James Mohler, MD, Associate Director and Senior-Vice President for Translational Research, Chair, Department of Urology, Professor of Oncology, Roswell Park Cancer Institute, discusses androgen-deprivation therapy (ADT), a standard treatment for men with metastatic prostate cancer.
Mohler believes ADT should only be used to prevent a death from prostate cancer. Before administering ADT, strict calculations should be performed to determine if the cancer is life threatening. Mohler suggests weighing tumor growth rate, tumor volume, health, family history, and age before administering ADT, in order to have a complete knowledge of the risks and benefits associated with treatment.
Additionally, the treatment modality has a substantial impact on the efficacy of ADT. Various methods should be discussed as part of a treatment plan, including whether treatment should be continuous or intermittent, with or without an antiandrogen, or with surgical intervention or an LHRH agonist.
Mohler believes the decision to begin ADT is often rushed, following a prostatectomy or radiation therapy. He believes that in the era of personalized medicine it is important to consider individual characteristics, to determine the most appropriate treatment.