Would you be willing to trade off some survival time to lower your risk of developing bone metastases (BM)?  Well, men in the UK and Sweden are willing.

 Men from the UK and Sweden with castrate resistant prostate cancer (CRPC) and at high risk for developing BM because they have been on androgen-deprivation (ADT) or hormone therapy for more than 3 years were asked to complete an online survey with 10 questions. They were asked if they would prefer to receive a hypothetical prophylactic medication (HPM), which provided an increased risk of developing osteonecrosis of the jaw (ONJ) as well as a possible increase of survival to decrease their risk of developing BM or to decline HPM thus not receiving any treatment benefit or risk. The researchers defined the HPMs by providing a delay in BM (0-23 months) and with a risk of ONJ (0-9%).

The proportion of men who chose HPM with different combinations of BM delay and ONJ risk was calculated. To further evaluate the impact of BM to patients, time tradeoff was used to assess men’s’ willingness to trade off between life years with and without bone complications (i.e., skeletal-related events, including spinal cord compression, surgery or radiation to bone, and pathologic fracture).

In the surveya total of 201 UK men and 200 Swedish men completed the survey. When asked about the tradeoff between life years with and without bone complications, 52% of UK patients and 26% of Swedish patients were willing to trade off 5 months of survival to avoid bone complications; nearly three-quarters of the men were willing to trade off 3 months of survival to avoid bone complications.

A majority of the surveyed men in both the UK and Sweden were willing to take the fabricated drugs, HPMs to delay the development of BM even with the treatment-related risk of developing ONJ and the trade off of giving up 3 to 5 months of survival.

What about you, would you trade increasing your risk of developing ONJ and decreasing your life expectancy to avoid the problems of bone metastases?

J Clin Oncol 32, 2014 (suppl 4; abstr 117): Yi Qian, A. Brett Hauber, Juan Marcos Gonzalez, Joshua Posner, Ateesha F Mohamed, Bertrand Tombal, Jean-Jacques Body, Francesca Gatta, Jorge Arellano

Joel T. Nowak, M.A., M.S.W.