Who should take the lead when managing metastatic prostate cancer?
The treatment landscape for men with metastatic prostate cancer is continuously evolving. Therapeutic options are no longer limited to surgical/medical castration, followed by additional hormone-based therapies with no proven survival benefit. A host of treatments are now available, ranging from cytotoxics, through novel androgen-axis targeted treatments, to radionuclide therapies. All these therapeutic options have benefits relating to overall survival and quality of life. Oncologists have extensive experience delivering these newer treatments, having participated in the initial studies, and having had subsequent access to these agents via the National Cancer Drugs Fund. However, now that these agents are available for their licensed indications with minimal restrictions, should urologists also prescribe them? How should the multidisciplinary team now approach the management of metastatic prostate cancer? Will the recently published results for the abiraterone plus prednisolone arm in STAMPEDE (in the metastatic castration sensitive setting) change our multidisciplinary approach, as patients may soon be receiving upfront abiraterone rather than docetaxel?
Our article in Trends in Urology & Men’s Health contains a survey of UK urologists and oncologists about their current and potential roles in the management of metastatic prostate cancer in the context of the rapid expansion in therapeutic options. Read the article here.
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