Alicia Morgans: Hi, my name is Alicia Morgans and I'm a GU medical oncologist and Associate Professor of Medicine at Northwestern University. I am so excited to have here with me today two good friends and colleagues, one, Dr. Felix Feng, who's a Professor of Radiation Oncology Medicine and Urology at UCSF. And Dr. Charles Ryan, who is a Professor of Medicine, as well as the Division Director of the Division of Hematology, Oncology, and Transplantation at the University of Minnesota. Thank you both so much for being here with me today.

Felix Feng: Happy to be here, Alicia.

Alicia Morgans: Wonderful. So we are in the midst of September, and really this is a time when we think about the importance of prostate cancer awareness. We come together as a community to raise both points of education, as well as, of course, enthusiasm among patients and caregivers and the bigger community of prostate cancer care that we have here in the US and around the world.

So I'm just wondering, we could start with Felix, what is the importance of prostate cancer awareness for you? And if you did have to send a message to patients and others who are thinking about prostate cancer this month and other times too, what would that message be?

Felix Feng: So prostate cancer is an area that I've devoted my career to just like the two of you have. And so obviously it's of critical importance to me and it's near and dear to my heart. And the reason why it's so important to me is when you think about the number of patients who are affected with prostate cancer in the United States and in the world, it's an astronomically high number. And the chances are that every single one of us knows somebody who's had prostate cancer or who's battling prostate cancer now. Whether it's a family member, a friend, an acquaintance, and a colleague. So I think prostate cancer is a disease that hits home for all of us. And so I think honestly throughout the year, we should be drawing awareness to prostate cancer and drawing awareness to the healthcare journey that many of our friends and colleagues and family members are going through.

But this particular month gives us a particular time to even draw more attention to the space. And so, number one, I think with prostate cancer awareness, we want to support our patients and their families and so forth. Number two, we want to call attention to ways in which we, the community, can help out our patients. Whether it's through research, whether it's through patient advocacy groups, whether it's creating better resources for patients. Those are two of the major things that I think we should focus on among others.

Alicia Morgans: Well, thank you. And I completely agree. I'm sure that Dr. Ryan does too. And the same question to you, Dr. Ryan, what does prostate cancer awareness month mean to you? And if you had to get a message or two across to patients, clinicians, family members to think about this month, what would that be?

Charles Ryan: Yeah, well I want to echo Felix's sentiment that it's extremely gratifying to devote your career to battling a condition and battling a disease that affects so many. And there are so many unique things about prostate cancer that make it a special endeavor and a challenging endeavor.

One of the most unique aspects of the disease is its diversity, its biological, and its clinical diversity. And I think that my learning over time has gone in such a direction that I really now begin to look at each new patient and each new case as sort of a different, unique mosaic of different biological events. And that leaves me very humbled in terms of what I think I know about this disease and the direction things are going.

My message to patients is that they join in that quest for understanding. And that they team with their doctor or doctors and their family members to gather the most information that they can about this condition, that they not think of it as one entity, that they do not hear the story of their brother-in-law or their cousin who had prostate cancer and think it's all going to be the same for them because each patient in each case if you will, is unique and merits a deep understanding and a dialogue between a patient and his doctor and family member.

And I think that I say that because it's really part of when one becomes a prostate cancer patient, one in a way kind of enters a community. And that community is there to help you. And it's a community around bringing in information. It's a community about disseminating information. It's a community about finding the right care for an individual at the right time. And part of what we do in conversations like this on UroToday is trying to build that community that patients and other physicians and anybody, other people can be involved in.

Alicia Morgans: I agree. And to think about some of those communities, certainly UroToday is a wonderful community, Prostate Cancer Foundation is a great community, Us TOO is a patient advocacy group, ZERO is a patient advocacy group. So as you're thinking, if you are a patient, about how to engage and where to engage, these are some of the places that are going to give you reliable information and connect you to a community of people who can share really truthful knowledge and understanding. Always to be wary of misinformation, as we've heard from Dr. Loeb several times on this program or on UroToday.

As I think about that, and I think about this community, Dr. Feng, one of the things that we do know in prostate cancer is that there are pretty substantial disparities among members of our community. African-American men really having a much higher rate of being diagnosed and about twice the mortality as compared to Caucasians. Do you have a message for this community, which is one that I think we really need to lift up all men with prostate cancer, certainly including dispelling any disparities that we have?

Felix Feng: Yes, certainly, number one, I agree with you fully that there are significant disparities in the context of prostate cancer. Certain populations that are affected disproportionately and disproportionately with aggressive disease as well. And so, my message to those patients and those potential patients is number one, please get the appropriate healthcare. And so I think one of the major issues is access to resources and so forth. And so, I'm a big champion for prostate cancer screening. I would say regular health visits, talk to your physicians about prostate cancer, advocacy groups, and so forth, outreach programs. I think that many people in our field are helping with outreach efforts in that regard. And I would ask the patient community to continue to partner with us, join with us in these efforts, and so forth.

And number two, recognizing that there are also, as Dr. Ryan put out there, there's heterogeneity within prostate cancer. And what that basically means is that the prostate cancer that one patient has may very well not be the same as the prostate cancer another patient has. And so there are more aggressive or less aggressive prostate cancers in general. And unfortunately, some of these aggressive prostate cancers are enriched in patient populations that have less access to healthcare. And so I would advocate for the research community to push forward with understanding the biology of prostate cancer in these underserved populations. In particular, understanding how we can do a better job of developing a treatment for these patients.

Alicia Morgans: I'm sure we all 100% agree with that. So, thank you. And as we wrap up, one of the things that I think about during September is that even though sometimes we work day-to-day and we feel like things move slowly. We, I think, have found ourselves really finding new treatments. Two new approvals just within the last few months. And there are new approvals I expect on the horizon with a lot of excitement in multiple areas of drug development to help men with advanced prostate cancer. And we do hope that these effective therapies will move even earlier on in the treatment of the disease so that we can be even more effective and hopefully ultimately cure this disease.

Dr. Ryan, do you have any comments on the progress and the way that things have evolved even over the last year in treatments for prostate cancer?

Charles Ryan: Well, we've definitely taken a significant step forward in the development of targeted therapies and personalized therapies. And we've been using that catchphrase for a long time, but now it's getting better. We're getting closer to actually being able to personalize the therapeutic approach for a patient. We're also integrating more treatments that are associated with a better quality of life. And thanks to work by people like you, Dr. Morgans, we are able to fully appreciate the quality of life impact, and we're able to counsel our patients about the quality of life impact.

So not only are the treatments getting more effective, but I'd like to think that the quality of life of our patients is getting better as a result as well. And that's extremely gratifying. And it fortifies us for the mission ahead even more.

Alicia Morgans: Well, I agree, as I have agreed with everything you both have said during these last few minutes of our conversation. And I just wanted to say, thank you both for the work that you're doing, really pushing the envelope, helping men, helping their families, lifting up the community to make sure that we continue to make progress. Thank you both for your time today.

Felix Feng: Thank you for inviting us.

Charles Ryan: Thank you.