Patient and Physician Perspectives on Prostate Cancer Data Presented at ASCO 2025: A Podcast

00:00:00: You are listening to an

00:00:02: ADIS

00:00:02: Journal podcast.

00:00:05: Welcome to this ADIS podcast in oncology and therapy.

00:00:09: The podcast will focus on data presented at the twenty twenty five American Society of Clinical Oncology annual meeting or ASCO for short.

00:00:19: The podcast is aimed at everyone interested in the latest research related to prostate cancer presented at ASCO twenty twenty five.

00:00:26: People don't need to be experts as the discussion will be in plain language with explanations given for any technical terms used.

00:00:33: Podcast speakers include Pedro Barata and Tom Holsey.

00:00:38: The views expressed in this podcast are solely those of the authors and do not necessarily reflect those of their employers, the podcast sponsor, ASCO or any of their affiliates.

00:00:48: The podcast was sponsored by Johnson & Johnson.

00:00:51: The authors received no honour area related to the development of this podcast.

00:00:55: Medical writing support was provided by Amica Scientific and funded by Johnson & Johnson.

00:01:02: I'm Tom Holsey and I'm a ten-year prostate cancer survivor.

00:01:07: I currently serve as a volunteer research advocate at the NCI-designated Harold C. Simmons Comprehensive Cancer Center at UT Southwestern here in Dallas.

00:01:17: I'm also wanted to serve in multiple roles at the American Urological Association, including the Urology Care Foundation Patient Education Council.

00:01:26: Clinical Trials Collective and AUA News Patient Editor.

00:01:33: Thank you, Tom.

00:01:33: I'm so happy to join you today.

00:01:36: I'm Peter Baratt.

00:01:36: I'm a dual medical oncologist.

00:01:38: I lead the clinical trial program here out of University Hospital Sideman Cancer Center, Case Western Reserve University in Cleveland, Ohio.

00:01:46: It's fantastic to get the chance to sit down with you and talk about prostate cancer.

00:01:49: And we're going to walk through a number of important topics.

00:01:53: Well, thank you, Dr.

00:01:53: Bharata.

00:01:54: It's my honor.

00:01:55: Dr.

00:01:55: Bharata and I are going to discuss three primary topics today.

00:02:00: The current landscape of prostate cancer diagnosis and treatment, novel and emerging therapies, including hormone-sensitive prostate cancer and hormone-resistant prostate cancer.

00:02:12: And the third area is going to be quality of life and supportive care.

00:02:16: Prostate cancer is commonly detected through the prostate specific antigen or PSA blood test.

00:02:23: This screening is typically offered to individuals between the ages of fifty and fifty-five, although those at higher risk may be tested earlier.

00:02:31: PSA is a protein produced by the prostate gland and elevated in the blood can indicate a potential issues such as prostate cancer.

00:02:40: If higher PSA levels are found, follow-up diagnostic procedures may include magnetic resonance imaging or MRI.

00:02:49: or the collection of tissue samples to confirm the diagnosis.

00:02:53: Once the prostate cancer is diagnosed, it is assessed for its risk level and extent of spread.

00:03:00: The disease may be localized, meaning the cancer remains within the prostate or metastatic, indicating that it's spread beyond the prostate and potentially outside the pelvis.

00:03:11: The choice of treatment guided by these assessments can involve several approaches.

00:03:15: These include active surveillance, prostatectomy, which is a surgical removal of all or part of the prostate, radiation therapy, hormone therapy, or a combination of these modalities.

00:03:28: Treatment decisions are made collaboratively between the patient and the physician with the options often depending on factors such as the healthcare setting or geographic location.

00:03:38: Increasingly, biomarker tests such as detecting DNA alterations and cancer cells from blood or urine samples are being utilized to inform these decisions.

00:03:49: These tests help evaluate the aggressiveness of the cancer, determine the necessity for tissue sampling, decide whether continued monitoring is appropriate, and more recently, support the personalization of treatment based on individual patient characteristics.

00:04:06: The landscape of prostate cancer is rapidly evolving, marked by significant developments such as recent FDA approvals, novel imaging technologies, and ongoing clinical trials.

00:04:19: These breakthroughs are redefining the standard of care, providing clinicians with advanced tools that enable them to tailor therapies to the unique needs of each patient.

