Join Philip Kantoff, MD, and Paul Nguyen, MD, as they present their multidisciplinary expertise on a range of cases pertaining to prostate cancer.

New evidence from multiple clinical trials may impact management of prostate cancer across the disease spectrum. For low-risk local tumors, Wilt et al reported similar survival in men randomized to surgery or observation, adding to the ongoing debate on the management of early tumors detected by PSA testing. With a median follow-up of 10 years, a phase III intergroup trial confirmed a significant survival advantage of adding radiation to androgen deprivation therapy in patients with locally advanced prostate cancer.  

For metastatic disease, a phase III randomized intergroup study found that the popular approach of intermittent hormone therapy shortens survival compared to continuous therapy. In addition to its approved use in the post-docetaxel setting, abiraterone acetate is also associated with favorable survival in chemotherapy-naïve patients in a new phase III study. Other therapies that have been approved based on randomized phase III data include sipuleucel-T, cabazitaxel, and denosumab. New agents continue to produce encouraging results in the treatment of castration-recurrent prostate cancer. Both the anti-androgen enzalutamide and radioactive agent alpharadin demonstrated improved survival in randomized clinical trials.

Oncologists, oncology nurses, and other clinicians who manage patients with prostate cancer face challenges in identifying the appropriate combination and sequence of treatments for all stages of prostate cancer. In patients with prostate cancer, the risk assessment status needs to be known, as well as the previous treatment history, prior to deciding on a treatment for the patient. It is increasingly critical for physicians to learn how to balance the risk of recurrence and the potential side effects of active treatment to guide patients in making informed, individualized decisions. Additionally, cryotherapy should be discussed with patients to determine most effective and appropriate use.