Tallahassee Archives

How to Best Select Doublet vs. Triplet Therapy in MCSPC

Posted by Scott B. Sellinger, MD | Dec 2024

Scott B. Sellinger, MD, FACS, addresses key considerations in deciding between doublet and triplet therapies for metastatic castration-sensitive prostate cancer.

In this 12-minute presentation, Dr. Sellinger highlights the superiority of androgen deprivation therapy (ADT) combined with androgen pathway inhibitors. He discusses evidence from pivotal trials, including TITAN, ARCHES, PEACE-1, and ARASENS, demonstrating that doublet and triplet therapies offer superior survival benefits compared to ADT alone.

Sellinger emphasizes that selecting between doublet and triplet therapy is both an art and a science, balancing clinical guidelines with patient-specific factors such as age, comorbidities, and access to treatment. While higher volume and symptomatic patients might benefit from more intensive triplet therapy, the importance of patient preference, PSA response, and cost considerations is underscored. He suggests that establishing clearer guidelines on doublet versus triplet therapy could help practitioners make more confident decisions for their patients in this nuanced field.

Molecular Targeted Imaging

Posted by Phillip J. Koo, MD | May 2024

Phillip J. Koo, MD, gives a high-level overview of the current state of molecular targeted imaging in identifying prostate cancer. Dr. Koo begins by establishing the sensitivity and accuracy of PSMA PET molecular targeted imaging at various PSA levels. He compares the efficacy of the four most commonly used commercially available agents in PSMA PET, noting that there is no data available that indicates one agent is superior to another.

Dr. Koo then delves into the sensitivity of different PSMA PET agents, including Gallium-68-PSMA-11 and Fluorine-18-DCFPyl. He highlights that imaging is not yet a reliable replacement for prostatectomy, using a few case studies as supporting evidence.

Dr. Koo concludes by reviewing the issue of biochemical recurrence and how it impacts disease management. He notes that molecular targeted imaging can detect recurrences in different sites in the body, and how current data may support a more aggressive treatment approach in the future.

Bone Health and Non-Cardiovascular Side Effects of ADT

Posted by Scott B. Sellinger, MD | May 2024

Scott B. Sellinger, MD, FACS, addresses ADT’s impact on bone health and other non-cardiovascular side effects of the therapy. He begins by noting that men on ADT are at significant risk of bone fracture, and reviewing the mechanisms behind the increased bone loss and fracture risk in these patients.

Dr. Sellinger presents best practices for assessing and treating patients with increased risk of fracture. He discusses lifestyle interventions, vitamin supplements, and other therapies to prevent bone loss.

Dr. Sellinger concludes by touching on non-cardiovascular side effects of ADT. He discusses best practices for combatting declines in mental, physical, and sexual health that result from ADT.

Burning Questions and Controversies in the Management of Advanced Prostate Cancer Patients

Posted by Scott B. Sellinger, MD | Jul 2022

Scott B. Sellinger, MD, President of Advanced Urology Institute and a Partner at Southeastern Urological Center in Tallahassee, Florida, breaks down treatment groups for advanced prostate cancer and details therapeutic options for each, including additional therapeutic options beyond androgen deprivation therapy such as ARIs, APIs, and PARP inhibitors.

A Value-Based Health Care Model and PCa

Posted by Scott B. Sellinger, MD | Apr 2018

Scott B. Sellinger, MD, FACS, explains how the constantly evolving Medicare Access and CHIP Reauthorization Act (MACRA) affects Medicare payments to urologists, and how urologists can participate in the Merit-based Incentive Payment System (MIPS). He also discusses the Large Urology Group Practice Association’s (LUGPA’s) efforts to develop urology-specific advanced alternative payment models (AMPs).