Future Directions in Treating Advanced Prostate Cancer


Raoul S. Concepcion, MD, FACS: This has been an excellent discussion. I really appreciate all of the input. I’d like to ask each of the panelists for any additional insight regarding the diagnosis and management of advanced prostate cancer. Dr. Shore, do you have any final thoughts?

Neal D. Shore, MD, FACS: Well, first, thank you, Raoul, for allowing me to participate in the panel, and thank you to the OncLive® team—great job, as always. There’s a lot of tremendous new information in diagnosis and management, as we’ve discussed. I think the point that strikes me is, it’s complicated now. It’s not like it was when I finished residency, let alone when I was in medical school. For the urologist, the radiation oncologist, and the medical oncologist in the community, I think there are 2 things worth contemplating. The first is that you’ve got to really be dedicated to this space, now, to do what’s in the best interest for your patients. And that seems to be a very hackneyed, simplified thing to say, but this disease is pretty complicated and is getting more complicated with all of the data that are out there.

The notion that I have to keep harping on to our colleagues, especially in urology, is, specialization, subspecialization, and collaboration—especially if you’re in a large group or you have a lot of folks who you work with. The same would be true for medical oncology and radiation oncology. It really does take dedication to keep up with this literature, because there’s just more and more of it coming. That’s the challenge. The good news is, we’re doing much better for our patients. They’re living longer, staying out of the emergency room, staying out of the hospital, and maintaining quality of life.

Raoul S. Concepcion, MD, FACS: Great. Mike?

Michael A. Carducci, MD, FACP: In many ways, I am echoing the same things. We have more questions than answers. And so, we really just have to watch a lot of the trends and, in many ways, stick to your guns, but also be an early adapter for some of these changes. We’ve already talked a little bit today about the tendency with more high-risk oligometastatic disease to be more aggressive. Is that a trend, or is that the right thing to be doing for more advanced disease? I still think there are so many questions, and clinical trials remain a focus for research centers like ours. But I think out in the community, where the real management goes on, we’ve really got to get folks on trials.

Raoul S. Concepcion, MD, FACS: Evan?

Evan Y. Yu, MD: There are many points that one could talk about, but I’d emphasize the point that this is something we can do now—all of us can take a better family history. It’s something that we can alter now, and it’s a little bit of a different take because it’s not just about the implications for the patient—potential therapeutic implications, prognostic implications, etc. It has implications, potentially, for family members of the patients. We always want to—when we can, in oncology—cure cancer. If we can’t, we want to at least extend survival and improve quality of life. This is an opportunity where we might be able to prevent cancers—get it before it even starts by identifying patients and families that are at high-risk.

Raoul S. Concepcion, MD, FACS: Well said. Glen?

Glen Gejerman, MD, DABR: This is a rewarding time to be dealing with patients with castration-resistant disease. It’s a lethal disease, and we’re gaining new tools. As the trials complete and we learn more about imaging and how to combine the therapies, if we continue to work in a collaborative fashion, we’re going to have a lot more to offer our patients.

Raoul S. Concepcion, MD, FACS: Perfect. On behalf of our entire panel, we’d like to thank you for joining us and we hope you found this Peer Exchange® to be useful and informative. Again, many thanks.

Transcript Edited for Clarity

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