Prostate Cancer - Episode 22

Additional Insights: Keeping Up With Advances in Prostate Cancer

November 19, 2019

EXPERT PERSPECTIVE VIRTUAL TUMOR BOARD

Leanne Schimke, CRNP, CUNP:When I first started, the only treatments we had were androgen deprivation therapy and chemotherapy. Since 2010, the world in prostate cancer has expanded, with all different medications in all different areas. And even with these 3 drugs, they keep getting new indications. Apalutamide is now also used in the metastatic hormone-sensitive space, in addition to the nonmetastatic castrate-resistant space. Enzalutamide is also now in nonmetastatic disease. Before, it was just in metastatic disease.

So we keep getting new indications for our drugs. The drugs keep prolonging patients’ lives. One of the biggest challenges for us now is actually, how do we sequence these medications to get the most benefit for our patients? Do we sequence them? Do we layer them? What is the best thing to do? What could maybe cause adverse effects for our patients, or actually harm them if we use them the wrong way? There’s research ongoing with that.

There’s a lot of hope in prostate cancer now because there’s a lot more time and length of life. However, I’ve also seen it go back to the 1980s because of PSA [prostate-specific antigen] screening. I’m seeing more men in their 50s coming in with metastatic hormone-sensitive prostate cancer who are presenting with back pain. They never had a rectal exam, or they never had a PSA test, or they were discouraged from having a PSA test despite having a family history of prostate cancer.

The other thing that’s great in prostate cancer now is genetics. We now know, along with breast cancer, thatBRCA1andBRCA2play a role in prostate cancer. So we’re looking at the family histories of our patients now. There are a lot of exciting things going on, and we have to try to keep up with everything.

Transcript edited for clarity.