Ep. 332 The Basics of Advanced Prostate Cancer Management for Urologists with Dr. Kristen Scarpato and Dr. Jason Hafron
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How can urologists confidently manage advanced prostate cancer?
This week on the Back Table Podcast.
So it has to prolong survival. So the first piece prolong survival. Second is preserve quality of life. Three is prevent complications like skeletal-related events or any of the side effects of the cancer. And then it's patient preference. And I think what Kristen said is really important is that you have to have that discussion with the patient, you know, going through what they essentially Prioritize. You know, if they're prioritizing cognitive or they have it in a cognitive position, you might lean one way or the other. If they have cognitive deficits, you might lean one way or the other. But I I think it's the there's a lot of nuance here, and I think it's just nuancing it to what the patient wants.
But if you follow the four Ps and keep it as simple as possible with urologists, I think you can really land on the right drug.
Hi everyone, welcome to Backtable Urology. As always, my name is Rujika Talwar. I'm a urologic oncologist in Nashville, Tennessee. Today I'm thrilled to be joined by two of my peers and we're gonna be tackling a topic that I think people either love or hate. And that is advanced prostate cancer for the urologist. And we're really gonna try to center this discussion on practical treatment strategies because for some, they found a really good way of integrating this into urology workflows and the urology clinic. And others say it really feels daunting and overwhelming. So today I have two experts who have certainly mastered this area and I think are gonna bring really good insights. To our discussion. First, I have Dr.
Kristen Scarpado. She's an associate professor of urology at Vanderbilt Urology, and she's director of our Advanced Prostate Cancer Clinic. Next, I have Jason Haffron, who is CMO of Michigan Institute of Urology. Thanks so much to you both for spending some time to chat with me today.
Thanks for having. Thanks
so much for having us.
Yeah.
And so, you know, just setting the stage here. Historically, many urologists have diagnosed metastatic disease, but don't necessarily feel comfortable managing it. These patients often have their initial biopsy, maybe PSA, PSMA PET scan with a urologist, and then end up getting referred out to medical oncology.
Why are more patients with advanced prostate cancer staying in urology care?
Now we're seeing more and more of these patients stay within the urology practices. So I wanna ask each of you, Kristen. I'll ask you first, why do you think this paradigm has shifted?
It's a great question and this is one of my many soap boxes, but allow me just a a moment here. Many of these patients start in urology and there's so much more that we can offer beyond ADT or hormone therapy for our patients and Here in the States, many patients have uh often progressed through other forms of treatment and have ongoing urologic needs. And so I think it really makes sense if there's an opportunity to continue to care for patients within urology. It is totally in the scope of our practice, I would say within reason. And that speaks to the collaboration that is necessary with radiation oncologists and Medical oncologists, but I don't think we should fear genetic testing or managing the side effects of hormones.
And now we have these newer oral agents that we'll talk about that don't require necessarily as intensive follow-up as chemotherapy or some other drugs that we typically think of as only being for medical oncologists. Oncologists. So I think with the landscape changing, with our understanding of prostate cancer and genetics, and with the meaningful relationships that we've formed with our patients, it really makes sense, I think, to keep these patients in urology or collaborate closely with our colleagues in medical oncology. Jason, what about you? What are your thoughts? Thoughts.
Yeah, it's been exciting. You know, when I started in urology, I never thought I'd be doing advanced prostate cancer. I came out and thought I would just do robots and take out prostates. But after a while, you know, we're always looking for new challenges or new opportunities to be intellectually stimulated.
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Chapters
8 chapters
1
How can urologists confidently manage advanced prostate cancer?
0:05–2:29
2
Why are more patients with advanced prostate cancer staying in urology care?
2:29–7:29
3
How should advanced prostate cancer treatments be matched to disease stage?
7:29–10:40
4
When should urologists use doublet or triplet therapy for prostate cancer?
10:40–18:51
5
How do you choose an ARPI based on side effects and patient goals?
18:51–26:50
6
How can clinicians reduce financial toxicity from prostate cancer treatment?
26:50–30:47
7
What labs, imaging, and symptoms should urologists monitor during treatment?
30:47–42:44
8
What are the future directions for oligometastatic prostate cancer care?
42:44–47:56
Speakers
1 identifiedMore from BackTable Urology
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