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Dr. Samuelson on the Comorbidities that Affect Treatment Decisions in Prostate Cancer

Scott Samuelson, MD
Published: Tuesday, Aug 07, 2018



Scott Samuelson, MD, medical oncologist at Utah Cancer Specialists, discusses the comorbidities that may affect treatment decisions for patients with metastatic prostate cancer.

The frontline treatment of patients with metastatic prostate cancer typically includes a taxane-based chemotherapy with docetaxel or an androgen receptor–blocking agent, such as abiraterone acetate (Zytiga). However, there are associated comorbidities that can affect the decision whether to pursue one or the other, explains Samuelson.

Abiraterone is a very well-tolerated drug, but it has significant issues with high blood pressure, says Samuelson. That is a common problem, he explains. Enzalutamide (Xtandi) is also a great drug, but compared with abiraterone, it tends to have more fatigue issues. A lot of patients complain about that, says Samuelson.

With docetaxel, there is already preexisting neuropathy, and diabetes is fairly common in that population. Therefore, when trying to decide the initial therapy or subsequent therapy, Samuelson says that physicians should always look at a patient’s comorbidities.


Scott Samuelson, MD, medical oncologist at Utah Cancer Specialists, discusses the comorbidities that may affect treatment decisions for patients with metastatic prostate cancer.

The frontline treatment of patients with metastatic prostate cancer typically includes a taxane-based chemotherapy with docetaxel or an androgen receptor–blocking agent, such as abiraterone acetate (Zytiga). However, there are associated comorbidities that can affect the decision whether to pursue one or the other, explains Samuelson.

Abiraterone is a very well-tolerated drug, but it has significant issues with high blood pressure, says Samuelson. That is a common problem, he explains. Enzalutamide (Xtandi) is also a great drug, but compared with abiraterone, it tends to have more fatigue issues. A lot of patients complain about that, says Samuelson.

With docetaxel, there is already preexisting neuropathy, and diabetes is fairly common in that population. Therefore, when trying to decide the initial therapy or subsequent therapy, Samuelson says that physicians should always look at a patient’s comorbidities.

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