00:04:29: As a direct result, treatments can now be more effectively personalized, which not only delays the progression of the disease, but also improves the overall quality of life for those affected.

00:04:41: The approach to prostate cancer treatment is shifting away from one-size-fits-all solutions and moving toward therapies that are specifically designed for each patient's tumor characteristics and genetic makeup.

00:04:53: Genomic testing is increasingly central to this transformation with its role expected to grow as additional drug approvals are received.

00:05:03: This movement toward precision medicine promises a future prostate cancer care that is more accurate, individualized, and focused on the unique needs of every patient.

00:05:15: Dr.

00:05:15: Braddock, turn it over you now.

00:05:17: Do you have any thoughts to share on the current landscape?

00:05:21: Sure, Tom.

00:05:22: Amazing summary of the current landscape compared to where we were a decade ago.

00:05:26: It's a lot of advancements.

00:05:27: You touch on very significant points.

00:05:31: Thinking of the treatments that can eradicate prostate cancer are the only two in the world that I know of.

00:05:36: one is surgery one is radiation.

00:05:37: both have evolved.

00:05:39: surgical techniques are better.

00:05:41: The good example is the quote unquote the robot right that improve the quality of life of people going through surgeries but also the radiation techniques and the machines they use are way better.

00:05:50: we were able.

00:05:51: to deliver higher doses of radiation, saving the healthy organs or the healthy tissue around it.

00:05:57: So you minimize the amount of side effects.

00:05:59: But as you move away from that and you think of other areas where we've seen changes, I mean, it's pretty standard these days to use fancy imaging beyond the CAT scans and the bone scan.

00:06:12: We're now using a lot of PET scans with a prostate specific tracers.

00:06:16: You really change how we see disease.

00:06:18: We see more disease.

00:06:19: He also alluded to genetics, right?

00:06:22: In other words, we're able to test the tumors and we're also able to test the genes we're born with.

00:06:27: and understand, for example, is the reason why developed prostate cancer because of the genes are inherent.

00:06:33: So those types of tests are available.

00:06:35: We should talk to our doctors about them and not just because they inform us about what might happen in the future, but also they open the door to new treatments available to folks who have specific targets.

00:06:49: which I think is a perfect segue for what we call precision medicine or precision oncology, where when we find a specific target, we can actually have a therapy, a treatment for that target.

00:07:00: And if you don't have the target, the treatment will not be effective.

00:07:03: So we're bringing that precision oncology to prostate cancer as well.

00:07:09: And then, of course, novel treatments have been developed and investigated in prostate cancer.

00:07:15: We go from Improving what we have, for example, we go from old chemotherapy to newer forms of target chemotherapies that attack cancer and leave alone the cells are not cancer, for example, bringing immunotherapy to prostate cancer.

00:07:31: Historically, immunotherapy doesn't help much.

00:07:35: There's a few exceptions to that.

00:07:36: But the novel era has challenged that concept.

00:07:41: And I'm thinking, by specific therapies, for example, completely novel therapies.

00:07:46: We are able now to have target radiation therapy.

00:07:51: Again, when we think of prostate cancer, overexpressing certain targets, and that's through clinical trials.

00:07:58: So the number of trials in the prostate cancer world has gone up.

00:08:02: So that means we are challenging the current standard.

00:08:06: and we bring something that has a potential to be better than what we have currently.

00:08:10: And that's actually true whether the goal is to cure, meaning get rid of prostate cancer, whether the goal is to control the disease.

00:08:18: So definitely we're experiencing special times.

00:08:23: There's a lot of effort and energy and time from a lot of teams around the world to make it better.

00:08:29: And at the same time that we come up with better treatments, of course, we have to keep the focus on having patients living their life the best way possible and hopefully with minimal side effects, that's the goal.

00:08:40: Thank you, Dr.

00:08:41: Barata.

00:08:41: That's some really exciting stuff.

00:08:43: And as a prostate cancer patient and survivor, that's just music to my ears.

00:08:50: Let's drill down a little bit now and talk about some of the personalized therapy for hormone-sensitive prostate cancer.

00:08:58: Recent research has focused on how genetic changes Permanent alterations in the DNA are molecular changes such as variations in proteins within the cells and can be identified through imaging or tumor testing.

