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| SLIDES
& TRANSCRIPTS
Saturday,
December 14, 2002
Prostate
Cancer II: Early versus Late Hormonal Therapy for Biochemical Failure
David
Crawford, M.D. |
| Slide
1: |
 Good
morning, Dr. Linehan, Dr. Smith, members of the SUO. One of the
areas that we are going to discuss right now I think is probably
one of the most controversial areas in urologic oncology, and
that is the timing of hormonal ablation.
I borrowed this slide
from Dr. Klotz, and I think says a lot about this whole issue.
A lot of folks think that people are going to die of something
else before they die of prostate cancer, and in fact that is the
case. But the timing of hormonal ablation, and I think that includes
not only rising PSA or biochemical failure, but also it includes
adjuvant therapies.
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| Slide
2: |
|  There
are a number of challenges I think we face in prostate cancer. One
good one is metastatic disease is decreasing. We all know that.
And though hormonal therapy historically has been used for metastatic
disease, we are using more of it now than we ever have, and we're
using it in an adjuvant setting, with T3 disease, rising PSA.
The radiation
oncologists are decades ahead of us in the surgery field about looking
at adjuvant therapies in prostate cancer, and showing the value
of this. We don't have it for surgery.
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| Slide
3: |
|  The
historical doctrine is that hormone therapy should be delayed. Why?
Because it is not thought to be curative. It can have significant
side effects. Yet, we are all using it earlier, and the controversy
exists. We have two excellent speakers this morning who are going
to discuss that.
The first one,
who is going to be sort of pro early hormonal therapy is Martin
Gleave. He is professor of urology at the University of British
Columbia and Vancouver. And he is going to take the point of early.
And then Dr. Messing is going to take kind of the opposite point
of view, which I think is interesting for him to take, but he puts
the modifier there "sometimes."
Martin.
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