As medical oncologists, urologists, radiation oncologists, and other clinicians, we find ourselves feeling very comfortable understanding Kaplan Meier survival curves and forest plots describing subgroups in the setting of different treatments. We review CTCAE adverse event data, drilling down on the 10% of adverse effects that happen most commonly, and nearly always arrive at the conclusion that “such and such treatment is relatively well tolerated”.
A Million Faces: What Prostate Cancer Awareness Means to Me
Prostate cancer is something that touches most of us, at least indirectly, at some point in our lives. It is the most common cancer in American men, and the second leading cause of cancer death in this country. Our continued efforts as clinicians, researchers, patients, family members, loved ones, and advocates are critical if this
Targeting the Unseen: Advances in Treatment of M0 CRPC
Biochemical or PSA-only recurrence of prostate cancer after initial treatment with surgery or radiation can be extremely stressful for patients and their families, particularly when the PSA rises quickly. In the last few weeks the field has been fortunate to hear reports of two practice changing studies for men with high-risk non-metastatic castration-resistant prostate cancer (M0CRPC) that make some strides in combating this issue. The Study of Apalutamide (ARN-509) in Men With Non-Metastatic Castration-Resistant Prostate Cancer (SPARTAN) and Safety and Efficacy Study of Enzalutamide
I am regularly asked about whether men undergoing active treatment for prostate cancer should add a statin to their daily medication routine to reduce the risk of prostate cancer recurrence, mortality, and complications. Nearly as often I hear questions about whether statins may be of use in prostate cancer survivors or men at risk of prostate cancer, raising the general idea that everyone and anyone may benefit from treatment with these commonly used medications.
In the last few weeks I have talked with numerous colleagues about the findings from LATITUDE and STAMPEDE presented recently at the ASCO Annual Meeting and published in the New England Journal of Medicine in June 2017. We find ourselves in the process of integrating the findings into a treatment landscape that is still grappling with the findings of CHAARTED, data demonstrating a survival benefit from the use of chemohormonal therapy in a similar high risk population of men with metastatic hormone sensitive prostate cancer (mHSPC) first presented only a few years ago.
For nearly the past decade, I have studied complications of cancer survivorship and how patients might better integrate this information into their treatment decisions. Most of this has centered on complications of hormonal therapy for men with prostate cancer, with an emphasis on assessing complications from the patient prospective using patient reported outcome measures, in addition to objective scientific measures like the CTCAE.
In my day-to-day practice caring for men with prostate cancer, questions about testosterone come up daily. Men wonder if they have too little testosterone, had too much testosterone exposure, and if they can get their testosterone back if they are receiving androgen deprivation therapy. One concern that men with a history of using supplemental testosterone bring up routinely is whether exposure to this additional testosterone increased their risk for prostate cancer.
Goal: To serve as an interface between community urologists, medical oncologists, radiation oncologists, advanced practice providers, and specialty nurses to remain updated on best practices, areas of controversy, and the latest advances in the care of advanced prostate cancer patients.