Delivering Optimal Outcomes in Prostate Cancer Despite Adverse Events

Eugene B. Cone, MD, a urologic oncology fellow at Brigham and Women’s Hospital and Massachusetts General Hospital, discusses the strategies for treating patients with prostate cancer who develop adverse events (AEs), such as cardiac events and immune-related events.

The days of the solo practitioner are numbered at this point, Cone says. In order to deliver optimal care to patients, physicians need to be in a multidisciplinary setting, which doesn’t necessarily have to be in academia. It is important to have other doctors to rely on for opinions or help when cardiac events do occur.

This methodology has been applied to a number of novel medications, such as abiraterone acetate (Zytiga) or enzalutamide (Xtandi), as well as some immune checkpoint inhibitors. Especially with the immune checkpoint inhibitors, Cone notes that the AEs run the gamut. Urologists and even medical oncologists have expressed discomfort when managing immune-related AEs. Having smart cardiologists and rheumatologists to call on when patients develop these events is key in delivering optimal outcomes.

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