Model Weighs Life Expectancy and Quality of Life in Evaluating Treatment Options
To help patients with testicular cancer decide on a treatment option, Cleveland Clinic researchers have developed a model to assist them in considering life expectancy and quality of life estimates as they make their choice.
Researchers led by Andrew Stephenson, M.D., head of Urologic Oncology at the Glickman Urological & Kidney Institute, examined the three most common treatment options for stage I nonseminomatous germ cell testicular cancer (NSGCT). Each treatment option – chemotherapy, surveillance or retroperitoneal lymph node dissection – is associated with excellent long-term survival.
However, the optimal treatment option in terms of maximizing survival is unclear in part because there is a lack of randomized trials comparing them. In the study, which used 24 hypothetical patients, surveillance was the preferred option except for patients with a high risk for relapse.
“This model will better enable patients, and their doctors, to consider the various outcomes for each treatment method and help them make informed decisions,” Dr. Stephenson said. “We believe it’s important to empower patients so they can visualize their quality of life after treatment.”
Dr. Stephenson and the research team decided to develop the model because patients have difficulty weighing complex information regarding multiple outcomes, especially when some of complications, like cardiovascular disease, may not occur for decades. Because the treatment option for this cancer cannot be based simply on maximizing survival, recommendations are typically based largely on physician bias.
The decision model and the study appear in the current issue of the Journal of Clinical Oncology.
About the Glickman Urological & Kidney Institute
The Glickman Urological & Kidney Institute is one of 26 institutes at Cleveland Clinic that group multiple specialties together to provide collaborative, patient-centered care. The institute is a world leader in treating complex urologic and kidney conditions in adults and children, and U.S. News & World Report has ranked the urology program among the top two in the nation for 10 consecutive years. Institute physicians have pioneered medical and surgical advances including partial nephrectomy, laparoscopic and robotic urologic surgery, and the bioartificial kidney, while serving tens of thousands of patients annually.
About Cleveland Clinic
Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. About 2,000 full-time salaried physicians and researchers and 7,600 nurses at Cleveland Clinic represent more than 100 medical specialties and subspecialties. In addition to its main campus, Cleveland Clinic operates nine community hospitals in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas and Cleveland Clinic Canada. In 2008, there were more than 4.2 million visits throughout the Cleveland Clinic health system and 165,000 hospital admissions. Patients came for treatment from every state and from more than 80 countries.
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