Prostate Cancer Awareness in the Time of COVID

Alicia Morgans | September 01, 2020

As the world continues to be affected by the COVID-19 pandemic, severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), prostate cancer awareness may seem like something that could be forgotten this year.  Just today in the state where I live, Illinois, we learned of 1,880 new cases of coronavirus yesterday, with over 180,000 deaths in the United States (US) since the pandemic started. Our normal lives have been disrupted, with restaurants and gyms open only with significant restrictions, and church services limited in number or only held online. 

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Alicia Morgans, MD

Alicia Morgans, MD, MPH is an Associate Professor of Medicine in the Division of Hematology/Oncology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois. She is a clinician and physician investigator specializing is investigating complications of systemic therapy for prostate cancer survivors. She has expertise in clinical trials and patient reported outcome measures, and as well as incorporating patient preferences and beliefs into clinical decision making.

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By Christopher Wallis

Introduction 

Prostate cancer, while commonly diagnosed in early forms, remains the second leading cause of cancer mortality in the United States and Europe.1 For patients who die of prostate cancer, some will be initially diagnosed and treated for metastatic castration-sensitive disease (mCSPC) while others will progress through non-metastatic castration-resistant disease (nmCPRC) following initial local therapy followed by androgen deprivation therapy (ADT) for biochemical recurrence. In either case, nearly all men who die of prostate cancer will have metastatic castration-resistant disease (mCRPC) prior to death.

By Thomas E. Keane, MBBCh, FRCSI, FACS
Published Date: December 2018

Prostate cancer is the leading incident cancer among men, and population growth and aging have fueled a 40% rise in global case burden since 2006.1,2 Despite recent improvements in treatment, patients with locally advanced and advanced prostate cancer experience significant emotional distress, diminished quality of life, and increased risk of cancer-specific mortality.1,2,3
By Neal Shore, MD, FACS
Published Date: September 2018

Radiation has been used to treat prostate cancer since the early 1900s.¹ In recent decades, advances in radiation delivery systems and the advent of computed tomography and magnetic resonance imaging have spurred the development of targeted, high-dose radiotherapy techniques such as intensity-modulated radiotherapy (IMRT), image-guided radiation therapy (IGRT), stereotactic radiation therapies, proton beam
By Matthew T. Roe, MD, MHS, MHS
Published Date: March 2017

Heart disease and cancer are the leading causes of death in the United States.1 Prostate cancer (PC) is the most common cancer in American men, and PC is most frequently diagnosed among men aged 65 to 74 years.2 The American Cancer Society’s estimates for PC in the United States for 2017 are about 161,360 new cases. Of these, about 26,730 are expected to die of the disease.1 
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Written by Christopher J.D. Wallis, MD, PhD and Zachary Klaassen, MD, MSc
August 31, 2020
The rapid spread of Coronavirus Disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) has dramatically reshaped the structure of Western society, including on health care delivery.
Written by Christopher J.D. Wallis, MD, PhD and Zachary Klaassen, MD, MSc
July 2, 2020
Prostate cancer is a clinically heterogeneous disease with many patients having an indolent course requiring no interventions and others who either present with or progress to metastasis. While underlying dominant driving mutations are not widespread, there have been a number of key genomic mutations that have been consistently identified in prostate cancer patients,
Written by Zachary Klaassen, MD, MSc and Christopher J.D. Wallis, MD, PhD
May 14, 2020
The coronavirus has the potential to impact the integrity and patient safety of ongoing trials as well as increase the operational burden on trial programs, therefore potentially limiting access to trials and new therapies for oncology patients. Opportunities for clinical trial enrollment may still be provided to patients during the COVID-19 outbreak, but likely require thorough evaluation on a case-by-case basis.
Written by Zachary Klaassen, MD, MSc and Christopher J.D. Wallis, MD, PhD
December 10, 2019

Despite prostate cancer (PCa) being the second most common cause of cancer mortality among American men,1 there are 2.9 million men in the United States living with PCa. As such, there are many “PCa survivors” that are either on active surveillance (AS)/watchful waiting (WW) or have undergone treatment for localized (ie. radiation therapy (RT), radical prostatectomy (RP), focal therapy, etc) or advanced disease. 

Written by Zachary Klaassen, MD, MSc
December 18, 2019

Understanding and elucidating the underlying genetic basis of carcinogenesis has been the holy grail for cancer researchers, for both the scientific understanding of disease pathophysiology and potential therapeutic implications. Perhaps the best example of the therapeutic implications of understanding carcinogenesis come from chronic myeloid leukemia where the identification of the “Philadelphia chromosome”;

