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Advanced Prostate Cancer
Center of Excellence
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Paul Pomerantz
Jul 28, 2021
Continue current therapy
Saad Benjelloun
Jul 29, 2021
Refer patient to radiation for SBRT for T12 and L3
Charles Maack
Jul 29, 2021
order a thoracic and lumbar MRI spine and refer to Radiation Oncology if lesions detected in MRI scan
Sandeep Kumar Sharma
Jul 30, 2021
refer patient to Radiation Oncology for SBRT of T12 and L3
sophie ivy
Jul 30, 2021
#2
Nasrin Ghaderian
Jul 30, 2021
discontinue darolutamide and discuss other systemic therapy such as abiraterone acetate or high dose testosterone
Edward Hettiaratchi
Jul 30, 2021
#2
olatokunbo Awodele
Jul 30, 2021
#2
Jeffrey Carrel
Jul 30, 2021
#2
Craig Carter
Jul 30, 2021
#2
Luiz Pereira
Jul 30, 2021
#2
Gib Abbitt
Jul 30, 2021
Happy to see high dose testosterone included as a potential treatment. Something new to consider.
Oliver Sartor
Jul 30, 2021
#1.....no need for MRI. SBRT those lesions and see what happens
Luis Alberto Glaría
Jul 30, 2021
refer patient to Radiation Oncology for SBRT of T12 and L3
José Luis Delgado
Jul 30, 2021
# 2
Charles Maack
Jul 30, 2021
My reasoning for #2 is "why subject patient to radiation before determining extent of lesions and if only then considered to be development of metastatic PCa consider appropriate form of radiation. Until determined, ADT meds continue since they have been effective at least in PSA control.
Paul Schellhammer
Jul 30, 2021
#1–Continued expression after one year of Daralutamide points to continued viability, therefore treat oligo mets/recognize a data free zone
Liefu Ye
Jul 30, 2021
order a thoracic and lumbar MRI spine and refer to Radiation Oncology if lesions detected in MRI scan
Juan Premoli
Jul 30, 2021
# 2
Paul Pomerantz
Jul 30, 2021
I think it’s interesting that everybody seems to want to pursue further evaluation of the two lesions as well as therapy. Since in his initial staging we do not have a targeted pet scan these lesions may have been present prior. Currently by most standards he is still castrate sensitive with a good response as he’s had no rising PSA so ideally if we had studies proving the value of targeted therapy at various metastatic sites I would agree with more aggressive approach. I don’t think at the present time we have data that supports that without evidence that these lesions were not present prior.
Len Scotland
Jul 31, 2021
Hi PSa level is undetectable and patient is asymptotic I will continue current management choice 3
Mark Lagos
Aug 01, 2021
#1
Richard Mandell
Aug 01, 2021
Continue present therapy. It seems to be working just fine.
Bahram Mofid
Aug 01, 2021
i agree with second option
Ruth Avila
Aug 04, 2021
#1
MICHAEL ZERNECK
Aug 20, 2021
No change! Patient is 75 and doing well.
Comment deleted by Moderator.
Charles Maack
Aug 30, 2021
Question remaining: What has since transpired with this patient?
pedro barata
Feb 09, 2022
Great comments and insights so far. So this patient ended up getting an MRI of spine that did not reveal the lesions by PSMA. The patient continues on ADT plus darolutamide with undetectable PSA and great tolerance
Arley Soares
Feb 17, 2022
#1
Charles Maack
Feb 17, 2022
Thus, as provided by Pedro Barata, #2 was administered, patient can now experience some relief not having to wonder about those lesions, did not have to experience effects/side effects of radiation treatment, and continued ADT still successful.
Prasanta Kumar Pradhan
Apr 02, 2022
MRI for further characterising the vertebral lesions seen on PSMA PET/CT
Paul Pomerantz
Apr 04, 2022
Might consider Lutetium at this point for oligomets seen on PSMA pet scan
Dec 05, 2024
Pending Moderator approval.
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Paul Pomerantz
Jul 28, 2021
Saad Benjelloun
Jul 29, 2021
Charles Maack
Jul 29, 2021
Sandeep Kumar Sharma
Jul 30, 2021
sophie ivy
Jul 30, 2021
Nasrin Ghaderian
Jul 30, 2021
Edward Hettiaratchi
Jul 30, 2021
olatokunbo Awodele
Jul 30, 2021
Jeffrey Carrel
Jul 30, 2021
Craig Carter
Jul 30, 2021
Luiz Pereira
Jul 30, 2021
Gib Abbitt
Jul 30, 2021
Oliver Sartor
Jul 30, 2021
Luis Alberto Glaría
Jul 30, 2021
José Luis Delgado
Jul 30, 2021
Charles Maack
Jul 30, 2021
Paul Schellhammer
Jul 30, 2021
Liefu Ye
Jul 30, 2021
Juan Premoli
Jul 30, 2021
Paul Pomerantz
Jul 30, 2021
Len Scotland
Jul 31, 2021
Mark Lagos
Aug 01, 2021
Richard Mandell
Aug 01, 2021
Bahram Mofid
Aug 01, 2021
Ruth Avila
Aug 04, 2021
MICHAEL ZERNECK
Aug 20, 2021
Charles Maack
Aug 30, 2021
pedro barata
Feb 09, 2022
Arley Soares
Feb 17, 2022
Charles Maack
Feb 17, 2022
Prasanta Kumar Pradhan
Apr 02, 2022
Paul Pomerantz
Apr 04, 2022
Dec 05, 2024
Pending Moderator approval.