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*For medical professionals to read for reference only, Professor Zhu Yao will show you the latest research on JAMA Oncol
.
Why do some localized prostate cancer patients "regret" after receiving treatment? For patients with localized prostate cancer, the guideline-recommended treatments include active surveillance, radical prostatectomy, and radiotherapy.
How to choose so that the patient will not regret it as much as possible? Recently, JAMA Oncology, one of the top oncology journals, published an online study on "Association of Treatment Modality, Functional Outcomes, and Baseline Characteristics in Patients with Localized Prostate Cancer" (Association of Treatment Modality, Functional Outcomes, and Baseline Characteristics) With Treatment-Related Regret Among Men With Localized Prostate Cancer)
.
"Medical Tumor Channel" specially invited Professor Zhu Yao from Fudan University Affiliated Cancer Hospital to share this research and interpret the research results from the perspective of clinical practicality, so as to provide "down-to-earth" clinical dry goods for the majority of doctors and patients online
.
"Live Long" or "Live Well"? The doctor-patient communication before treatment needs to be more specific to the medical community: Do you have any prostate cancer patients with similar conditions? How to effectively reduce the regret of patients after treatment? Professor Zhu Yao: In order to avoid regret after treatment to the greatest extent, clinicians need to fully communicate with patients before treatment
.
In the case of prostate cancer, any treatment decision will greatly affect the rest of the patient's life
.
For metastatic malignant tumors, the treatment goal is mainly based on prolonging the survival of patients
.
Unlike metastatic malignancies, patients with localized prostate cancer may live as long as 10-15 years with radiotherapy and surgery
.
Based on this situation, clinicians must consider the possible long-term effects of treatment-related side effects on patients
.
Specifically, it needs to be comprehensively considered according to the patient's own physical quality, the individual's inclination towards life functions, and the patient's interpretation of the pros and cons of treatment
.
Clinicians may face two types of patients with malignant tumors: the core requirement of one type is to live as long as possible; the other type is willing to sacrifice part of the length of life in exchange for a better quality of life
.
The latter intention involves a more subtle issue, that is, some patients may be willing to sacrifice 10% of their lifespan in exchange for a 40%-50% improvement in their quality of life; others may be willing to sacrifice only 5% of their lifespan
.
Therefore, clinicians need to fully understand the patient's treatment expectations and communicate with them about the possible side effects of treatment
.
This is also the "essence" of this study: the full participation of patients in the process of treatment decision-making
.
Not only tumor treatment, but also pre-treatment communication needs to be "individualized" in the medical field: in clinical practice, there are often mismatches and unequal knowledge, concepts, and equivalence between doctors and patients, which increases the difficulty of doctor-patient communication
.
How do you communicate with patients before making treatment decisions? Prof.
Zhu Yao: This study has given clinicians a lot of inspiration
.
Considering the patient's own characteristics, if the patient has received higher education or is older, and the sexual function before and after treatment is relatively small, the regret after treatment is relatively small
.
On the other hand, patients with fewer side effects or complications after treatment have less regret
.
The lesson we can learn from this research is that clinicians need to be patient, not just sick
.
For the patient population without a higher education, the "social support" mentioned in this study, such as that from family and other patients, was also of great help in reducing patients' treatment-related regret
.
With this support, patients can gain a greater understanding of issues such as possible long-term side effects of treatment
.
For clinicians, minimizing the impairment of normal function and long-term complications of patients can also significantly reduce patients' treatment-related regret
.
How to improve the communication effect? The "multidisciplinary model" may be useful in the medical community: what are the implications of this study for decision-making in the treatment of localized prostate cancer? Prof.
Zhu Yao: The focus of this study corresponds to the issue of medical satisfaction in Chinese clinical practice
.
It is not difficult to find that the less the patient's treatment-related regret, the higher the treatment satisfaction
.
The evaluation of treatment efficacy is also multi-faceted, including survival rate, quality of life and so on
.
This study quantified the issue of treatment satisfaction
.
From this study, clinicians need to focus on the following three aspects: 1) The generation of treatment-related regrets reminds clinicians to continuously optimize clinical skills and treatment levels; 2) This study focuses on patients' overall personality, psychological characteristics and expectations for treatment, This is precisely the lack of clinical practice in our country
.