00:09:11: These discoveries are helping to pinpoint individuals who may benefit from more targeted treatment strategies.

00:09:18: Hormone-sensitive prostate cancer refers to prostate cancer that responds to therapies aimed at lowering hormone levels.

00:09:25: For patients with this form of disease, advancements in genetic and molecular analysis offer hope.

00:09:31: for initiating treatment earlier.

00:09:34: By doing so, clinicians can improve patient outcomes and reduce the risk of cancer progressing to the state of hormone resistance or spreading further.

00:09:44: Dr.

00:09:44: Berata, can you talk about some of the studies that were presented at ASCO and what really resonated with you and how these findings could impact standard of care practices for patients that have hormone-sensitive prostate cancer?

00:09:59: Yeah, of course, Tom.

00:10:01: Just a reminder for the audience, unfortunately, patients can't present with advanced disease.

00:10:08: By advanced disease, I mean cancer in different places of the body.

00:10:13: So we call that stage four or advanced or metastatic prostate cancer.

00:10:17: There's actually two ways to get there.

00:10:20: One is those folks that would try to cure whether you got radiation or surgery at some point and unfortunately cancer came back and at some point we see disease in the scans.

00:10:33: So we call that recurrent metastatic disease or recurrent metastatic prostate cancer.

00:10:38: But then you have the second group of people where they walk in the clinic, they walk in the emergency room or in the physician's office and unfortunately they're having back pain, they're having urinary symptoms and you get scans and you find metastatic disease at the beginning.

00:10:54: So we call that the second group, newly diagnosed metastatic disease, where folks are diagnosed with metastatic disease and there has not been receiving treatment for prostate cancer in the recent past.

00:11:04: We have this term called metastatic hormone sensitive disease or metastatic hormone sensitive prostate cancer.

00:11:10: Why?

00:11:11: Because prostate cancer is sensitive to testosterone levels.

00:11:16: So when we lower testosterone levels, also known as castration, which is a horrible name, not friendly at all, but that's what it means is lowering the levels of testosterone, we're able to get the cancer asleep, go dormant, or in remission for quite some time and some patients longer than others.

00:11:33: So that's the approach we do with everybody.

00:11:35: And maybe Tom, when thought this might be crossing your head, it might be, well, can we get better than that?

00:11:40: Can we actually personalize this?

00:11:42: Everybody needs the same thing.

00:11:44: And the answer is no.

00:11:45: So if we do lower testosterone to everybody, some patients will need more treatments than others.

00:11:50: So the backbone of everything we do is to explore that hormonal pathway, which basically feeds prostate cancer.

00:11:57: The question around personalized medicine.

00:11:59: in this particular setting, patients with development start disease, the first thing is you got to test.

00:12:04: So you test the genes you were born with, and you test the tumor.

00:12:09: And there's certain things you can find out.

00:12:11: You can find out, for example, that the tumor or you were born with certain alterations that mess up the way the DNA gets fixed in our cells.

00:12:22: I don't want to be too technical, but we call that homologous recombination or DNA repair family genes.

00:12:28: Those are genes like BRCA-I, BRCA-II, ATM, FANCA, RAT-I, and so on.

00:12:34: The reason what's important is because tumors who have those alterations tend to behave not as nicely as the others who don't.

00:12:43: So we call that a prognostic factor.

00:12:46: But on the other hand, tumors who express those alterations, those genes are changed.

00:12:53: We have therapies that work better.

00:12:56: than for folks who don't have those genomic alterations.

00:13:00: And by the way, you will find about one-fifth of patients will have those alterations.

00:13:05: So when you do genetic testing for a patient who presents metastatic disease, then the question is, okay, can we do something about it?

00:13:12: And the answer is yes.

00:13:13: And just an example at ASCO, we saw data that a PARP inhibitor called NERAPRAB works remarkably well for patients with HRR alterations, works better on top of the backbone hormonal approach than the hormonal approach by itself.

00:13:30: The studies call amplitude and it's premature because we don't have the final results yet, but just an example.

00:13:35: Tumors can express many things.

00:13:37: HR is just one of them.

00:13:39: There are certain genes that also predict things not going as well.

00:13:42: For example, PTAN or RB-I or TP-P-P-III.

