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Overview
Patterns of care in prostate cancer have changed tremendously in the past 20 years, altering the way patients with this tumor present and how they are evaluated before and after diagnosis. With the use of new and combined treatments, the frequency and variety of complications have differed from those previously reported. Advances have been made in prostate cancer imaging, in biopsy methodology, in understanding causative factors and disease, in treatment related quality of life, and in predicting the behavior of individual tumors using risk strata. Despite these advances, no consensus has emerged regarding the optimal treatment for the most common patient with prostate cancer.
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Statement of Need
About 500,000 people in the United States are currently affected by bladder cancer, making the disease the fourth most common cancer among men and the eleventh most common among women.
About 70% of bladder cancer patients present with superficial, nonmuscle invasive disease. Intravesical administration of bacillus Calmette-Guérin (BCG) following resection of the nonmuscle invasive tumor is the current standard management strategy. Patients with carcinoma in situ (CIS) treated with intravesical BCG have a 60% to 70% chance of a complete
and durable response. About 20% of patients discontinue BCG therapy due to local and systemic toxicity, however, and 30% to 40% show evidence of recurrence following treatment. Patients who cannot tolerate BCG therapy or have a tumor recurrence after one or more inductions need careful assessment and consideration of salvage therapies. The therapeutic options include a repeat course of BCG alone, BCG plus interferon, and/or intravesical chemotherapy. For some patients, radical cystectomy may be the best option for long-term disease-free survival. Unfortunately, because of comorbid conditions, the patient may not be clinically suitable
for this major surgical procedure or may not be accepting of the surgery’s physical and psychological consequences.
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3rd International Targeted Focal Therapy in Prostate Cancer
Friday, January 29, 2010
Cascade Conference Center
Vail, Colorado
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HIGHLIGHTS
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