Prostate cancer remains a leading cause of cancer-related death in men. Concurrently, the incidence of metastatic hormone-sensitive prostate cancer (mHSPC) at diagnosis has significantly risen as a result, in part, of recent advances in imaging. Given the increased utilization of prostate-specific membrane antigen-targeted positron emission tomography imaging and other modalities with improved accuracy in the detection of cancer, combined with changes in screening and other secular trends, more men get diagnosed at an oligometastatic stage in which timely treatment may improve survival. However, the optimal timing of initiation and the specific sequence of systemic agents are not yet clearly defined. Worldwide, both urologists and oncologists may primarily direct the medical management of mHSPC. This collaboration potentially invites differing treatment recommendations dependent upon the treating physician's medical specialty. Ideally, a shared decision-making approach incorporating multidisciplinary tumor board discussions and personalized analysis will provide personalized treatment recommendations to optimize the benefit for mHSPC patients. Here, we conducted a concise review and evaluation of existing literature, and provide one perspective on health care delivery for mHSPC worldwide. PATIENT SUMMARY: Given the improvement in imaging techniques and changes in screening practices, the incidence of metastatic hormone-sensitive prostate cancer will likely continue to rise. An early, multimodal treatment approach involving a multidisciplinary team is critical to delivering the best care to this patient population.
European urology focus. 2018 Dec 23 [Epub ahead of print]
Annika Herlemann, Samuel L Washington, Matthew R Cooperberg
Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany., Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA., Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA. Electronic address: .