Podcast #332 · 29 Sept 2026
The Basics of Advanced Prostate Cancer Management for Urologists
- Radiation Oncology
- Prostate Cancer
- Medical Oncology
- Prostate-Specific Membrane Antigen PET (PSMA PET)
- Androgen Deprivation Therapy (ADT)
- Urologic Oncology
- Urology
- Radioligand Therapy
- Oligometastatic Disease
- Biochemical Recurrence (BCR)
- Metastatic Castration-Resistant Prostate Cancer (mCRPC)
- Germline Testing
What does a urologist actually need to know to confidently manage advanced prostate cancer in the clinic? On this episode of BackTable Urology, host Dr. Ruchika Talwar interviews Dr. Kristen Scarpato, director of the advanced prostate cancer clinic at Vanderbilt University Medical Center, and Dr. Jason Hafron, chief medical officer of the Michigan Institute of Urology. They break down how the landscape has shifted, why more patients stay in urology for treatment, and how to select and monitor therapy based on disease state, comorbidities, and patient goals.
This podcast is supported by
Timestamps
Resources
- Advanced Prostate Cancer: AUA/SUO Guideline
- Trial Design and Objectives for Patients With Prostate Cancer: Recommendations From the Prostate Cancer Working Group 4 (JCO)
- ARACOG (AFT-47): Darolutamide vs Enzalutamide and Cognitive Function, ClinicalTrials.gov NCT04335682
- ARASENS: Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer (NEJM)
- PSMAddition: 177Lu-PSMA-617 Plus Standard of Care in mHSPC, ClinicalTrials.gov NCT04720157
- Medicare Plan Finder, referenced on air for comparing Part D out-of-pocket drug costs
More about this episode
The discussion covers sorting therapies by disease state rather than drug class, doublet and triplet intensification, the nuances of choosing between abiraterone, enzalutamide, apalutamide, and darolutamide, and Dr. Hafron’s “four Ps” framework for drug selection. Dr. Scarpato addresses financial toxicity, surveillance protocols, and red flag symptoms. Both guests share their referral triggers for medical oncology, approaches for oligometastatic disease and metastasis-directed therapy, and practical tips for running an advanced prostate cancer clinic.