Management of Patients with Advanced Prostate Cancer

Panelists: Raoul S. Concepcion, MD, Urology Associates, PC; Steve Dobbs, Urologic Associates of Oklahoma; Bryan A. Mehlhaff, MD, Oregon Urology Institute; Daniel R. Saltzstein, MD, Urology San Antonio Research;
Neal D. Shore, MD, Atlantic Urology Clinics
Published Online: Tuesday, January 22, 2013
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Raoul D. Concepcion, MD, begins the discussion by posing the question as to what sorts of models or protocols are being put into place to evaluate and manage patients with regards to sequencing different types of therapies (immunotherapy, oral therapy, cytotoxic chemotherapy).

Daniel R. Saltzstein, MD, says that a multidisciplinary approach works best for his practice where a radiation oncologist is involved with a medical oncologist. Though he can offer his patients clinical trials, few trials have actually been completed to determine appropriate drug combinations and sequencing.

Bryan Mehlhaff, MD, stresses that every community will have a slightly different setup, depending on what a urologist feels comfortable with. It remains important, Mehlhaff says, to keep patients in the loop and provide them with options every step of the way.

Though his practice has 20 physicians, Steve Dobbs, FACHE, has not looked into bringing a full-time medical oncologist in. As drugs are approved, urology as a business will have to adjust to reimbursement with regards to disease management and episodic care.

Concepcion wraps up the discussion by emphasizing the need to change practice models in urology to avoid marginalizing itself as reimbursement changes.
View More From This Discussion
Episode 1 Prostate Cancer Management: Introduction and Overview
Episode 2 Managing ADT-Associated Skeletal-Related Events
Episode 3 Immunotherapy in Advanced Prostate Cancer, Part I
Episode 4 Immunotherapy in Advanced Prostate Cancer, Part II
Episode 5 NCCN Guidelines for Advanced Prostate Cancer
Episode 6 Treatments for Post-Docetaxel Prostate Cancer, Part I
Episode 7 Treatments for Post-Docetaxel Prostate Cancer, Part II
Episode 8 Emerging Therapies in Prostate Cancer
Episode 9 Dr. Shore Reviews Emerging Therapies in Prostate Cancer
Episode 10 Management of Patients with Advanced Prostate Cancer
Episode 11 Dr. Shore Discusses Therapy Combination in CRPC
Episode 12 Dr. Shore on the Management of Patients with CRPC
Episode 13 Reimbursement Issues in Prostate Cancer, Part I
Episode 14 Reimbursement Issues in Prostate Cancer, Part II
Episode 15 Revenue Opportunities and GPOs for Urology Groups
Episode 16 Dr. Shore on Current Clinical Trial Challenges in CRPC
Episode 17 Effective Management of Prostate Cancer Conclusion
Expert Panelists
Raoul S. Concepcion

Raoul S. Concepcion, MD

Urologists in Cancer Care
Director of Clinical Research
Urologic Surgeon
Urology Associates, PC
Nashville, TN

Steve Dobbs

CEO, Urologic Associates of Oklahoma,
Tulsa, Oklahoma

Bryan A. Mehlhaff, MD

Principal Investigator, Division of Clinical Research, Oregon Urology Institute, Springfield, Oregon

Neal D. Shore, MD

Director, CPI, Carolina Urologic Research Center, Grand Strand Urology/Atlantic Urology Clinics, Myrtle Beach,
South Carolina

Daniel R. Saltzstein, MD

Medical Director, Urology San Antonio Research, San Antonio, Texas
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