How do you treat a high grade prostate cancer with bulky direct bladder invasion?

Interesting to see a treatment paradigm presented where an insurer would fathom A) protons and B) fluciclovine for staging, and C) second generation anti-androgen on top of LHRha to treat a locally advanced, non metastatic prostate cancer. I agree that there is the possibility that some of these thi...

I would treat for cure using my usual approach for very-high risk patients, which is antihormone therapy with 2-3 years of antihormones including abiraterone or another one of the other oral 2nd gen blockers, plus 50 Gy of IMPT to the pelvic nodes and 78 Gy gross tumor boost.

I would use MRI and Axu...

Quite proton heavy answers!

I’m not sure that comparative effectiveness research is how we should determine the use of high cost therapies that have not been shown to improve outcomes in prospective studies. Protons have been around for decades, and yet no RCTs for prostate cancer have been complete...