Two Onc Docs
Metastatic Prostate Cancer x Dr. Charles Ryan 2025 UPDATE
Mar 24, 2025
Dr. Charles Ryan, a leading GU oncologist from MSK in NYC, returns to share vital updates on metastatic prostate cancer. He discusses the differences between castrate-sensitive and castrate-resistant prostate cancer, crucial for treatment strategies. Advancements like PARP inhibitors and immunotherapy take center stage, alongside the necessity for genomic testing. Ryan emphasizes learning from clinical trials, whether outcomes are positive or negative. He also inspires future oncologists by showcasing the stunning progress in cancer treatment, blending research with heartfelt encouragement.
34:53
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Quick takeaways
- Castrate sensitive and castrate resistant prostate cancer define different disease states, affecting treatment strategies and outcomes substantially.
- Collaboration and mentorship in oncology are essential for fostering innovative research and enhancing patient care through improved treatment strategies.
Deep dives
Understanding Castrate Sensitive vs. Castrate Resistant Prostate Cancer
Castrate sensitive prostate cancer exists when the disease grows in the presence of normal testosterone levels, while castrate resistant prostate cancer refers to disease progression at low testosterone levels, typically below 50 ng/dL. The FDA defines castrate levels, which may drop to under 30 ng/dL during treatment with medications designed to lower testosterone. Patients with a rising PSA but negative imaging for metastasis may be treated with androgen receptor-targeted therapies, such as enzalutamide or through androgen deprivation therapy combined with enzalutamide for those at higher risk. For lower-risk patients, observation may be a viable approach.
