Challenging Cases in Advanced Prostate Cancer- mHSPC

E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, discusses plans of action and best practices for challenging cases in advanced prostate cancer with an experienced panel. He stresses the importance of openly discussing medical options with a patient when it comes to screening, and also emphasizes that once the diagnosis is known, more screening may not be necessary. One of the discussants, Neal Shore, MD, adds that ADT monotherapy could be considered malpractice in certain cases as couplet therapy has been shown to be the new standard of care. The panel also details how the STAMPEDE trial shows that cases with a high metastatic burden don’t benefit much from radiation and demonstrates the importance of monitoring the side effects of ADT in patients, especially in regard to cardiovascular disease. They then discuss differences in treatment between Japan and the United States.