Jason Efstathiou, MD, DPhil, defines oligometastatic prostate cancer and the impact advanced PET/CT imaging has had on the identification of this disease state. He reviews the data deliberating on treatment tailored for these patients in both the primary high-risk and recurrent settings.
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Abraham Morgentaler, MD, FACS, describes the phenomenon of testosterone flare following prostate cancer treatment with luteinizing hormone-releasing hormone (LHRH) agonists and argues that this flare does not necessarily cause disease progression. He also discusses the effects of testosterone therapy in patients with untreated prostate cancer.
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Jason A. Efstathiou, MD, DPhil, emphasizes the need for continued clinical trials to refine therapy options for high-risk and locally advanced prostate cancer patients. He reviews six major considerations regarding the current state of external beam radiation therapy (EBRT) for the treatment of high-risk disease.
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Adam S. Kibel, MD, argues that aggressive curative therapy is the best practice for the management of high-risk prostate cancer. He observes that local therapies like surgery, along with combination therapies like external beam radiation therapy plus brachytherapy and androgen deprivation therapy, have shown themselves to be effective for improving overall survival.
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Adam S. Kibel, MD, argues that the preponderance of evidence shows surgery outperforming radiation therapy when treating prostate cancer patients. He discusses the randomized data still needed to accurately compare these two treatments and multiple case series and a meta-analysis that favor surgery in terms of overall survival, as well as the benefit of surgery in terms of providing an opportunity for optimal staging and subsequent treatment.
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