Edouard J. Trabulsi, MD, FACS, professor, co-director, Multidisciplinary Genitourinary Oncology Center, Prostate Diagnostic Center, vice chair of research, director, Division of Urologic Oncology, Department of Urology, Sidney Kimmel Cancer Center, discusses postoperative radiation in patients with prostate cancer.

Patients with prostate cancer who have positive margins are at a very high risk of recurrence, Trabulsi says. There have been several large, randomized trials in the United States and Europe of postoperative radiotherapy looking at patients who fit this category. The US trial showed decreased rates of metastasis and improved survival in patients who received postoperative radiotherapy, says Trabulsi.

A population of men are cured with surgery alone, so additional therapy for them may not be necessary. Additionally, urologists are concerned about the postsurgical side effects and overtreatment with the postoperative radiation. Trabulsi says that prostate-specific antigen could potentially differentiate between who needs postoperative radiation and who does not.

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Edouard J. Trabulsi, MD, FACS, professor, co-director, Multidisciplinary Genitourinary Oncology Center, Prostate Diagnostic Center, vice chair of research, director, Division of Urologic Oncology, Department of Urology, Sidney Kimmel Cancer Center, discusses postoperative radiation in patients with prostate cancer.
 

Dr. Trabulsi Discusses Postoperative Radiation in Prostate Cancer

Edouard J. Trabulsi, MD, FACS, professor, co-director, Multidisciplinary Genitourinary Oncology Center, Prostate Diagnostic Center, vice chair of research, director, Division of Urologic Oncology, Department of Urology, Sidney Kimmel Cancer Center, defines locally advanced prostate cancer.

In defining a tumor as locally advanced, clinicians generally look at tumor parameters, such as clinical stage on a rectal exam, prostate-specific antigen (PSA), and Gleason score. These factors give an idea of a given patient’s risk category, Trabulsi says.

That information, plus imaging is used to determine whether a patient’s demonstrable disease outside of the prostate is high risk enough to lead to a strong prediction of locally advanced disease. This is done by inspecting results of imaging or a physical exam, Trabulsi explains.

For high-risk patients with locally advanced prostate cancer, researchers at Thomas Jefferson University Hospital are conducting a trial assessing cabazitaxel (Jevtana) in combination with hormone therapy and radiotherapy (NCT01420250).

Edouard J. Trabulsi, MD, FACS

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Dr. Trabulsi Discusses Postoperative Radiation in Prostate Cancer

Dr. Trabulsi Defines Locally Advanced Prostate Cancer