University of Louisville

Chemical Engineering Department Seminar Series

February 13, 2009

11:00 a.m. - 12:00 noon

Ernst Hall, Room 310

"Advances in Prostate Cancer"

Damian A. Laber, M.D., FACP

Associate Professor of Medicine

Director of Hematology and Medical Oncology Fellowship Program

University of Louisville

Scientist and Director of Genitourinary Cancer Clinical Research Program

James Graham Brown Cancer Center

www.browncancercenter.org

Learning Objectives:  1. Understand the natural history of prostate cancer.  2. Review the treatment options for specific stages of the disease.  3. Understand the importance of available supportive measures.  4. Learn some of the novel investigational approaches that may change how we treat patients with prostate cancer.

Abstract

Prostate cancer (PC) is the leading non-cutaneous cause of malignancy in American men and it is estimated that over 200,000 men will be diagnosed with prostate cancer and approximately 27,000 would die from the disease every year.  Since the advent of prostate specific antigen (PSA) screening, the majority of patients are diagnosed with localized disease and about 5% are diagnosed after the cancer has metastasized.  Primary therapy for localized prostate cancer typically includes radical prostatectomy, external beam radiation therapy, brachytherapy, or active surveillance, but 30-40% of patients will eventually develop recurrent or metastatic disease.  Androgen deprivation therapy achieved through medical or surgical castration has been the cornerstone of treatment for patients with metastatic disease.  However, almost all patients progress to castrate-resistant (CR) phenotype after a median of 18-36 months.  Once metastatic CRPC develops, responses to alternative hormonal therapy or chemotherapy are not durable, with a median overall survival of approximately 18 months.  Several second-line hormonal treatments have been utilized in this setting, but responses had been short and non-durable.  In this population of patients where castrate-refractory state emerges, palliation with chemotherapy is usually utilized.

Over the last century, advances in the management of men with prostate cancer (PC) have been slow.  This review focuses on the management principles and therapy options against PC.  A good understanding of the prognosis, treatment options and scientific advances is of utmost importance for the physician advising men suffering from PC.  Research to improve survival and quality of life for our patients should be strongly supported.