Topic: Localized Disease

Hypofractionation for Prostate Cancer

Seth R. Blacksburg, MD, MBA, explains the rationale for hypofractionation for prostate cancer and reviews the modality’s biochemical control, toxicity, and cost-effectiveness through prospective and randomized trials. He also discusses stereotactic body radiation therapy (SBRT) as an alternative treatment option.

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Prostatectomy: What is the Future?

John F. Ward, MD, FACS discusses patient selection in definitive prostate cancer treatment and avoiding over and undertreatment. He then analyzes the impact of the evolving United States Preventive Services Task Force (USPSTF) recommendations for PSA screening on prostate cancer incidence, over and undertreatment, and amount of biopsies performed in urologic practice.

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Long-Term Outcomes of HDR

Juanita M. Crook, MD, FRCPC, reviews the radiobiologic rationale for high-dose-rate brachytherapy (HDR BT), its technical advantages, the evolution of HDR fractionation, and recent toxicity reports for both HDR BT boost and HDR BT monotherapy according to prescribed dose and fractionation.

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Minimizing Morbidity and Maximizing Outcomes with ADT

Laurence Klotz, MD, FRCSC, discusses causes of adverse effects of androgen deprivation therapy (ADT) treatment for prostate cancer and approaches to reducing these side effects. Specifically, Dr. Klotz advises physicians about patient counseling, prescribing innocuous drugs like bisphosphonates and metformin, targeting the adrenal pathway, and utilizing intermittent ADT.

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