00:13:47: It turns out there's a medication.

00:13:49: that's already using breast cancer and investigators are now trying to figure out for p-tent deficient tumors or p-tent altered tumors, does the medication work better?

00:13:59: The medication is called capivazertip.

00:14:01: The study is called Capitalo-II-I.

00:14:03: And the answer is yes, it works better in addition to the hormonal inhibition than hormonal inhibition by itself.

00:14:11: Again, I'm just giving you examples how doing genetic testing allows us to open the door to precision therapy approaches.

00:14:19: But the conversation can go beyond the genes.

00:14:22: What about the scans?

00:14:23: Most tumors do express PSMA.

00:14:25: So the next question is, OK, if we have a PSMA target for the Asian therapy, we call that Lutetian PSMA.

00:14:32: On top of hormonal inhibition, does it work?

00:14:35: And it appears that it does.

00:14:37: We'll see this data very soon in Europe, in the European meeting, and the studies call PSMA addition.

00:14:43: And bottom line, this therapy is already available later on.

00:14:47: for patients who progress on hormones.

00:14:50: But the question is, does it work early on?

00:14:52: And the answer seems to be yes.

00:14:53: We have a number of therapies inhibiting the endogen pathway.

00:14:57: The most recent one is called our allutamide and data was presented recently.

00:15:01: It's called Aeronote.

00:15:02: It's also available on top of enzolutamide and apollutamide and abradron.

00:15:07: The benefit of having different ones available is allows us to choose the one that has the better safety profile.

00:15:14: So... Ten years ago, you basically look at normal scans, CAT scan and bone scan, and almost everybody would be getting the same treatment.

00:15:21: And we're going from that point to the situation where we have fancy scanning.

00:15:27: And we can appreciate if there's expression of that target PSMA that allows us this special radiation.

00:15:32: We can do genetic testing and open the door to target therapies that build upon backbone treatment.

00:15:37: So we're personalizing the therapies available for individuals.

00:15:41: The idea is to control the cancer for a much longer period of time, and at the same time, hopefully their quality of life is preserved as much as possible so they can remain on treatment that works while they live their lives.

00:15:53: And this advances enables clinicians to initiate targeted therapies earlier, offering hope for better disease control and, like you said, better quality of life.

00:16:04: But despite these advancements, there remains a significant group of patients with unmet needs, individuals whose tumors lack identified biomarkers or whom current testing methods are inconclusive, may not have access to personalized therapies.

00:16:22: Furthermore, limitations in the routine implementation of germline or somatic testing, whether due to cost availability or healthcare infrastructure, can prevent some patients from receiving optimal individualized care.

00:16:35: As a result, these patients may continue to rely on standard treatment protocols, which may not be as effective or may come with an increased risk of side effects.

00:16:45: Okay, next topic we're going to talk about is new therapeutics for hormone resistant.

00:16:50: prostate cancer.

00:16:52: And this type of cancer refers to prostate cancer that no longer responds to therapies designed to lower hormone levels.

00:17:00: As the disease progresses beyond hormone sensitivity, effective treatment options become more limited and the management of the cancer becomes increasingly complex.

00:17:10: Treating hormone resistant prostate cancer remains a significant challenge.

00:17:15: However, early clinical trials provide hope for the future of cancer care.

00:17:19: And there are several innovative therapeutic strategies that are currently under investigations, including radioligans.

00:17:27: And this is a novel agent that targets cancer cells using radioactive molecules, potentially delivering therapeutic effects directly to the tumor sites.

00:17:37: Antibody drug conjugates.

00:17:40: These medicines combine an antibody with a cytotoxic drug, allowing chemotherapy to be delivered directly to the cancer cells.

00:17:49: This approach aims to minimize damage to healthy cells while maximizing the destruction of cancer cells.

00:17:56: Another one is the biospecific T cell engagers.

00:18:00: These medicines use two linked antibodies to bring cancer cells into proximity with T cells.

00:18:06: This interaction enables T cells to recognize and kill the cancer cells, harnessing the immune system to target the disease.

00:18:14: And the last one is therapy combinations.

00:18:16: This combines different therapeutic modalities which may further expand future treatment options, potentially enhance efficacy and overcome resistance mechanisms.

