Boston Archives

The Importance of Diagnosing and Treating Oligometastatic Prostate Cancer and ADT Usage

Posted by Marc B. Garnick, MD | Jun 2024

Dr. Marc Garnick explores the diagnosis and treatment of oligometastatic prostate cancer with the strategic use of androgen deprivation therapy (ADT). Advanced imaging techniques are essential for identifying oligometastatic disease, such as PET scans and advanced MRI. These technologies enhance the precision of detecting small metastatic lesions, facilitating timely and appropriate treatment decisions. By reducing androgen levels that fuel prostate cancer growth, the strategic use of ADT not only helps in controlling the primary tumor but also in managing metastatic lesions, thereby extending the therapeutic window and improving overall survival rates.
Dr. Garnick also addresses the timing and duration of ADT in the context of oligometastatic prostate cancer. He highlights individualized treatment plans based on patient-specific factors, including the extent of disease, patient health status, and response to initial therapies. This personalized approach ensures that patients receive the most effective treatment while minimizing potential side effects associated with prolonged ADT usage.

Convergent Therapeutics: Next-Generation Targeted Radiotherapies

Posted by Philip Kantoff, MD | Jun 2024

Philip Kantoff, MD, explores the advancements in targeted radiotherapies, emphasizing their potential to revolutionize prostate cancer treatment. He introduces next-generation targeted radiotherapies, such as radioligand therapy, which utilize molecules designed to bind specifically to cancer cell markers, delivering lethal doses of radiation directly to the tumor cells. This approach minimizes damage to surrounding healthy tissues, a limitation of traditional radiotherapy.

Dr. Kantoff highlights convergent therapeutics, which combines targeted radiotherapy with other treatment modalities, including immunotherapy and conventional chemotherapy. Kantoff also addresses the challenges of implementing these advanced therapies in clinical practice.

New Spacer Technology for Prostate Cancer Radiation Therapy

Posted by Peter F. Orio III, DO, MS | Oct 2023

Peter F. Orio III, DO, MS, discusses the critical role of rectal spacing in reducing the toxicity associated with radiation therapies in the treatment of prostate cancer. While not yet FDA approved, Dr. Orio reviews several pivotal trials on SpaceOAR and Barrigel which support the use of rectal spacing technology in prostate cancer treatment.

Dr. Orio underscores the role of rectal spacing technology in a patient-centric approach to cancer care. Throughout his presentation, Dr. Orio focuses on the mechanisms behind rectal spacing technology which preserve patient quality of life more effectively than traditional approaches when done correctly.

Dr. Orio then reviews the weaknesses and dangers of rectal spacer technology and analyzes reports in the FDA MAUDE database for SpaceOAR Classic, SpaceOAR Vue, and Barrigel. He cautions physicians and surgeons to know their own skill-level and to always choose the safety of the patient.

NIH NCI Study on Focal Therapy

Posted by Faina Shtern, MD | Sep 2023

Faina Shtern, MD, presents a review of image-guided focal therapy in diagnosing and treating localized prostate cancer. Dr. Shtern examines the benefits of minimally-invasive, image-guided focal therapy combined with radiogenomics using studies from the National Institutes of Health and the National Cancer Institute.

Dr. Shtern discusses the importance of using radiogenomics, a combination of MRI and genetic cancer profiling, in diagnosing localized prostate cancer, as some prostate cancer lesions may not appear on an MRI alone. Using radiogenomics in patient diagnosis can help practitioners determine the appropriateness of image-guided focal therapy as a treatment, and provides a comprehensive picture for monitoring the patient post-treatment.

Treatment of Localized Disease

Posted by Peter F. Orio III, DO, MS | Sep 2023

Peter F. Orio III, DO, MS, discusses the treatment of localized prostate cancer, with emphasis on maximizing the value for the patient. Dr. Orio explains Michael Porter’s equation for determining patient value: patient-relevant outcomes, divided by the cost to achieve the outcomes.

Dr. Orio then reviews the benefits and limitations of common treatments for prostate cancer, including:

External Beam Radiation Therapy with and without Androgen Deprivation Therapy
Brachytherapy
Radical Prostatectomy with and without Pelvic Lymph Node Dissection
Focal Therapies

Dr. Orio concludes by emphasizing that the goal of treatment is to cure the patient and avoid reducing QoL as much as possible. As long as the physician keeps that goal top of mind, the journey to remission will be different for every patient