on the tumor, treatment-related factors such as oncologic outcomes and side effects, as well as other patient-related considerations, these options can be overwhelming, which is why the guideline panel strongly suggests physicians and patients engage in shared decision making to select the best care option for each individual patient.

"Selecting optimal care for each prostate cancer patient is a complex process that requires physicians to help patients choose options consistent with the patient's own values and in accordance with the best available scientific evidence," said Dr. Sanda, who chaired the guideline development panel. "The new clinical guideline offers a framework to facilitate such shared decision-making, while also specifying which cancers are better managed by active surveillance, as well as providing guidance as to which treatments are appropriate for cancers warranting intervention. It also provides specifics for implementing care options, managing side effects and administering post-treatment follow-up."

The Localized Prostate Cancer Clinical Guideline makes 68 statements in total, including the recommendation that active surveillance is the preferred care for low-risk localized prostate cancer, while radical prostatectomy or radiotherapy plus androgen deprivation therapy are recommended as the treatment standard for patients with intermediate- or high-risk localized prostate cancer.

The guideline was developed by a panel of AUA, ASTRO, and SUO-selected experts, all of whom have specific expertise with regard to prostate cancer. It was then distributed to peer reviewers of varying backgrounds as part of the AUA's extensive peer review process before being approved by the AUA, ASTRO and SUO Board of Directors. Shared decision making, care options based on cancer severity, as well as, specific care options including active surveillance, radical prostatectomy, high intensity focused ultrasound and focal therapy management are among the statements covered in this guideline. The full text of the evidence-based Localized Prostate Cancer Guideline is now available online.