Health Care Delivery for Metastatic Hormone-sensitive Prostate Cancer Across the Globe

Eur Urol Focus. 2019 Mar;5(2):155-158. doi: 10.1016/j.euf.2018.12.003. Epub 2018 Dec 23.

Abstract

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.

Keywords: Health care delivery; Metastatic hormone-sensitive prostate cancer; Multidisciplinary; Prostate cancer.

Publication types

  • Review

MeSH terms

  • Androgen Antagonists / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Clinical Decision-Making
  • Combined Modality Therapy
  • Delivery of Health Care / standards*
  • Humans
  • Incidence
  • Interdisciplinary Communication
  • Male
  • Neoplasm Metastasis
  • Neoplasms, Hormone-Dependent / drug therapy
  • Neoplasms, Hormone-Dependent / epidemiology
  • Neoplasms, Hormone-Dependent / pathology
  • Neoplasms, Hormone-Dependent / secondary*
  • Positron-Emission Tomography / methods
  • Prostate-Specific Antigen
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / secondary*
  • Retrospective Studies

Substances

  • Androgen Antagonists
  • Antineoplastic Agents
  • Prostate-Specific Antigen