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Urologists need to be more actively engaged in the identification and prevention of skeletal-related events (SREs) for patients with metastatic prostate cancer. Additionally, the ability to effectively treat SREs emphasizes the importance of identifying metastases earlier with PSA doubling or bone scans.
Paul R. Sieber, MD, believes that many physicians underestimate SREs and that further education is needed. Recent trials have discovered that bone metastases occur in nearly a quarter of patients with early prostate cancer who were previously thought to not experience SREs. To help detect metastatic disease earlier, Sieber's practice has started to incorporated sodium fluoride PET bone scans.
To prevent SREs, Mark S. Austenfeld, MD, and Neal D. Shore, MD, believe urologists need to be more proactive and involved in maintaining bone health. Austenfeld promotes the use of calcium, vitamin D, exercise, and pharmacological intervention using Prolia (denosumab).
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