Six big things in metastatic prostate cancer

[marnieg46]

Those members of the Fight Prostate Cancer hub of the HU site, who follow or intend to follow, the general standard of care currently in place in America and Australia might find Declan Murphy’s recent podcast of interest.  

Declan, from the Peter MacCallum Cancer Centre in Melbourne, has published extensively especially in the area of prostate cancer and is an internationally recognised key opinion leader in all aspects of PC. 

This podcast is centered around interviewing two GU oncology experts who recently visited Australia to do a lecture tour on hot topics in metastatic prostate cancer.  

Dr Tian Zhang from Southwestern in Dallas, and Dr Rahul Aggarwal from UCSF were asked by Declan to highlight and discuss three key areas in each of metastatic hormone sensitive prostate cancer and metastatic castrate resistant prostate cancer to help unpick the stream of data in these fast-moving areas.   

To quote Declan – ‘What areas did they chose to highlight?? Well have a listen!’ 

Note:  this podcast does not explore alternative treatment or non-treatment options that some may choose to follow but does outline the standard of care approach offered in many countries.

   youtu.be/ohSvuveq_-0(Not working as expected?)

[cujoe]

Ms M - Excellent presentation moderated by your friends and Ron's doc at PM. Delcan and Dr. Eapsen are the sort of docs that would make one want to the be treated at PeterMac. Too long a commute for most of us in the US, but perfect for Ron and for your new contributing role there.

The notion of PSMA scans 'correctly staging" PCa vs "restaging" is a very useful distinction and shows the value of PSMA use earlier in the diagnosis of disease state.

The discussion at the end about patient selection in clinical trials points out the problem for outliers - that they may be deprived of access to potential drugs with narrow efficacy profiles, because the drugs are never approved. (Due to that narrow efficacy - i.e.; only "blockbuster" drugs get approved and make it to market.)

It seems to reflect Siddhartha Mukherjee's Second Rule in his The Laws of Medicine: " 'Normals' teach us rules; 'outliers' teach us laws." . . . He goes on the say, "Every outlier represents an opportunity to refine our understanding of disease . . .rather than spending an enormous effort trying to figure out why a drug had commonly failed . . . try to understand why it had occasionally succeeded."

This is obviously an issue that Delcan is passionate about. He may well be an medical practitioner "outlier" himself.

Thanks for the link. All good info for PCa patients to take the time to review.

Ciao - K9

[marnieg46 in reply to cujoe]

Yes to all the points you raise cujoe.

We've been very fortunate in having access to Declan at important points along the journey. He's always very generous with his time even though he's not Ron's MO. In person he's just like he presents in the video. I thought you'd like the 'resstaging' distinction.

[NPfisherman]

Marnie,

I will add to K9 Terror's statements. A great video... some of their talking points mirrored my own thoughts and statements... They see Docetaxel being pushed back to a later state, and the standard being ARPI and ADT on diagnosis.... This makes total sense based on the CHECKMATE 650 trial results.. As I said to George71, the future of cancer therapy is immunotherapy... not taxane /chemotherapy...

They also talked about too many patients being started on ADT only and how that was leading to resistance... and let's not forget death...

Thanks for posting this interesting video with Peter Mac's Declan Murphy... a renown MD in Urology/Oncology and Ron's MO...

Dave

[marnieg46 in reply to NPfisherman]

Thanks Dave. Glad you found it of interest.

I often think back to 2019 when Ron first became metastatic with multiple mets and he was sent to a different hospital to be considered for a trial. Although he didn't qualify for the trial, in the report back to his urologist, the MO suggested he would benefit from double therapy. I often think back and wonder if his urologist had taken up the suggestion Ron might of had longer duration before becoming castrate resistant. Not sure if it was Renu or Declan who commented that once a person develops mets they should be referred by his urologist to a MO.

[d3is4me]

Marnie Thank you very much for this video. It is the most informative discussion I have seen since being DX, gives me 100% confidence in my decisions on doctors and treatments.

Ross

[marnieg46]

That's great Ross you found it helpful Yes I agree. Very comprehensive.

Coincidental but just a few minutes ago Ron asked how you were going but I hadn't checked with you in a while. Hope all still goes well.

[MateoBeach]

thanks Marnie. Very interesting discussion and valuable perspectives. Big hugs to you and Ron.