In a recent randomized clinical trial, the PRESIDE Trial, Enzalutamide (Xtandi) showed that chemotherapy with docetaxel (Docetaxel) not only improved survival in men with metastatic castration-resistant prostate cancer (mCRPC), it sometimes reversed enzalutamide resistance.    PRESIDE was a randomized clinical trial that treated 687 men with mCRPC across 123 European sites. All the men were administered enzalutamide in addition to hormone therapy (ADT). After 13 weeks, 271 men had an increase in their PSA and/or an increase in tumor size based on scans. At this point, they were rando ..read more

It is common practice for patients, myself included, to disclose a lot of personal information about our medical situation to digital medical companies on social media platforms like Facebook and Twitter. We disclose information about our treatments, scans, side effects, etc. When we do this, we need to know that this information is tracked and used to generate ads that specifically address our health interests.  We share our health data when they sign up for and use medical apps and websites or share details about our health issues with others on social media. Digital medicine companies ..read more

I am not in the habit of publishing entire abstracts, but given the considerable interest in the therapy termed "BAT" or bipolar androgen therapy, I thought that this specific abstract, along with the link to the complete guide, would answer many questions that we hear regularly.  This guide is written in plain language and is specifically designed for patients and their families. It is written by Dr. Samuel Deneade, M.D., the father of BAT.     Abstract Bipolar androgen therapy (BAT) is a new treatment concept for men whose prostate cancer has become resistant to standard ..read more

Men with prostate cancer with both nodal and bone metastases due worse with ADT plus docetaxel chemotherapy than men with only bone metastases. In addition, increased nodal metastases burden is a negative prognostic biomarker.  A presentation by Dr. Áine Haran at ESMO 2022 discussed an ancillary study from the phase III STAMPEDE trial of docetaxel (chemotherapy) and abiraterone acetate (Zytiga) and prednisolone, specifically looking at the differential treatment responses in men who are hormone sensitive and have metastases in their lymph nodes (soft tissue) (mHSPC). The presentation ev ..read more

Fall Open Enrollment for Medicare every year begins on October 15 and finishes on December 7.  (This is also known as Medicare's Open Enrollment Period or Annual Election Period.) You can make changes to your health insurance coverage during this time, such as adding, deleting, or modifying your Medicare Advantage and Part D coverage for the coming year.  Even if you are satisfied with your existing health and medication coverage, now is the time to assess it.  Compare it to alternative options, and ensure that your current plan will satisfy your next year's needs.   Durin ..read more

TAKE-HOME MESSAGE This phase II randomized controlled trial evaluated the preventive impact of the addition of Metformin versus placebo to androgen deprivation therapy (ADT) on ADT-induced metabolic and anthropometric (body/fat ratios and size) complications in 79 men with locally advanced prostate cancer who received radical radiotherapy. At 1 year, both groups had similar weight, waist circumference, HbA1c, fasting lipid profile, the prevalence of metabolic syndrome, and biochemical response. The conclusion is that Metformin did not have a preventive impact on ADT's anthropometri ..read more

Several men have asked us if they are better off having 177Lu-PSMA-617 (Pluvicto) a radiopharmaceutical drug that treats PSMA positive metastases or Xofigo, a radiopharmaceutical drug that treats bone metastases. There is no simple answer, and the answer is not the same for each of us. Making a sound decision can be helped by understanding the mode of action and the limits of each treatment.  Like some other radiopharmaceuticals, both of these treatments have two components, a drug that delivers, or targets, the therapy to the cancer cells and a radioactive particle that treats or destroy ..read more

Catherine Marshall, MD, MPH, an assistant professor of oncology at Johns Hopkins Medical Center in an interview with GU Oncology helped clarify current changes in the therapy of metastatic hormone sensitive prostate cancer (mHSPC).  When we talk about mHSPC, we really mean two things, according to Dr. Marshall: (1) confirmed metastatic disease based on conventional scans (eg, CT or nuclear bone scans) showing evidence of lymphadenopathy (involved lymph nodes), visceral disease (metastases to soft-tissue sites other than lymph nodes), or bone lesions on bone scan; and (2) recently diagnos ..read more

According to an international study led by Alan Pollack, M.D., Ph.D., chair and professor of radiation oncology at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, and published in The Lancet, adding short-term hormone therapy (ADT) and pelvic lymph node radiotherapy to standard of care prostatectomy surgical bed treatment benefits prostate cancer patients whose PSA levels are rising post-prostatectomy.  According to Dr. Pollack, a rising PSA following prostatectomy for prostate cancer is a sign of a recurrence, which happens in more than half ..read more

Several new anticancer medications have been approved based on clinical trials that used subpar control arms.  According to the authors of a recent "Comments and Controversies" paper in the Journal of Clinical Oncology, this problematic practice is still going on.   According to Simon Van Wambeke, MD, of ZNA (Hospital Network Antwerp), Jan Palfijn in Belgium, and colleagues, the PROfound trial is a recent example.  Men with metastatic castration-resistant prostate cancer (mCRPC) who already had progressed on at least one second-line androgen receptor-targeted drug, enzalutamide ..read more