It also confirms from another perspective that clinicians do not only focus on the disease itself when making medical decisions; 3) As mentioned in the study, "surgery patients have more regrets after treatment, and radiotherapy patients have less regrets", This also reminds clinicians that a multidisciplinary model should be introduced in the process of communicating with patients
.
Concentrating the process of communication and communication on one platform may result in a significant reduction in patient treatment-related regret
.
Experts comment on the long-term impact of essential treatment based on the patient's own physical fitness, personal inclination towards life functions, and the patient's interpretation of the benefits and harms of treatment
.
The patient must be fully involved in the treatment decision-making process
.
According to the patient's own characteristics (higher education, older age, and less influence on sexual function before and after treatment), the regret after treatment is relatively less
.
With the necessary social support, patients without higher education can also understand to a greater extent the possible long-term side effects of treatment
.
In the process of clinical treatment, clinicians need to continuously optimize clinical skills and treatment level, pay attention to the patient's overall personality, psychological characteristics and expectations for treatment, and introduce a multidisciplinary model
.
Expert Profile Professor Zhu Yao Chief Physician of Fudan University Affiliated Cancer Hospital, Doctoral Supervisor Deputy Director of Urology Department of Fudan University Affiliated Cancer Hospital Secretary General of Prostate Cancer Expert Committee of Chinese Society of Clinical Oncology Vice Chairman of Shanghai Anti-Cancer Association Youth Council 2019 Fudan University Youth May 4th Medal Winners of Shanghai Health and Health Commission Youth May 4th Medal were selected for the 2018 Shanghai "Medical Garden Rising Star" Outstanding Young Medical Talents Selected in the 7th Fudan University Top Ten Medical Youths Selected in the 3rd batch of Fudan University Outstanding Talents Program Selected as the editorial board member of Prostate Cancer and Prostatic Disease in the 2015 Shanghai Youth Science and Technology Rising Star Program, and the National Natural Review expert won the first prize of the Shanghai Science and Technology Progress Award as the second completer.
Representative papers published in European Urology and Clinical Cancer Research and other authorities Journal references: [1] Wallis Christopher JD, Zhao Zhiguo, Huang Li-Ching et al.
Association of Treatment Modality, Functional Outcomes, and Baseline Characteristics With Treatment-Related Regret Among Men With Localized Prostate Cancer.
[J] .
JAMA Oncol , 2021.
.
Why do some localized prostate cancer patients "regret" after receiving treatment? For patients with localized prostate cancer, the guideline-recommended treatments include active surveillance, radical prostatectomy, and radiotherapy.
How to choose so that the patient will not regret it as much as possible? Recently, JAMA Oncology, one of the top oncology journals, published an online study on "Association of Treatment Modality, Functional Outcomes, and Baseline Characteristics in Patients with Localized Prostate Cancer" (Association of Treatment Modality, Functional Outcomes, and Baseline Characteristics) With Treatment-Related Regret Among Men With Localized Prostate Cancer)
.
"Medical Tumor Channel" specially invited Professor Zhu Yao from Fudan University Affiliated Cancer Hospital to share this research and interpret the research results from the perspective of clinical practicality, so as to provide "down-to-earth" clinical dry goods for the majority of doctors and patients online
.
"Live Long" or "Live Well"? The doctor-patient communication before treatment needs to be more specific to the medical community: Do you have any prostate cancer patients with similar conditions? How to effectively reduce the regret of patients after treatment? Professor Zhu Yao: In order to avoid regret after treatment to the greatest extent, clinicians need to fully communicate with patients before treatment
.
In the case of prostate cancer, any treatment decision will greatly affect the rest of the patient's life
.
For metastatic malignant tumors, the treatment goal is mainly based on prolonging the survival of patients
.
Unlike metastatic malignancies, patients with localized prostate cancer may live as long as 10-15 years with radiotherapy and surgery
.
Based on this situation, clinicians must consider the possible long-term effects of treatment-related side effects on patients
.
Specifically, it needs to be comprehensively considered according to the patient's own physical quality, the individual's inclination towards life functions, and the patient's interpretation of the pros and cons of treatment
.
Clinicians may face two types of patients with malignant tumors: the core requirement of one type is to live as long as possible; the other type is willing to sacrifice part of the length of life in exchange for a better quality of life
.
The latter intention involves a more subtle issue, that is, some patients may be willing to sacrifice 10% of their lifespan in exchange for a 40%-50% improvement in their quality of life; others may be willing to sacrifice only 5% of their lifespan
.