00:18:28: But it's important to note that these new medicines and approaches are currently under investigation and have not yet been approved for clinical use.

00:18:37: With all that said, Dr.

00:18:39: Bharata, would you care to share some of your thoughts on this and highlights?

00:18:43: my big question is how does this impact the patient and their standard of care?

00:18:48: So I'm fantastic question.

00:18:49: Going back to what I mentioned earlier, we know that prostate cancer is actually similar to breast cancer.

00:18:55: It depends on hormones to thrive and we're able to take advantage from that knowledge to control the cancer for quite some time.

00:19:03: We measure in years actually.

00:19:05: However, at some point tumors will become resistant and will wake up if you will and start progressing.

00:19:12: And so of course you need treatments beyond hormonal treatments that are able to control the cancer, hopefully get rid of it, right?

00:19:20: But when we can get rid of it, control it, get it to sleep again, and people are able to live their lives while they go through treatments.

00:19:27: When we present things that way, we have a number of treatments already available that work.

00:19:32: We use chemotherapy, similar to other cancers like docitaxel or cabanitaxel.

00:19:37: We have a special type of treatment that's radiation to the bone, that's called radian two to three.

00:19:43: In general, we don't use for most patients immunotherapy, but it does play a role in a small subset of patients who have a specific marker.

00:19:51: The same with target therapies, PARP inhibitors, for a number of patients who have that specific target, which is around twenty-twenty-five percent of them.

00:19:58: A good proportion of patients are not candidates for those type of treatments.

00:20:03: And of course, we think of the right strategy to sequencing them.

00:20:06: However, As you can imagine, it's not an infinite number of treatments available.

00:20:10: So we have to do better.

00:20:12: One of the great advancements we had in recent years is a target radiation therapy.

00:20:19: We've known for a long time this target called PSMA, process-specific membrane antigen.

00:20:24: They're molecules that attack to an antibody that finds the PSMA and is able to release radiation to those cells.

00:20:32: So that therapy is called lutetium PSMA.

00:20:35: It's available for patients with cancer.

00:20:38: But right now that therapy is available by itself.

00:20:41: So one of the questions would be, is it better if we combine it with other therapies that are available out there?

00:20:47: And so there's a number of efforts combining Lutitian PSMA with chemotherapy, with immunotherapy, with target therapy, trying to explore or investigate if there's an additional benefit of providing those combinations.

00:21:01: So that's one type of strategy.

00:21:04: Then there's completely novel immunotherapy approaches.

00:21:07: You alluded to bi-specific therapies.

00:21:10: There's one very exciting one, which is called Pasrita-Mic, which basically finds cells from prostate cancer, finds the T cells from our immune system, and gets them to talk to each other.

00:21:22: And the idea is that our immune system fights cancer, and this drug is just a facilitator, if you will, in simplistic ways.

00:21:29: We have trials exploring the role of that kind of approach.

00:21:33: for men with metastatic cholesterol resistant disease.

00:21:37: Then we have what I mentioned earlier, antibody drug conjugates.

00:21:42: What is that?

00:21:43: Smart chemotherapy.

00:21:44: So we know there are certain targets that matter to prostate cancer.

00:21:49: PSMA is one of them, but there's other, scale K-II or B-IIH-III, et cetera.

00:21:55: You take to a chemotherapy product that basically gets inside the cancer cells that you found and it kills the cells that way.

00:22:03: So, there's a number of antibody drug conjugates against B-seven H-three, KLK-two, etc.

00:22:10: that are also being explored.

00:22:12: In my opinion, they're likely going to replace the old chemotherapy that we currently use for patients with prostate cancer.

00:22:22: Then you can go after other approaches that use therapies available, but we just never thought of combining them that way.

00:22:29: An example of insolutomide, which is available for patients and radium-II-III, which is available to patients.

00:22:35: And when we combine both of them, patients leave a lot longer than when we do insolutomide alone.

00:22:40: It's almost like we also try to revisit what we've learned over time and try to see how can we improve upon where we are.

00:22:47: There's a mix of leveraging what's known, what's available, moving those therapies early on, combining existing therapies and bringing novel therapies to patients.

00:23:04: And by doing all of the above, we're able to provide meaningful activity and control the cancer for patients who progress despite hormonal therapy.

