BackTable Urology Ep. 210 Personalizing ADT Across the Prostate Cancer Spectrum with Dr. Rana McKay
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Jan 21, 2025 Dr. Rana McKay, a medical oncologist from UC San Diego specializing in prostate cancer, passionately discusses the role of androgen deprivation therapy (ADT) in treatment. She delves into the evolution of ADT options and emphasizes personalizing treatment to align with patient goals. The conversation also highlights the important role of PSA PET imaging in management and the shift between continuous and intermittent therapy. Plus, McKay advocates for better patient education to improve outcomes and minimize side effects in this crucial healthcare area.
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Primary ADT for Specific Patients
- Consider primary ADT for elderly, sicker patients with localized prostate cancer.
- These patients may not be suitable for surgery or radiation due to underlying urinary issues.
Starting ADT: Patient Counseling
- For intermediate-risk prostate cancer patients starting ADT, discuss treatment intent and side effects thoroughly.
- Consider shorter-duration injections or pills for patients fearful of side effects.
Variety of ADT Agents
- There are various ADT agents available, including degarelix, leuprolide, and relugolix.
- GnRH antagonists may offer faster testosterone recovery and potentially lower cardiovascular risks.