Topic: Advanced Disease

Is Focal Ablation of Prostate Cancer Ready for Prime Time?

Herbert Lepor, MD, defines focal ablation and its quality of life, oncological, and cost benefits to patients. He then discusses best practices for the procedure, including optimal patient selection, energy source options, and extent of the ablation zone. Furthermore, he explains the research and improvement needed to make focal ablation of prostate cancer ready for prime time.

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M0 Space and The SPARTAN Trial

Matthew E. Nielsen, MD, MS, discusses the challenge asymptomatic microscopic hematuria (AMH) poses in our urologic practices. He summarizes the evolution of guidelines for evaluating hematuria and trade-offs in benefit, harm, and cost of different diagnostic approaches.

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Advanced Disease — A Real Need for Understanding and Shared Care

Daniel P. Petrylak, MD, stresses the importance of taking a multidisciplinary approach when treating prostate cancer. Not only does this mean involving urologists, oncologists, and primary care physicians for better access to therapies and coordination of care, but also involving nutritionist, mental health professionals, and pain management experts for maintaining patients’ quality of life.

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Integrating the AUA Guidelines into Your Practice

Michael S. Cookson, MD, MMHC, describes how urologists can use American Urological Association (AUA) guidelines to better manage metastatic castration resistant prostate cancer (mCRPC) patients. He stresses the importance of urologists serving as the primary caregiver, the multidisciplinary care model, and organized sequencing of treatments and therapeutics.

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Immunotherapy 101 for the Urologist

Raoul S. Concepcion, MD, summarizes the mechanism of action behind the immune response to cancer. He also provides an update on the current and emerging immunotherapies for cancer treatment, including vaccines, checkpoint inhibitors, CAR T-cell therapies, viral vectors, and adoptive cell therapy.

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Timing of ADT and Chemotherapy

Thomas E. Keane, MD, explains how the current prostate cancer treatment paradigm is evolving. He discusses the optimal timing of androgen deprivation therapy (ADT), and how moving it upfront, even in a castrate sensitive setting, could benefit patients, but potentially hinder responsiveness to second-line therapies.

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