00:23:16: And that's really what has been going on in the construction resistance setting.

00:23:20: Thank you.

00:23:21: The last area I like to cover is one that really near and dear to me and that's the quality of life and supportive care.

00:23:30: A holistic approach to cancer survivorship is vital for ensuring each patient's well-being and overall quality of life.

00:23:37: This perspective emphasizes supporting the whole person rather than focusing solely on the disease itself.

00:23:43: By recognizing the many facets of recovery, care extends beyond medical treatments and incorporates additional treatments or elements essential to the healing.

00:23:56: Holistic support means tending to all the aspects of the patient's health, including mental, psychological, and social well-being.

00:24:03: It acknowledges that the cancer's impact reaches far beyond the physical symptoms and medical interventions affecting every part of a patient's life.

00:24:11: In essence, a holistic survivorship of nurturing the mind, body, and soul.

00:24:16: And addressing mental health is a crucial aspect of supporting patients with prostate cancer.

00:24:22: The diagnosis and subsequent treatment can profoundly affect the man's sense of identity and masculinity.

00:24:29: The side effects associated with treatment can often lead to emotional and psychological challenges, underscoring the importance of addressing mental health issues to support both recovery and long-term wellness.

00:24:42: Considering this, it is essential to recognize therapy as a fundamental part of cancer care.

00:24:49: Therapy is not merely suggested or considered an afterthought.

00:24:53: Instead, trained therapists must be integrated into every medical setting to serve as a core component of comprehensive treatment.

00:25:03: Dr.

00:25:03: Beretta, back to you.

00:25:05: Do you have any thoughts on the potential impacts that some of the findings at ASCO could have on the usual care.

00:25:13: And most importantly, what does it mean to the patient?

00:25:16: Thank you, Tom, for highlighting a very important point.

00:25:20: It's not just how much people leave.

00:25:22: It's what's their quality of life.

00:25:24: How good do they live?

00:25:25: Super, super important.

00:25:26: And we can highlight a couple of efforts out there.

00:25:29: Folks are really committed to this.

00:25:31: One is from a cooperative group called SWAG.

00:25:34: So there's a number of cooperative groups which are academic led federally funded.

00:25:39: groups looking at the levels of depression measured by validated tools in patients enrolled in large phase three trials.

00:25:50: And in fact, depression was associated in this study with patients younger age, non-black race, Hispanic ethnicity specifically, with Medicaid or no insurance, and also associated with worse disease.

00:26:07: clinical characteristics.

00:26:08: So in other words, patients who have worse disease features, if you will.

00:26:13: So this is an important effort that was presented recently.

00:26:17: I can shift gears as well and look at some academic-led educational tools being developed.

00:26:24: For example, Prostate Cancer Foundation has leveraged a tool to improve awareness of genetic tumor testing among black men with prostate cancer with advanced disease.

00:26:34: This tool was developed by patients and clinicians and genetic counselors altogether and the feedback they've got from the eleven patients to begin with was actually very informative tool and they're going to use that to talk to their providers.

00:26:47: There's a different effort which is also led by the NCI who's looking to cancer risk communication, looking into shared decision making, what happens when you have a biopsy?

00:26:59: results come back What's the risk for cancer?

00:27:02: What does that mean?

00:27:03: Well, how does communication happening, you know, and what's the risk of cancer getting worse or coming back or spreading?

00:27:09: So that's been presented as well.

00:27:11: With COVID, we got an emergence of telehealth, which to me is really elegant way of providing care to patients who are not always able to come to see us at the cancer centers.

00:27:23: So there's a pilot study funded by the NIH trying to enhance this telehealth model for patients with prostate cancer that going through hormonal treatment.

00:27:34: Thirty-nine patients, relatively small studies, kind of prove of concept.

00:27:37: And the vast majority of patients found the telehealth model to be less or equally stressful than in-person care.

00:27:45: And actually, they would prefer it for future care.

00:27:47: So there's different aspects that can be considered.

00:27:51: Nice work being put together by different care teams, being sponsored not only by governmental funds, but also by patient advocacy groups, academic researchers that really tackle these different angles that you alluded to very nicely.

00:28:04: So I really think those efforts are truly relevant and could use the investigators who are able to take these studies forward.

