2015 Conference Recap

BY MARK SCHOLZ, MD

Every year’s Conference presents recurring themes.  This year’s focus was prevention, combination treatment and timeliness were emphasized. We live in an era of exploding technological progress. It is a delightful problem to have a wealth of new treatment options and diagnostic tools.  However, just like buying a new car or a new smart phone, it takes a little time to learn the ropes and fully exploit the complete range and capabilities of the new technology.  A short blog can’t cover everything from a three-day conference.  Here are a few comments.

 

Dr. Dan Margolis, an expert on prostate imaging from UCLA, presented information on 3 Telsa, multi-parametric MRI’s capacity as a substitute for random needle biopsy in men with elevated PSA who have never been previously diagnosed with prostate cancer.  MRI offers the advantage of being equally or more accurate than random biopsy without relying on invasive techniques.

 

Dr. Chuck Drake, from John Hopkins, the preeminent expert in the world on immune therapy for prostate cancer, presented exciting data on how many of the new immune drugs work synergistically when given in combination.  “Synergism” means that when either drug is given by itself the anticancer effect is rather modest.  But when the two drugs are given in combination, the anticancer effect is multiplied.  Provenge has already been FDA approved for prostate cancer.  Hopefully Yervoy will also be an approved indication for prostate cancer in the next six to 12 months.  The combination of these two drugs together offers immense hope for jumpstarting immunologic treatment for prostate cancer.

 

Dr. John Mulhall, the expert in the world on sexuality and prostate cancer from Memorial Sloan Kettering, spent a lot of time emphasizing mindfulness in the selection of treatment. In other words, he was saying that it is better to minimize damage by selecting the least toxic form of prostate cancer treatment than trying to fix an already established problem.

 

Dr. Peter Grimm, sometimes called “The Father of Seed Implant Therapy,” delivered a candid overview of the world of radiation therapy, emphasizing the improved cure rates and reduced toxicity seed implant therapy offers.  He also spoke on how increased financial incentives to do IMRT, Proton therapy and SBRT, distorts the decision making process and slants treatment away from seed implants.

 

This is only the briefest of overviews and no words can express all the fun and games that Dr. Mark Moyad injected into the proceedings. I can only say that initial feedback from the attendees was extremely positive.

2015 PCRI Conference DVDs, which include all the presentations, will be available in six weeks at a suggested donation of $150. For more information, email: info@pcri.org.  In addition, the PCRI will be presenting its second annual Mid-Year Update, March 26, 2016, an afternoon of educational sessions in developments in the prostate cancer world. Laurence Klotz, MD who has been called “The Father of Active Surveillance” will be one of the speakers. Learn more at: www.pcri.org/2016-mid-year-update

The September Prostate Cancer Conference

BY MARK SCHOLZ, MD

PCRI’s Prostate Cancer Conference for Patients is less than two weeks away.  The Conference is a unique event giving opportunity for patients to interact closely with experts in prostate cancer and leaders in research.  It is also a great venue to establish a connection with other patients who have “been there and done that.” This is a weekend to stay informed about the latest in prostate cancer.

That’s where the invited experts come in - we ask them to present their lectures in a way that can be understood by patients. This year’s program will stress breakthroughs in imaging, immunology, new hormone therapy, expanded roles for chemotherapy and the latest thinking on radiation.  The Saturday program will include:

 

·         Dr. Matthew Cooperberg from UCSF is providing an update on active surveillance .

·         Dr. John Mulhall from Memorial Sloan Kettering  will educate us on the latest methods for maintaining normal sexual function after treatment for prostate cancer.

·         Dr. Peter Grimm, from Prostate Cancer Center of Seattle, a world authority on seed implantation reviewing the latest breakthroughs in the area of radiation therapy.

·         Dr. William Oh from Mount Sinai will discuss breakthroughs in injectable radiation that targets bone metastases and new roles for chemotherapy.

·         Dr. Tomasz Beer from the University of Oregon will provide the latest thinking on the powerful new hormonal agents Xtandi and Zytiga.

·         Dr. Dan Margolis a world-renowned prostate imaging expert from UCLA will explain new used for multiparametric imaging of the prostate.

·         Dr. Charles Drake from Johns Hopkins, the world’s preeminent immune expert in prostate cancer will share the latest breakthroughs in this rapidly advancing field.

Dr. Mark Moyad, our moderator, will also be speaking about supplements and diet and how they can lead to increased survival and better quality of life. 

Cancer care is advancing so rapidly that it takes a team effort between you and your physician to achieve the best care.  For the average patient it is overwhelming to try to stay up to date with the latest clinical studies, journal articles and protocols. Often the best place for information is an event like this that specializes in distributing the latest information in a digestible format. 

