Timing of initiation of ADT for men with biochemical progression after first-line surgery

For many years your sitemaster has been advising patients that overly early use of androgen deprivation therapy (ADT) in many men with progressive prostate cancer is not necessarily the best decision (for a number of possible reasons). … READ MORE …

Long-term adjuvant ADT improves results of brachy-boost therapy in unfavorable-risk prostate cancer patients

TROG 01.03 RADAR, begun in 2003, was a (partly) randomized clinical trial to help optimize therapy of unfavorable-risk patients. … READ MORE …

The importance of 3 weeks … before starting docetaxel along with ADT

A new study in BJU International has shown the importance of waiting at least 3 weeks after initiation of androgen deprivation therapy (ADT) until initiation of docetaxel chemotherapy in the treatment of men with newly diagnosed, metastatic, hormone-sensitive prostate cancer (mHSPC). … READ MORE …

High-risk patients get conflicting messages from radiation oncologists and urologists after first-line surgical treatment

In spite of data suggesting that brachy boost has better outcomes for high-risk patients, it is being utilized less often and surgery is being utilized more often. … READ MORE …

Very early salvage radiation has up to fourfold better outcomes and saves lives

Another subject that has come up a lot recently is when to have salvage radiation. It is always a pressing decision for those 30 percent of prostatectomy patients who have detectable PSA after prostatectomy. … READ MORE …

How early salvage radiation therapy can be used to prevent metastases and save lives

Several clinical trials have established that adjuvant radiation reduces the risk of biochemical recurrence, but only one trial looked at and demonstrated an improvement in metastasis-free survival and prostate cancer-specific survival. … READ MORE …

New immunotherapeutics aren’t working well when combined with standard forms of care

A newly published article in the journal Science Translational Medicine has questioned the merits of treating prostate cancer patients with immunotherapies while they are simultaneously being treated with medical forms of castration (androgen deprivation therapy or ADT), chemotherapy, and/or radiation therapy. … READ MORE …

When to start doing Kegel exercises for the best effect after surgery

For many years now, The “New” Prostate Cancer InfoLink has argued (on the basis of no good data at all) that starting to do Kegel exercises prior to having surgery for prostate cancer was likely to be able to accelerate recovery of good continence after one’s surgery. … READ MORE …

Other items from the annual meeting of the AUA

A combination of travel and other commitments made it difficult for your sitemaster to complete his summaries of significant information presented at this year’s annual meeting of the American Urological Association (AUA), so here’s the final wrap-up. … READ MORE …

“Psychosocial interventions in prostate cancer offer limited benefits”

The heading above is the title of a Reuters-generated article on the Medcape Oncology web site. The article is based on a new review article just published in BJU International. … READ MORE …

Side effects of salvage radiation — difficult to draw conclusions based on database analyses

Two analyses of Italian and US databases have investigated whether delaying initiation of radiation therapy could diminish the side effects of radiation after prostatectomy. The conventional wisdom is that waiting longer allows the newly cut tissues more time to heal completely before the onslaught of radiation. … READ MORE …

Low detectable PSA after prostatectomy – watch or treat?

In a previous article, we looked at evidence that a low detectable level of PSA predicts eventual biochemical recurrence (a confirmed PSA greater than 0.2 ng/ml) when there is aggressive pathology. … READ MORE …

When should the patient and doctor consider salvage radiation therapy?

Patients and their doctors often have to make a critical decision soon after surgery – at what point after surgery, if at all, should salvage radiation therapy be started? … READ MORE …

Re-thinking the application of hormone therapy

There has long been discussion about the appropriate and inappropriate uses of androgen deprivation therapy (ADT) in the management of progressive prostate cancer. The “New” Prostate Cancer InfoLink has regularly commented on the inherent dangers of using ADT to “manage PSA levels” as opposed to managing a patient’s actual clinical condition. … READ MORE …

Timing of salvage hormone therapy when radiotherapy has failed

The question of when one should initiate hormone therapy in a man who has a rising PSA after radiation therapy has long been a topic of controversy. And a reanalysis of data from RTOG 85-31 has not helped to give us a definitive answer. … READ MORE …