SNMMI 2019: Co-Managing the Patient with Metastatic Castration-Resistant Prostate Cancer

Las Vegas, Nevada ( Dr. Phillip Koo gave a talk on the concept of co-managing the patient with metastatic castrate-resistant prostate cancer (mCRPC). For treatment to be standardized we need to establish consistent care, lower costs, and improved outcomes. They are known oncological clinical pathways that standardize the care processes using evidence-based medicine. In the US there are 60 health insurance plans that are implementing oncology pathways.   There are over 170 million individuals in the US who are covered by these insurance plans, which are potentially being treated under a plan-sponsored pathway.

Personalization of therapy is also a fundamental growing principle. In this specific field of theranostics, this includes PET adapted therapy, dose intensification, and artificial intelligence/machine learning.

The standard multidisciplinary care of medical oncology, surgical oncology, and radiation oncology should be enhanced to include nuclear oncology, interventional oncology, supportive oncology, pathology, integrative oncology, and others. It is important to foster and develop relationships between partner specialties to equal the relationship with colleagues in the same specialty. A common language should be established between all these specialties and the multidisciplinary rounds should be standardized and frequent. Patients should be discussed, and treatments should be decided together. Furthermore, medical professional conferences should be attended by physicians of all specialties so that they could keep being updated on the newest medical studies and novel data and share views and opinions together.

Dr. Koo concluded his talk mentioning the great online and free resource of “” as it has excellent content including video interviews, abstracts, conference summaries and much more which are relevant to nuclear medicine physicians, medical oncologists, radiation oncologists, urologists, and other relevant healthcare personnel. Lastly, managing adverse effects is also very important, and nuclear medicine physicians should know how to deal with these adverse effects if they plan to be more clinically involved in treating these patients. 

Presented by: Phillip Koo, MD, Division Chief of Diagnostic Imaging at the Banner MD Anderson Cancer Center in Arizona 

Written by: Hanan Goldberg, MD, Urology Department, SUNY Upstate Medical University, Syracuse, New York, USA, Twitter: @GoldbergHanan at the 2019 SNMMI Therapeutics Conference: Therapies, Theranostics, and Building Your Radionuclide Clinical Practice, October 25-27, 2019 in Las Vegas, Nevada