Dr. Stacy Loeb is an urologist with significant experience in clinical care and research on prostate cancer. This K07 award will allow the applicant to gain additional skills to foster a career as an independent investigator. This will be accomplished in collaboration with a multidisciplinary mentorship team. Background: One in 6 US men are diagnosed with prostate cancer during their lifetime but only 1 in 36 die from it. Treatment is often curative but may lead to side effects. An alternative option is conservative management, which delays or avoids the side effects of treatment. The major risk of conservative management is that the disease may progress without treatment. During conservative management, there are many options for follow-up testing to monitor for disease progression, ranging from blood tests and physical exams to imaging and biopsies. However, there is no consensus regarding the type, frequency and sequence of follow-up testing. More frequent and invasive tests may identify disease progression earlier, but may increase costs and complications. In a recent Consensus Conference, the NIH declared that identifying the optimal protocol for conservative management is a major priority in prostate cancer research. Project: The goal of this proposal is to compare the effectiveness, harms and costs of alternative strategies for conservative management using a mathematical model. The model will also look at the influence of patient features, tumor features, and preferences on the choice of strategy. This information will be distributed to prostate cancer patients and physicians through the preliminary design of a website. The research plan coincides with the applicant's proposed training curriculum, to ensure a successful bridge to submission of an R01 proposal. Mastery of these new skills will help the applicant transition into an independent cancer investigator with the capacity to compare the effectiveness and costs of new prostate cancer management options, and to design decision support tools for prostate cancer patients.
The goal of the proposed research is to improve conservative management of prostate cancer, which can decrease the burden of overdiagnosis caused by prostate cancer screening. The project will use multidisciplinary methods (systematic review, mathematical modeling, and creation of a decision aid) to compare the benefits, harms, and costs of alternative strategies for the conservative management of prostate cancer. This Career Development Award will also promote Dr. Stacy Loeb's transition to an independent clinician-scientist, conducting innovative health services research in prostate cancer.
|Tosoian, Jeffrey J; Loeb, Stacy; Epstein, Jonathan I et al. (2016) Active Surveillance of Prostate Cancer: Use, Outcomes, Imaging, and Diagnostic Tools. Am Soc Clin Oncol Educ Book 35:e235-45|
|Loeb, Stacy; Folkvaljon, Yasin; Robinson, David et al. (2016) Immediate versus delayed prostatectomy: Nationwide population-based study (.). Scand J Urol 50:246-54|
|Lepor, Abbey; Catalona, William J; Loeb, Stacy (2016) The Prostate Health Index: Its Utility in Prostate Cancer Detection. Urol Clin North Am 43:1-6|
|Tosoian, Jeffrey J; Carter, H Ballentine; Lepor, Abbey et al. (2016) Active surveillance for prostate cancer: current evidence and contemporary state of practice. Nat Rev Urol 13:205-15|
|Carlsson, Sigrid; Drevin, Linda; Loeb, Stacy et al. (2016) Population-based study of long-term functional outcomes after prostate cancer treatment. BJU Int 117:E36-45|
|Loeb, Stacy; Folkvaljon, Yasin; Robinson, David et al. (2016) Evaluation of the 2015 Gleason Grade Groups in a Nationwide Population-based Cohort. Eur Urol 69:1135-41|
|BjÃ¶rklund, Johan; Folkvaljon, Yasin; Cole, Alexander et al. (2016) Postoperative mortality 90 days after robot-assisted laparoscopic prostatectomy and retropubic radical prostatectomy: a nationwide population-based study. BJU Int 118:302-6|
|Loeb, Stacy; Curnyn, Caitlin; Sedlander, Erica (2016) Perspectives of Prostate Cancer Patients on Gleason Scores and the New Grade Groups: Initial Qualitative Study. Eur Urol :|
|Loeb, Stacy; Walter, Dawn; Curnyn, Caitlin et al. (2016) How Active is Active Surveillance? Intensity of Followup during Active Surveillance for Prostate Cancer in the United States. J Urol 196:721-6|
|Loeb, Stacy; Folkvaljon, Yasin; Makarov, Danil V et al. (2015) Five-year nationwide follow-up study of active surveillance for prostate cancer. Eur Urol 67:233-8|
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