Prostate cancer care in the Middle East is highly variable and access to specialist multidisciplinary management is limited. Academic tertiary referral centers offer cutting-edge diagnosis and treatment; however, in many parts of the region, patients are managed by non-specialists with limited resources.
Due to many factors including lack of awareness and lack of prostate-specific antigen (PSA) screening, a high percentage of men present with locally advanced and metastatic prostate cancer at diagnosis. The aim of these recommendations is to assist clinicians in managing patients with different levels of access to diagnostic and treatment modalities.
The first Advanced Prostate Cancer Consensus Conference (APCCC) satellite meeting for the Middle East was held in Beirut, Lebanon, November 2017. During this meeting a consortium of urologists, medical oncologists, radiation oncologist and imaging specialists practicing in Lebanon, Syria, Iraq, Kuwait and Saudi Arabia voted on a selection of consensus questions. An additional workshop to formulate resource-stratified consensus recommendations was held in March 2019.
Variations in practice based on available resources have been proposed to form resource-stratified recommendations for imaging at diagnosis, initial management of localized prostate cancer requiring therapy, treatment of castration-sensitive/naïve advanced prostate cancer and treatment of castration-resistant prostate cancer.
This is the first regional consensus on prostate cancer management from the Middle East. The following recommendations will be useful to urologists and oncologists practicing in all areas with limited access to specialist multi-disciplinary teams, diagnostic modalities and treatment resources.
World journal of urology. 2019 Jul 11 [Epub ahead of print]
Deborah Mukherji, Bassem Youssef, Christelle Dagher, Albert El-Hajj, Rami Nasr, Fadi Geara, Danny Rabah, Saad Al Dousari, Rabih Said, Raja Ashou, Wassim Wazzan, Michel Jabbour, George Farha, Nibras Al Hamdani, Yousuf Al Hallaq, Hassan Ghazal, Haifa Dbouk, Bassel Bachir, Clement El Khoury, Ghazi Sakr, Hero K Hussain, Khaled Sayyid, Khaled Ibrahim, Mohammad Haidar, Nicolas Zouain, Nizar Bitar, Walid Alameh, Fadi Abbas, Sami Faddoul, Elie Nemer, Georges Assaf, Fadi Farhat, Muhammad Bulbul, Sally Temraz, Ali Shamseddine, Silke Gillessen, Aurelius Omlin, Raja Khauli
Division of Hematology/Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, 1107 2020, Beirut, Lebanon. ., Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon., Division of Hematology/Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, 1107 2020, Beirut, Lebanon., Division of Urology, Department of Surgery, American University of Beirut Medical Center, Riad El Solh, 1107 2020, Beirut, Lebanon., Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia., Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait., Division of Hematology/Oncology, Department of Internal Medicine, Saint Georges Hospital University Medical Center, Beirut, Lebanon., Department of Radiology, Saint Georges Hospital University Medical Center, Beirut, Lebanon., Division of Urology, Department of Surgery, Saint Georges Hospital University Medical Center, Beirut, Lebanon., Department of Radiation Oncology, Mount Lebanon Hospital, Faculty of Medicine-University of Balamand, Beirut, Lebanon., Department of Surgery, Medical City Teaching Hospital Baghdad, Baghdad, Iraq., Division of Hematology/Oncology, Department of Internal Medicine, Clemenceau Medical Center, Beirut, Lebanon., Division of Oncology, Jamal Amel Hospital, Tyre, Lebanon., Department of Radiation Oncology, Hotel Dieu de France, Saint Joseph University Faculty of Medicine, Beirut, Lebanon., Division of Urology, Department of Surgery, Mount Lebanon Hospital, Beirut, Lebanon., Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon., Department of Surgery, Makassed Hospital, Beirut, Lebanon., Division of Hematology/Oncology, Department of Internal Medicine, Hammoud Hospital University Medical Center, Saida, Lebanon., Department of Radiation Oncology, Clemenceau Medical Center, Beirut, Lebanon., Division of Hematology/Oncology, Department of Internal Medicine, Sahel General Hospital, Beirut, Lebanon., Department of Surgery, Sahel General Hospital, Beirut, Lebanon., Middle East Tumor Institute, Beirut, Lebanon., Doctors Center Radiology, Beirut, Lebanon., Department of Urology, Saint Joseph University, Beirut, Lebanon., Division of Cancer Sciences, University of Manchester and the Christie, Manchester, UK., Department of Medical Oncology and Haematology, Cantonal Hospital Saint Gallen, University of Bern, Bern, Switzerland., Division of Urology, Department of Surgery, American University of Beirut Medical Center, Riad El Solh, 1107 2020, Beirut, Lebanon. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/31297628
Go Beyond the Abstract and Read a Commentary by the Authors