00:28:12: Thank you for your insights there, Dr.

00:28:14: Beretta.

00:28:15: Lastly, as we wrap things up, do you have any final thoughts that you would like to share?

00:28:24: Thank you, Tom.

00:28:25: Again, I appreciate the opportunity.

00:28:27: I guess raising awareness is a big deal.

00:28:29: One of my take-home messages is just talk about it as much as you can.

00:28:33: Every single forum, every single meeting is an opportunity to raise awareness.

00:28:38: So that's really important.

00:28:39: Empowered folks decide better.

00:28:42: I think empowerment is really, really important and it goes side by side with that concept.

00:28:47: So as I recap on our conversation today, You really brought up important points.

00:28:54: You walk us through the management of the cancer today.

00:28:58: Many cases were able to get rid of it, so do not avoid getting access to care.

00:29:04: Go see your doctor, tell them what's going on.

00:29:07: You might be diagnosed early, and in that case, you're likely going to be cured, and that's great news.

00:29:11: That's the best news you can get.

00:29:13: There are treatments that can cure people.

00:29:15: Unfortunately, we cannot cure everybody, and when we don't, What happens?

00:29:20: And it's a long, long, long list of things that we need to approach.

00:29:24: The care teams need to bring that up.

00:29:26: We need to be thinking about the disease, certainly, and that's with the right testing.

00:29:30: We need to think about beyond scans and blood work and biopsies.

00:29:34: We need to think about genetics.

00:29:37: The genetics have an implication not only for the patient, but also for the families.

00:29:41: We need to think about accessing novel treatments, novel approaches.

00:29:47: for tumors who are not resistant to hormones as well as those who are.

00:29:50: So accessing clinical trials is absolutely crucial because all the treatments approved to use, they were tested in clinical trials.

00:29:58: Clinical trials is the medicine of the future.

00:30:00: So we certainly need to encourage folks to ask for a clinical trial for their condition.

00:30:05: and you have trials throughout from the beginning, from very early stages with a goal of cure or for those cases where cure is not possible, however, tumor control is possible.

00:30:14: And finally, We walk through quality of life aspects in that really comprehensive approach, physical approach, psychological approach, emotional approach, social approach, financial approach.

00:30:27: We really care about that and there's many efforts, very good efforts in that direction because when we treat cancer, we don't treat cancer, we actually treat people with cancer.

00:30:38: And that's really the holistic approach that we have to have in our care teams to provide it to patients.

00:30:44: And what about you, Tom?

00:30:45: What are your take home points from our conversation today?

00:30:48: First of all, I love your takeaways here, Dr.

00:30:50: Baradis, especially an educated patient.

00:30:53: It is an empowered patient.

00:30:55: And I like the fact clinical trials are the medicine of the future.

00:30:58: Those are just spot on.

00:31:00: Since my own diagnosis in twenty fifteen, there's been significant progress in prostate cancer diagnostics and treatments.

00:31:08: These advancements mean that patients have access to targeted therapies capable of destroying cancerous cells.

00:31:13: while minimizing harm to surrounding healthy tissue.

00:31:17: New treatments are designed to exploit features unique to the cancer cells, such as what you had mentioned earlier, specific proteins like PSMA, which are present on the surface of the cancer cells.

00:31:30: The treatment paradigm has shifted toward addressing cancers based on the genomic makeup of the tumor.

00:31:35: This enables researchers to identify key genetic mutations linked to the disease progression and customize treatments accordingly.

00:31:44: For patients, this means access to therapies that are precisely tailored to their individual needs.

00:31:51: Ongoing research and clinical trials are continually expanding our knowledge base.

00:31:56: And with this means for patients, this brings hope as new therapies are moving the field closer to achieving precision oncology, where every patient can benefit from highly personalized treatment options.

00:32:09: And in closing, I'd like to just reference two great resources for patients.

00:32:15: One is the prostate cancer foundation, which Dr.

00:32:18: Barata, you've already mentioned, then also zero prostate cancer, great resources for the patient.

00:32:24: And with that, Dr.

00:32:26: Barata, I want to thank you for your time.

00:32:28: Thank you so much, Tom.

00:32:29: Amazing conversation.

00:32:30: Thank you.

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