How do you manage an elderly, high risk prostate cancer patient who refuses any local therapy?

Topics: Radiation Oncology • Genitourinary Cancers

Assume a life expectancy of approximately 5-10 years. What factors would influence your consideration of intermittent ADT vs. watchful waiting?

Answer from: Radiation Oncologist at Community Practice

In general, for patients who refuse treatment, I try to understand their goals and their fears. Often, elderly patients state that they are ready to die, and don't want to prolong their lives. If I think that treatment is likely to significantly improve the quality of their lives, I will explain why...

Comments

Radiation Oncologist at Woodlands Medical Specialists
Two pieces of information might be useful in helpi...

Radiation Oncologist at OhioHealth Radiation Oncology
"If we really understand the patient's goals, we c...

Answer from: Radiation Oncologist at Academic Institution

Certainly, understanding of patient goals is foremost here - why are they not considering local therapy with a 5-10 year life expectancy? What are their fears- what risk are they willing to tolerate of morbidity from progression and hormonal therapy to avoid treatment now? Aside from that, TOAD sugg...

Comments

Radiation Oncologist at Case Western Reserve University/ University Hospitals Seidman Cancer Center
To add to the wise Dr. @Neil B. Desai (a thou...

Answer from: Radiation Oncologist at Academic Institution

The only thing I can add in addition to the previous answers is I frequently have a frank discussion with the patient as to what "dying OF prostate cancer" (as opposed to "dying WITH prostate cancer") means for most patients. This includes discussion about the (eventually) painful bony metastases an...

Answer from: Radiation Oncologist at Community Practice

Patients are to be informed of reasons for treatment and accept their decision not to be treated.

Related Questions