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VU to lead prostate cancer treatment research effort

May. 23, 2013, 9:00 AM

David Penson, M.D., MPH, and colleagues will study patient-reported outcomes and compare the effectiveness of different prostate cancer treatments. (photo by John Russell)

David Penson, M.D., MPH, professor of Urologic Surgery, has received a $2 million research award from the Patient-Centered Outcomes Research Institute (PCORI) to study localized prostate cancer, the second leading cause of death among American men.

“The goal is to find out what works best, in which patients, and in whose hands,” said Penson, the Paul V. Hamilton, M.D. and Virginia E. Howd Professor of Urologic Oncology, who also directs the Vanderbilt Center for Surgical Quality and Outcomes Research.

Over the next three years, Penson will study patient-reported outcomes and compare the effectiveness of treatment of prostate cancer in 3,691 men diagnosed with prostate cancer in five states in 2011.

Working with Tatsuki Koyama, Ph.D., assistant professor of Biostatistics, and Daniel Barocas, M.D., MPH, assistant professor of Urologic Surgery, Penson hopes to better educate men on the types of treatment available, known complications and overall quality of life following treatment.

“This is very important work focused on understanding the expectations of patients and improving outcomes in men who have prostate cancer. Dr. Penson is an internationally recognized leader in this field and we are very proud of his high-impact work,” said R. Daniel Beauchamp, M.D., chair of the Section of Surgical Sciences.

The $2 million study builds on Penson’s recent success in developing a network of tumor registries that collect patient data that may hold the key to more scientifically proven treatment plans that make the most sense for each patient.

Vanderbilt started this network in 2010 through a $7.6 million Agency for Healthcare Research and Quality (AHRQ) grant. Penson’s Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study continues to collect critically important data such as treatment, complications and short-term cancer rates by following nearly 4,000 men diagnosed with prostate cancer.

Though men diagnosed with prostate cancer have a variety of treatment options, including surgical removal of the tumor, radiation therapy and active surveillance, each of these comes with its own risks, side effects and impacts on overall quality of life.

Doctors already know that patients treated with surgery, compared to radiation therapy, for example, are more likely to experience urinary and sexual dysfunction in the first several years following treatment. And those treated with radiation therapy more frequently develop bowel dysfunction early on.

What isn’t clear is how to take this information and personalize it for individual patients in a way that helps them make clinical decisions consistent with their own personal preferences and values.

“No one wants to tackle cancer by guessing,” said Penson. “For the first time, we really have an opportunity to give patients the tools and information they need to lead a healthier, fuller life.”

To ensure key findings from the study are made widely available to men with prostate cancer, Penson has partnered with active patient advocacy leaders at Vanderbilt and nationally.

Dan McCollum, health information specialist at the Eskind Biomedical Library and a prostate cancer survivor, will lead patient stakeholder communications.

He will work with the Vanderbilt-Ingram Cancer Center’s Office of Patient and Community Education to identify interested prostate cancer survivors to serve on a patient advisory council.

The Tennessee chapter of the Men’s Health Network, a patient advocacy group focused on men’s health issues, including prostate cancer, will assist in engaging patients from outside of Vanderbilt.

And the Health Ratings Center of Consumer Reports will assist with study design and future dissemination of information to the public.

“I’m really excited about this award because it will generate rich information that patients can use to make personalized decisions on both how and where to treat their prostate cancer, based on hard science and actual patient outcomes,” Penson said.

“Vanderbilt has one of the highest volume clinical treatment programs in the world for men with prostate cancer,” said Joseph Smith, M.D., chair of Urologic Surgery and William L. Bray Professor of Urology. “Dr. Penson’s work is crucial in allowing us to personalize these treatment recommendations.”

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