Video - Treatment options for Metastatic Prostate Cancer

[Barree]

While this link is for treatment of OligoMetastatic disease it also contains a refreshing approach to ongoing  treatment of Advanced metastatic disease - worth a look.

OligoMetastatic Prostate Cancer Disease with Dr. Eugene Kwon from the Mayo Clinic.

Just click on the link or copy and paste it into your browser

https://www.youtube.com/watch?feature=player_embedded&v=NkqizmvqJPo

 

 

[Paul Edwards]

This video is of the talk that Dr Kwon gave at the 2014 PCRI Conference.

 

Dr Kwon was a speaker at this year's PCRI Conference on "The Revolution in Prostate Cancer Imaging". For my money, his talk was one of the highlights of the 2016 Conference.

 

[Tony Sheehan]

This is  a good  presentation and I totally agree with Dr Kwon's opinion at the end.

My question is who offers this type of treatment in Australia? 

[Barree]

So do I Tony, I only wish I had an answer to your question. At this point in time I don't know of anyone in Australia using this approach to treatment.  However, I am intending to discuss this matter with an oncologist I have consulted previously  -  and my subsequent enquires have revealed, has the necessary multifaceted attributes together with access to the range of treatment facilities necessary - to offer this type of treatment. Hopefully (if he considers it appropriate) he will be prepared to take me on and approach my ongoing treatment in this manner. Time alone will tell, he might nicely tell me to get lost, but it's worth a try.

[Popeye]

Tony: I agree this is a must watch presentation for patients. I found it inspirational and relevant to where I might be heading. In answer to your question " Who offers this type of treatment?" I can give you an explanation of where I am heading which might be an answer for you. After diagnosis in 2012 I had radiation and ADT as my primary treatments, this was followed by radiation damage to the bladder and recurrence of active PCA in the remains of the prostate, prostate bed and bladder neck. I underwent salvage surgery with an RP and bladder removal including lymph nodes in November 2014. My PSA in March 2014 was stable at 0.008 and I ceased the ADT injections. My PSA remained at 0.008 even through the period of my surgery until July 2015 when it started to rise with a doubling rate of approx. 4 months. My last PSA was at the end of August and was 0.11. I have just met with my urologist who has convinced me to wait another 6 months and then we will do a PSMA PET scan to ascertain where the active PCA may be. His thinking is that this new type of scan can pinpoint smaller tumours more accurately than previous scan equipment. However experience indicates that the PSMA PET scan is invaluable with PSA levels of at least 0.2. He is confident that depending where the scan detects any active cancer cells we might be able to treat these with stereotactic radiotherapy in the first instance. I have just met with the radiation oncologist yesterday and he is in agreement also. Interestingly he made a comment that there has been a steady increase in the use of stereotactic radiotherapy for this type of treatment recently.

 

Much of what I saw and heard in this presentation seemed to apply to me on a personal level. I am hoping that the targeting of any PCA for me will be able to be done by the radiotherapy but I will have to wait and see. I am not looking forward to restating ADT nor other drugs if necessary I guess only time will tell. 

[Paul Edwards]

Dr Kwon suggests that “Available agents and technologies should be combined aggressively to evoke better outcomes" and that oncologists must abandon the “one step at a time” approach to treatment. 

 

To be fair to Australian oncologists, the reason for their sequencing of drugs and the the “one step at a time” approach is largely determined by what drugs are subsidised under the Pharmaceutical Benefits Scheme and the conditions imposed by the Pharmaceutical Benefits Advisory Committee as to how and when those drugs can be used.

 

There are a few wealthy people who can spend hundreds and thousands of dollars on particular drugs.  For most of us ordinary Australian blokes, we do not have this kind of money to buy expensive cancer drugs.  We depend upon the Government making subsidised cancer drugs available under the Pharmaceutical Benefits Scheme.

 

 

Australian men with advanced prostate cancer should be able to have the same treatments that are available to American men with advanced prostate cancer.  Your committee continues to advocate for increased subsidies for prostate cancer cancer drugs under the Pharmaceutical Benefits Scheme.