Welcome to the second issue of the fourth volume of Everyday Urology – Oncology Insights. This issue turns its focus to prostate cancer, with insight from experts Fred Saad, MD, FRCS, and Sanjeev Kaul, MD, MCh. Our spotlight features reports from the American Society of Clinical Oncologists annual meeting, which gathered medical oncologists and healthcare professionals from around the world between May 31 and June 4, 2019 for insightful presentations which provide key data and guide advances in clinical practice.

In our cover story, “Optimizing Bone Health in Prostate Cancer,” Fred Saad emphasizes the importance of protecting the bones of cancer patients. Dr. Saad discusses the fact that Osteoporosis is underdiagnosed in men and is prevalent in hormone sensitive prostate cancer patients, including those with non-metastatic disease. He dives into treatment-induced bone loss, including the effects of androgen deprivation therapy, glucocorticoids, novel hormonal agents, and radium-223. Saad provides expert analysis on how bone health can be protected for these patients — including administering supplements of Vitamin D and Calcium for patients receiving Androgen Deprivation Therapy among other therapies.

Sanjeev Kaul, MD, MCh provides our Expert Perspective by reviewing genetic tests and inherited risks for prostate cancer in “Genetic Evaluation of Hereditary Prostate Cancer.” He discusses recent advances including the Genetic Evaluation of Men study which used sequencing technology to find detectable mutations in men with prostate cancer. Dr. Kaul emphasizes the implications of BRCA mutations for prostate cancer as well as other germline mutations which can help providers and patients make decisions about surveillance and treatment. Further, he provides advice on when genetic screening and counseling is right for patients.

Our spotlight includes practice-changing updates from ASCO 2019 in Kidney, Bladder, and Prostate Cancer. Included is coverage of my presentation “Concurrent or Layered Treatment with Radium-223 and Enzalutamide or Abiraterone plus Prednisone/ Prednisolone: A Retrospective Study of Real-World Clinical Outcomes in Patients with mCRPC.” In the Bladder Cancer session, Arlene O. Siefker-Radtke presented a preliminary analysis of the FIERCE-22 trial on Vofatamab for Metastatic Urothelial Carcinoma. In the Kidney Cancer sphere, a presentation by Brian Rini, MD is featured, among other studies — turn to the Spotlight section for more exciting ASCO advances which we review. 

Written by: Neal Shore, MD, FACS, is an internationally recognized expert in systemic therapies for patients with advanced urologic cancers and innovative therapies to treat patients suffering from prostate enlargement symptoms. Dr. Shore was recently appointed President-Elect of the Large Urology Group Practice Association (LUGPA), which seeks to provide urologists with all the tools they need to effectively care for patients. Neal D. Shore, MD, FACS, is the Medical Director of the Carolina Urologic Research Center. He practices with Atlantic Urology Clinics in Myrtle Beach, South Carolina. Dr. Shore has conducted more than 100 clinical trials, focusing mainly on prostate and bladder disease.