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HIGHLIGHTS FROM THE 2024 ADVANCED PROSTATE CANCER CONSENSUS CONFERENCE |
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| Identification, Assessment and Management of Side Effects of Systemic Therapies
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| How to Select ADT and an ARPI Based on Cardiovascular Risk Profile |
| Charles Ryan, MD |
| Charles Ryan discussed selecting androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors based on cardiovascular risk profiles in prostate cancer patients. Key considerations included the cardiovascular risks associated with ADT, including increased risks of cardiovascular death, nonfatal cardiovascular disease, myocardial infarction, and stroke. |
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| The Importance of Bone Protection
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| Noel W. Clarke, MBBS, FRCS, ChM
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| Noel Clarke emphasized the importance of bone protection in patients with prostate cancer, particularly those receiving androgen deprivation therapy (ADT) and novel androgen receptor signaling inhibitors (ARSIs). He highlighted the substantial risk of skeletal-related events in patients with advanced or metastatic disease, underscoring the impact of these therapies on fracture risk.
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| Gynecomastia – How to Assess and Treat? |
| Lisa Horvath, MBBS, Ph.D. |
| Lisa Horvath discussed the assessment and management of gynecomastia as a common side effect of androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors in prostate cancer. She emphasized the importance of differentiating gynecomastia from chest fat based on clinical features and highlighted prophylactic tamoxifen as an effective intervention compared to radiotherapy for preventing gynecomastia. |
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| Hot Flushes – How Can We Help Our Patients? |
| Anthony Joshua, MBBS, Ph.D., FRACP |
| Anthony Joshua presented strategies for managing hot flushes in patients undergoing androgen deprivation therapy (ADT) for prostate cancer, highlighting the significant impact of hot flushes on patient quality of life and treatment adherence. He discussed various interventions including lifestyle changes, cognitive behavioral therapy, acupuncture, and hormonal therapies such as estradiol patches, venlafaxine, and gabapentin. |
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| Testosterone Recovery After Stopping ADT – Who Is at Risk for Long-Term Non-Recovery?
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| Pierre Blanchard, MD, Ph.D.
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| Pierre Blanchard discussed factors influencing testosterone recovery after stopping androgen deprivation therapy (ADT) in prostate cancer patients. Key points included the varying recovery times associated with different ADT agents (agonists versus antagonists), the impact of treatment duration and patient characteristics on recovery, and the implications of delayed testosterone recovery on patient outcomes and quality of life.
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| Global Access of Advanced Prostate Cancer in Low- and Lower-Middle Income Countries
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| How Do We Modify the Diagnostic Pathway to Deal with Rising Rates of Prostate Cancer in Africa? |
| Onyeanunam Ngozi Ekeke, MD |
| Onyeanunam Ngozi Ekeke addressed the rising rates of prostate cancer in Africa by modifying the diagnostic pathway. Key points included the need for patient education to improve awareness and early detection, implementation of targeted screening programs for high-risk populations, development of risk stratification models specific to African populations, and increased access to biopsy services and imaging technologies such as MRI and PET scans where available. |
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| Dealing with Inequality – What Can We Learn from the Indian Healthcare System |
| Vedang Murthy, MD, DNB, DipEPP |
| Vedang Murthy explored lessons from the Indian healthcare system on addressing inequality, focusing on innovative approaches within the context of limited resources. In India, where a large majority of patients are uninsured, cost efficiency and indigenization are key principles driving healthcare decisions. Strategies include utilizing locally developed technologies like the bhabhatron for radiotherapy and the SSI Mantra robotic platform for surgery, as well as adopting low-cost systemic therapy options such as low-dose abiraterone with food. |
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| Dealing with Inequality – What Can We Learn from the Brazilian Unified Healthcare System (SUS): Opportunities for Big Data Mining and System Remodeling |
| Fernando Maluf, MD, Ph.D. |
| Fernando Maluf discussed leveraging big data and system remodeling within Brazil's healthcare system to address inequalities in cancer care. Initiatives include transforming public hospitals into research units, promoting clinical trials for innovative treatments, and improving access to oral oncology medications. |
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