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BackTable / Urology / Podcast / Episode #93

Management of Advanced Prostate Cancer for the Urologist

with Dr. Rana McKay

On this episode of BackTable Urology, Dr. Aditya Bagrodia and Dr. Rana McKay, a medical oncologist at UC San Diego, discuss guidelines and advances in prostate cancer treatment.

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Management of Advanced Prostate Cancer for the Urologist with Dr. Rana McKay on the BackTable Urology Podcast)
Ep 93 Management of Advanced Prostate Cancer for the Urologist with Dr. Rana McKay
00:00 / 01:04

BackTable, LLC (Producer). (2023, April 19). Ep. 93 – Management of Advanced Prostate Cancer for the Urologist [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Rana McKay discusses Management of Advanced Prostate Cancer for the Urologist on the BackTable 93 Podcast

Dr. Rana McKay

Dr. Rana McKay is a medical oncologist and associate professor at UC San Diego Health in California.

Dr. Aditya Bagrodia discusses Management of Advanced Prostate Cancer for the Urologist on the BackTable 93 Podcast

Dr. Aditya Bagrodia

Dr. Aditya Bagrodia is an associate professor of urology and genitourinary oncology team leader at UC San Diego Health in California and adjunct professor of urology at UT Southwestern.

Synopsis

First, they define three types of prostate cancer. Metastatic castration-sensitive disease refers to patients with metastatic cancer who have low testosterone levels because of androgen deprivation therapy (ADT). Nonmetastatic castration-resistant disease is nonmetastatic cancer with testosterone levels unresponsive to ADT. This category is harder to define as the classification varies based on imaging modality. Finally, metastatic castration-resistant disease is the most lethal type of prostate cancer, as there is an unmet need in developing therapeutics for these patients. Traditionally, the castrate level is defined as a testosterone level <50 ng/dL.

Then, the doctors discuss different types of ADT, which include GnRH agonists, GnRH antagonists, and anti-androgen receptor medications. When explaining ADT to her patients, Dr. McKay always identifies the class of the agent and common side effects (i.e.- bone composition changes, metabolic changes, and mood and libido changes). Dr. McKay notes that she has observed many patients who have had success with ADT and shares lifestyle tips that she recommends to mitigate the side effects of ADT.

Next, the doctors summarize treatment options for different types of prostate cancer patients, including those with de novo metastatic prostate cancer, metastatic hormone sensitive disease, biochemically recurrent disease, and chemotherapy naive patients. In addition, they reflect on past landmark trials and current prospective trials about different combinations of therapies. They end the episode by discussing lutetium-177 as a new therapy for prostate cancer.

Resources

Veracyte Decipher Prostate Genomic Classifier
https://www.veracyte.com/diagnostics/prostate-cancer

Prostate Cancer Foundation
https://www.pcf.org/

Zero Prostate Cancer
https://zerocancer.org/

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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