Is it ever reasonable to offer EBRT alone for a patient with high risk prostate cancer?
Is age ever a concern given the potential side effects of long term ADT?
3 Answers
Mednet MemberInvited Expert
Radiation Oncology · University of Chicago
Answered on
I think there could be 3 broad reasons to consider not combining RT with ADT for high risk prostate cancer:
- Disease risk: If a patient falls into a more favorable part of the high risk spectrum (e.g. high risk by PSA only, MRI without ECE/SVI/LNI/larger nodule size, or perhaps lower-risk genomic cla...
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Radiation Oncology · David Geffen School of Medicine at UCLA
Answered on
It is reasonable to omit ADT and treat with EBRT only in cases where the patient refuses ADT or if there is a major comorbidity (heart, CV disease, severe depression, Parkinson's, etc.) where ADT may increase the risk of adverse outcome.
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Radiation Oncology · Radiation Medical Group
Answered on · Updated on
"High risk" is a very heterogeneous group.
A single (+) core with Gleason 8, with nonpalpable disease, with PSA < 10 ng/mL is "high risk" (I consider that sort of case to be a "technical" high risk case).
12/12 (+) cores with Gleason 5+4 and a PSA of 40 ng/mL is "high risk" (I consider that sort of ...
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