International Prostate Cancer Update Archives

Anti-Androgen Trials

Posted by Daniel P. Petrylak, MD | Jun 2020

Daniel P. Petrylak, MD, Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center, gives an overview of the most important, recent anti-androgen trials, as well as those that are currently still underway. He highlights how the trials were conducted, what the researchers found, and what he feels is still missing from the research. Dr. Petrylak compares and contrasts the different studies and draws conclusions about each. He also goes over a couple of trials with novel anti-androgens with unique mechanisms of action, which are currently in phase 1, that are showing promise.

Panel on Androgen Deprivation Therapy: A Closer Review of the Cardiovascular Risk

Posted by Thomas E. Keane, MD | Jun 2020

Thomas E. Keane, MD, Professor and Chairman of the Department of Urology at the Medical University of South Carolina, Charleston, leads a panel discussion including Lawrence I. Karsh, MD, Peter J. Rossi, MD, and Neal D. Shore, MD, FACS, to discuss the process of treating prostate cancer in a patient who is at risk for cardiovascular disease and how extra care is needed in such cases. They also stress the importance of being in contact with a patient’s PCP even if one chooses to do their own assessment of patient risk, as well as when ADT should not be considered an option, such as in the case of a patient with significant CAD and elevated liver enzymes. The group, over the course of the panel, discuss the many ADT options available, including their strengths and weaknesses.

Multiparametric MRI for the Detection of Clinically Significant Prostate Cancer

Posted by Jelle Barentsz, MD, PhD | Jun 2020

Jelle Barentsz, MD, PhD, Professor of Radiology at the Nijmegen Medical Center of Radboud University in Nijmegen, The Netherlands, discusses the ins and outs of diagnosing clinically significant prostate cancer (csPC) using mpMRI. He goes on to discuss how to improve the diagnostic accuracy of mpMRI, including optimizing image acquisition, use of training sessions to refine the radiologist’s expertise and interpretation of results, as well as how to reduce systematic and random error associated with MRI-directed biopsy.

The Capacity of MRI to Predict Extracapsular Disease

Posted by Jelle Barentsz, MD, PhD | Jun 2020

Jelle Barentsz, MD, PhD, Professor of Radiology at the Nijmegen Medical Center of Radboud University in Nijmegen, The Netherlands, discusses the capacity of MRIs to predict extracapsular disease. He notes that this is not a perfect technology and it is not possible to predict with one hundred percent accuracy, but he emphasizes how it can be useful for staging. He also discusses when it is necessary to wait and how long to wait after a biopsy for a staging MRI. Lastly, he covers situations where it is not necessary to wait for an MRI.

Androgen Deprivation Therapy: A Closer Review of the Role of Anti-Androgens

Posted by Thomas E. Keane, MD | May 2020

Thomas E. Keane, MD, Professor and Chairman of the Department of Urology at the Medical University of South Carolina in Charleston, discusses the role of anti-androgens in androgen deprivation therapy (ADT). Dr. Keane looks at some studies out of Canada showing the ideal T levels during ADT, but goes on to point out that both the FDA and EU regulatory authorities do not follow these guidelines. He emphasizes throughout his talk why this is problematic and why doctors should be following the Canadian guidelines. He also goes over some of the adverse effects of ADT and emphasizes the increased risk for cardiovascular and liver disease. Dr. Keane goes on to discuss different clinical data that show how to address these risks.