Treating Non-Metastatic Castrate Resistant Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD
PCRI's Alex asks Dr. Mark Scholz, a medical oncologist specializing in prostate cancer, all about the "M Zero" (M0) stage of prostate cancer. This is a specific stage of prostate cancer in which a man develops a rising PSA while on hormone therapy, but wherein there are no visible metastases outside of the pelvic lymph nodes.
0:07 What is the "M Zero" (Non-Metastatic, Castrate-Resistant) space? The M0 space occurs when a man who has previously been treated has relapsed, begun intermittent hormone therapy, and then the PSA begins to rise despite the man having a low testosterone, but there are no metastases visible on scans.
1:39 Does a clear scan and a rising PSA mean that micro-metastases exist? The prevailing thought is that there is micrometastatic disease.
2:03 Does non-metastatic cancer have symptoms? There may be side effects from treatment, but not from the disease.
2:25 Are drugs like Xtandi, Nubeqa, and Erleada being used on non-metastatic castrate-resistant patients? Yes, some of these drugs have recently been approved for the non-metastatic space, and they may even be more effective in this space than in the metastatic space.
2:59 What are the effects of these new drugs on the treatment of M0 patients? They can delay the onset of metastases for around two years.
3:29 How are Erleada, Xtandi, and Nubeqa different from Zytiga? Zytiga bocks the chemical synthesis of testosterone inside the cancer cell whereas Erleada, Xtandi, and Nubeqa block the androgen receptors.
4:10 What are the differences between first-generation and second-generation hormone therapies? First-generation hormone therapies stop the testicular production of testosterone, and second generation hormone therapies are designed to stop the production
4:59 Are second-generation therapies associated with the same side effects as first-generation ones? Are they more intense? The side effects are not necessarily more intense, but the second generation medicines do have some potential unique side effects that men need to be aware of. Zytiga can cause irritation of the liver and a change in potassium levels that need to be monitored. Xtandi has been associated with more fatigue, and Erleada has been associated with rashes.
5:47 Where in a patient's sequencing (or order of treatments) should Provenge be used? While it may be ideal for a man to use Provenge early in the M0 stage, insurance companies have only approved Provenge for men with visible metastases. Some men in M0 may have visible lymph node metastases in the pelvis, and so that would qualify him to receive Provenge, but otherwise, men will have to wait until metastases begin to develop before they can have Provenge covered by insurance.
Don’t know your stage? Take the quiz: Visit http://www.prostatecancerstaging.org
To learn more about prostate cancer visit http://www.pcri.org
To download the free Staging Guide visit http://www.pcri.org/prostate-cancer-s...
Who we are:
The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
The information on the Prostate Cancer Research Institute's YouTube channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.
#ProstateCancer #Prostate #MarkScholzMD
Видео Treating Non-Metastatic Castrate Resistant Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD канала Prostate Cancer Research Institute
0:07 What is the "M Zero" (Non-Metastatic, Castrate-Resistant) space? The M0 space occurs when a man who has previously been treated has relapsed, begun intermittent hormone therapy, and then the PSA begins to rise despite the man having a low testosterone, but there are no metastases visible on scans.
1:39 Does a clear scan and a rising PSA mean that micro-metastases exist? The prevailing thought is that there is micrometastatic disease.
2:03 Does non-metastatic cancer have symptoms? There may be side effects from treatment, but not from the disease.
2:25 Are drugs like Xtandi, Nubeqa, and Erleada being used on non-metastatic castrate-resistant patients? Yes, some of these drugs have recently been approved for the non-metastatic space, and they may even be more effective in this space than in the metastatic space.
2:59 What are the effects of these new drugs on the treatment of M0 patients? They can delay the onset of metastases for around two years.
3:29 How are Erleada, Xtandi, and Nubeqa different from Zytiga? Zytiga bocks the chemical synthesis of testosterone inside the cancer cell whereas Erleada, Xtandi, and Nubeqa block the androgen receptors.
4:10 What are the differences between first-generation and second-generation hormone therapies? First-generation hormone therapies stop the testicular production of testosterone, and second generation hormone therapies are designed to stop the production
4:59 Are second-generation therapies associated with the same side effects as first-generation ones? Are they more intense? The side effects are not necessarily more intense, but the second generation medicines do have some potential unique side effects that men need to be aware of. Zytiga can cause irritation of the liver and a change in potassium levels that need to be monitored. Xtandi has been associated with more fatigue, and Erleada has been associated with rashes.
5:47 Where in a patient's sequencing (or order of treatments) should Provenge be used? While it may be ideal for a man to use Provenge early in the M0 stage, insurance companies have only approved Provenge for men with visible metastases. Some men in M0 may have visible lymph node metastases in the pelvis, and so that would qualify him to receive Provenge, but otherwise, men will have to wait until metastases begin to develop before they can have Provenge covered by insurance.
Don’t know your stage? Take the quiz: Visit http://www.prostatecancerstaging.org
To learn more about prostate cancer visit http://www.pcri.org
To download the free Staging Guide visit http://www.pcri.org/prostate-cancer-s...
Who we are:
The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
The information on the Prostate Cancer Research Institute's YouTube channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.
#ProstateCancer #Prostate #MarkScholzMD
Видео Treating Non-Metastatic Castrate Resistant Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD канала Prostate Cancer Research Institute
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