Global survey: Management of low intermediate risk prostate cancer

GLOBAL PROSTATE CANCER SURVEY

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* 1. You diagnose a fit 65 year-old man with Grade Group 2 (Gleason 3+4=7) prostate cancer. His PSA is 6.6. He has no LUTS and is sexually active with normal erections.

His MRI had shown a prostate volume of 40cc with a 1cm PIRADS 4 lesion in the midline at the anterior base. You performed a targeted (fusion or cognitive) plus template transperineal biopsy.

All 4 targeted cores showed Gleason 3+4=7 cancer. The core with the most Gleason pattern 4 had 7mm of 3+4 with 30% pattern 4. All 24 template cores (outside the targeted area) were benign.

Staging with PSMA PET showed avidity of the primary tumour but was negative for metastases.

You offer the patient management options for localised clinically significant prostate cancer. He takes these in and then asks, which ONE would YOU recommend?

Radiotherapy (brachytherapy or external beam)

Active surveillance

Focal therapy (any energy source)

Watchful waiting

Nerve-sparing radical prostatectomy (any surgical approach)

Other (please specify)

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* 2. What is your specialty?

Radiation Oncologist

Urologist

Medical Oncologist

Radiologist

Other (please specify)

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* 3. In which world region do you work?

Asia-Pacific

Europe

Africa

South America

North America

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* 4. Your gender

Female

Male

Other

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* 5. Your practice is mainly:

Public

Private

Academic

Community

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* 6. In which type of area do you mainly work?

Metropolitan/ city

Non-metropolitan/ remote

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* 7. Years in fully qualified specialist practice

<10

10 - 20

>20

Trainee/ resident (not yet specialist-qualified)