Alec S. Koo, MD

Alec S. Koo, MD, FACS, managing partner, Skyline Urology, board of directors, Large Urology Group Practice Association (LUGPA), discusses degarelix (Firmagon) for the treatment of patients with prostate cancer.

Degarelix is an LHRH antagonist that, both functionally and theoretically, has advantages over agonists. It also suppresses testosterone levels quicker and more efficiently, Koo explains.

Usually, when patients begin on agonists, an initial flare occurs and testosterone levels take longer to drop, Koo says. Degarelix should be administered when patients first start on LHRH therapy.

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Alec S. Koo, MD, FACS, managing partner, Skyline Urology, board of directors, Large Urology Group Practice Association, discusses degarelix (Firmagon) for the treatment of patients with prostate cancer.

Dr. Koo on Degarelix for the Treatment of Prostate Cancer

Alec S. Koo, MD, FACS, managing partner, Skyline Urology, board of directors, Large Urology Group Practice Association (LUGPA), discusses targeted focal therapy for localized prostate cancer.

Focal therapy is a new concept that destroys small tumors while leaving the prostate intact and sparing most of the surrounding healthy tissue. It is intended to reduce the morbidity of treatment.

The efficacy of these treatments need to be proven over time, Koo says, and data will show in a number of years if cancer was missed in the areas left untreated.

Dr. Koo Discusses Focal Therapy for Prostate Cancer

Alec Koo, MD, FACS, managing partner, Skyline Urology, board of directors, Large Urology Group Practice Association, discusses results from a recent study on active surveillance in prostate cancer.

Koo explains one of the main issues in localized prostate cancer, which has potentially led to criticism of prostate specific antigen (PSA) testing, is that patients who are screened and diagnosed with the disease are over-treated.

Active surveillance should be implemented in patients who have recently been diagnosed or have low-risk for disease progression. Practitioners then weigh disease stage against patients' life expectancy and outlook on life, and have a shared decision-making process with patients regarding a treatment plan, Koo says. Active surveillance is most appropriate in patients who are classified with low-risk or very low-risk disease, he explains.

A recent study involving nine practices of 1900 patients over a 6-month period examined active surveillance rates. For the combined group of low-risk and very low-risk diseases, the active surveillance rate was 52% compared to previously reported active surveillance rates of 9% to 27%, Koo says.

Alec Koo, MD, FACS, managing partner, Skyline Urology, board of directors, LUGPA, discusses results from a recent study on active surveillance in prostate cancer.

Author | Alec S. Koo, MD

Articles

Dr. Koo on Degarelix for the Treatment of Prostate Cancer

Dr. Koo Discusses Focal Therapy for Prostate Cancer

Dr. Koo on Active Surveillance Rates in Prostate Cancer