On Sunday morning, most of our Saturday speakers will participate in a smaller group setting and review their presented topics.  The conference will end with a speaker roundtable to see what treatment the experts will recommend when confronted with actual patient situations. 

The PCRI Conference is for your empowerment. We want it to give you hope and a new confidence in facing the challenging tasks of making important treatment decisions that will impact you for the rest of your life.  

Sign up online: http://prostate-cancer.org/events-calendar/conference-2014/

Managing Too Much Information—The PCRI’s Approach

BY MARK SCHOLZ, MD

Knowledge is power. And what you don’t know can indeed hurt you.  However, in this modern information age, the deluge of unfiltered data can be completely overwhelming. How can patients without professional training sort it all out and distil for themselves a sensible plan of action?

No one can offer a quick fix.  Prostate cancer is too complex and there are too many behind-the-scene conflicts-of-interest simply to trust the first smiling doctor you encounter.  Although you can’t escape from the responsibility of doing your homework, you had better make sure you’re in the right classroom.

Because prostate cancer is so varied in how it affects men, PCRI has divided the disease into five major categories, which we have called Shades of Blue.  This division emphasizes the extreme diversity of this infirmity we call prostate cancer, a condition that ranges from totally innocuous to fatal.

In the process of learning about prostate cancer, failing to stick to the domain of a single Shade is like wandering randomly between five classrooms that are teaching five different subjects. Is it any wonder there is so much confusion? Patients don’t need more information. They need unbiased information that is tailored to their specific needs, i.e. their Shade of prostate cancer.

When you think about it, it’s obvious why we need a new approach to information management. In the old days, new discoveries came slowly. The doctors who were thought leaders had plenty of time to attend medical conferences to discuss disease management in a leisurely fashion to achieve broad consensus. Those days are gone forever. In this era of rapidly changing technology, consensus about a treatment probably means the treatment is out of date. These days, new treatments are vetted by experts on primetime news. Unfortunately, breaking news, due to its fundamental need to be controversial and attract an audience, tends to emphasize fringe thinking.

Relying on traditional university centers to define a sensible, middle-of-the-road plan of action is also no longer possible.  Prostate cancer is big business and most large treatment centers specialize in one form of therapy such as radiation or surgery to the exclusion of all the others. Studies show that large specialty centers do indeed yield better quality than centers treating fewer numbers of patients. However, the large centers are understandably biased toward recommending their specific form of therapy. Their advice about which treatment to select is all too often tainted by their financial conflict of interest.

The PCRI’s mission is to fill the cavernous need for unbiased information that has been created by the accelerated rate of technological discovery. Rapidly exploding technology and new treatments are a great blessing as long as these powerful tools are applied selectively and appropriately to individuals who can benefit, while withholding potentially toxic treatments from those who won’t benefit or may actually be done some harm.

With the annual PCRI conference rapidly approaching, PCRI will continue striving to fulfill its mission to provide up-to-date and scientifically-based information that helps patients and their families sort through the ever expanding number of treatment options.

Summertime

BY MARK SCHOLZ

The PCRI Conference is less than month away!   Every summer I scurry around making preparations.  Speakers have to be coordinated, exhibitors lined up, registrations fulfilled, entertainment scheduled. 

For this year we have significantly expanded the agenda:

Friday:  We have added introductory sessions that will be presented by our seasoned helpline facilitators, Jim O’Hara and Nathan Roundy.

Saturday Morning: Features the treatment of localized disease with various forms of radiation including seed implantation as well as covering high intensity focused ultrasound (HIFU).  In addition we will hear from the preeminent expert in the world on Active Surveillance, Dr. Laurence Klotz.  The morning will be rounded out with an update on the latest breakthroughs in imaging.

Saturday Afternoon: Will cover a multitude of recently FDA-Approved treatments for advanced prostate cancer presented by Eugene Kwon from the Mayo Clinic and Charles Drake from Johns Hopkins and yours truly. Amazing improvements have been made into medications that block testosterone, stimulate the immune system and poison cancer cells.

Saturday Evening: PCRI presents AdMeTech Foundation's “Dance for a Cure” with a LIVE performance by Jonathan Roberts and Anna Trebunskaya from the ABC hit series "Dancing with the Stars".

Sunday Morning: Our esteemed conference moderator Mark Moyad presents his latest thoughts on diet and supplements.  Snuffy Myers will talk about PSA Relapse. Stephen Auerbach discusses sexual rehabilitation.  Tim Wilson from the City of Hope updates us on robotic surgery.

Sunday Afternoon:  Breakout sessions with extensive Q & A will address the following topics: Diet, Focal Therapy, PSA Relapse, Active Surveillance, Radiation and Surgery. We will close with a round table of experts answering questions from the audience and discussing a selected clinical case.

I hope the rest of you are getting sand in your bathing suits and a mildly irritating sunburn.  See you in September.