Therefore, clinicians need to fully understand the patient's treatment expectations and communicate with them about the possible side effects of treatment
.
This is also the "essence" of this study: the full participation of patients in the process of treatment decision-making
.
Not only tumor treatment, but also pre-treatment communication needs to be "individualized" in the medical field: in clinical practice, there are often mismatches and unequal knowledge, concepts, and equivalence between doctors and patients, which increases the difficulty of doctor-patient communication
.
How do you communicate with patients before making treatment decisions? Prof.
Zhu Yao: This study has given clinicians a lot of inspiration
.
Considering the patient's own characteristics, if the patient has received higher education or is older, and the sexual function before and after treatment is relatively small, the regret after treatment is relatively small
.
On the other hand, patients with fewer side effects or complications after treatment have less regret
.
The lesson we can learn from this research is that clinicians need to be patient, not just sick
.
For the patient population without a higher education, the "social support" mentioned in this study, such as that from family and other patients, was also of great help in reducing patients' treatment-related regret
.
With this support, patients can gain a greater understanding of issues such as possible long-term side effects of treatment
.
For clinicians, minimizing the impairment of normal function and long-term complications of patients can also significantly reduce patients' treatment-related regret
.
How to improve the communication effect? The "multidisciplinary model" may be useful in the medical community: what are the implications of this study for decision-making in the treatment of localized prostate cancer? Prof.
Zhu Yao: The focus of this study corresponds to the issue of medical satisfaction in Chinese clinical practice
.
It is not difficult to find that the less the patient's treatment-related regret, the higher the treatment satisfaction
.
The evaluation of treatment efficacy is also multi-faceted, including survival rate, quality of life and so on
.
This study quantified the issue of treatment satisfaction
.
From this study, clinicians need to focus on the following three aspects: 1) The generation of treatment-related regrets reminds clinicians to continuously optimize clinical skills and treatment levels; 2) This study focuses on patients' overall personality, psychological characteristics and expectations for treatment, This is precisely the lack of clinical practice in our country
.
It also confirms from another perspective that clinicians do not only focus on the disease itself when making medical decisions; 3) As mentioned in the study, "surgery patients have more regrets after treatment, and radiotherapy patients have less regrets", This also reminds clinicians that a multidisciplinary model should be introduced in the process of communicating with patients
.
Concentrating the process of communication and communication on one platform may result in a significant reduction in patient treatment-related regret
.
Experts comment on the long-term impact of essential treatment based on the patient's own physical fitness, personal inclination towards life functions, and the patient's interpretation of the benefits and harms of treatment
.
The patient must be fully involved in the treatment decision-making process
.
According to the patient's own characteristics (higher education, older age, and less influence on sexual function before and after treatment), the regret after treatment is relatively less
.
With the necessary social support, patients without higher education can also understand to a greater extent the possible long-term side effects of treatment
.
In the process of clinical treatment, clinicians need to continuously optimize clinical skills and treatment level, pay attention to the patient's overall personality, psychological characteristics and expectations for treatment, and introduce a multidisciplinary model
.
Expert Profile Professor Zhu Yao Chief Physician of Fudan University Affiliated Cancer Hospital, Doctoral Supervisor Deputy Director of Urology Department of Fudan University Affiliated Cancer Hospital Secretary General of Prostate Cancer Expert Committee of Chinese Society of Clinical Oncology Vice Chairman of Shanghai Anti-Cancer Association Youth Council 2019 Fudan University Youth May 4th Medal Winners of Shanghai Health and Health Commission Youth May 4th Medal were selected for the 2018 Shanghai "Medical Garden Rising Star" Outstanding Young Medical Talents Selected in the 7th Fudan University Top Ten Medical Youths Selected in the 3rd batch of Fudan University Outstanding Talents Program Selected as the editorial board member of Prostate Cancer and Prostatic Disease in the 2015 Shanghai Youth Science and Technology Rising Star Program, and the National Natural Review expert won the first prize of the Shanghai Science and Technology Progress Award as the second completer.
Representative papers published in European Urology and Clinical Cancer Research and other authorities Journal references: [1] Wallis Christopher JD, Zhao Zhiguo, Huang Li-Ching et al.
Association of Treatment Modality, Functional Outcomes, and Baseline Characteristics With Treatment-Related Regret Among Men With Localized Prostate Cancer.
[J] .
JAMA Oncol , 2021.
