Choosing the Optimal Treatment for Patients With Prostate Cancer

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Nasir Chaudry, MD, discusses treatment decisions for patients with prostate cancer and the importance of individualized treatment based on the specific case and patient preferences.

Nasir Chaudry, MD, Allegheny Health Network, discusses treatment decisions for patients with prostate cancer and the importance of individualized treatment based on the specific case and patient preferences.

Transcription:

0:09 | It's always important first, basically be able to establish whether the patient has organ confined disease or not organ confined disease. One of the changes that we have seen in the last year, year and a half, is the change in how you do basically a staging workup. In the past, CT bone scan used to be the standard. Now, we are looking at the recent NCCN guideline changes. Everyone should be undergoing PSMA scan with basically intermediate-risk disease. I think that's kind of the first step in the process.

0:49 | All this is assuming someone has intermediate- or high-risk disease.I think it's been well established for low-risk prostate cancer that the standard of care is observation. There are things that can change that, but that's usually the mainstay.

1:10 | When you're considering treatment for patients, it's best to kind of give them a realistic viewpoint of what each of the therapies will accomplish. Give them a realistic estimate on cure rates, and mainly the [adverse] effect profile. When you're looking at radiation vs surgery, they are both very ontologically sound treatments, and they're usually going to give fairly good cure rate. Obviously cure rates do depend on whether they're intermediate-risk, whether they're high-risk disease, but you're never wrong going with each of the therapy. The big distinction between them is what [adverse] effect profile the patient's willing to undergo, and also looking at the realistic life expectancy of the patient. In general, younger patients tend to go more towards surgery, and for older patients, [we’d] generally encourage them more to go toward radiation. Obviously, these are not steadfast rules, but they are the kind of the general trends.

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