Written by Zachary Klaassen, MD, MSc
November 15, 2019
Despite the exciting advances in treatment over the last decade for metastatic castration-resistant prostate cancer (mCRPC), the disease remains incurable with a median overall survival of 12-35 months.1-4 Targeting the immune system to expand treatment options in the advanced disease state has resulted in significant improvements
Written by Hanan Goldberg, MD
December 10, 2019
In 2018 1.3 million prostate cancer (PCa) cases were diagnosed worldwide, with approximately 20% having metastatic disease.1 Oligometastatic PCa is defined as a state of low-volume metastatic disease that appears to be prognostically different and likely amenable to different treatment options, which could potentially change the disease trajectory when compared with high-volume metastatic disease.2
Written by Zachary Klaassen, MD, MSc
April 16, 2019
In 2018 in the United States, there will be an estimated 164,690 new cases of prostate cancer (19% of all male cancer incident cases, 1st) and an estimated 29,430 prostate cancer mortalities (9% of all male cancer deaths, 2nd only to lung/bronchus cancer).1 Over the last four decades, there was a spike
Written by Zachary Klaassen, MD, MSc
April 16, 2019
The discovery of prostate-specific antigen (PSA) in the late 1970s and its widespread application and adoption in the 1980s and 1990s ushered in the prostate cancer screening and disease monitoring era. As the first tumor marker for prostate cancer, it is organ specific but not cancer specific.1
Written by Zachary Klaassen, MD, MSc
April 16, 2019
Secondary to the introduction of prostate specific antigen (PSA) screening in the 1980’s/1990’s, symptomatic presentation of prostate cancer has become less frequent. Symptoms of locally advanced prostate cancer may include obstructive urinary symptoms, gross hematuria, and/or upper tract urinary obstruction leading to renal failure.
Written by Zachary Klaassen, MD, MSc
April 16, 2019
Over the last decade, imaging for prostate cancer has improved immensely. Specifically, prostate multiparametric MRI (mpMRI) has improved primarily as a result of an increase in magnet strength from 1 to 3-tesla. mpMRI consists of anatomic and functional imaging techniques:
Conference Coverage
Recent data from conferences worldwide
Presented by William T. Lowrance, MD, MPH
The AUA 2020 virtual annual meeting was highlighted by an update on the AUA guidelines for advanced prostate cancer, presented by Dr. William Lowrance and Dr. Michael Cookson. Dr. Lowrance notes that this guideline was produced by a multidisciplinary panel with representation from the AUA, ASCO, ASTRO, and SUO was well as a patient advocate.
Presented by Elena Castro, MD, PhD
San Francisco, CA (UroToday.com) In this talk, Dr. Elena Castro gave an overview of the genomic landscape of advanced prostate cancer. It has been shown that in over 70%
Presented by Samuel Denmeade
Washington, DC (UroToday.com) As part of the SUO 2019 advanced prostate cancer session, Dr. Samuel Denmeade discussed his work with bipolar androgen therapy (BAT)
Presented by Samuel Denmeade, MD
Washington, DC (UroToday.com)  Since Huggins’ noble prize-winning work on the role of androgens in prostate cancer progression in 1940, hormonal suppression has been the mainstay
Presented by Kelly Stratton, MD
Athens, Greece (UroToday.com) Dr. Kelly Stratton gave an overview of the role of surgery in advanced prostate cancer. Advanced prostate cancer 
Presented by Derya Tilki, MD
Athens, Greece (UroToday.com) Dr. Derya Tilki was the first to present at the Educating Masterclass on Biochemical Recurrence after Radical Prostatectomy.
Presented by Karim Fizazi, MD, PhD
Barcelona, Spain (UroToday.com) At the Friday session at the 2019 European Society for Medical Oncology annual meeting (ESMO) meeting on prostate cancer, Karim Fizazi
Presented by Maria J. Ribal, MD
Barcelona, Spain (UroToday.com) Dr. Maria Ribal from Barcelona started the urogenital cancer treatment at a glance session by giving an overview of challenging paradigms in advanced prostate cancer. Dr. Ribal notes that not only is the incidence of prostate cancer the highest among male malignancies,
Presented by Himisha Beltran, MD
San Francisco, CA (UroToday.com) Dr. Misha Beltran presented a summary of the biologic basis for sequencing novel treatments for metastatic prostate cancer.  There is an increasing need for biomarkers in advanced prostate cancer management
Presented by Srikala S. Sridhar, MD, FRCPC, Alberto Briganti, MD, PhD, and Heather Ann Payne, MBBS, FRCP, FRCR
San Francisco, CA (UroToday.com) During the general session on optimizing diagnosis and treatment of clinically significant nonmetastatic prostate cancer at the Annual ASCO GU 2019 meeting
Presented by Kim Chi, MD
Phoenix, Arizona (UroToday.com) The LATITUDE study, published in July 2017, was a phase III randomized, clinical trial that evaluated the efficacy of abiraterone 
Presented by Laurence Klotz, MD
Tel-Aviv, Israel (UroToday.com) Laurence Klotz, MD gave a presentation on intermittent androgen deprivation therapy (IADT) and its association with cardiovascular disease (CVD). He began stating the many advantages of intermittent androgen deprivation therapy.
Presented by Jehonathan Pinthus, MD
Tel-Aviv, Israel (UroToday.com) Jehonathan Pinthus, MD presented the RADICAL PC trial and elaborated on the correlation of prostate cancer (PC) to cardiovascular disease (CVD). It is known that PC patients are at risk for CVD. Patients are deemed to be high-risk if they have a global risk estimate for severe CVD events with a rate of more than 2% per year.
Presented by Silke Gillessen, MD
Copenhagen, Denmark (UroToday.com)  Dr. Sommer gave an overview of the complications associated with the treatment for advanced prostate cancer. The first topic discussed was the acute side effects of androgen deprivation therapy (ADT). These include decreased libido, erectile dysfunction, hot flashes, and fatigue.
Presented by Karim Fizazi, MD, PhD
Chicago, IL (UroToday.com) Dr. Karim Fizazi and colleagues presented their much-anticipated results from the LATITUDE trial at the 2017 ASCO annual meeting’s plenary session. In a phase III, double-blind, randomized setting, LATITUDE tested androgen deprivation therapy