Dr. Nguyen on Treatment Considerations in High-Risk Prostate Cancer

Paul L. Nguyen, MD, senior physician and director of Genitourinary Clinical Center for Radiation Oncology at Dana-Farber Cancer Institute, as well as a professor of radiation oncology at Harvard Medical School, discusses treatment considerations in high-risk prostate cancer.

Patients with high-risk prostate cancer should be considered for radiation therapy plus a brachytherapy boost and 2 years of hormone therapy, Nguyen explains.

Patients who undergo a radical prostatectomy with unfavorable disease features should receive early salvage therapy without adjuvant therapy, Nguyen says.

In Nguyen’s practice, most patients with high-risk prostate cancer receive 6 months of hormone therapy plus salvage radiation.

However, for patients with favorable disease features such as pathologic T2 disease, a Gleason score of 7, a positive margin, and a very low prostate-specific antigen level, radiation therapy may be offered alone, as androgen deprivation therapy may provide little additive benefit, concludes Nguyen.