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Expert Opinion / Cases · July 28, 2021

75 Year Old Man With Non-Metastatic Castration Resistant Prostate Cancer

Written by
Pedro C. Barata MD

 

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  • Paul Pomerantz

    Continue current therapy


  • Saad Benjelloun

    Refer patient to radiation for SBRT for T12 and L3


  • Charles Maack

    order a thoracic and lumbar MRI spine and refer to Radiation Oncology if lesions detected in MRI scan


  • Sandeep Kumar  Sharma

    refer patient to Radiation Oncology for SBRT of T12 and L3


  • sophie ivy

    #2


  • Nasrin Ghaderian

    discontinue darolutamide and discuss other systemic therapy such as abiraterone acetate or high dose testosterone


  • Edward Hettiaratchi

    #2


  • olatokunbo Awodele

    #2


  • Jeffrey Carrel

    #2


  • Craig Carter

    #2


  • Luiz Pereira

    #2


  • Gib Abbitt

    Happy to see high dose testosterone included as a potential treatment. Something new to consider.


  • Oliver Sartor

    #1.....no need for MRI. SBRT those lesions and see what happens


  • Luis Alberto Glaría

    refer patient to Radiation Oncology for SBRT of T12 and L3


  • José Luis Delgado

    # 2


  • Charles Maack

    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

    #1–Continued expression after one year of Daralutamide points to continued viability, therefore treat oligo mets/recognize a data free zone


  • Liefu Ye

    order a thoracic and lumbar MRI spine and refer to Radiation Oncology if lesions detected in MRI scan


  • Juan Premoli

    # 2


  • Paul Pomerantz

    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

    Hi PSa level is undetectable and patient is asymptotic I will continue current management choice 3


  • Mark Lagos

    #1


  • Richard Mandell

    Continue present therapy. It seems to be working just fine.


  • Bahram Mofid

    i agree with second option


  • Ruth Avila

    #1


  • MICHAEL ZERNECK

    No change! Patient is 75 and doing well.


  • Arley Soares

    #2


  • Charles Maack

    Question remaining: What has since transpired with this patient?


  • Sep 27, 2021

    Pending Moderator approval.
    Delete

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