Tag Archive for: Radium-223

How Has Advanced Prostate Cancer Treatment Evolved?

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How Has Advanced Prostate Cancer Treatment Evolved? from Patient Empowerment Network on Vimeo.

How has the advanced prostate cancer research landscape evolved? Expert Dr. Rana McKay discusses how prostate cancer treatment options have expanded and how PSMA PET imaging has revolutionized detection.

Dr. Rana McKay is an associate clinical professor of medicine at Moores Cancer Center at UC San Diego Health. Learn more about Dr. McKay.

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Transcript:

Katherine:

Dr. McKay, I’d like to have you tell us how the landscape of advanced prostate cancer has changed over your career.  

Dr. McKay:

Oh, my goodness. It has absolutely rapidly evolved over the last decade. I think when I was just starting my career, it was right around the time where abiraterone (Zytiga) and enzalutamide (Xtandi) were being heavily tested and just getting approved and entering into the clinic.

And as we think about all of the evolution that’s happened since that time, we now have multiple androgen receptor pathway inhibitors in the clinic. We have radioligand therapies in the clinic, radium-223. The first radioligand therapy across any solid tumor malignancy to improve overall survival and on the heels of that, most recently, lutetium PSMA, which is a targeted radioligand therapy.

There are several different kinds of chemotherapies, and I think two more diagnostics have evolved. We are now integrating molecular profiling across multiple areas in the disease natural history and actually have several FDA-approved treatments based off of results of molecular profiling, whether that be germline hereditary testing or just tumor testing like, PARP inhibitors and immunotherapy.

And then, additionally, to kind of continue on that same thought of our diagnostics changing is one of the greatest disruptors in our treatment of prostate cancer has been the introduction of PSMA PET imaging that has really revolutionized our ability to be able to detect disease at lower levels of PSA.   

And that’s opened up options for focal therapy, radiation therapy, and other sorts of strategies. So, it’s really been just remarkable, all of the different advances that have occurred in prostate cancer over the last decade. 

Strategies for Treating Advanced Prostate Cancer Symptoms

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Strategies for Treating Advanced Prostate Cancer Symptoms from Patient Empowerment Network on Vimeo.

What are strategies for treating advanced prostate cancer symptoms? Expert Dr. Tanya Dorff reviews approaches to protect bones and options for managing sexual dysfunction symptoms.

Dr. Tanya Dorff is Associate Professor in the Department of Medical Oncology & Therapeutics Research at City of Hope. Learn more about Dr. Dorff.
 

Related Resources:

What Is Advanced Prostate Cancer?

 Understanding Advanced Prostate Cancer Treatment Approaches

 Managing the Side Effects of Advanced Prostate Cancer Treatment

Transcript:

Katherine:

That’s really promising. What about treating symptoms of the disease itself, like bone pain?  

Dr. Dorff:

Bone metastases are the predominant pattern of spread, and so, what really drives the story for a lot of our prostate cancer patients during their journey with cancer has to do with bone complications – not always pain, but unfortunately, there can be pain pretty frequently. 

So, we start by trying to protect the bones early on. We know that when we use our hormonal therapies, osteoporosis can develop, so we want to avoid that. I’ve had patients where their cancer was well-controlled, but they had an osteoporosis fracture that they were miserable from, so it starts at the beginning, at protecting the bones, checking a bone density scan and/or using a bone-supportive agent like zoledronic acid (Zometa) or denosumab (Xgeva), and then, in the metastatic setting, as the disease progresses, we intensify that use of bone-supportive agents. 

We sometimes end up using radiation therapy, which is primarily external-beam traditional kind of radiation, but there is also the radiopharmaceutical Radium-223 (Xofigo), which delivers the radiation kind of more internally through the bloodstream to areas of the bone that are active from the prostate cancer, and sometimes we end up needing something even like surgery, but the bones are a major part of the story.  

Katherine:

Yeah. What about sexual dysfunction? Are there approaches that can help?  

Dr. Dorff:

So, this is generally an area that’s managed more by urology. There definitely are things that urologists do to help patients who have lost sexual function due to prostate cancer treatments. They can involve medicines, they can involve slightly more invasive things like a suppository or an intracavernosal injection. There are also more mechanical ways, like a pump device or a penile implant, but generally, anything beyond the first level, which is Viagra, will be handled more by a urologist than a medical oncologist.