Diminution du sur-traitement et des conséquences associées au traitement des cancers urologiques

 

Patrick Richard

Université de Sherbrooke

 

Domaine : cancer

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2018-2019

Due to recent innovation in diagnostic methods, more and more urological cancers are now being diagnosed at an early stage. This has resulted in an increase in the number of patients being treated. Unfortunately, this increase has not coincided with a decrease in cancer-related deaths. Many believe that this phenomenon is the result of many patients undergoing unnecessary treatment. I believe that it is therefore essential to find treatment alternative to decrease overtreatment and its associated complications.

This research program targets the three commonest cancers of the urinary system which are prostate, bladder and kidney cancers. The first study will examine the barriers to a greater adoption of renal tumor biopsy in the management of small renal masses and will try to debunk some of these barriers. The second project will evaluate, in a mouse model, a potential treatment alternative (oncolytic virus) to the current treatment given after surgery to patients with superficial bladder cancer. A treatment alternative is essential given that the current one is poorly tolerated by most patients. The third project will aim to better characterize some of the complications associated with the treatment of prostate cancer. More specifically, it will focus on secondary surgical approaches that aim to correct post-prostate ablation urinary incontinence, and will aim to identify factors related to their mid/long-term complications. Lastly, the fourth project will examine the safety of active surveillance as an alternative to immediate surgery for patients diagnosed with a complex cyst.

The objective of active surveillance is to delay surgery until there is sign of local tumor progression with the goal to decrease the number of patients that will undergo an unnecessary intervention. Ultimately, this research program goals are to decrease the rate of unnecessary interventions and to improve the quality of care of patients diagnosed with urological cancers.