Should we be stopping new starts of patients who can be triaged for 2-3 months like prostate cancers on ADT when significant community spread of COVID-19 is detectable in our area?
I would for those patients requiring ADT, which is the way I interpreted the question. I want to elaborate more because @Dr. First Last brought up other scenarios we should consider and he brings some more good points:
Many patients could get active surveillance for a period of time before ADT is co...
Lets break it down by risk group:
Very low/low risk: Should be put on active surveillance and return in 6 months for a PSA.
Favorable intermediate risk: Should be put on active surveillance for the current time and return in 3-6 months for a repeat PSA. Very good data that early on active surveillan...
I agree with my colleague, @Dr. First Last. I would add that many patients for whom ADT is not necessary can be convinced to a more appropriate Active Surveillance strategy and avoid or delay ADT and XRT altogether. High risk patients can safely be treated with a longer interval of 'neoadjuvant' ADT...
I agree with my colleagues above. Our hypofractionation regimen is 7020 cGy/26 fractions to the prostate and prox SVs and 5200 cGy/26 fractions to the distal SVs and lymph nodes. As @Dr. First Last referenced above, the 10 year results from our phase III clinical trial were just published in the JCO...
Don't forget prostate SBRT in 5 fractions, every other day.
A commonly employed regimen is 8 Gy to prostate and 5 Gy to SV. Some series have even given 5 Gy to nodes for high risk patients. There have been thousands of patients treated with prostate SBRT now with excellent PSA control and low single...
Yes, at the Lynn Cancer Institute we have delayed all non-essential starts and follow ups, including prostate and breast patients that are on hormonal therapy.
As per FAQ’s posted by ASTRO:
New patient consults and new patient starts may be triaged on a case-by-case basis according to the urgency of the situation following discussion with the multidisciplinary care team. Examples of non-urgent cases that may be delayed for up to two months include prostate...
This is all very important what has been discussed so far about prostate cancer, but how about addressing the original question of this post "stopping new starts of patients who can be triaged for 2-3 months LIKE prostate cancers on ADT" (=but NOT prostate cancers, but other cancers)? I need your in...