Dr Margulis on Patient Factors to Consider in the Treatment of RCC

Vitaly Margulis, MD, urologic oncologist, Harold C. Simmons Comprehensive Cancer Center, professor, urology, Paul C. Peters, MD, Chair in Urology, UT Southwestern Medical Center, discusses significant factors and comorbidities that may affect treatment decisions for patients with renal cell carcinoma (RCC). 

In an OncLive® State of the Science Summit™, Margulis and colleagues from Moffitt Cancer Center each gave presentations on topics spanning RCC care. Margulis says that, in his approach to patient care, 2 primary factors guide his decision making. Firstly, the patient's unique characteristics and circumstances, including their overall performance status, play pivotal roles in treatment decisions, he explains. Additionally, Margulis considers a patient’s life expectancy based on their comorbidities. Knowing the patient's goals helps create a treatment plan that aligns with their expectations, Margulis notes. Symptoms also hold significant weight in the assessment of the patient, as does the socioeconomic support structure surrounding the patient, Margulis expands.

The second factor to consider centers around the specifics of the cancer itself. Understanding the extent of the disease is paramount, Margulis expands. Assessing the symptomatic nature of both the primary tumor and any metastatic sites provides valuable insights into symptom management and the overall burden of the disease on the patient, he notes.

Risk assessments are another critical aspect of making treatment decisions, particularly when metastatic disease is identified. Categorizing the patient into an appropriate risk group based on various factors, including the extent of metastasis and the cancer's aggressiveness, informs treatment decisions and helps predict outcomes, he says.

Furthermore, the patient’s socioeconomic status can affect treatment decisions. For example, many patients require systemic therapies that often necessitate travel to specialized cancer centers for infusions, Margulis continues. Some patients face logistical challenges in accessing these facilities due to geographical distance, transportation limitations, or a lack of caregiver support, he notes. These obstacles can result in patients’ noncompliance with prescribed treatments, leading to suboptimal treatment outcomes, he concludes.